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1 TENDER DOCUMENT FOR PROCUREMENT OF C.P.S.U. MEDICINES FOR FINANCIAL YEAR 2012-13

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Page 1: CPSU MEDICINE NEW SBD 2012-13 - SPMCILspmhoshangabad.spmcil.com/SPMCIL/UploadDocument/MEDICINE...The General Manager SPM reserves the right to increase the ordered quantity by 25%

1

TENDER DOCUMENT FOR PROCUREMENT

OF

C.P.S.U. MEDICINES FOR FINANCIAL YEAR 2012-13

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NotTransferable

TENDER DOCUMENT“FOR PROCUREMENT OF CPSU MEDICINES.”

No.14(14‐4)/CPSU MEDICINES/2012‐13/Advt.17/326 Date27.04.2012 This TenderDocumentContains- 25 Pages TenderDocuments is Sold to:

M/s Address Details of Contact personin SPMCIL regarding this tender:

Name, Designation :Rajkumar R. Officer (Material)

Address : Security Paper Mill Hoshangabad – 461005 (M.P)

Phone : 07574-279847

Fax : 07574-255170 Email : [email protected]

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CONTENTS OF TENDER

CHAPTER CONTENT PAGE NO.

SECTION-I NOTICE INVITING TENDER 04 SECTION-II GENERAL INSTRUCTIONS TO TENDERERS 06

SECTION-III SPECIAL INSTRUCTIONS TO TENDERERS 07 SECTION-IV GENERAL CONDITIONS OF CONTRACT 08

SECTION-V SPECIAL CONDITIONS OF CONTRACT 09 SECTION-VI LIST OF REQUIREMENTS 10 SECTION-VII TECHNICAL SPECIFICATIONS 12 SECTION-VII I QUALITYCONTROL REQUIREMENTS 13 SECTION-IX QUALIFICATION/ELIGIBILTY CRITERIA 14 SECTION-X ACCEPTANCE OF TERMS & CONDITIONS 15 SECTION-XI PRICE SCHEDULE 16 SECTION-XII QUESTIONNAIRE 17 SECTION -XIII BANKGUARANTEEFORMFOREMD 18 SECTION-XIV MANUFACTURER’S AUTHORIZATION FORM 19 SECTION-XV BANK GUARANTEE FORM FOR PERFORMANCE SECURITY 20 SECTIONXVI CONTRACTFORM 21 SECTIONXVII LETTEROFAUTHORITYFORATTENDINGABIDOPENING 23 SECTIONXVIII SHIPPING ARRANGEMENTSFORLINERCARGOES 24

SECTIONXIX PROFORMA OF BILLS FOR PAYMENTS 25

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(SECTION – I)

NOTICE INVITING TENDER

No. 14(14-4)/CPSU MEDICINES/2012-13/Advt.17/326 Date27.04.2012 1. Sealedtendersareinvitedfromeligibleandqualifiedtenderersforsupplyoffollowingmaterials.

Schedule No.

BriefDescriptionofmaterials

Earnest Money (inRs.) Remarks

1.

Procurement of CPSU Medicines

Rupees 6,000/- (Six Thousand Only.)

Only CPSU / State /Central Govt. deptt. / Undertaking canparticipate in this tender.

Type of Tender Single bid, National Competitive Bid. (Open Tender)

Dates of saleof tender documents: From 27.04.2012 to17.05.2012 during office hours

Place of sale of tender documents Security Paper Mill, Hoshangabad

Closing date and time for receipt of tenders Up to 14.00 Hrs till 18.05.2012

Place of receipt of tenders Security Paper Mill, Hoshangabad

Time and date of opening of tenders 15.00 Hrs on 18.05.2012 Place of opening of tenders Security Paper Mill, Hoshangabad Nominated Person/ Designation toReceive Officer (Material)

2. Interested tenderers may obtain further information about this requirement from the Office of

The General Manager, Security Paper Mill, Hoshangabad.

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3. Tender documents may be purchased on payment of non-refundable fee of Rs.250/- per set in the form of account payee demand draft/ cashier’s cheque/ certified cheque, drawn in favour of the General Manager, Security Paper Mill, payable at Hoshangabad (M.P.)

4. If requested, the tender documents will be mailed by registered post/speed post to the domestic Tenderers and by international air-mail to the foreign Tenderers, for which extra expenditure per set will be Rs. 100/- (Rupees One Hundred) for domestic post and Rs. 500/- (Rupees Five Hundred) for international air-mail. The tenderer is to add the applicable postage cost in the non-refundable fee mentioned in para 3 above.

5. Tenderer may also download the tender documents from the website http://spmhoshangabad.spmcil.com and submit tenders by utilizing the downloaded document, along with the required non-refundable fee as mentioned in para 3 above.

6. Tenderers shall ensure that their tenders, duly sealed & signed complete in all respects, as per instructions contained in this tender document are dropped in the tender box located at the address given below on or before the closing date and time indicated in the Para 1 above, failing which the tenders will be treated as late and rejected.

ADDRESS

The General Manager, Security Paper Mill, Hoshangabad - 461 005 (M.P.) India.

7. In the event of any of the above mentioned dates being declared as holiday/ closed day for the purchase organization, the tenders will be sold/ received/ opened on the next working day at the appointed time.

8. The Tender Documents are not transferable.

(Rajkumar R.)

Officer (Material) For General Manager

Copy To :Incharge (Dispensary) / SK (G)

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(SECTION – II)

GENERAL INSTRUCTIONS TO TENDERER

Kindly refer http://spmhoshangabad.spmcil.com/spmcil/uploaddocument/GIT.pdffor further details.

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(SECTION-III)

SPECIAL INSTRUCTIONS TO TENDERERS

ThefollowingSpecialInstructionstoTenderers willapplyforthispurchase.Thesespecial instructionswillmodify/substitute/supplementthe corresponding GeneralInstructionsto Tenderers(GIT)incorporatedinSectionII.

ThecorrespondingGITclausenumbershavealso been indicated in the text below. IncaseofanyconflictbetweentheprovisionintheGITandthatintheSIT,theprovision contained in the SIT shall prevail.

Sl. No. GIT ClauseNo. Topic SIT Provision

1 10.1 d) Earnest Money Deposit 1 2 19 Tender Validity 2 3 34 Comparison on CIF Destination basis. 3

1. Earnest Money Deposit:

Tender should be accompanied with Earnest Money Deposit (Non-interest bearing) of Rs. 6,000/- (Six Thousand Only) in the form of FDR/ Crossed non-interest bearing Demand Draft from any scheduled commercial Bank in India, payable at SPM Branch, Hoshangabad(M.P.). No other mode of deposit shall be accepted. Please note that without EMD the offer will be summarily rejected.

2. Tender Validity: The tender shall remain valid for acceptance for a period of 90 days after the date of tender opening prescribed in the tender document. Any tender valid for a shorter period shall be treated as unresponsive & rejected.

3. Comparison on F.O.R. SPM Hoshangabad(CIF) Basis. The Comparison of the responsive tenderers shall be on Total Price quoted F.O.R. SPM Hoshangabad basis as per Price Schedule in Section – XI of this Tender Document. The tenders received and accepted will be evaluated to ascertain the best and lowest evaluated tender in the interest of the purchaser for the complete scope of supply as per covered in the document.

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(SECTION-IV)

GENERAL CONDITIONS OF CONTRACT

Kindly refer http://spmhoshangabad.spmcil.com/spmcil/uploaddocument/GCC.pdffor further details.

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(SECTION-V)

SPECIAL CONDITIONS OF CONTRACT

The following Special Conditions of Contract (SCC) will apply for this purchase. The correspondingclausesof General Conditions ofContract (GCC) relating totheSCCstipulations havealsobeenincorporatedbelow.TheseSpecial Conditionswillmodify/substitute/supplement the corresponding (GCC)clauses.Wheneverthereisany conflictbetweentheprovisioninthe GCCandthatintheSCC,the provision contained in theSCC shall prevail. (Clausesof GCClistedbelowincludeapossibilityforvariationintheirprovisionsthroughSCC. There could be otherclauses in SCC asdeemed fit)

S.No GCC ClauseNo. Topic SCC Provision

1 19.3 Option clause 1 2 22.1 Payment Terms 2 3 ---- Medicines Life 3

1. Option Clause: The General Manager SPM reserves the right to increase the ordered quantity by 25% at any time, till the final delivery date of the contract, by giving reasonable notice even though the quantity ordered initially has been supplied in full before the last date of expiry of Delivery period.

2. Payment Terms:

100% Payment shall be done within 30 days on receipt and acceptance of goods by the purchaser and on production of all required documents by the supplier. Payment shall be made through RTGS/NEFT. The firm may give their E-payment details accordingly.

3. Terms of Medicines Life:

The life of Medicines supplied should be for minimum One-year period from the date of supply for consumption.

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(SECTION-VI)

LIST OF REQUIREMENTS/ MEDICINES

Schedule No. Brief description of Medicines Quantity

1 CAP. AMPICILLINE 250 mg 5,000 Nos.

2 TAB. PARACETAMOL 15,000 Nos.

3 TAB. ALBENDA ZOLE 1,000 Nos.

4 ORS POWDER (WHO) (21.0 gm) 10,000 Nos.

5 POVIDINE IODINE SOLUTION 24 Bott.

6 TAB. BENZITHRO 250 5,000 Nos.

7 SYP. VIBITONE (100 ml.) 1,000 Bott.

8 TAB. DICLOFENAC 50 5,000 Nos.

9 TAB. NIMESULIDE 100 7,000 Nos.

10 TAB. RANITIDINE 150 8,000 Nos.

11 OINT. EUTHERIA 5,000 Nos.

12 OINT. POVIDINE IODINE (15) 5,000 Nos.

13 SYP. CITRASOL (100 ml.) 1,000 Bott.

14 INJ. GENTAMYCIN (80 mg.) 500 Nos.

15 TAB. B COMPLEX (VITAMIN) 5,000 Nos.

16 TAB. DOMPERIDONE 5,000 Nos.

17 CAP. DOXY CYLLINE CYCLIN 150 3,000 Nos.

18 TAB CEFADROXIL 500 3,000 Nos.

19 TAB LIVOFLOXACIN 500 2,000 Nos.

20 SYP. DIGENZY MES (100 ml.) 500 Bott.

21 COUGH SYP (CPM) (110 ml.) 300 Bott.

22 OINT. CLOTRIMAZOLE 15 gm. 1,000 Nos.

23 OINT. SILVER SULPHANADIGINE20mg. 1,000 Nos.

24 GLUTASOL (1 LITRE) 30 Bott.

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Schedule No. Brief description of Medicines Quantity

HINDUSTAN ANTIBIOTICS:-

25 IV. METRONIDAZOLE (100 ml.) 700 Nos.

26 TAB. DICLOFENAC + PCM 5,000 Nos.

27 HAMYCIN SUSP (10 ml.) 300 Bott.

28 IV MANITOL 20% (1000 ml.) 50 Nos.

29 CIPROFOXACIN E/E DROP 500 Nos.

30 IV DNS 2,000 Nos.

31 IV NS 1,000 Nos.

32 IV 10% DEXTROSE 500 Nos.

IDPL:-

33 CAP. CEBEXIN – Z 5,000 Nos.

34 TAB. IDICET 5 mg. 5,000 Nos.

35 CAP. IDICON 150 mg 500 Nos.

36 TAB. CIPORAL – TZ 5,000 Nos. Amount of EMD : Rs. 6,000/-(Rupees: Six Thousand Only.)

Required Delivery Schedule : Within 2 Months(Tentatively)

(Delivery shall commence immediately after issue of NAC/ Purchase order whichever is earlier)

Required Terms of Delivery : F.O.R SPM, Hoshangabad Destination : Security Paper Mill, Hoshangabad Preferred mode of Transportation : Road

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(Section-VII)

TECHNICAL SPECIFICATIONS

NOT APPLICABLE FOR THIS TENDER

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(Section-VIII)

QUALITY CONTROL REQUIREMENTS

NOT APPLICABLE FOR THIS TENDER

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(Section-IX)

QUALIFICATION/ELIGIBILITY CRITERIA

1. Only CPSU / State /Central Govt. deptt. / Undertaking canoffer firm. Other firms shall not be entertained and will be considered as unsolicited.

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(SECTION – X)

Tender Form

ACCEPTANCE OF TERMS & CONDITIONS

Date………. To ………………………………. ………………………………. ………………………………. (completeaddress of SPMCIL) Ref: Your Tender document No. …………………………dated ………… We, the undersigned have examined the above mentioned tender enquiry document, including amendment No.--------,dated--------- (ifany),thereceiptof whichisherebyconfirmed.We now offerto supplyanddeliver………. (descriptionofgoods and services) inconformitywithyour abovereferreddocumentforthesumof (totaltenderamountinfiguresand words), asshown in the price schedule(s), attached herewith andmade part of this tender. Ifourtenderisaccepted,weundertaketo supply thegoodsandperformtheservicesas mentioned above, in accordance with the deliveryschedulespecified in the List ofRequirements. Wefurtherconfirmthat,ifourtenderisaccepted,weshallprovideyouwithaperformance security of required amount in an acceptable form in terms of GCC clause 6, read with modification, if any, inSection V – “Special Conditions of Contract”, for due performance of the contract. Weagreeto keepourtendervalidforacceptanceforaperiodup to-------,asrequiredintheGIT clause 19, read with modification, if any in Section-III – “Special Instructions to Tenderers” or for subsequentlyextended period,ifany,agreedtobyus.We alsoaccordinglyconfirmtoabideby thistenderup totheaforesaidperiodandthistendermaybeacceptedanytimebeforetheexpiry oftheaforesaidperiod.Wefurtherconfirmthat,untilaformalcontractisexecuted,thistender read withyourwrittenacceptancethereofwithintheaforesaidperiod shallconstituteabinding contract between us. Wefurtherunderstandthatyouarenotboundtoacceptthelowestoranytenderyoumayreceive against yourabove-referred tender enquiry. ……………………….. (Signature with date) ……………………….. (Name and designation) Duly authorized to sign tender for and on behalf of ………………………………………. ……………………………………….

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(SECTION – XI)

PRICE SCHEDULE

No……………………………………………… Date: …..………...

Note: Levies/Taxes would not be paid on forwarding ad freight charges.

Signature of Bidder

S.No. Details of heads Quantity in Nos Rate Per Nos.

01 Basic Price

02 Packing Charges

03 Forwarding Charges

04 Excise Duty in percentage (%) only

05 CST (With and Without “C”

from)/ VAT in percentage (%) only

06 Freight charges (Approximate/Actual) + Service Tax on Freight

07 Unloading charges

08 Others if any, (Please specify)

09 Total Price (FOR‐SPM Hoshangabad) (in figures only)

Rs……………………………………………………………………

.………………………………………………………………..……

10 Total Price (in words Only) Rs……………………………………………………………………

………………………………………………………………………

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(SECTION – XII)

QUESTIONNAIRE

Thetenderershouldfurnishspecificanswerstoallthequestions/issuesmentionedbelow.In caseaquestion/issuedoesnotapplytoatenderer,thesameshouldbeansweredwiththe remark“not applicable”. Wherevernecessaryandapplicable,thetenderershallenclosecertifiedcopyasdocumentary proof/ evidence to substantiate the corresponding statement. Incaseatendererfurnishesawrongorevasiveansweragainstanyoftheundermentioned question/ issues, its tenderwill be liable to be ignored. 1. Brief description and of goods and services offered: 2. Offer is valid for acceptance upto ……………………………………………. 3. Your permanentIncome TaxA/CNo. as allotted by the Income Tax Authority of

Governmentof India Pleaseattachcertifiedcopy of yourlatest/currentIncomeTaxclearancecertificate issued by theabove authority.

4. Status : a. Areyoucurrentlyregisteredwith the Directorate General of Supplies & Disposals

(DGS&D), New Delhi,and/orthe NationalSmallIndustriesCorporation (NSIC), NewDelhi,and/orthepresentSPMCILand/ortheDirectorateofIndustriesof theconcernedStateGovernmentforthegoodsquoted?Ifso,indicatethedate upto whichyouare registered and whetherthereisanymonetarylimitimposed on your registration.

b. Areyou currentlyregisteredundertheIndian CompaniesAct,1956or anyother similar Act? Pleaseattachcertifiedcopy(s)ofyourregistrationstatusetc.incaseyouranswer(s)to above queries is in affirmative.

5. Please indicate name & full address of your Banker(s) 6. Pleasestatewhetherbusinessdealingswithyoucurrentlystandsuspended/bannedby any Ministry/

Deptt. of Governmentof India or by any State Govt. ………………………. (Signature with date) ………………………. ………………………. (Full name, designation & address of theperson duly authorizedsign on behalf of the tenderer) For and on behalf of ………………………….. ………………………….. (Name, address and stampof the tendering firm)

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(SECTION – XIII)

BANK GUARANTEE FORM FOR EARNEST MONEY DEPOSIT

NOT APPLICABLE FOR THIS TENDER

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(SECTION – XIV)

MANUFACTURER’S AUTHORIZATION FORM

To, ...………………………………..

…………………………………..

(Name and address of SPMCIL)

Dear Sir, Ref. Your Tender document No. ……………………………………………….. date ………….. We, ………………………………………………………………………………, who are proven and reputable manufacturers of ……………………………………..…….. (name and description of the goods offered in the tender) having factories at ………………….………………… hereby authorize Messrs ……………………………………….……………………. (name and address of the agent) to submit a tender, process the same further and enter into a contract with you against your requirement as contained in the above referred tender enquiry documents for the above goods manufactured by us. We further confirm that no supplier or firm or individual other than Messrs. ……………………. …………………………..(name and address of the above agent) is authorized to submit a tender, process the same further and enter into a contract with you against your requirement as contained in the above referred tender enquiry documents for the above goods manufactured by us. We also hereby extend our full warranty, as applicable as per clause of the General Conditions of Contract read with modification, if any, in the Special Conditions of Contract for the goods and services offered for supply by the above firm against this tender document. Yours faithfully,

…………………………………..

…………………………………..

[signature with date, name and designation]

For and on behalf of messrs ……………………………………….

[name& address of the manufacturers]

Note : This letter of authorization should be on the letter head of the manufacturing firm and should be signed by a person competent and having the power of attorney to legally bind the manufacturer.

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(SECTION – XV)

BANK GUARANTEE FORM FOR PERFORMANCE SECURITY

_______________________ [insert:Bank’sName,andAddressofIssuingBranchorOffice] Beneficiary: [insert: Name and Address ofSPMCIL] Date: PERFORMANCE GUARANTEE No.: WHEREAS …………………………………………………………………………….……(name and address of the supplier) (hereinafter called “the supplier”) has undertaken, in pursuance of contract no……………………………. dated …………. to supply (description of goods and services) (herein after called “the contract”). AND WHEREASithasbeen stipulatedbyyouinthesaid contractthatthe suppliershallfurnish youwithabankguaranteebyascheduledcommercialbankrecognizedby youforthesum specified therein assecurityfor compliancewith its obligations in accordance with thecontract; ANDWHEREAS we have agreed to givethe supplier such a bankguarantee; NOWTHEREFORE weherebyaffirmthatweareguarantorsandresponsibleto you,onbehalfof thesupplier,uptoatotal of…………………… …………… ………………….(amountofthe guaranteein wordsandfigures),andweundertaketopayyou,uponyourfirstwrittendemand declaringthesuppliertobeindefaultunderthecontractandwithoutcavilorargument,anysum orsumswithinthelimitsof(amountofguarantee)asaforesaid,withoutyourneedingtoproveor to show grounds or reasons for your demand or the sum specifiedtherein. Weherebywaivethenecessityofyourdemandingthesaid debtfromthesupplierbefore presentinguswiththe demand. We further agree thatnochangeoradditiontoorother modificationoftheterms ofthecontracttobe performedthereunderor ofanyofthecontract documents whichmaybemade betweenyouandthesupplier shallinanywayreleaseusfrom anyliabilityunderthisguarantee and weherebywaivenoticeof anysuchchange,additionor modification. We undertake to pay SPMCIL up to the above amount upon receipt of its first written demand, without SPMCIL having tosubstantiateits demand. Thisguaranteewillremaininforceforaperiodoffortyfivedaysafterthecurrency of this contract and any demand in respect thereof should reach theBank not later than the above date. ……………………………. (Signature of the authorized officer of the Bank) …………………………………………………………. Name and designation of the officer …………………………………………………………. Seal, name & address of the Bank and address of the Branch …………………………………………………………. Name and designation of the officer …………………………………………………………. ….………………………………………………………. Seal, name & address of the Bank and address of the Branch

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(SECTION – XVI)

CONTRACT FORM (Address of SPMCIL’s office issuing thecontract) Contract No…………. dated……………. This is incontinuation to this office’ Notification of Award No……………..….. dated ……. 1. Name & address of theSupplier: …………………………………….. 2. SPMCIL’s Tender document No……… dated…………. and subsequent Amendment

No.…………., dated……… (If any), issued by SPMCIL 3. Supplier’sTenderNo………dated……..andsubsequentcommunication(s)No…………dated

…….. (If any), exchangedbetween thesupplier andSPMCIL in connection withthis tender. 4. InadditiontothisContractForm, thefollowing documents etc,whichareincludedin the

documentsmentionedunderparagraphs2and3above,shallalsobedeemedtoformandbe read and construed as partof this contract:

i. General Conditions of Contract; ii. Special Conditions of Contract;

iii. List of Requirements; iv. TechnicalSpecifications; v. Quality Control Requirements;

vi. Tender Form furnishedby the supplier; vii. Price Schedule(s) furnishedby thesupplier in its tender;

viii. Manufacturers’ Authorization Form (if applicable for this tender); ix. SPMCIL’s Notification ofAward

Note:Thewordsandexpressionsusedinthiscontractshallhavethesamemeaningsasarerespectively assigned to them in the conditions of contract referred to above. Further, thedefinitionsandabbreviationsincorporatedunderSection–V-‘GeneralConditionsofContract’of SPMCIL’s Tender document shall also apply to this contract. 5. Someterms,conditions,stipulationsetc.outoftheabove-referreddocumentsarereproduced below

for readyreference: 1. Briefparticularsofthegoodsandserviceswhichshallbesupplied/providedbythesupplier

are as under:

Schedule No.

Brief descriptionof goods/ services

Accounting unit

Quantity to be supplied

Unit Price (in Rs.)

Total price

Any other additional services (if applicable) and cost thereof: ……………………….. Total value (in figure) (In words)

(ii) Delivery schedule (iii) Details ofPerformanceSecurity (iv) Quality Control

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(a) Mode(s), stage(s) and place(s) of conducting inspections and tests. (b)Designation and address of SPMCIL’s inspectingofficer.

(v) Destination and despatch instructions (vi) Consignee including port consignee, if any (vii) Warrantyclause (viii) Paymentterms (ix) Paying authority

………………………………. (Signature, name and address of SPMCIL’s authorized official) For and on behalf of……………………………………………………………….……. Received andaccepted this contract …………………………………………………….. (Signature, name and address of the supplier’sexecutive duly authorized to signon behalf of the supplier) For and on behalf of …………………….……………………… (Name and address of the supplier) ……………………. ……………………….(Seal of the supplier) Date: Place:

(SECTION – XVII)

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Letter ofAuthority for attending a Bid Opening

(Refertoclause24.2ofGIT) The General Manager Security Paper Mill Hoshangabad M.P – 461 005 Subject: Authorizationfor attendingbid openingon ……….(date)intheTender of ……… Followingpersonsareherebyauthorizedtoattendthebidopeningforthetendermentioned aboveonbehalfof (Bidder)inorderofpreference given below.

OrderofPreference Name SpecimenSignatures I.

II.

Alternate Representative

Signatures ofbidder or Officer authorized to sign the bid Documents on behalf of the bidder.

Note: 1. Maximumoftworepresentativeswillbepermittedtoattendbidopening.Incaseswhereitis

restrictedto one,firstpreference will beallowed.Alternate representativewill bepermitted when regular representatives are not able to attend.

2. Permissionforentryto thehall wherebidsareopened may be refusedin case authorization as prescribedabove is notproduced.

(SECTION – XVIII)

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SHIPPING ARRANGEMENTS FOR LINER CARGOS

NOT APPLICABLE FOR THIS TENDER

(SECTION – XIX)

PROFORMA OF BILLS FOR PAYMENTS

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(ReferClause 22.6 of GCC)

NameandAddress oftheFirm.......................................................................................................... BillNo...................................................................Dated................................................................. Purchase order.............................................No...................................Dated.................................... Name and address of theconsignee.................................................................................................

S.No Authority for purchase

Description of Stores

Number or quantity

Rate Rs. P.

Price per Rs. P.

Amount

Total 1. C.S.T./Sales Tax Amount 2. Freight (ifapplicable) 3. Excise Duty(if applicable) 4. Packing and Forwardingcharges (if applicable) 5. Others (Please specify) 6. PVC Amount (with calculation sheet enclosed) 7. (-) deduction/Discount 8. Net amount payable (inwordsRs.) Despatch detail RRNo. /other proof of despatch.................................................. Dated.................................................................................................................(enclosed) InspectionCertificate No............................................Dated...................(enclosed) Modvat Certificate No ...........................................................................(enclosed) Excise DutyGatepass……......................................................................(enclosed) Place: Date: ReceivedRs...................................(Rupees)............................................................. Iherebycertifythatthepaymentbeingclaimedisstrictlyintermsofthe contract and all the obligationsonthe part ofthe supplierfor claimingthatpayment hasbeenfulfilledasrequired under the contract. Revenue stamp Signature and of Stamp Supplier