ojh; ifj;kstuk vfHk;ark dk dk;kZy;

fcgkj jkT; iqy fuekZ.k fuxe fyfeVsM

dk;Z izeaMy la[;k &1] iVukA
AA fufonk vkea=.k lwpuk AA
¼dsoy bZ&VsUMj i)fr ds vuqlkj osclkbV www.eproc.bihar.gov.in ij½

Doc No. BRPNN/PT1/G021/ Date : 2018

fcgkj jkT; iqy fuekZ.k fuxe fyfeVsM@dsUnzh;@jkT;
ljdkj@,eñbZñ,lñ@lhñ ihñMCywñMhñ@lkoZtfud {ks= esa fucaf/kr laosndksa ls nks chM
iz.kkyh ¼rduhdh ,oa foŸkh;½ varxZr fuEufyf[kr dk;Z gsrq nj izLrko vkeaf=r fd;s tkrs
gSaA ;fn laosnd fcgkj jkT; iqy fuekZ.k fuxe fyfeVsM esa iwoZ ls fucaf/kr ugha gS] rc
,djkjukek ds iwoZ fuxe esa fuca/ku djkuk vfuok;Z gksxkA
ifjek.k Bid
vxz/ku Processing
izkDdfy foi= dk dk;Z
ftyk dk;Z dk fooj.k dh Fee
r jkf’k ewY; (Online dh
jkf'k
Ø0 ¼yk[k : ¼ :Œ Payment) vof/k
¼yk[k
Œ esa½ ¼vizR;i.kh ¼ekg
:Œ
esa½ ¼vizR;i.k Z;½ ¼:Œ esa½
esa½
hZ;½ esa½
1 2 3 4 5 6 7 8
iVuk fLFkr
ehBkiqj&fpjSa;k¡Vk¡M+
Hkk;k jsyos LVs’ku uo
fufeZr ¶ykbZvksHkj ds ik;k
iVu la[;k& 30 vkSj 31 ls 09
1 761-96 10]000 15-24 17]700
k fpjSa;k¡Vk¡M+&,Dthfo’ku ekg
jksM ¶ykbZvksHkj dks
tksM+us gsrq ,d vfrfjDr fljk
¼Extra Arm½ dk fuekZ.k
dk;ZA
-
2- chM i= izkIr djus dh vof/k ,oa le; % fnukad&26+@02@2018 ls
14@03@2018 dks vijkg~u 3-00 cts
rd flQZ osclkbV
www.eproc.bihar.gov.in ijA
3- chM lefiZr dh vafre frfFk ,oa le; % fnukad& 15@03@2018 dks vijkg~u 3-00
cts
rd osclkbV www.eproc.bihar.gov.in ijA
4- rduhdh chM [kksyus dh frfFk] le; ,oa LFkku % fnukad& 17@03@2018 dks
vijkg~u 4-00 cts osclkbV
www.eproc.bihar.gov.in ijA
5- fufonk dh oS|rk vof/k % chM lefiZr dh vafre frfFk ls 120 fnu
rdA

6 Áh&chM CkS<d dh frfFk % fnukad&07+@03@2018 dks vijkg~u

12-30 cts
fcgkj jkT; iqy fuekZ.k fuxe fy0] iVuk ds
lHkkd{k esaA
7- Øekad 2] 3 ,oa 4 ¼fufonk lacaf/kr frfFk½ esa fdlh fnu vodk'k ?kksf"kr gksus dh
fLFkfr eas vxyk dk;Z fnol ekU; gksxk rFkk vyx ls bldh dksbZ lwpuk ugha nh tk;sxhA
8- rduhdh chM esa lQy laosndksa dk gh foŸkh; chM flQZ osclkbV www.eproc.bihar.gov.in
ij [kksyk tk,xkA
9- bZ&VsUMfjax dh izfØ;k esa Hkkx ysus gsrq laosndksa dks www.eproc.bihar.gov.in ij
iathd`r gksuk gksxkA ;g mUgsa osclkbV (www.eproc.bihar.gov.in) ls MkmuyksM djus@
bZ&VsUMj dh izfØ;k eas Hkkx ysus gsrq vfuok;Z gSA
10- bZ&fufonk i=] vU; fu;e ,oa 'kŸksZa osclkbZV ¼www.eproc.bihar.gov.in½ ls izkIr fd;k
tk ldrk gSA

11- laosnd }kjk ifjek.k foi= flQZ osclkbZV ls izkIr djus ds mijkUr osclkbZV ij gh
bysDVªkfud fufonk i= dks Hkj dj viyksM djuk gSA vU; lHkh egRoiw.kZ dkxtkr cSad
Mªk¶V@vxz/ku dh jkf'k@lHkh izek.k i= tks fufonk ds fy, vko';d gS dks LdSu dj
bZ&fufonk ds lkFk layXu djuk vfuok;Z gSA chM izkfIr dh vafre frfFk
17@03@2018 ds vijkg~u 3-00 cts rd ojh; ifj;kstuk vfHk;ark] dk;Z izeaMy]
iVuk&1@mi eq[; vfHk;ark] nf{k.k fcgkj vapy] iVuk esa ifjek.k foi= dk ewY; ,oa
vxz/ku dh jkf'k dks ewy :i ls tek djuk vfuok;Z gSA
12- fdlh Hkh izdkj dh tkudkjh vFkok 'kqf) i= dks osclkbZV www.brpnnl.nic.in,
www.prdbihar.gov.in ,oa www.eproc.bihar.gov.in ij izdkf'kr fd;k tk;sxkA

13- bZ&VsUMfjax dh izfØ;k ls lacaf/kr fdlh Hkh izdkj dh tkudkjh ,oa iathdj.k gsrq
bZ&izkssD;ksjesaV gsYiMsLd] cSad vkWQ bf.M;k fofYMax] izFke rYyk] ,eŒ@22]
Jh d`".kkuxj] jksM uaŒ & 25] iVuk ¼nwjHkk"k la[;k&0612&2523006] eks0ua0&
7542028164) ls lEidZ fd;k tk ldrk gSA

14- fo’ks"k tkudkjh gsrq v/kksgLrk{kjh ds dk;kZy; esa dk;Z vof/k esa lEidZ fd;k tk ldrk
gS vFkok osclkbV www.brpnnl.nic.in/ www.prdbihar.gov.in ij ns[kk tk ldrk gSA lEidZ
inkf/kdkjh dk uke & Jh lquhy dqekj] ojh; ifj;kstuk vfHk;ark ,oa eksckbZy ua0&
9431821557

gŒ@&
ojh; ifj;kstuk vfHk;ark
fcgkj jkT; iqy fuekZ.k fuxe fyfeVsM
dk;Z izeaMy] iVuk&1
Doc No. BRPNN/PT1/G021/………………………..W.E. Date……………………

izfrfyfi %& mi funs'kd] lwpuk ,oa tulEiZd foHkkx] iVuk dks fgUnh ,oa vaxzsth
nSfud lekpkj i=a ,oa ,d mnwZ lekpkj i= esa izdkf'kr djus gsrq lefiZrA
gŒ@&
ojh; ifj;kstuk vfHk;ark
fcgkj jkT; iqy fuekZ.k fuxe fyfeVsM
dk;Z izeaMy] iVuk&1
Doc No. BRPNN/PT1/G019/…………………………… Date… ………………

izfrfyfi %& uksMy inkf/kdkjh@vkbZ0 Vh0 eSustj] fcgkj jkT; iqy fuekZ.k fuxe
fyfeVsM] iVuk dks bZ&,MojVbtesaV vkWu ykbZu iz.kkyh ij izdk’ku gsrq izsf"krA
gŒ@&
ojh; ifj;kstuk vfHk;ark
 fcgkj jkT; iqy fuekZ.k fuxe fyfeVsM
dk;Z izeaMy] iVuk&1
Doc No. BRPNN/PT1/G019/…………………………… Date… ………………

izfrfyfi %& csolkbZV bapktZ] fcgkj jkT; iqy fuekZ.k fuxe fyfeVsM] iVuk dks fuxe
ds osclkbZV ij izdk’ku gsrq izsf"krA
gŒ@&
ojh; ifj;kstuk vfHk;ark
fcgkj jkT; iqy fuekZ.k fuxe fyfeVsM
dk;Z izeaMy] iVuk&1
Doc No. BRPNN/PT1/G016/……………………………. Date… ………………

izfrfyfi %& mi eq[; vfHk;ark] nf{k.k fcgkj vapy@Áca/k funs’kd]

fc0jk0iq0fu0fu0fy0] iVuk dks lwpukFkZ ,oa vko';d dkjZokbZ gsrq lefiZrA

ojh; ifj;kstuk vfHk;ark

fcgkj jkT; iqy fuekZ.k fuxe fyfeVsM
dk;Z izeaMy] iVuk&1
fu;e ,oa 'kŸksZa %&

1- fufonk@ nj izLrko ds lkFk ifjek.k foi= dk ewY;] chM izkslsflax ’kqYd ,oa vxz/ku dh
jkf'k dks fuEu :i esa layXu djuk vfuok;Z gSA
¼i½- dkWye & 5 esa ifjek.k foi= dk ewY; ¼tks ykSVk;k ugha tk;sxk½ fdlh Hkh jk"Vªh;d`r
cSad@vuqlwfpr cSad }kjk fuxZr cSad Mªk¶V tks ojh; ifj;kstuk vfHk;ark] dk;Z
ize.My] iVuk&1] fcgkj jkT; iqy fuekZ.k fuxe fyfeVsM ds inuke ls fuxZr gks rFkk
iVuk esa Hkqxrs; gksA
¼ii½- dkWye & 6 esa vxz/ku dh jkf’k dks fuEu :i ls layXu djuk vfuok;Z gS tks ojh; ifj;kstuk
vfHk;ark] dk;Z ize.My la[;k &1] fcgkj jkT; iqy fuekZ.k fuxe fyfeVsM ds inuke ls
izfrfKr gksxkA
a fcgkj jkT; ls fuxZr] cSad Mªk¶V@Mkd?kj dk ,d] nks ,oa rhu of"kZ; lkof/k
tek@NSC@KVP
b ,d djksM+ ls Åij ds ifj;kstuk ds fy, 'kŸkZjfgr cSad xkjaVh Hkh ¼chM ihfj;M ds 45
fnuksa ckn rd oS/k½ Lohdk;Z gksaxsa] tks fdlh Hkh vuqlwph Hkkjrh; cSad ls fuxZr
gks ¼fcgkj jkT; ds ckgj ds cSad ls fuxZr dh fLFkfr esa] ,djkjukek ds iwoZ fcgkj jkT;
varxZr fdlh vuqlwfpr cSad esa ifjofrZr djkuk gksxk½A
¼iii½- dkWye & 7 esa vafdr jkf’k dks chM izkslsflax 'kqYd vkWuykbZu eksM ;kfu
bUVjusV Hkqxrku xsVos ¼ØsfMV @ MsfcV dkMZ½] usV cSafdx] ,u0 b0Z ,Q0
Vh0 @ vkj0 Vh0 th0 ,l0 ds ek/;e ls Hkqxrku fd;k tkuk vfuok;Z gSA
a. “Bid Processing Fee is mandatory to be paid through online mode i.e. Internet payment
gateway (Credit/Debit Card), Net banking, NEFT/RTGS.”
b. “Bids along with necessary online payments must be submitted through e-Procurement
portal www.eproc.bihar.gov.in before the date and time specified in the NIT. The department
doesn’t take any responsibility for the delay/Non Submission of Tender/Non Reconciliation
of online Payment caused due to Non-availability of Internet Connection, Network
Traffic/Holidays or any other reason.”)
2- laonsd dks rduhdh chM esa fuEu vgZŸkk vfuok;Z :i ls iw.kZ djuk gksxk rFkk leLr
izek.k i=kas ¼l{ke inkf/kdkjh }kjk fuxZr½ dks LdSu dj viyksM (UPLOAD) djuk
vfuok;Z gSA fufonk izkfIr ds ckn dksbZ Hkh dkxtkr@izek.k &i= vkfn Lohdk;Z
vFkok fopkj ;ksX; ugha gksxkA
¼i½- vk;dj PAN/TAN ,oa th0 ,l0 Vh0 eas fucaf/kr gksus dk izek.k i=A
¼ii½- laosnd dks fdlh ljdkjh laLFkku@fcgkj jkT; iqy fuekZ.k fuxe fy0 }kjk
¼d½Debar ¼[k½Blacklisted ,oa ¼x½ foxr ,d foŸkh; o"kZ ds vUnj Rescind u gksus dh
lwpuk dk 'kiFk i=A
(iii). foxr ik¡p foŸkh; o"kksZa esa ls fdlh ,d foŸkh; o"kZ dk Civil Construction work ls
lacaf/kr dk;Z dk] vkWfMVsM VuZ vksHkj (A.T.O.) ftlesa fufofnr dk;Z fo'ks"k ds
vuqekfur ykxr dk fdlh ,d o"kZ eas de ls de 40 % ds lerqY; gksuk vfuok;Z gSA VuZ
vksHkj ds lk{; ds :i esa Audited Profit & Loss Account layXu djuk Hkh vfuok;Z gSA
¼iv½- laosnd dks muds ftEesa] lEikfnr fd;s tk jgs vU; dk;ksZa ds ,djkjukek dh jkf'k]
chM izkfIr dh vafre frfFk rd lEikfnr fd;s x;s dk;ksZas dh jkf'k ,oa lEiknu gsrq vo'ks"k
dk;ksZa dh jkf'k dh Li"V fooj.kh] dk;Zokj rS;kj dj vyx ls rkfydk :i esa] 'kiFk&i= ds
ek/;e ls lefiZr djuk vfuok;Z gSA ;fn muds ftEes dksbZ dk;Z ugha Hkh gS rks Hkh
'kiFk&i= ds ek/;e ls 'kwU; izfrosnu djuk vfuok;Z gSA
¼v½ laosnd }kjk Bid Amount dk 25 izfr'kr ¼de ls de½ invest djus dk 'kiFk i= ftlesa
dk;Z dk uke vafdr djuk vfuok;Z gksxkA
¼vi½ mijksä fcUnq ¼ii½] ¼iii½] ¼iv½ ,oa ¼v½ ls lacaf/kr 'kiFk&i= dk izk:i
csolkbZV ls MkmuyksM dj izkIr fd;k tk ldrk gSA 'kiFk i= fufonk izdk’ku dh frfFk ,oa
izkfIr dh frfFk ds chp ds vof/k dk gksuk vfuok;Z gSA
¼vii½ foxr ikap foŸkh; o"kksaZ ds vUnj] izR;sd fufofnr iqy ds 50 % yackbZ ds ,d iqy dks
iw.kZ djus dk
vuqHko ¼ljdkjh@v)Zljdkjh laLFkk }kjk fuxZr½A ;g vko';d ugha gS fd lacaf/kr iqy
fuekZ.k dk dk;Z
mDr ikap foŸkh; o"kZ esa gh vkjaHk gqvk gksA
¼viii½ mijksä fufofnr ¶ykbZvksHkj ds fy, fuEuokj vgZŸkk ¼ljdkjh@v)ljdkjh
laLFkk }kjk fuxZr½ vfuok;Z gSA

Øñl dk;Z en fd;s x;s dk;Z fd;s x;s dk;Z dh vof/k

añ
1 RCC Pile Work (1200mm Dia)
2 Concreting (RCC/PCC Work)
3 Bituminious Work
4 Mastic Asphalt
dh ek=k
455 M foxr ikap foŸkh; o"kZ esa ls fdlh ,d
foŸkh; o"kZ esa gksuk vfuok;Z gSA
986-00 M3 foxr ikap foŸkh; o"kZ esa ls fdlh ,d
foŸkh; o"kZ esa gksuk vfuok;Z gSA
215-00 M3 foxr ikap foŸkh; o"kZ esa ls fdlh ,d
foŸkh; o"kZ esa gksuk vfuok;Z gSA
225-00 M2 foxr ikap foŸkh; o"kZ esa ls fdlh ,d
foŸkh; o"kZ esa gksuk vfuok;Z gSA

¼ix½ 'kgj ds chp ¼?kuh vkcknh@O;Lrre ekxZ½ esa ¶ykbZvksHkj cukus dk

vuqHko vfuok;Z gSA
¼x½ laosnd dks ¶ykbZvksHkj ds ,ykUesUV (Alignment) esa vkus okys lhoj
ykbZu] ikuh dk ikbZi ykbZu ,oa fo/kqr ykbZu f’kf¶Vax dk vuqHko gksuk
pkfg,A
¼xi½ ¶ykbZvksHkj fuekZ.k ds nkSjku dadzhfVax dk;Z] cSfpax
IykaV@VªkaftDV feD’pj@daØhfVax iEi ds }kjk fd;k tkuk gS rFkk lqij LVªDpj
ds dk;Z gsrq laosnd dks T-Beam & Deck Slab/ Pre-Cast Concrete Girder Launching
dk vuqHko gksuk pkfg,A
¼xii½ fuekZ.k dk;Z ds le; ;krk;kr dk lqxe ifjpkyu dh O;oLFkk cuk;s j[kuk
vfuok;Z gksxkA
¼xiii½ fufofnr nj esa leLr dj ;Fkk vk;dj] enokj th0 ,l0 Vh0] ekfydkuk gd@
Seigniorage Fees ,oa L.W.C. bR;kfn 'kkfey gksxsaA
3-¼i½- fufofnr nj] izHkkoh vuqlwfpr nj ls de] cjkcj ;k vf/kd] izfr'kr esa vafdr
djrs gq, viyksM (UPLOAD) djuk gksxkA nj izfr'kr dks vadksa ds lkFk&lkFk 'kCnksa
esa Hkh vafdr djuk gksxkA
¼ii½- fufofnr nj] izHkkoh vuqlwfpr nj ls de fn;s tkus dh fLFkfr esa vfHk;ark
izeq[k&lg&vij vk;qä&lg&fo'ks"k lfpo] iFk fuekZ.k foHkkx] iVuk ds
i=kad&3376¼E½] fnukad&17-08-10 ds dafMdk 4 esa fn;s x;s fn'kk funsZ'k dk
vuqikyu fd;k tk;sxkA
¼iii½- fufonk esa] vfUre :i esa laosnd dk p;u gkus ds i'pkr] ,djkjukek djus ds iwoZ
laosnd dks deZpkjh Hkfo"; fuf/k (EPF) dk;kZy; esa fucaf/kr gksus dk izek.k i= lefiZr
djuk vfuok;Z gksxkA vU;Fkk muds i{k esa fd;s x;s dk;kZoaVu dks jn~n dj fn;k
tk;xkA Hkfo"; esa mudk dksbZ nkok ekU; ugha gksxk ,oa mudk vxz/ku jkf'k tCr dj
fy;k tk;sxkA
¼iv½ bl fufonk es Joint Venture Lohdk;Z ugha gksxkA
4-¼i½- fuekZ.k ls lacaf/kr ;a=&la;a=@LVsftax ,oa 'kVfjax ds LokfeRo@Lease ij ysus
dk lk{; ls lacaf/kr izek.k&i= ¼'kiFk i= ds lkFk½ gksuk pkfg,A foHkkxh; inkf/kdkjh
vFkok ifj;kstuk }kjk dk;Z ls lacaf/kr] ;a=&la;a=ksa dk HkkSfrd lR;kiu fd;k tk,xkA
 ¼ii½-rduhdh chM esa ,d i`Fkd i`"B (psdfyLV) ij leLr okafNr lwpukvksa ;Fkk vxz/ku] dk;Z
laca/kh vgZRkk] dk;Z vuqHko] fuca/ku vkfn dks i`"B la[;k ds lkFk vafdr djrs gq,
viyksM (UPLOAD) gksuk pkfg,A
5- fufonknkrk dks lykg nh tkrh gS fd fufonk nsus ds iwoZ dk;Z LFky dk fujh{k.k dj
ysa ,oa dk;Z LFky dh fLFkfr rFkk vU; fLFkfr;kas dks iw.kZ voxr gks ysaA dk;Z
vkoaVUk ds i'pkr~ dk;Z LFky ij dk;Z ls lacaf/kr vU; dksbZ Hkh nkok Hkfo"; esa
ekU; ugha gksxkA fu/kkZfjr le;kof/k esa dk;Z iw.kZ ugha gksus ij ,djkjukek eas fufgr
'kŸkksZa ds vuqlkj dkjZOkkbZ dh tk;sxhA
6- nLrkost dh ewy izfr dks l{ke inkf/kdkjh] }kjk ekaxus ij izLRkqr djuk gksxkA
7- fuxe }kjk vuqeksfnr czkaM dk LVhy vo;o ,oa xzsM lhesaV dk O;ogkj djuk laosnd }
kjk vfuok;Z gksxkA
8- vksHkj gsM en ds varxZr gksus okys O;; ;Fkk th0 ,l0 Vh0] xq.k fu;a=.k] xksnke
fuekZ.k& lg& LFky&dk;kZy; dk fuekZ.k] fctyh] ikuh] i;Zos{k.k gsrq okgu ,oa ,d
dEI;wVj vkWijsVj dk O;; dk ogu laosnd }kjk gh fd;k tk,xkA
9- vuqekfur jkf'k ?kV&c<+ ldrh gS rFkk dk;Z LFky ds vuqlkj fu:i.k esa ifjoŸkZu fd;k tk
ldrk gSA
10- fufonkdkjksa }kjk tek fd;s x;s vxz/ku dh jkf'k ij fdlh izdkj dk lwn foHkkx }kjk ns;
ugha gksxkA
11- l'krZ chM Lohdk;Z ugha gksxkA fuxe ds fu;ekoyh varxZr dk;Z lEiUu gksxkA
12- fufonknkrk }kjk QthZ@xyr vuqHko izek.k&i= ;k fufonk ls lacaf/kr vU; xyr dkxtkr
izLrqr djus ;k nsus ij] tek vxz/ku dh jkf’k dks tCr dj yh tk;sxhA
13- v/kksgLrk{kjh dks fcuk dkj.k crk, chM dks jn~n djus dk vf/kdkj lqjf{kr gSA
gŒ@&
ojh; ifj;kstuk vfHk;ark
dk;Z izeaMy] iVuk&1

Bid Security (Bank Guarantee Unconditional)

WHEREAS,…………………………………………………………………[Name of Bidder] (hereinafter called

“the Bidder”) has submitted his bid dated……………………[Date] for the construction of
………………………………..[Name of Contract] (hereinafter called “The Bid”)
KNOW ALL MEN by these presents that We…………………………………………[Name of Bank]

of …………………………………[Name of Country] having our registered office at

…………………………………………. (hereinafter called “the Bank) are bound unto

…………………………………….[Name of Employer] (hereinafter called “the Employer”) in the sum of

…………………………………*1 for which payment well and truly to be made to the said Employer the Bank
binds himself, successors and assigns by these presents.
SEALED with the Common Seal of the said Bank this …………….. day of …………20………

THE CONDITIONS of this obligation are :

(1) If the bidder withdraws his Bid during the period of bid validity specified in the Form of Bid : OR
(2) If the Bidder refuses to accept the correction of errors in his Bid; OR

(3) if the Bidder, having been notified of the acceptance of his Bid by the Employer during the period of
Bid validity;
(a) Fails or refuses to execute the Form of Contract Agreement in accordance with the Instructions to
Bidders, if required; or
(b) Fails or refuses to furnish the Performance Security, in accordance with the Instructions to
Bidders;
We undertake to pay to the Employer up to the above amount upon receipt of its first written demand, without the
Employer having to substantiate its demand, provided that in its demand the Employer will note that the amount
claimed by it is due to it owing to the occurrence of one or all of the three conditions, specifying the
occurred condition or conditions.
The Guarantee will remain in force up to and including the date ……………… days after the deadline
for submission of bids as such deadline is stated in the Instructions to Bidders.
Or as it may be extended by the Employer, notice of which extension (s) to the Bank is hereby waived. Any
demand in respect of this Guarantee should reach the Bank not later than the above date.

DATE ………………………….. SIGNATURE OF THE BANK……………………………….

WITNESS………………………. SEAL ……………………………………………………………………………

 AFFIDAVIT
(To be executed before Magistrate 1st Class/ Notary Public on appropriate Stamp
paper)

I __________________________ S/o ______________________ age

____ resident of Village/Molalla______________, P.O.____________,
P.S. ____________, Dist. ____________, Pin Code ____________ do
hereby solemnly affirm and declare as under :-

(1) That I am the Prop./Partner/Managing Director / Authorized

Signatory of M/s. _____________________________________
(Full address).

(2) That the above named prop./firm/ company is not blacklisted by

central govt./ any department of any state govt. / any PSU of any
state govt. or central govt.

(3) That the said prop./firm/company is presently not debarred from

tendering by central govt. / any department of any govt. / PSU of
any state govt. or central govt.

(4) That I also here by certify that any contract awarded to us has not
been rescinded, during last one year prior to the date of this bid by
central govt./ any department of any state govt/ PSU of any state
govt or central govt.
(5) That I also affirm/ undertake that all the facts and documents
submitted by me are genuine and also signed by the genuine
person(s).
In the case of any documents and/or information furnished is found
false or is objected to by any of the persons concerned, the
Department/Nigam will be at liberty to take appropriate action.

Deponent
Place:-
Date:-
 AFFIDAVIT

(To be executed before Magistrate 1st Class/ Notary Public on appropriate Stamp paper)

I __________________________ S/o ______________________ age ____

resident of Village / Molalla _________________,
P.O.________________, P.S. ____________, Dist.
____________, Pin Code ____________ do hereby solemnly affirm and
declare as under :-

(1) That I am the Prop./Partner/Managing Director/Authorized Signatory of M/s.

_______________________________________________________ (Full address).

(2) That the Financial Information Summary of the above named Prop. / Firm / Company in Last
5 years is as follows:-

SL Description FINANCIAL FINANCIAL FINANCIAL FINANCIAL FINANCIAL

no. of Annual YEAR YEAR YEAR YEAR YEAR
(......to......) (......to......) (......to......) (......to......) (......to......)
Turn over as
per Audited
P/L Account.

Civil
1. Construction
Works

2. Other Works

3. Total

contd...............
 (2)
(3) That the Civil Construction Work(s) Summary of the above named Prop./firm/ company,
Undertaken in India as on last date of submission of bid is as follows:-

SL Name of Work(s) Agreement Work value executed Balance Work

No. Amount till date of submission Value as on date
of Bid. of submission of
(Rs.)
Bid.
(Rs.)
(Rs.)

(4) That No other Civil Construction work is undertaken / pending in any department across
India other than the work mentioned in clause (3) above.

(5) That I also affirm/ undertake that all the facts and documents submitted by me are genuine
and also signed by the genuine person (s).

In the case of any documents and/or information furnished is found false or is objected to by
any of the persons concerned, the Department/Nigam will be at liberty to take appropriate
action.

Deponent
Place:-
Date:-