Transcript
Page 1: TENDER NOTICE FOR PRINTING OF FORMS & REGISTERS tender.pdf · Page 2 of 13 TENDER DOCUMENT FOR PRINTING OF FORMS & REGISTERS 1. Name of Tender: ESIC Model Hospital, Bapunagar, Ahmedabad

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TENDER NOTICE FOR PRINTING OF FORMS & REGISTERS

Medical Superintendent invites sealed tenders from the interested tenderers for Printing of

forms to ESIC MODEL HOSPITAL BAPUNAGAR, AHMEDABAD for one year which is extendable

further with mutual understanding, if needed.

Name of

Work

Tender

form

Fee

Estimated

value of

Contract

Earnest

Money

Deposit

(EMD)

Security

Deposit

Sale of Tender

Document

Last date

and time of

tender

submission

Printing of

forms &

Register

200/- 06 lacs

Rs.

12000/-

Only

Rs.

30,000/-

16/07/2015 to

07/08/2015 all working

days during 10:00AM to

03:00PM & during

10:00AM to 12:00PM on

last date of submission

and Saturday.

07/08/2015

upto

02:00PM

Tender document can be purchased/Inquired from the General Branch of the ESIC Model

Hospital Bapunagar, Ahmedabad-380024 on any working day from 16/07/2015 to 07/08/2015 between

10:00AM to 03:00PM and on last date of submission & Saturday from 10:00AM to 12:00PM at a non

refundable cost of Rs. 200/- payable through demand draft/Banker cheque of any scheduled bank

drawn in favour of “ESI Fund Account No-1” payable at Ahmedabad. Tender Document can be

downloaded from ESIC Headquarter website www.esic.nic.in in “Tenders” tab &

www.eprocure.gov.in may be submitted along with prescribed tender form fee in above manner.

Duly filled and sealed tenders are to be dropped in the tender box available in the Chamber of the Dy.

Medical Superintendent (Room No.: 208).

Medical Superintendent

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TENDER DOCUMENT FOR PRINTING OF FORMS & REGISTERS

1. Name of Tender: ESIC Model Hospital, Bapunagar, Ahmedabad invites sealed quotations from the

reputed printer for the printing works under Rate Contract for one year under single bid system.

2. Scope of Work: Printing of various forms (One sided/both sided), Register, Covers and other

material as per the sample details provided in “Annexure –C”

3. Details of Tender fees, Estimated value of Contract, Earnest Money Deposit and Security Deposit for

the contract:

Name of Contract Tender fee

(Non refundable)

Approximately

value of Contract

Earnest Money

Deposit

Security

Deposit

Printing of Forms

& Registers 200/- 6,00,000/- 12,000/- 30,000/-

Please note that,

a) Tender fee/Document cost is payable in form of Demand Draft/Bankers Cheque drawn on any

scheduled bank in favour of ESI Fund Account No.-1 payable at Ahmedabad. Party

downloading the form from website shall have to deposit the same along with Bid Document as

prescribed in above manner.

b) The actual contract value may vary as per requirement. The details of the item to be supplied are

furnished in the Annexure– C, with specifications. However, it should be clearly noted that the

Model Hospital Bapunagar shall place the order only as per the requirements from time to time

which may vary from the quantity mentioned in the tender and the supplier cannot raise any

objection in this regard.

c) EMD/SD as above mentioned will be accepted in the form of Demand Draft/Bankers’ Cheque

from any Schedule bank drawn in favour of ESI Fund Account No. 1 payable at Ahmedabad

shall accompany the bid.

d) EMD shall remain valid for a period of 30 days beyond the final validity period of bids (120

days). A bid received without Bid security (EMD) shall be rejected at the bid opening stage.

e) The Eearnest money shall be refunded to the unsuccessful Tenderers after finalization of the

contract. It shall be refunded to the successful tenderer on receipt of Security Deposit (SD).

f) No interest is payable on the EMD/SD.

g) The bid security (EMD) may be forfeited, If a bidder withdraws his bid during the specified

period of bid validity specified in the bid document. In the case of successful bidder, if the bidder

fails to : Submit the surety bond after awarding of the contract or furnish the Performance

security within the time specified in the document.

h) In case of breach of any terms and condition under this contract, The Security Deposit (SD) will

be liable to be forfeited by Medical Superintendent besides annulment of the Contract.

4. Period of Rate Contract:

The rate contract shall be for a period of one(01) year from the date of award of contract and it

may be extendable for a further period as deemed fit on similar terms and condition/ rate on

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mutual consent subject to satisfactory performance of the firm.

5. Eligibility Criteria for Tenderer:-

a) The average annual turnover of the firm should be of Rs 18(Eighteen) Lakh minimum in printing

business, during financial year 2011-12, 2012-13 & 2013-14.

b) The firm should be existed prior to 2012(i.e. the firm should be existed since last three year.)

c) The bidder shall be free from encumbrance and there shall not be any vigilance case/ CBI Case/

Court Case pending against him, even the firm/Bidder should not have been blacklisted by the

Govt. / PSUs or any other government Agency or Private institution (Undertaking in this regard

shall have to be furnished in format given in Annexure-B attached to this tender documents).

d) The bidder shall have valid registration or trade license to carry/supply the item in

question.(Shops and Establishment Registration or Sale Tax act (VAT) registration or Registered

under certain enactment or any other certificate issue by government or Government Agency)

e) The Vendor must have PAN No and Bank Account in any of the Nationalized Banks/ Scheduled

Banks.(In case of Ltd./Pvt. Ltd./Partnership Firm, the PAN and Account shall be in the name of

the Firm/Company and in case of Individual Ownership, the PAN and Account may be in the

name of Owner.)

6. General Term and Condition:-

a) While submitting the tender for this work, the tenderers will be deemed to have read,

understood and accepted all the items and conditions stated in the tender document and shall be

complied with by the tendering firm.

b) vendor shall comply with all the statutory requirements/ norms issued by the Govt. from time to

time

c) If the successful Bidder fails to fulfill his obligations under this tender i.e. on adherence to terms

and conditions contained in this tender, the ESIC Model Hospital, Bapunagar after due notice to

the Printer may blacklist the firm. In such events, the Contract will stand terminated and the

EMD/Performance Securities of such Firm shall be forfeited to the ESIC.

d) The Medical Superintendent also reserves the right to terminate the contract before the contract

period expiry with one month notice. For any dispute regarding quality / service and rates the

decision of the Medical Superintendent shall be final and binding to the Contractor.

e) In the event of any disputes arising out of the execution of Rate Contracts/Supply Orders, the

matter will be referred to Medical Superintendent, ESIC Model Hospital Bapunagar , Ahmedabad.

f) All disputes relating to this tender can be legally resolved through courts in Ahmedabd only.

g) The tendering firms will have to give a undertaking to the effect that they have not been

blacklisted or their business dealings with the Government departments have not been banned.

This undertaking may be furnished in the format given in „Annexure – B‟ attached to this tender

document.

h) Tender must reach this office not later than the time and date notified in the tender form stated in

the schedule of tender. In the event of tender received after scheduled date and time, the tender

will not be allowed in bidding and it will be rejected summarily.

i) Each page of the Tender and all its annexures shall be signed and stamped by authorized

representative of Tenderer in token of acceptance of the terms and conditions laid under the

Tender Document. No page should be removed /detached from the tender document.

j) All entries in the Tender form shall be legible and filled clearly. Any overwriting or cutting which

is unavoidable shall be signed by the authorized signatory.

k) Tender incomplete in any form will be rejected out rightly.

l) Conditional Tenders will be rejected out rightly.

m) The Annexures enclosed received without the signature of authorized person will not be

entertained and will be rejected summarily.

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n) Tenders not received in the prescribed format shall be ignored and no correspondence in this

regard will be entertained. Telegraphic/Telex/Fax/email/Letterhead/Quotations will not be

accepted and ignored straightaway.

o) Canvassing in any form by the tenderer or his representative with any of the officials of ESIC

Model Hospital shall render the tender liable to be rejected

p) This tender or contract and both are non transferrable.

q) As the tenderers are requested to quote their prices on F.O.R. destination basis, (Free delivery to

the consignee's premises). No kind of Tax or duty or other levies /transport charge,/ insurance or

any charges reimbursed/paid/Borne by this hospital and No kind of exemption certificate will be

issued.

r) The rates quoted by the selected firm and approved by this office shall remain valid throughout

the period of contract and requests to increase the rates for any item(s) during the currency of the

contract shall not be considered.

s) Supply of all items should be duly tied up in convenient bundle into gum pad of say 100forms,

each with indication slip provided after 500 forms/cards/covers. Every forms/cards/covers must

have an imprint line given on the left hand side top or bottom corner indicating the concise name

of the printer, month of printing and quantity viz printer name.

7. Special Term and condition related with contract:-

a. The Medical Superintendent, ESIC Model Hospital Bapunagar Ahmedabd. reserves the right

to withdraw/relax any of the terms and conditions mentioned above.

b. It will be the responsibility of the supplier to ensure that items supplied are of the requisite quality

and free from all defects. The acceptance of items will be given only when the items are found up

to the specifications given in the tender enquiry and free from all defects. The decision of the

Medical Superintendent, ESIC MH, Bapunagar, Ahmedabad shall be final as to the quality of the

items and shall be binding upon the tenderers. Any item fails conformity with specification will

be rejected out rightly and it shall be replaced immediately (with in Three days from the

information about rejection) at the risk and cost of the supplier.

c. The Medical Superintendent has the right to authorize/appoint/depute any person to supervise the

services.

d. The Medical Superintendent, ESIC Model Hospital Bapunagar, Ahmedabad reserves the right to

conclude parallel Rate Contracts with a number of suppliers and place Orders on any of such firm

that may be the most economical to it or suitable to its requirements.

e. If the contractor fails in fulfilling the terms and conditions mentioned here in different parts of

this tender document, such failure will constitute a breach of the contract and the Medical

Superintendent shall be entitled to make other arrangements at the risk and expense of the

contractor. Also nonperformance/unsatisfactory performance or violation of terms and condition

of the contract will make the contractor liable for forfeiture of security deposit. The decision of

the Medical Superintendent shall be final and binding on this count.

f. The Medical Superintendent, ESIC Model Hospital,Bapunagar, Ahmedabad reserves the right to

opt a purchase/price preference from to Small Scale industries etc. in accordance with the policies

of the Govt. in force from time to time.

g. The term and condition of this tender document are the part of the contract document related with

the execution of the contract.

8. Bid Prices:

a. The tenderer are requested to submit their rate in “Annexure-C” (Details of Printed

forms/Register/Slips etc.)

b. The rates/ prices including the taxes, if any, should be quoted in Indian Rupees only in words as

well as figures.

c. The price quoted should be valid for the one year.

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d. Tenderers are requested to quote their prices on a firm & fixed basis only for the entire period of

the Rate Contract. Tenders of the firms received with prices quoted on variable basis shall be

rejected straightaway.

9. Penalty Clauses for non-satisfactory service:-

Whenever and wherever the empanelled vendors are requested to print any Form, the vendor shall

honour and comply the supply order within 21 days from the date or receipt of the order. In case

of non compliance of any order, a penalty of Rs. 500/- for each default shall be imposed on the

firm. The penalty amount shall be recovered either from the pending bills or from the security

deposit. This office will not enter in to further correspondence after imposing any penalty for

delayed supply.

10. Submission of tender:- All tenderer are instructed to submit the bid envelop as following manner.

a) The envelope no.-1 containing DD/BC (And also cost of Tender form i.e. as prescribed, if

form is downloaded from website)

b) Envelope no.-2, containing Tender document filled with all due information in prescribed

manner with all applicable self-attested documents/sample of item where YES stated in

check list as per “Annexure-” D except EMD.

c) Both above envelop required to be placed in third envelope, sealed and super scribed

“Tender for supply of stationary and miscellaneous in ESIC Model Hospital Bapunagar

Ahmedabad”

d) Documents may be dropped either in the box earmarked for the purpose or be sent by

Registered post. Documents received late by post shall not be accepted at all due to postal

Delay. Document received after the scheduled date and time shall be rejected out rightly.

11. Deadline for submission of bids

a. The above envelopes shall be sealed and addressed to The Medical Superintendent ESIC

Model Hospital Bapunagar Ahmedabad” and must reach on or before the 07/08/2015 by

02.00PM.

b. No bids will be received/accepted after the expiry of the prescribed date and time for submission

of the bids.

c. The Medical Superintendent, ESIC Model Hospital, Bapunagar, Ahmedabad may, at his

discretion, extend the deadline for submission of bids.

14. Bid Opening and Evaluation

a) The Technical Bids will be opened at 07/08/2015 at 2.30 PM in the office of the Dy Medical

Superintendent in the presence of such tenderers or their authorized representatives who may

choose to be present at the time of opening of technical bid.

b) The envelope no.1 containing EMD (also cost of Tender form i.e. as prescribed above, if form is

downloaded from website) shall be opened first. Envelope no.2 (containing Tender doccument)

shall be opened only if the bidder submits EMD as stated this form (also cost of form i.e. as

prescribed above in the event if form is downloaded from website).without EMD & cost of form

(in case if it is downloaded from website) the tender will not be entertained & will be rejected

summarily).

c) The envelope no. 2 i.e., “Tender Document” of only those bidder shall be opened who has

fulfilled the terms & condition as stated above at ii. The Tender Doccument will be evaluated by

Tender Evaluation Committee and shortlist the eligible technically qualified bidder as per terms &

conditions of tender document and their quoted rates will be considered for evaluation.

15. Selection of Eligible Tenderer:-

The selection of successful bidder shall be made on the rate offered by the bidder keeping in the

view of terms & conditions and specification laid under tender document.

16. Rights of Acceptance/Rejection:-

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The Medical Superintendent ESIC Model Hospital Bapunagar, Ahmedabad reserves the right to

reject all or any tender in whole or in part, without assigning any reason there

17. Acceptance of Bid :-

The successful bidder shall give its acceptance within 07 days from award of work order and

required to enter into an agreement with Medical Superintendent, ESIC Model Hospital,

Bapunagar, on bond paper of Rs.100/ ( Rupees One hundred only) . The cost of bond paper will

be born by successful bidder. In case, if successful bidder fails to give acceptance or enter into

agreement within stipulated time, the award of contract will be deemed to be cancelled and EMD

amount will be forfeited.

18. PAYMENT TERMS:

a. 100% Payment will be made only after satisfactory supply as per specification, inspection,

complete acceptance of the items by the Medical Superintendent or any other person(s) authorized

by him. If the supplied item found to be of substandard, the same will be returned and required to

be reprinted by the successful bidder. Any item fails conformity with specification will be rejected

out rightly and it shall be replaced immediately at the risk and cost of the supplier.

b. Advance payment will not be made under any circumstances. The payment shall be made

through RTGS/NEFT/ECS only. In case of Cheque, the same may be dispatched through Speed

Post/registered post.

c. Successful tenderer will have to supply the material within six weeks from the date of issue of

supply order on the rate quoted by them and approved by the competent authority of this hospital.

d. In case of delay / failure in supply, the indented items shall be purchased from the market at the

risk and cost of the Contractor. The extra expenditure involved in procuring supplies from

elsewhere will be recovered from the Contractor in full at discretion of the Medical

Superintendent.

e. The recovery thus due shall be deducted from any sum then due to the Contractor from the ESIC

Model Hospital or from any other contract placed with the said contractor by the ESIC Model

Hospital.

f. The Security Deposit will be forfeited if the printing matter is not supplied as per sample

provided/supply order.

Signature of tenderer with stamps

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Annexure-„„A‟‟

TENDER APPLICATION/DECLARATION FORM

1 Name of the firm:

2 A Full Postal Address

B Telephone No.

C Fax No.

D E-Mail Address

3 Ownership Details:

A Name of Director/Prop/Partner(s)

B Residential Address of

Director/Prop/Partner(s)

C Cell Phone No.

D E-mail Address

4 If your Firm Registered under: ******

A Vat (Commercial tax Registration

No)

B Any other authority under which

firm registered

Registration No. for above

C PAN Details: *******

D Name Appears on PAN Card

PAN No.

5 Bank Details: *******

A A/c Holder name

B Bank Name

C A/c No.

D Branch Name

E IFSC Code

6 Annual Turnover(In Rupees for

following financial year) ******

A Year-2013-14

B Year-2012-13

C Year-2011-12

D Average Annual Turnover

I ….................................................................................. proprietor/partner/director of M/s

…...................................................................... hereby declare that the information given in this form is

true and correct to the best of my knowledge and belief.

Name & signature of tenderer with Stamps

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„„Annexure-B‟‟

UNDERTAKING

1. I the undersigned certify that I have gone through the terms and conditions mentioned in the tender

document and undertake to comply with them.

2. The rates quoted by me are valid and binding upon me for the entire period of contract and it is

certified that the rates quoted are the lowest quoted for any other institution/hospital in India and also

certified that the rate quoted is less than the MRP of the quoted Item. It is also certified that item

quoted are of Standard Quality and workmanship.

3. The earnest money of Rs. ……………. To be deposited by me has been enclosed herewith vide

Demand Draft/Banker Cheque no. ……………….. dated: ………..drawn on Bank

…………………………..Branch …………………………………..

4. I hereby undertake to supply the items as per directions given in the tender document/supply order

within stipulated period.

5. I/We give the rights to Medical Superintendent to forfeit the earnest money deposited by me/us if any

delay occur on my/agent’s part of failed to supply the article within the appointment time or the items

of desired quality.

6. There is no vigilance/CBI case or court case pending against the firm.

7. This is to declare & certify that the neither myself nor my firm has ever been blacklisted by any

Govt./Semi Govt./Public/Private Intuition.

8. I/We hereby certify that the firm poses all the required license/certification to perform the work.

Date:- Signature of the tenderer:-

Place:- Full Name:-

Designation:-

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„„ANNEXURE – C”

SPECIFICATIONS OF PRINTED FORMS/REGISTERS/SLIPS/ETC

Sr.

No. Items Name

Annual

Requirement Paper size Quality

Rates in

digits Rates in words

1 Treatment sheet 104750 A4 70GSM

2 Blood Form 279000 A4 -do-

3 X-ray Form 187350 A4 -do-

4 Urine Form 33200 A4 -do-

5 Temperature Chart 38000 A4 -do-

6 I.P. Certificate 12000 A4 -do-

7 Discharge Card 47200 13.5x18cm As per

sample

8 Transfer Form 11250 A4 70GSM

9 OPD Ticket 25000 A4 -do-

10 Admission Form 17000 A4 -do-

11 Memorandum Form 6000 A4 -do-

12 Bill Details

List 6000 A4 -do-

13 Permission letter 8000 Legal -do-

14 Check List 4000 Legal(34.5cm

X20.5Cm) -do-

15 Reference Slip(1) 5000 A4 -do-

16 Reference Slip(2) 5000 A4 -do-

17 OT List 10600 A4 -do-

18 File Flap 2000 56cmX 11cm As per

sample

19 Office File 2247 36cm X 26cm As per

sample

20 Blood Investigation

Form 417050 A4 70GSM

21 Patient Counseling

Form 3000 A4 -do-

22 Blood Demand

Form 2635 A4 -do-

23 U.S.G. Gravid

Uterus Form 10000 A4 -do-

24 U.S.G.Pelvis 5000 A4 -do-

25 U.S.G. Abdomen 11000 A4 -do-

26 P.N.D.T.

Form(Form-F1) 20000 A4 -do-

27 U.S.G. KUB-P 3000 A4 -do-

28 Ovulation Study

Form 2000 A4 -do-

29 X-ray Cover

14''X17'' 5000 -

As per

sample

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30 X-ray Cover

12''X15'' 12000 - -do-

31 X-ray Cover

10''X12'' 9000 - -do-

32 X-ray Cover8''X10'' 8000 - -do-

33 ECG Mount Paper 20000 30cm X 23cm -do-

34 Duty List 5000 A4 70GSM

35 Certificate for

Payment 2000 A4 -do-

36 Inspection Note 6000 Legal -do-

37

Stool

form(Discharge

Certificate)

31000 A4 -do-

38 Ward Diet sheet 2500 A4 -do-

39 U.O. Note 4500 A4 -do-

40 Adjustment Bill

form 3000 A4 -do-

41 Cheque list 5000 A4 -do-

42 Certificate form 5000 A4 -do-

43 T.R.-30 5000 Legal -do-

44 Brown Cover-

5''X12'' with address 5000 - -do-

45 T.R.-22(Outer) 2000 29cm X 43cm -do-

46 E.L.(GRO-59) 2000 29cm X 22cm -do-

Registers:-

Sr.

No. Items Name with page number

Annual

Require

ment

Paper size Quality Rates Remarks

1 Hospital Admission

Book(400page) 2 45cmX 28cm 60GSM

2 Ward Admission Book(400page) 2 45cmX 28cm -do-

3 HIV Patient Register (200page) 5 45cmX 28cm -do-

4 Patient Register(200page) 4 33cm X 20cm -do-

5 Routine case Register(200page) 2 33cm X 20cm -do-

6 Antental Case visit Reg.(200page) 1 45cm X 28cm -do-

7 Attenndance Register(100page) 60 22cm X 15cm -do-

8 O.P.D. Register(400page) 7 33cm X20cm -do-

9 Lab Report Register(400page) 5 33cm X20cm -do-

10 Weekly Register(400page) 3 33cm X20cm -do-

11 Daily Report Reg.(400page) 3 33cm X20cm -do-

12 T.B. Register(400page) 3 45cmX 28cm -do-

13 Dots Register(CM-162)-200page 123 45cmX 28cm -do-

14 Stock Consumption Register

(200page) 37 28cm X 22cm -do-

15 Indent Book(100X2 page) 107 28cmX 22cm -do-

16 Camp Register(200page) 3 33cmX 20cm -do-

17 Donor Registration

Reg.(200page)BD-2 2 A4 Land scape -do-

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18 Donor Deferral

Reg.(200page)BD-5 1 A4 -do-

19 Blood Donor.Counseling

Reg.(200page)BD-9 2 A3 landscape -do-

20 Transfusion Trans. Ins.

Reg.(200page)TTI-1 2 A4 -do-

21 Kit stock Reg.(200page)TTI-2 2 A4 -do-

22 Bio hazard waste Discard

Reg.(200page) 2 A4 Landscape

23 Rapid and other Tesst

Reg.(200page)TTI-5 2 -do- -do-

24 Patient Sample Receiving

Reg.(200page)CM-3 2 -do- -do-

25 Patient Blood Grouping

Reg.(200page)CM-4 2 -do- -do-

26 Donor cell Grouping

Reg.(200page)CM-5 2 -do- -do-

27 Deonor serum Rouping

Reg.(200page)CM-6 2 -do- -do-

28 Blood Compatibiliy & Issue

Reg.(200page)CM-7 2 -do- -do-

29 Anti Human Globulin testing

Reg.(200page)CM-8 1 -do- -do-

30 Daily whole Blood red Blood cell

stock Reg.(200page)CM-9 2 A4 -do-

31 Master Register(200page)CM-10 2 A4 landscape -do-

32 Daily charge Hand over

Reg.(200page)GD-1 1 A3 landscape -do-

33 Grievance Redressal

Reg.(200page)GD-3 1 A4 landscape -do-

34 Staff proficiency

Reg.(200page)GD-8 1 A4 landscape -do-

35 Teaching and training

record(200page)GD-9 1 A4 -do-

36 Internal Audit non confo

rmance(200page)GD-12 1 A4 -do-

37

Calibration and preventive

Maintenance

schedule(200page)GD-13

1 A4 Double -do-

38 Equipment break Down

Reg.(200page)GD-14 1 A4 dDuble -do-

39 Thermo graph change

reg.(200page)Gd-15 1 A4 -do-

40 Consumable stock

Reg.(200page)GD-16 1 A4 land scape -do-

41 Blood Bank External quality

Assessment (200page)GD-17 1 A4 land scape -do-

42 Inter laboratory Comparison For

B.G.(200page)GD-18 1 A4 land scape -do-

43 Error reporting

Register(200page)GD-9 1 -do- -do-

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44 Quality control

Reg.(200page)GD-21 1 A4 -do-

45 Quality control of normal saline

and distilled(200page)GD-22 1 A4 -do-

46 Cell counter control

Register(100page) 1 45cmX 28cm -do-

47 Patient entry Reg.(400page) 8 33cm X 20cm -do-

48 Cell Counter Reg.(200page) 16 33cm X 20cm -do-

49 Urine Reg.(200page) 12 33cm X 20cm -do-

50 Inventory Reg.(100page) 1 45cmX 28cm -do-

51 Stock Reg.(Insturment Store)-

300page 4 32cm X 20cm -do-

52 Impress cash Book-200page 2 37cmX 25cm As per

sample

53 S-32(200page) 6 34cm X 21cm -do-

54 T.R.-29(200page) 3 34cm X21cm -do-

55 T.R.-4(CRI. Br.)-200page 2 42cm X 30cm -do-

56 ABC Register (Pay Bill Reg.)-

200page 10 41cm X 33cm -do-

57 Branch Diary(S-31) -200page 14 33cm X20cm -do-

58 Account No.-1(150page) 1 42cm X33cm -do-

59 Account No.-2(150page) 3 42cm X 33cm -do-

60 Assistant Diary(S-229)-200page 36 33cm X 21cm -do-

61 Staff Yearly register for Staff

Nurse(400Pages) 3 30cm X 21cm -do-

62 Staff Yearly Register for

NO(200Pages) 6 30cm X 21cm -do-

63 Death Certificate Book(50X2

pages) 20 29cm X 23cm 70GSM

64 B.I.-1(50X2pages) 30 25cm X19cm 70GSM

Signature of the Tenderer

With seal of the firm

Page 13: TENDER NOTICE FOR PRINTING OF FORMS & REGISTERS tender.pdf · Page 2 of 13 TENDER DOCUMENT FOR PRINTING OF FORMS & REGISTERS 1. Name of Tender: ESIC Model Hospital, Bapunagar, Ahmedabad

Page 13 of 13

„„ANNEXURE- D‟‟

CHECK LIST OF THE DOCUMENTS TO BE SUBMITTED WITH THE TENDER

(Confirm the enclosure of all the below listed applicable documents without which tenderer may not be

eligible to participate in the tender.)

Sr. No.

Items

Confirm

(Yes/Not

Applicable)

1 Tender Document fee If download from web site

2 Earnest Money Deposit

3 Original Tender form with complete Tender Application/Declaration

Form in annexure A, Undertaking in Annexure B, And Rate in Annexure

C with all pages serially numbered , signed and stamped on each page

4 Copy of registration of firm (Shops and establishment Registration or

factory act registration or Registered under certain enactment or any

other certificate issue by government or Government Agency)

4 Audited Balance sheet with details of

annual turnover, profit & loss account etc.

if last three financial year as mentioned

here.

Year-2013-14

Year -2012-13

Year-2011-12

5 Income tax returns of three financial year

as mentioned here.

Year-2013-14

Year -2012-13

Year-2011-12

6 Attested Photo copy of PAN Card

7 Details of the Bank Account No.

8 Copy of any other registration mention at “Annexure-A” Sr. No. 4(B)

Date: Signature of Authorized Person

Full Name:

Place:

Company‟s Seal


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