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QUALIFYING REQUIREMENT

Manufacture’s Name & Address:

To,

AGM (C&M)

Contracts & Materials Department,

NTPC Ltd, Bongaigaon Thermal Power

Project, PO: Salakati,

Distt: Kokrajhar, Assam.

PIN: 783369.

We declare that we meet the Qualifying Requirement stipulated at Clause No. A i.e.’ Qualifying requirement for enlistment of Vendor for Supply of OP Cement’ on our own as indicated below:

Reference of QR	Clause No.1.00 of QR	Clause No.2.00 of QR	Clause No.3.00 of QR
Whether the manufacturer meets	(Yes/No)*	(Yes/No)*	(Yes/No)*
the requirement

* Manufacturer to strike out whichever is not applicable.

Note: (1) The detailed information is furnished on pages 2 to 6 of this schedule.

	Signature ……………………………………
	Printed Name of authorised person having
	Power of Attorney …………………………..
Date: ……………..	Designation ………………………………….
Place: ……………….	Seal of Firm ………………………

Page 2 of 6

PAST EXPERIENCE DATA AGAINST CLAUSE No. 1.00 (a) OF QR

Manufacture’s Name & Address:

To,

AGM (C&M)

Contracts & Materials Department,

NTPC Ltd, Bongaigaon Thermal Power

Project, PO: Salakati,

Distt: Kokrajhar, Assam.

PIN: 783369.

In order to meet the qualifying requirements of clause 1.00 (a) of Qualifying requirement for enlistment of Vendor for Supply of OP Cement, we declare that we are the BIS Certified manufacturer of 43 grade OP Cement for last three years as per clause 1.00 (a) of QR reckoned as on date of Bid opening/ Last date of receipt of application, as per details given below:

Sl.	Details of Allotment of Original BIS	Date of Validity of Present Licence	Copies Enclosed
No.	Licence for BIS:8112	for BIS:8112
			(Yes / No) *

* Manufacturer to strike out whichever is not applicable.

Note: Documents in support of above details is enclosed at Annexure ……..

	Signature ……………………………………
	Printed Name of authorised person having
	Power of Attorney …………………………..
Date: ……………..	Designation ………………………………….
Place: ……………….	Seal of Firm ………………………

	Page 3 of 6
	PAST EXPERIENCE DATA AGAINST CLAUSE No. 1.00 (b) OF QR
Manufacture’s Name & Address:	To,

AGM (C&M)

Contracts & Materials Department,

NTPC Ltd, Bongaigaon Thermal Power Project, PO: Salakati,

Distt: Kokrajhar, Assam. PIN: 783369.

In order to meet the qualifying requirements of clause 1.00 (b) of Qualifying requirement for enlistment of Vendor for Supply of OP Cement, we declare that we have supplied 43 grade OP cement as per are BIS: 8112 during last three years as per clause 1.00 (b) of QR reckoned as on date of Bid opening/Last date of receipt of application, as per details given below:

Sl.	Documentary evidence for supply	Documentary evidence for supply	Documentary evidence for supply between
No.	between Bid Opening date/Last date of	between one year of Bid Opening	two years of Bid Opening date/Last date of
	receipt of application and one year of	date/Last date of receipt of	receipt of application and three years of Bid
	Bid Opening Date/Last date of receipt	application and two years of Bid	Opening Date/Last date of receipt of
	of application	Opening Date/Last date of receipt of	application
		application
	Copy Enclosed(Yes/No)*	Copy Enclosed(Yes/No)*	Copy Enclosed(Yes/No)*

* Manufacturer to strike out whichever is not applicable.
Note: Documents in support of above details is enclosed at Annexure ……..
	Signature ……………………………………
	Printed Name of authorised person having
	Power of Attorney …………………………..
Date: ……………..	Designation ………………………………….
Place: ……………….	Seal of Firm ………………………

Page 4 of 6

	PAST EXPERIENCE DATA AGAINST CLAUSE No. 2.00 OF QR
Manufacture’s Name & Address:	To,
	AGM (C&M)
	Contracts & Materials Department,
	NTPC Ltd, Bongaigaon Thermal Power
	Project, PO: Salakati,
	Distt: Kokrajhar, Assam.
	PIN: 783369.

In order to meet the qualifying requirements of clause 2.00 of Qualifying requirement for enlistment of Vendor for Supply of OP Cement, we declare that we have executed in a single or separate contract(s), the works as per clause 2.00 of QR i.e. Supply of 43 grade OP cement to reputed consumers/end users during the preceding seven (07) years reckoned as on date of bid opening/ last date of receipt of application, as per details given below:

Sl. No.	Name of consumers/end users	PO No. & Date	PO Qty(MT)	Value of the order	Remarks
	and full address with Telephone			Executed
	and Fax No
1	2	3	4	5	6

Note: Documents in support of above details is enclosed at Annexure ……..
	Signature ……………………………………
	Printed Name of authorised person having
	Power of Attorney …………………………..
Date: ……………..	Designation ………………………………….
Place: ……………….	Seal of Firm ………………………

Page 5 of 6

	FINANCIAL DATA AGAINST CLAUSE 3.00 OF QR
Manufacture’s Name & Address:	To,
	AGM (C&M)
	Contracts & Materials Department,
	NTPC Ltd, Bongaigaon Thermal Power
	Project, PO: Salakati,
	Distt: Kokrajhar, Assam.
	PIN: 783369.

In order to satisfy the Qualifying Requirements (QR) of clause 3.00 of qualifying requirement for enlistment of Vendor for Supply of OP Cement, we declare that we meet all the stipulations of clause 3.00 of Qualifying Requirements as per details given below:

Clause		Description		Details/Remarks
Ref.	No.
Clause	3.00	Turnover (in Rs. Lakh)
of QR
		Our annual Turnover (excluding other income) in the preceding three(03) financial years as on	date
		of bid opening/ last date of receipt of application is as under
		2011 – 2012		Rs ………. ........Lakh
		2012 – 2013		Rs ………......... Lakh
		2013 – 2014		Rs ………......... Lakh
		Our average annual turnover in the preceding three(03) financial years as on the date of bid
		Opening/last date of receipt of application.		Rs ……….......... Lakh
		Audited results for the above preceding three financial years are enclosed: Annexure _____		(Yes / No)*
		OR
		Certification of financial statements from a practicing Chartered Accountant is enclosed:
		Annexure______		(Yes / No) *

* Manufaturer to strike out whichever is not applicable.