1.
|
Name & address of the Client
|
_______________________________
|
2.
|
Details of works executed by Shri/M/s
|
_______________________________
|
3.
|
Name of work with brief particulars
|
_______________________________
|
4.
|
Agreement No. and Date
|
_______________________________
|
5.
|
Date of Commencement of work
|
_______________________________
|
6.
|
Stipulated date of completion
|
_______________________________
|
7.
|
Actual date of completion
|
_______________________________
|
8.
|
Details of compensation levied for delay, if any
|
_______________________________
|
9.
|
Tendered amount
|
_______________________________
|
10.
|
Gross amount of the work completed
|
_______________________________
|
11.
|
Name and address of the authority under whom works executed
|
_______________________________
|
12.
|
Whether the contractor employed qualified Engineer/Overseer during execution of work ?
|
_______________________________
|
13.
|
(i) Quality of work (indicate grading)
|
Outstanding/V. Good/Good/ Poor
|
|
(ii) Amount of work paid on reduced rate basis, if any
|
_______________________________
|
14.
|
(i) Did the contractor go for arbitration ?
|
_______________________________
|
|
(ii) If yes, total amount of claim.
|
_______________________________
|
|
(iii) Total amount awarded
|
_______________________________
|
15.
|
Comments on the capabilities of the contractor
|
|
|
(a) Technical Proficiency
|
Outstanding/V.Good/Good/Poor
|
|
(b) Financial Soundness
|
Outstanding/V.Good/Good/Poor
|
|
(c) Mobilization of adequate T&P
|
Outstanding/V.Good/Good/Poor
|
|
(d) Mobilization of manpower
|
Outstanding/V.Good/Good/Poor
|
|
(e) General behaviour
|
Outstanding/V.Good/Good/Poor
|
|
Note : All columns should be filled in properly & countersigned
|
|
|
|
Signature of the Reporting Officer with Official Seal
|
|
Officer of the rank of Superintending Engineer or equivalent
|
|
ANNEXURE – V
FORM OF SOLVENCY CERTIFICATE FROM A SCHEDULE BANK
This is to certify that to the best of our knowledge and information M/s / Shri ______________________________________________________________________ having marginally noted address, a customer of our bank are/is respectable and can be treated as good for any engagement upto a limit of Rs. _____________________________________________ (Rs. ___________________________________________________________________). This certificate is issued without any guarantee or responsibility on the Bank or any of the Officers.
Signature for the Bank.
Note : In case of partnership firm, certificate to include names of all partners as recorded with the Bank.
WORKING CAPITAL CERTIFICATE FROM A SCHEDULE BANK
(For Class IV (B&R), Class III (Elect.) & Class III (PH)
Certified that Shri./ M/s _________________________________________________ S/o W/o _____________________________________________________________ and resident(s) of _________________________________________________________________________ has / have been maintained a saving bank account/current account/fixed deposit account with this branch of bank since ________________________________________ and an amount not less than Rs. ______________________________________ (Rs. ____________________________ ____________________________) has been available to the credit in his/her/their C.A./ S.B. account No. _____________________.
(Signature)
Seal of the Bank
ANNEXURE – VI
LIST OF DOCUMENTS / INFORMATION REQUIRED TO BE SUBMITTED FOR CHANGE OF CONSTITUTION
A.
|
Documents to be submitted
|
|
(1)
|
Copy of proposed partnership deed duly signed/proposed Memorandum of articles.
|
|
(2)
|
Attested copy/copies of valid ITCC/(s) in respect of each proposed partner.
|
|
(3)
|
An undertaking sworn in before a 1st class Magistrate by all partners to the effects that the new firm will take over all assets and liabilities.
|
|
(4)
|
Dissolution deed/consent of relating partners/death certificate in case of death of a partner.
|
B.
|
Furnish the following details in respect of each partner with whom contractor’s firm want to enter into partnership.
|
|
(i)
|
Whether he is enlisted with Punjab Mandi Board
|
|
(ii)
|
Whether he is a dismissed Government servant.
|
|
(iii)
|
Whether he is a partner / director of any other firm enlisted with this Punjab Mandi Board
|
|
(iv)
|
Whether he is member of Indian Parliament or State Legislature.
|
|
(v)
|
Whether his name has been blacklisted or removed form the approved list of contractors or demoted to lower class or orders banning/suspending business with him by any department in the past.
|
|
(vi)
|
Whether he is a dismissed/removed/retired Government servant within the last 3 years.
|
|
(vii)
|
Whether he has any relative working in Punjab Mandi Board, if yes, give details.
|
|
(viii)
|
Whether he has any civil or criminal case pending in any court of India, if yes give details.
|
ANNEXURE – VII
CONTRACTOR PERFORMANCE REPORT FOR WORKS COMPLETED OR UNDER EXECUTION, FOR REVALIDATION OF ENLISTMENT
1.
|
Name of the Contractor
|
:
|
2.
|
Name of work
|
:
|
3.
|
Agreement No.
|
:
|
4.
|
Name of division in which the work was executed
|
:
|
5.
|
Estimated cost put to tender
|
:
|
6.
|
Tendered cost
|
:
|
7.
|
Gross amount of final bill/work done till date
|
:
|
8.
|
Stipulated date of Start and Completion
|
:
|
9.
|
Actual date of completion or percentage progress
|
:
|
10.
|
Amount of reduced rate items, if any
|
:
|
11.
|
Did the contractor go for arbitration
|
:
|
12.
|
If yes, total amount claimed and amount awarded
|
:
|
Signature of the Contractor
Part II (to be filled by the department)
Note : This performance report duly completed by EE & SE should be forwarded to
Enlistment authority within two weeks of its receipt form the contractor.
Certified that details given by the contractor in Part-I have been verified and found to be correct/have been corrected wherever necessary.
Signature of Executive Engineer
3. Quality of work (Please grade as Very Good/Good/Satisfactory/Poor) :
(a) Grading by EE Signature of Executive Engineer
(b) Grading by SE Signature of Superintending Engineer
ANNEXURE – VIII
PUNJAB MANDI BOARD
APPLICATION FOR REVALIDATION OF ENLISTMENT AS CONTRACTOR
(The applicant should study carefully the Rules of revalidation and the list of documents to be annexed with the application form before filling the form. Application found deficient in any respect is liable to be rejected without any further correspondence.
-
1.
|
Name of applicant
|
Shri / M/s _________________________________________
|
|
2.
|
Nationality
|
Indian Other
|
|
3.
|
Address
|
---------------------------------------------------------------------------
|
|
|
Regd. Office
|
|
|
|
|
|
|
|
|
________________________________________________
|
|
4.
|
Telephone No
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Fax Number
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
E-mail
|
________________________________________________
|
|
5.
|
Constitution
|
Individual
|
|
|
|
|
|
|
|
Sole Proprietorship
|
|
|
|
|
|
|
|
Partnership Firm
|
|
|
|
|
|
|
|
Public Limited Company
|
|
|
|
|
|
|
|
Private Limited Company
|
|
6.
|
If partnership firm, names of the partners/if company, name of directors
|
|
1
|
________________________________________
|
|
2
|
________________________________________
|
|
3
|
________________________________________
|
|
4
|
________________________________________
|
|
5
|
________________________________________
|
|
6
|
________________________________________
|
7.
|
(a) Name of persons holding power of attorney
|
___________________________
|
|
(b) Nationality
|
Indian
|
|
Other
|
|
|
(c) Liabilities
|
|
8.
|
Name of Bankers with full address
|
___________________________
|
|
|
___________________________
|
|
|
___________________________
|
9.
|
Place of Business
|
___________________________
|
10.
|
Full time technical staff in applicant’s employ :
|
|
|
(a) to (e) for Civil, Electrical & PH
|
|
|
-
(a)
|
Graduate engineers with minimum 2 years experience
|
|
|
|
|
(b)
|
Graduate engineers excluding (a) above
|
|
|
|
|
(c)
|
Diploma engineers with minimum 3 years experience
|
|
|
|
|
(d)
|
Diploma engineers with minimum 1 year experience excluding (c)
|
|
|
|
|
(e)
|
Diploma engineers excluding (c) & (d)
|
|
11.
|
Does the applicant have sufficient T&P, machinery, equipment and workshop as per requirements mentioned in the enlistment Rules for the class & category applied for (Attach details on separate sheet for owned & hired)
|
|
Yes
|
|
No
|
|
|
12.
|
Does the application possess valid Electrical License (for electrical)
|
13.
|
(a) Details of existing enlistment with PMB
|
|
(i) Enlistment No. & date ___________________________________
|
|
(ii) Date of validity ___________________________________
|
14.
|
Is any person working with the applicant is a near relative of the officer/official of Punjab Mandi Board (see rules 18 of the Enlistment Rules)
|
|
If yes, give details Yes
|
|
No
|
|
|
15.
|
Details of works completed and in progress during the last 3 years (to be filled in Performa as given in Annexure III. This list should include all works whose gross amount of work done is more than the required magnitude for the class in which registration is required.
|
16.
|
Certificate :
|
(i)
|
I/ We (including all partners) certify that I/We have read the rules at Enlistment of Contractors in Punjab Mandi Board as amended upto date and shall abide by them.
|
(ii)
|
I/We certify that I/We ill not get myself/ourselves registered as contractor in Punjab Mandi Board under more than one name.
|
(iii)
|
I/We certify that the information given above is true to the best of the knowledge. I/We also understand that if any of the information is found wrong. I am liable to be debarred.
|
(iv)
|
(a) I certify that I did not retire as an Engineer of Gazetted rank or as a Gazetted Officer employed on Engineering or administrative duties in any engineering Department of the Government of Punjab/Punjab State Undertakings during the last three years. I also certify that I have neither such a person under my employment nor shall I employ any such person within three years of his retirement except with the prior permission of the competent authority (strike out whichever is not applicable)
|
|
Name
|
Signature
|
Address
|
1.
|
________________
|
__________________
|
____________________________
|
2.
|
________________
|
__________________
|
____________________________
|
3.
|
________________
|
__________________
|
____________________________
|
4.
|
________________
|
__________________
|
____________________________
|
Annexure – III
WORKS COMPLETED AND IN PROGRESS DURING THE LAST THREE YEARS (Including all works awarded)
(Add additional sheets, if necessary)
Sr.
No.
|
Name of Work &
Agreement
|
Date of Start
|
Date of Completion
|
Reasons for delay & compensation levied if any
|
Tendered Cost
|
Gross cost of completion
|
Net amount received
|
Name, designation & complete address of the authority for whom the work was done.
|
|
|
|
Stipulated
|
Actual
|
|
|
|
|
|
NOTE : Attached copy of certificate from concerned department
Machinery to be owned by the Contractor TABLE – 1A
Class
|
Category
|
Machinery to be owned by the contractor
|
Civil
|
I
|
RW : DRR-3, WT-2, Bit.Sp-2, Truck/Ttroll/
Tip-2, Sheep F.R.-2. Lab equip. as per Annex. ‘A’
|
B.W. : CM (weigh batching)-1, CM-2, Build. Hoist-2, Steel C&S-1000 sqm. Vibrator (Needle & Surface)-4 and with well equip. Lab. As per Annexure ‘A’
|
|
II
|
RW : DRR-2, BIT. Sp-2, Sheep foot Roller-1,
WT –2 and with well equipped lab. As per Annex. ‘A’
|
BW : Con. Mix (full bag cap.)-2, Steel C&S-250 sqm.
Build. Hoist-1, Vibrator (Needle & Surface)-2
with well equipped lab. As per Annexure ‘A’
|
|
III
|
RW : DRR-1, WT-1, Bit.Sp-1, Sheep F.R.-1 & with well equipped lab. As per ‘A’
|
B.W. : Con. Mix (full bag cap)-1, Steel C&S-100 sqm., Vibrator (Needle)-1 and with well equipped lab as per Annexure ‘A’
|
|
IV
|
Nil
|
|
H
M
P
|
DRR-3, Bit. Sp.-2, Tip.-4, Troll.-1, HMP (Electronic)-1, Pav.F-1, F.Loader-1, Air comp.-1 , Vehicle mounted bitumen spray pump,WT-1 , tractor trolly -1and Lab equip. as per Annexure ’A’
|
|
OH SR
|
C.M.-1, Steel C&S-50sqm. Vib.(needle)-1. Pump
|
|
Tube well
|
Boring Rig
|
Public Health
|
SWD/ WS
/S
|
CI-1
|
CM-1, Vib. (needle)1, D.Level, 200 sqm Steel Sca/Shut.
|
Cl-2
|
CM-1, Vib. (needle)-1, D. level, 100 sqm Steel Sca/Shut.
|
Cl-3
|
Nil
|
E
L
E
C
|
Cl-1
|
As reqd. by Chief Electrical Inspector
|
Cl-2
|
As reqd. by Chief Electrical Inspector
|
Cl-3
|
As reqd. by Chief Electrical Inspector
|
Sub. Stn.
|
As reqd. by Chief Electrical Inspector
|
Annexure – ‘A’
|