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Misc. Item S. NAME OF ITEM SPECIFICATION

NO.

1 Acid Bottle

2 Table Glasses 2x3 & Folder type double glass

3 Mosquito Repellents and Refills

4 Battery Cell Big & Pencil

5 Bicycles

6 Broom Coconutper kg, Bamboopre kg, Phooleach

7 Buckets 20 ltr.

8 Good Quality Towels

Medium, full size & Car size

9 Cleaning Spray

10 Wiper Steel Make

11 Sealing Wax per pkt.

12 Tray Service Plastic

13 Tube Lights 40 wt. compelete tube light set, CFL-15,18&23 watt

14 Spray Pump

15 Finit per ltr.

16 Floor Swabs

17 Floor Wipers Big size

18 Khadi Duster

19 Plastic Jugs

20 Duster Yellow/White Various Type

21 Buckets Plastic 20 & 25 Ltr.

22 Waste Paper Basket

23 Crockery Items cup plate set

cup six pec. set

24 Urinal Cubes per kg

25 Broom Hard

26 Name Plate Brass/Plastic/plastic with hanger

27 Toilet Brush Hard various size (Plastic)

28 Naphthalene Ballsper kg

29 Coaster 6 pec. set

30 Leather Folder superior quality

31 Drawing Pin

32 Cushion chair

33 Odonil

34 Phenyl per ltr.

35 Toilet Brush

36 File Tray Plastic

37 Torch Two & three cell

38 Tumbler

39 Tumbler Cover

40 Vim Powder kg.

41 Water Pipe PVC per mtr.

42 Towel Ordinary Set Towel/Hand Towel/Dusters

43 Soap Cakes and Cases

44 Room Refreshers

45 Desert Cooler Stand iron

46 Sooja Steel Wooden Handle

47 Bastey

48 Alpin per pkt.

49 Lock 60mm, 80mm

50 Mug Plastic

51 Calculator 10 digit & 15 digit

52 Juna

53 Binder Clip All Size

54 Dustpen

55 Blindes With complete fitting per sq. feet

56 Curtain medium per mtr., superior per mtr., rod work complete per sq. feet

57 Folding Cord

58 Mattress jute/foam 6x3 & Bedsheet 6x3

59 Blanket 6x3

60 Brown paper roll

61 Board markar (all type)

62 Clip Folder spiral

63 Color pencil

64 Chart paper (all color)

65 File cobra

66 Chalk (all colors)

67 Case book

68 Ivory sheet white

69 Graph paper (Big/Small)

70 Iron ring (for broom)

71

Pen for transperancy (mix coloured)

72 Register unrolled

73 Sketch pen mix coloured

74 Stamp

75 U pin

76 All out machine/liquid

77 Bambo- 6”8”,”12”

78 Dustbin-30 ltr, 60 ltr

79 Doormat, floor mat

80 Dettol hand wash liquid

81 Flexi board

82 Harpic

83 Jala brush

84 Juice glass

85 Key board

86 Service tray

87 Serving bowl

88 Scotch bright

89 Tharmas, 1ltr 2 ltr

90 Hot case (tea containor)

91 Steel jug

92 Spoon

93 Vim bar

94 Account book

95 Tube large (iron, plastic)

96 Casual leave register

97 Water glass

98 Answer sheet A/B

99 Khurpi-Big/Small

100 Fawra

101 Gaiti

102 Cutter for mali

103 Hedge for grass

104 Bleaching powder

105 Budget register

106 Contingency register

107 BM 8 Register

108 TA register

109 Clif board

110 Surf powder

111 Talwar for mali

112 Kudaal

113 Lawn mover

114 Candle

115 Seel

116 Match box

117 Marking cloth

118 Water campher

119 Press electronic

120 Washing brush

121 Khurpi-big/small

122 Good night coil

123 Emergency torch

124 Tape

125 Towel hanger ( Steel )

126 Soap case (Steel )

127

Student chair-Top board under book boxes

128

Big wrapper (Dust pocha) for floor cleaning

129 Wiper swabes

130 Brass seal

131 Lawn mover

132 Water Camper

133 Baamboo Rod

134 Dustbin 20 & 30 Litre

135 Scotch brite

136 Plastic Bag for dustbin

137 Cleaning Brush

138 Lifeboy gel

139 Chart paper Cloured

140

ELECTRICAL ITEMS

S.

NO

.

NAME OF ITEM SPECIFICA-------TION

1 Oil Based Heating System 9 Fins

2 Stabilizers Various Make and Size, -5Kw, 1 Kw, 2 Kw, 4

Kw, 5 Kw,

3 Call Bell Electric, Remote, Cordless

4 Air Conditioner

with installation

Window1-5 Ton, 2-0 Ton/Split 1-5 Ton, 2-

00 Ton

5 Water Cooler 15Ltr., 20/40 Ltr., 40/80 Ltr.,

6 Water Filter 20 Ltr.

7 Desert Coolers GI Body ISI Mark Motor 3 speed

Heavy Body ISI 8 Pedestal Fans 400mm sweep, 450 mm sweep

9 Heat Converters Bajaj ISI/ Turbo

10 Hot Case ISI Mark

11 Emergency Tube Light Maharaja

12 Refrigerator 190 Ltr

13 Table Lamps

14 Tape Recorder

15 Geyser 25 Ltr., 35Ltr.

16 Heaters Single/Double rod

17 Electric Items Various Type Tube Light 40 watt., Bulb 100, 200, Watt, Plug Top

5/15amp, Changr over 100amp.

18 Telephone Wires

19 Electric Wires 1-0, 1-5, 2-5, 4-0 6-0 mm per roll

20 Electric Tube lights

21 Telephone Instruments Various Make

22 Mobile Handsets Various Make

23 Inverters Luminous with Trolley 600, 800, 1400 VA

Two battery Without Installation

24 Plugs

25 Remote Bell

26 Extension Boards 15 Amp

27 Automatic Air Dispensers

28- Fuse – 63, 100, 140, 200, 250,

300, 400, 540, 630 & 800 anp.

29- Celling Fan Regulator

30- MCCB – 63 & 100 Amp

31- Condencor – 2.5, 4, 5 & 10 MFD

32- Power Cable – 25, 35, 50, 100 &

150 Amp four quair armed

33- MCB – 6, 16, 20, 25, 32 & 63

AMP

34- Batton 1 each

35- Round Plug

36- Wire Clip

37- Connector – 60 AMP Strip type

38- Switch – 5 & 16 AMP Combined

39- Batton Nail

40- Blower & heater thermostate

41- Blower & heater Quail / element

42- Machine Screw

43- Multimeter Battery 9 volt

44- Disstilled Water

45- Electrician Plaer & Stripper

46- Screw Driver

47- Tester

48- Spanner Set open Head

49- Spanner Ring Type

50- Gotti Pana set

COMPUTER ITEMS

S.

NO

.

NAME OF ITEM SPECIFICATION

1- C.D. Writeable Moserbear

2- C.D. Re-Writeable Moserbear

3- Cartiridge 1200 Series Laserjet (HP)




7- Cartiridge 1180 Series Inkjet (HP)

Colour

8- Cartiridge 1180 Series Inkjet (HP)

Black

9- Dot Matrix Vipro


11- Cartiridge 2010 Series Laserjet (Samsung)

12- Cartiridge 640 Series Deskjet (HP)

Colour/Black

13- Cartiridge 840 Series Deskjet (HP)

Colour/Black



16- Photostate Toner I.R.2016 (Canon)

17- Photostate Toner 5821 (Xerox)

18- Photostate Toner 5834 (Xerox)

19- Photostate Toner 160 (HCL)

20- Photostate Toner 200 (HCL)


22- Photostate Toner (Richo)

23- Pen Drive 1 GB, Kingstan

2 GB, Kingstan

4 GB, Kingstan

24- Computer Cartridge Page Pro 1390

(Konica Minolta)

25- Computer Cartridge Page Pro 1400

(Konica Minolta)

26- Optical Mouse

27- Key Board Ordinary

Multimedia

28- Antiglare Screen 14”

17”

29- Paper Holder

30- Fax Cartridge KXT 131 (Panasonic)

31- Fax Cartridge Thermal (Panasonic)

32- Fax Cartridge 640 (Xerox)

33- Fax Cartridge WC640 (Xerox)

34- Fax Cartridge L 220 (Canon)

35- Fax Cartridge A 650 (Sharp)

36- Combo Drive

37- Dustcover For Computer & Printer

38- Cartridge Cannon

FURNITURE ITEMS

S. NO. NAME OF ITEM SPECIFICATION

1 Executive Revolving Chairs Hydrolic Soft Leather foam adjustable

height 5 Wheel Base, With Arm, Heavy

Duty. (Water proof design)

2 Revolving Chairs Hydrolic Half Back Soft Leather/Cloth,

Adjustable Height, 5 Wheel Base.

3 Computer Chairs Hydrolic cloth adjustable height with

arms, 5 Wheel Base.

4 Computer Chairs Hydrolic cloth adjustable height without

arms, 5 Wheel Base.

5 Computer Table 3x2, 18mm Laminated Board with

Keyboard & Shelves for Computer,

Printer, Speaker, etc. 20 Gauge Pipe.

6 Computer Table 4x2 Laminated Board with sliding

Keyboard 20 Gauge with Shelves for

Computer, Printer, Speaker, etc.

7 Tub Type Chairs Cushion seats and back with arms 18

Gauge, Round Pipe, Cloth Cover,

16”x16” seat 28 density rust proof.

8 Round Steel Pipe Chairs Cushion seats and back with arms 18

Gauge, Round Pipe, Cloth Cover,

16”x16” seat 28 density rust proof.

9 Square Steel Pipe Chairs Cushion seats and back 18”x18” with

seat & arms 28 density.

10 Office Table 4x2½ 1 draws sun mica top, Pipe Frame,

20 Gauge, 1mm mica, 18mm thick top,

MS Sheet, 22 Gauge.

11 Office Table 4x2½ 3 draws sun mica top, Pipe Frame,

20 Gauge, 1mm mica, 18mm thick top,

MS Sheet, 22 Gauge.

12 Executive Table 5x3 Side cabinet 3 draws & cabinet, 22

Gauge, 20 Gauge Pipe, 22 Gauge Sheet,

18mm Board, 1mm Mica.

13 Steel Almirah 1280x860x430 mm with locker, 3

Shelves, 22 Gauge sheet, door & body.

14 Steel Almirah 1280x860x430 mm without locker, 3

Shelves, 22 Gauge, door & body.

15 Steel Almirah 1980x860x760 mm with locker, 4

Shelves, 22 Gauge, door & body.

16 Steel Almirah 1980x860x760 mm without locker, 4

Shelves, door & body.

17 Wooden Almirah 1280x860x430 mm without locker, fly

rail, Hinges, 18mm board, laminated

with lock.

18 Book Cases 1980x860x760 mm with glass, 22 Gauge

sheet & modi glass.

19 Book Cases 1500x860x430 mm with glass, 4mm

thick, 22 Gauge sheet & modi glass.

20 Steel Racks 6x3-6 shelves heavy, Shelves 20 Gauge,

40x40x1.6mm.

21 Steel Racks 9x3-8 shelves heavy, Shelves 20 Gauge,

40x40x1.6mm.

22 Steel Racks 8x3-7 Shelves Heavy Shelves 20 Gauge,

40x40x1.6mm.

23 Steel Racks 3x3½x15” 3 Shelves Heavy Shelves 20

Gauge, 40x40x1.6mm.

24 Sofa Set Teak Wood 5 Seater 4” Cushion seat 28

density with arms, foam/cloth.

25 Center Table 4x2 Wood & Glass finish, 10 mm thick,

Heavy Duty.

26 Filling Cabinet 54 H x 24 D x 18 W, 4 draws, 20 Gauge

with locks.

27 Visiter Stool 12”x12”x18” heavy, 20 Gauge Pipe

Frame, MS Top.

28 Three Seater Chairs Perforated 5x18x18, 20 Gauge, with side

arms.

29 Notice Board 4x6, 4x2, 2x3, 2x2½, open thumb pin

road with ¾” Aluminium Bidding

18mm.

30 Wooden Counters Laminated Board, 18mm thick 1 side

draws, 2½ feet height, 1mm mica top per

Sq. ft.

31 Carpets Ribbed, (Jute 12mm) Superior, (Acrylic

12mm) Venial (PBC 4mm thick) per Sq.

ft.

32 Chowki 18x18 12 mm Laminated Boards, 1mm

mica,

33 Catalogue Card Cabinet 14”x16”, 4 draws with locks 20 Gauge,

MS Sheet.

34 Daris 6x3, 12x12, 18x18 (Cotton)

35 Wooden Dewans Sun mica & Board finish 6’x3’, 12” box,

18mm board, 1mm sun mica.

36 Door Mates 2’x3’, 4x2, 2½x1½, Jute/Rubber.

37 Dressing Table 6’-24”x12” box (4x1 mirror modi glass).

38 Foot Rest 50x40x40

39 Folding Sheet Back Chair Tin, Steel Folding Chair without

arms.

40 Flower Boxes Standard Size.

41 Aluminium Ladders 6ft., 8ft., 10ft., 18ft, Double & Single

1.2mm thick.

42 Library Stacks 8’x3’x15” with shelf 18 mm laminated

wood.

43 Dinning Table & Chairs 6x3 sun mica top 6 Cushion Chairs,

Dinning Table Teak Wood 18mm Top,

Chairs 28 density foam & cloth.

44 Paper Tray Steel, Wooden & Plastic Standard.

45 Side Racks 3x2½x1½ wooden finish.

46 Standing Screen 60”x72” 3 & 4 fold, Wooden or Pipe

Frame with Curtain.

47 Iron Safe 21x16x16, 16 Gauge & Inside Lock.

48 Side Tables 15x15x12, 18mm board, 1mm mica

board.

49 Stationery Rack 6x3x1½, 6 panels, 20 Gauge, 1.6mm

angle (open type).

50 Wheel Barrow 3x1½ 16 Gauge Sheet with wheels 6”

(Rubber).

51 Trolleys 2x1½x24 ht. as per sample.

52 Garden Table & Chairs Supreme/Nilkamal 6 Chairs Set.

53 Double Bed 6x6 Laminated Board & sun mica finish

with 12” box, 18mm board, 1mm mica

top.

54 T.V. Trolley 2x1½ Superior qualities with shelves

open.

55 Cup Boards, Steel 6½’x3’x22” 3 shelves & lockers 20

Gauges.

56 Slanting Writing Desk With Brass Fitting. (Ramp) 14”x22”

10mm Acrylic Sheet.

57 Letter Box 1’x1½’ 18mm Board, 1mm mica.

58 Cash Box 10”x14”x6” with lock, 18 Gauge.

59 Counter Chairs Steel Round Pipe Soft Cushion

revolving heavy duty adjustable height.

60 Charging Tray 2’x3’ 18 Gauge Heavy Sheet.

61 Iron Hospital Bed 6x3 with side of 1½ Pipe Frame MS

Sheet.

62 Corner Tables 12x15x15 MS Top 20 Gauge, Pipe &

Frame.

63 National Emblem Bras Standard Size.

64 Conference Tables 18mm Board 1mm mica thick &

Polished Per Sq. ft.

65 Conference Chairs Steel Round Pipe Soft Cushion Superior

with arms heavy duty 18” density.

66 Revolving Books Stand 4 legs 85 H, 3 shelves.

67 Wheel Chairs Folding & Fixed 38Lx25Wx32H

68 Newspaper Display Stand 3’x2’ Laminated Board 18 mm.

69 Podium Stand 4x2 Laminated Board 18 mm Top &

Frame 1mm mica.

70 Folding Bed 6x3 Ply Board, 12mm thick, 18 Gauge

Pipe.

71 Dinner Wagon Service Trolley Superior quality.

72 Lawn Mover Superior quality.

73 Fawada Superior quality.

74 Kudal Superior quality.

75 Khurpi – Small & Big Superior quality.

76 Fawara – Small & Big Superior quality.

77 Grass Cutter Superior quality.

78 Gainti Superior quality.

79 Thurmus – 1 & 2 Litre Superior quality.

80 Wooden Florring Superior quality.

81 Aluminum Partician with Glass Superior quality.

82 Visiter Chair – Chrome

83 Dual Desk Seating two persons of overall size 48”

x36” x18” with top of size 48”x18” &

seat size 48”x14”. Top & seat made in

25 mm particle Board Duly postformed

& base made in 25x25 mm square pipe

duly powder coated

84 Chair with Right Arm with base

box

Superior quality.

STATIONARY ITEMS

S.

NO.

NAME OF ITEM SPECIFICATION

1 Attendance Register 2 Qr. & 4 r.

2 Assiistant Diary Register 4 Qr. & 6 Qr.

3 Ball Pen Cello & Cello griper

4 Bill Registeres Red Bidding 8 Qr.

5 Carbon Paper fs &A-3

6 Colour Paper Ream

7 Clip Folder Various Type

8 Call Book

9 Stapler Machine 10 no. 45 no.

10 Scissors Iron/Plastic

11 Rubber Stamps Plastic

12 Cello Tape Big, Medium, Small

13 Pencil Box Natraj

14 Printed Registers 10 Qr.& 6 Qr.

15 Dak Pad Raxeen& Cloth

16 Diary Register PBC

17 Despatch Register 10 Qr.

18 Desk Calander Plate Plastic

19 Desk Calender Refill Big, Small Size

20 Peon Book standard

21 Eraser Non- Dust

22 Yellow/White Envelopes (Cloth-coated/Laminated with Printed and

unprinted) Four Rings) 9x4 & 11x4

23 Fevi Quick

24 Plastic Folders Medium & superior

25 File Board

26 Gel Pen Refill Acheiver & cello

27 File Movement Register

28 Ball Pen cello & renold

29 Printed File Covers

30 White Fluid Bottle

31 Index Folder

32 Conference Plastic & leather

33 File Register

34 Stick Folder

35 CAM 100 sheet pad

36 Cloth-coated File Folders

37 Plastic Lead Folder

38 Gem Clip

39 GAR Forms

40 GAR Register Red-Binding

41 Gum Brush

42 Highlighter Pen (Pocket)

43 Index Register Full and Half

44 Log Book

45 Note Sheet Pads Fs & A-4

46 Printed & Unprinted Note /Writing Pads

47 Quick Fix

48 Pen/Mug Stand (Glass Type)

49 Pilot Pen (0.5 & V.5)

50 Gel Pen Various Type

51 Pencil Lead Shorthand

52 Permanent Marker

53 Correction Pen Different Make

54 Diary Executive Different Make

55 Typing Paper A-4 & Fs

56 Packing Paper

57 Ring Folder Two, Three & Four

58 Planner Diary

59 Bodkins Pokers

60 Paper Roll For Pen Stand

61 Pocket Note Book Various Make

62 Pension Form Per set

63 Registers 96 pg,144 pg,192 pg,240 pg,384 pg

64 Register PBR

65 Report File

66 Fax Roll

67 Glue Sticks

68 Pens cello & renold

69 Paper Weight Glass /acerlic

70 Stapler Pins 10no& 24no.

71 Scale Plastic/Steel

72 Stamp Pad small & big

73 Shorthand Note Book

74 Sign Pen

75 Stock Register Red-Binding

76 Sharpner

77 Spiral Writing Pad With Printed Superior/Ordinary

78 Paper Cutter Natraj

79 Cotton Tags per bundle

80 Gum Sticks Tubes

81 Gum Bottles 700ml

82 Office Paste glue stick

83 Pin Cushion

84 Punching Machine double & single

85 Tag White

86 Transparency Sheet per pad

87 Green Thread

88 File Covers With Jaconet Inside

89 TAR-6 Form per pad

90 Visiting Card Album

91 U-Clips

92 Printed Stationery Various Type GPF Statement, GPF

Register, GAR 29, etc.

93 Writing Pad Various Type & Make

94 Self Adhesives Note Pad of various size & Make

95 Refill Jotter Pen

96 Photostat Paper A-4, Fs. & A-3

97 Duplicating Paper A4 Size

98 Stencil Paper

99 Register 10 Qr.Alphabet

100 Kadak

101 Flag Multicolour Page Marker, Pestit Different Size

102 Gaurd File

103 Pad Ink

104 Register Binded

105 Pen Stand two & fourPen

106 Pen Stand Pen

107 Letter Pad A-4 & Fs. 100 Sheet

108 Chart Paper Colour

109 Book Despatch & Receiving

Register

Director General Medical Health & Family Welfare

Uttarakhand. Vill- Dhandhlakhond, Shashdhara Road] Dehradun – 248001.

Ref.no.-21p/SA/28/2009/

Dated: 30 Oct..2012

NOTICE INVITING APPLICATIONS FOR REGISTRATION

TERMS AND CONDITIONS 1. Sealed applications in prescribed form are invited upto 20-11-12 till 3.00 p.m. for empanelment

of suppliers/contractors/service providers(Dehradun based) for inviting limited tenders from them

for outsourcing of various services including maintenance contracts .

2. The applicants interested in empanelment with the DGMH&FW, Uttarakhand may send their

applications in prescribed form along with the proof of their turnover for the last three years;

mentioning that they possess necessary capacity, equipment and facilities for supply of particular

items which they offer.

3. The applicants should specifically mention the items for which they seek registration. In future,

whenever there is a requirement for purchase of stores or for maintenance or for providing any

service, the Notice inviting Tender may be

sent to the registered vendors.

4. The Departent may form a committee to verify the documents submitted by the vendors, to see

the premises/workshops of the vendors, and also to verify the quality of products/services

supplied to clients by visiting some client premises before deciding on the registration.

5. The registered vendors shall be required to submit Tenders as per the terms and conditions laid

down in the particular Notice inviting Tenders.

6. DGMH&FW, Uttarakhand reserves the right to register any vendor and to cancel the

registration of any vendor at any time, without giving any notice and without assigning reason.

7. Submission of the application does not confer any right on any applicant for registration with

the DGMH&FW, Uttarakhand

8. The decision of the DGMH&FW, Uttarakhand in all the matters connected with or incidental

to registration shall be final and binding on all and shall not be called in question on any ground.

9. Registration will not ipso facto confer any right on any vendor to receive Notice inviting

Tender from the DGMH&FW, Uttarakhand

10. List of items the supplier/contractor/service provider intends to supply and annual transaction

made in the last 3 years should be shown in 3 separate columns.

11. Following information is also required

a. PIN/TIN No. Registered with local TradeTax Authority

b. Total payment made on A/C of TDS/Income Tax/VAT etc. for the year 2009-10, 2010-11 &

2011-12.

12. The application form along with the detailed list of all Stationery items; Computer items;

Electric items; Electronic items; Furniture items; Livery items; Tyre tube; Toiletry & other

miscellaneous items and Maintenance/Contracts and services likely to be required by

DGMH&FW, Uttarakhand can be obtained, without any payment, from the Staff Officer,

DGMH&FW, Uttarakhand.

(Telephone No.0135-2608749).

13. DGMH&FW, Uttarakhand.reserves the right to purchase any item or to award

maintenance/Rate services contract to any vendor even who is not empanelled with it.

Note:- Documentary proof must be attached with the application of registration, to verify the Credentials, manufacturing capability, quality control systems, past

performance (for the goods in question), after sales service, financial background etc. of the firm.

Director Generel

DGMH&FW, Uttarakhand

No…………………………… Dated:……………………….

APPLICATION FORM FOR REGISTRATION

The application duly filled in and accompanied with necessary documents in

sealed cover addressed to Staff officer,

DGMH&FW, Uttarakhand, Vill- Dhandhlakhond, Shashdhara Road, Dehradun – 248001

should reach

this office by3.00 p.m. on 05 Sep, 2012.

REQUISITE IFORMATION 1. Name of the applicant : ________________________________________

2. Address : ________________________________________

(Attach documentary proof) _________________________________________

__________________________________________

3. Constitution of the applicant : ________________________________________

_________________________________________

__________________________________________

4. Name & Address of : ________________________________________

Proprietor/Partners/Directors _________________________________________

of the applicant _________________________________________

5. Telephone Nos. : Off___________________ Res._______________

6. Turnover for the last three :_________________________________________

years _________________________________________

(Attach documentary proof) _________________________________________

7. List of regular clients with : ________________________________________

the name of contact person _________________________________________

and Telephone Nos. __________________________________________

8. Specifically mention about the items for which registration is required under

particular head:

A. SUPPLY OF VARIOUS ITEMS

(i) Stationery items :___________________________________

____________________________________

____________________________________

(ii) Printing/Binding :___________________________________

____________________________________

____________________________________

(iii) Computer items :___________________________________

____________________________________

____________________________________

(iv) Electronic items :___________________________________

____________________________________

____________________________________

(v) Electric items :___________________________________

____________________________________

____________________________________

(vi) Furniture items :___________________________________

____________________________________

____________________________________

(vii) Livery items :___________________________________

____________________________________

____________________________________

iii) Toiletry and other items :___________________________________

Miscellaneous items ____________________________________

(ix) Tyre Tube (for Tata sumo, Ambessadar’ Quallis, gypsy

etc.): ___________________________________

Miscellaneous items ____________________________________

____________________________________

B. MAINTENANCE/RATE :___________________________________

CONTRACT ITEMS ____________________________________

____________________________________

9. Permanent Account Number : __________________________________

(PAN)/Tenders Identification ___________________________________

Number (TIN) allotted under ___________________________________

The Income Tax Act

(Attach photocopy)

10. Registration No. under : __________________________________

CST/VAT ___________________________________

(Attach photocopies) ____________________________________

Signature: ____________________________

11- List of relevant documents_____________________________

(Authorised Signatory)

Name: _______________________________

Designation: __________________________

Stamp of the

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