AFFIDEVIT

AFFIDAVIT
I, Rameshwar Pani Proprietor of M/s Sri Krishna Engineers S/o. Sri Purna Ch. Pani aged about 43
years Occupation Business, resident of Beheramal, Bijunagar, Dist Jharsuguda(Odisha), do hereby
Solemnly declare that:
1. I am submitting Tender for Supply of Blasting Shelters against NIT No.

MCL/GM/IBV/MM/ET/F167/15-16/26 Dated: 21.11.2015, vide Bid Id: 43867
2. All information furnished by me on-line in respect of fulfillment of eligibility criteria and qualification
information of this Tender is complete, correct and true.
3. All scanned copy of documents uploaded by me in support of the information furnished online by me
towards eligibility are valid and authentic.
4. I have never been banned or delisted by any Govt. or Quasi Govt. Agency or any Public Sector
Undertaking.
5. I am a Micro Enterprise covered under the provision of Micro Small and Medium Enterprises Act’2006
and registered with the authority of the State Government.
6. If any information furnished by me online and scanned copy of documents uploaded in support of the
information furnished online by me towards eligibility is found to be fake / incorrect at any time,
Mahanadi Coalfields Ltd. may cancel my Tender and penal action as deemed fit may be taken against
me, including termination of the contract, forfeiture of Earnest Money and banning / delisting of our firm
and all partners of the firm for a minimum period of 01 (one) year.
Signature of the Tendered

Dated…………………….
Identified by Me.
Signature & Seal of Notary.
(N.B: NJSP of RS.10/- Not available, hence requisite court fee affixed)
Advocate, Jharsuguda
AFFIDAVIT
1. I am submitting Tender for Supply Modified Portable Rest Shelter for Opencast Mines against NIT
No.MCL/GM/BA/MMD/ET/F-102n103 (13-14)/RS/15-16/17 Dated: 17.07.2015, vide Bid Id: 39586
Undertaking.

Dated……………………..
Identified by Me.
SELF CERTIFICATE
Your NIT No: MCL/GM/IBV/MM/ET/F167/15-16/26

e.Tender ID: 2015_MCL_16351_1
Our Bid ID: 43867
We are the manufacturer of the Blasting Shelter but our turn over is less than 1.5 corers
annually, hence ED is not applicable for us (CA certificate enclosed).
For Sri Krishna Engineers.

SELF CERTIFICATE
Technical Specification Parameters

Our Bid ID: 43867
Blasting Shelter will be supplied strictly as per the drawing and materials composition
mentioned in NIT CL. 25 D.

SELF CERTIFICATE

Our Bid ID: 43867
The under signee is the proprietor of M/s. Sri Krishna Engineers and holding the DSC in
my name and this tender was the uploaded through my DSC. Hence no document is
required.
(Rameshwar Pani)
Prop. Of M/s. Sri Krishna Engineers.

SELF CERTIFICATE/PER FORMANCE REPORT

Our Bid ID: 43867
The Item covered in the supply order/s submitted against the tender have been fully
executed without any complaint on account of performance of the products supplied. No
warranty claim as regards to such supplied is/are pending as on the last date of
submission of bid.
For, Sri Krishna Engineers.
DECLERATION
Our Bid ID: 43867
We are hereby declared that we have not been banned or de-listed by any
Government or quasi-Government agencies or PSU’s etc.
For, Sri Krishna Engineers
AFFIDAVIT
I, Rameshwar Pani Proprietor of M/s. Sri Krishna Engineers solemnly declare that:
1. I am submitting Tender for “supply of Cement Capsule as per DGMS Circular. (Approval) no-05
of 2013 Dhanbad” against NIT No.MCL/GM/OA/PUR/E-Tender/ Cement Capsule/14-15/49 Dated:
11/03/2015 vide Tender ID 2015_MCL_13944_1
2. All information furnished by me/us on-line in respect of fulfillment of eligibility criteria
and qualification information of this Tender is complete, correct and true.
3. All scanned copy of documents uploaded by me / us in support of the information

furnished online by me / us towards eligibility are valid and authentic.
4. * I/We have never been banned or delisted by any Govt. or Quasi Govt. Agency or any
Public Sector Undertaking.
OR
I/We have been banned by the organization named “--------- xxxxxxx--------------“for a

period of ------xxxxxxx------- year/s, effective from -----xxxxxxx----- to ----xxxxxx--------
5. If any information furnished by me / us online and scanned copy of documents uploaded

in support of the information furnished online by me / us towards eligibility is found to be
fake / incorrect at any time , Mahanadi Coalfields Ltd. may cancel my Tender and penal
action as deemed fit may be taken against me / us , including termination of the contract ,
forfeiture of Earnest Money and banning / delisting of our firm and all partners of the firm
for a minimum period of 01 (one) year .

Dated:
Signature & Seal of Notary
Identified by me
(Advocate, Jharsuguda)
AFFIDAVIT
I/We, ----------------------------------------------------, authorized representative of M/s.

………………………………………………….. Solemnly declare that:
1. I/We am/are submitting Tender for supply of ---------------------------------------------

------------------------------------------------------------------------------------------------------- against NIT
No.---------------------------------------------- dated ------------, vide Bid ID -----------------------
2. All information furnished by me/us on-line in respect of fulfillment of eligibility criteria and
qualification information of this Tender is complete, correct and true.
3. All scanned copy of documents uploaded by me / us in support of the information furnished
online by me/ us towards eligibility are valid and authentic.
4. * I/We have never been banned or delisted by any Govt. or Quasi Govt. Agency or any Public
Sector Undertaking.
5. I/We are a Micro/ Small Enterprise covered under the provision of Micro Small and Medium
Enterprises Act’2006 and registered with the authority of the State Government.
6. If any information furnished by me / us online and scanned copy of documents uploaded in

support of the information furnished online by me / us towards eligibility is found to be fake /
incorrect at any time, Mahanadi Coalfields Ltd. may cancel my Tender and penal action as
deemed fit may be taken against me / us, including termination of the contract, forfeiture of
Earnest Money and banning / delisting of our firm and all partners of the firm for a minimum
period of 01 (one) year.
Dated……………………..
Signature & Seal of Notary Public
BEFORE THE NOTARY PUBLIC: JHARSUGUDA

AFFIDAVIT
I Sri Rameshwar Pani Proprietor of M/s. Sri Krishna Engineers S/o. Sri Purna Ch. Pani aged about 41 years
Occupation Business, resident of Beheramal, Bijunagar, Dist Jharsuguda(Odisha), do hereby solemnly affirm &
state as follows:-
1. That, I am submission tender for the work “Fabrication & supply of 09 Nos. Steel Boards along with letter
writing by auto glow radium sticker for display Safe Operation Procedure & matter contained
In “SMART CARD” at Belpahar-OCM” of Lakhanpur Area. Against NIT No.MCL/LKPA/BOCM/PO/Safety/
14-15/767 Dt.31.10.2014
2. That, I shall abide by CMPF clause of tender document and ensure implement ion of CMPF and Misc. Provision
Act.1948 and allied scheme framed their under in respect of workers deployed by me.
3. That, None of the partners of my firm is relative of employee of Mahanadi Coalfields Limited.
4. That, all information furnished by me respect of fulfillment of eligibility criteria and qualification, information of
this tender is complete, correct and true.
5. That, all documents/credential submitted along with this tender are genuine, authentic true and valid.
6. That, if any information and documents submitted is found to be false/incorrect any time department May
cancel my tender and action as deemed fit may be taking against me, including termination of the contact ,for
feature of all dues including earnest money and banning/ de-listing of my firm and all partners of the firm etc.
7. That, I have not been banned or de listed by any Govt. or quasi govt. agencies or PSU’s at this time in relating
to my firm.
8. That, I am swearing this affidavit I order to produce it before the concerned authority of MCL/CIL, to prove the
fact stated above in this affidavit.
The facts stated above are true to the best of my knowledge & belief.
Identified by Me. DEPONENT
Advocate, Jharsuguda NOTARY PUBLIC: JHARSUGUDA
NB: NJSP worth of Rs.10/- is not available

Hence requisite court fee is affixed,
Advocate, Jharsuguda.
BEFORE THE NOTARY PUBLIC: LAKHANPUR

AFFIDAVIT
I Sri Jyoti Ranjan Pattnaik S/o. Late Amulya Kumar Pattnaik Proprietor of M/s. LUCKY ENGINEERING
aged about 51 years Occupation Business, resident of Old Rly. Siding,Belpahar, Dist- Jharsuguda
(Odisha), do hereby solemnly affirm & state as follows:-
1. That, I am submission tender for the work Fabrication, supply & installation of 10 Nos. Glow sign
boards for display the safety slogan at Lilari-OCP of Lakhanpur Area against NIT
.MCL/LKPA/Lilari/Safety/
14-15/1680 Dt.01.12.2014.
2.That, I shall abide by CMPF clause of tender document and ensure implement ion of CMPF and Misc.
Provision Act.1948 and allied scheme framed their under in respect of workers deployed by me.
4. That, all information furnished by me respect of fulfillment of eligibility criteria and qualification,
information of this tender is complete, correct and true.
5. That, all documents/credential submitted along with this tender are genuine, authentic true and
valid.
6. That, if any information and documents submitted is found to be false/incorrect any time department
May cancel my tender and action as deemed fit may be taking against me, including termination of the
contact ,for feature of all dues including earnest money and banning/ de-listing of my firm and all
partners of the firm etc.
7. That, I have not been banned or de listed by any Govt. or quasi govt. agencies or PSU’s at this time in
relating to my firm.
8. That, I am swearing this affidavit I order to produce it before the concerned authority of MCL/CIL, to
prove the fact stated above in this affidavit.
Advocate, Jharsuguda NOTARY PUBLIC: LAKHANPUR


AFFIDAVIT
I Sri---------------------------------------------------S/o. --------------------------------------------- Proprietor of M/s.

------------------------------------------------------ aged about 51 years Occupation Business, resident of
---------------------------------------------------------------------------------------------------------------------------, do hereby
solemnly affirm & state as follows:-
1. That, I am submission tender for the work

------------------------------------------------------------------------------------------------------------------------------------------
---------- -------------------------------------------------against NIT No.
-------------------------------------------------------------------------------------- ------ Dt.
---------------------------
valid.


AFFIDAVIT
I Sri Jyoti Ranjan Pattnaik Proprietor of M/s. LUCKY ENGINEERING S/o. Late Amulya Kumar Pattnaik
1. That, I am submission tender for the work ““Fabrication, supply & erection of 30Nos. of steel boards along with
letter writing on radium sticker for display No-entry boards, Caution boards & Safety slogan boards etc.” at Lilari-
OCP of Lakhanpur Area against NIT no.MCL/LKPA/LILARI/Safety/14-15/1571 Dt.15.11.2014.
2.That, I shall abide by CMPF clause of tender document and ensure implement ion of CMPF and Misc. Provision
to my firm.


AFFIDAVIT
state as follows:-
1. That, I am submission tender for the work “Fabrication, supply & erection of 30Nos. of steel boards along with
to my firm.


AFFIDAVIT
state as follows:-
1. That, I am submission tender for the work “Fabrication, supply & erection of 30Nos. of steel boards along with
to my firm.


AFFIDAVIT
state as follows:-
1. That, I am submission tender for the work “Fabrication & supply of 08 Nos. Steel Board’s along with writing by
auto glow radium sticker for display Safe Operation Procedure, Code of Practice & the matter contained In
“SMART CARD” at Lilari-OCP of Lakhanpur Area. Against NIT No.MCL/LKPA/Lilari/Safety/14-15/1489
Dt.05.11.2014
to my firm.


AFFIDAVIT
aged about 51 years Occupation Business, resident of Old Rly. Siding, Belpahar, Dist- Jharsuguda
1. That, I am submission tender for the work “Fabrication & supply of 08 Nos. Steel Board’s along with
writing by auto glow radium sticker for display Safe Operation Procedure, Code of Practice & the matter contained
In “SMART CARD” at Lilari-OCP of Lakhanpur Area. Against NIT No.MCL/LKPA/Lilari/Safety/14-15/1489
Dt.05.11.2014
valid.

AFFIDAVIT
I Sri Rameshwar Pani Proprietor of M/s. Sri Krishna Engineers S/o. Sri Purna Ch. Pani aged about 42
years Occupation Business, resident of Beheramal, Bijunagar, Dist Jharsuguda (Odisha), do hereby
1. That, I am submission tender for the work “Painting and letter writing on rest shelter’s 09 nos. & blasting
shelter’s 06 nos. of Lakhanpur-OCP of Lakhanpur Area. Against NIT No.
MCL/LKPA/LKP-OCP/SOM/MGR/Safety/14-15/992 Dt.:24.12.2014
2. That, I shall abide by CMPF clause of tender document and ensure implement ion of CMPF and Misc.
valid.


AFFIDAVIT
1. That, I am submission tender for the work “Fabrication & Supply & Installation of 04 Nos. Steel Boards
for display safety policy of CIL at Lakhanpur-OCP of Lakhanpur Area. Against NIT No.
MCL/LKPA/LKP-OCP/SOM/MGR/Safety/14-15/993 Dt.:24.12.2014
valid.


AFFIDAVIT
I Sri Hasmat Ali Khan Proprietor of M/s. H.A.Enterprises S/o. late Sami Ahmad Khan aged about 44
years Occupation Business, resident of Gandhi Chowk, Brajrajnagar, Dist Jharsuguda (Odisha), do
hereby solemnly affirm & state as follows:-
1. That, I am submission tender for the work “Painting and Letter writing on Rest shelter’s 09 nos. &
Blasting shelter’s 06 nos. of Lakhanpur-OCP of Lakhanpur Area. Against NIT No. MCL/LKPA/LKP-
OCP/SOM/MGR/Safety/14-15/992 Dt.:24.12.2014


AFFIDAVIT
I Sri Hasmat Ali Khan Proprietor of M/s. H.A.Enterprises S/o. late Sami Ahmad Khan aged about 44
years Occupation Business, resident of Gandhi Chowk, Brajrajnagar, Dist Jharsuguda (Odisha), do
1. That, I am submission tender for the work “Fabrication & Supply & Installation of 04 Nos. Steel Boards
for display safety policy of CIL at Lakhanpur-OCP of Lakhanpur Area. Against NIT No. MCL/LKPA/LKP-
OCP/SOM/MGR/Safety/14-15/993 Dt.:24.12.2014

GUARANTEE CERTIFICATE
We hereby given the guarantee/ warranty towards satisfactory

Performance of the supplied materials against bill no: SKE/14-15/56
Dt: 04.02.2015 for a period of 12 months from the date of Commissioning
or 18 months from the date of receipt and acceptance at Consignees end
whichever is earlier.
To,
The Staff Officer (MM),
Mahanadi Coalfields Limited,
Lakhanpur Area,
Subject: Request for Extension of Delivery Period.

Reference: Supply Order No: MCL/GM/LKPA/PUR/F46/14-15/Rest shelter/125.
Dt; 27.11.2014.
Dear Sir,
As per above supply order the delivery period was 19.01.2015 but due to short supply of electricity by
WESCO, we are unable to deliver the materials in time. Now we have already executed the total quantity
on dated 04.02.2015
Hence as we are a Local MSME unit, we request to your good self kindly extend the delivery
period up to 04.02.2014 in place of 19.01.2015 without imposing any L.D. we hope you will do the
needful action for the above and oblige.
Thanking you,
Yours faithfully,
Sri Krishna Engineers,
C.C to:
Depot. Officer, R/stores.

AFFIDAVIT
aged about 51 years Occupation Business, resident of Old Rly. Siding, Belpahar, Dist- Jharsuguda
1. That, I am submission tender for the work “Fabrication & Providing of 25 Nos. steel warning boards
(Dismantle type) for Lakhanpur-OCP of Lakhanpur Area. Against NIT No.MCL/LKPA/LKP-OCP/PO/Safety/14-
15/1173 Dt.24.02.2015
valid.


AFFIDAVIT
1. That, I am submission tender for the work “Fabrication & Providing of 25 Nos. steel warning boards
(Dismantle type) for Lakhanpur-OCP of Lakhanpur Area. Against NIT No.MCL/LKPA/LKP-OCP/PO/Safety/14-
15/1173 Dt.24.02.2015
valid.



AFFIDAVIT
1. That, I am submission tender for the work “Extension of existing fencing of substation yard and change of
barbed wire to wire mesh” at Lakhanpur-OCP of Lakhanpur Area. Against NIT No.MCL/LA/LKP-OCP/Ch.Manager
(E&M)/15-16/NIT/236 Dt.05.06.2015
valid.
Advocate, Jharsuguda NOTARY PUBLIC: Jharsuguda


AFFIDAVIT
I Sri Ranjit Moulic Proprietor of M/s. Ranjit Moulic S/o. Sri Gobind Moulic, aged about 40 years
Occupation Business, resident of Gumadera, Belpahar,Dist Jharsuguda (Odisha), do hereby solemnly
affirm & state as follows:-
barbed wire to wire mesh” at Lakhanpur-OCP of Lakhanpur Area. Against NIT
No.MCL/LA/LKP-OCP/Ch.Manager (E&M)/15-16/NIT/236 Dt.05.06.2015
2. That, I shall abide by CMPF clause of tender document and ensure implementation of CMPF and Misc.
4. That, all information furnished by me respect of fulfillment of eligibility criteria and qualification, information
of this tender is complete, correct and true.
6. That, if any information and documents submitted is found to be false/incorrect any time department May cancel
my tender and action as deemed fit may be taking against me, including termination of the contact ,for feature of
all dues including earnest money and banning/ de-listing of my firm and all partners of the firm etc.
7. That, I have not been banned or de listed by any Govt. or quasi govt. agencies or PSU’s at this time in relating to
my firm.

Advocate, Jharsuguda NOTARY PUBLIC, JHARSUGUDA


AFFIDAVIT
I Sri Ranjit Moulic Proprietor of M/s. Ranjit Moulic S/o. Sri Gobind Moulic, aged about 40 years
1. That, I am submission tender for the work “Providing & Fixing of Steel Boards with Picture and letter writing on
it” against NIT no.MCL/LKPA/GM/ASO/2015-16/984 DT: 01.07.2015
to my firm.


AFFIDAVIT
1. That, I am submission tender for the work “Providing & Fixing of Steel Boards with Picture and letter
writing on it” against NIT no.MCL/LKPA/GM/ASO/2015-16/984 DT: 01.07.2015
valid.

To,
The Chief Manager (E&M),
Lakhanpur Area,
Subject: Performance Security Deposit.

Reference: Your Work Order No:MCL/LA/LKP-OCP/Ch.Mgr (E&M)/15-16/027 Dated: 21.06.2015.
Dear Sir,
With reference to the above work order terms and condition, we here by deposit Performance security deposit of
Rs.7, 339.00 (Rupees Seven thousand three hundred thirty nine) only vide DD No.570611 Dated: 03.07.2015 of
SBI SAMDA Branch.
We hope you will take the needful action at your end.
Thanking you,
Yours faithfully,
For, SRI KRISHNA ENGINEERS.
Encl: As Above.
DECLERATION
NIT NO: GM/TA/MMD/e-Tender/Cement Capsules/2015/43 Date: 02.07.2015.
Tender ID: 2015_MCL_14805_1”
We are hereby declared that we have not been banned or de-listed by any Government or quasi-government
agencies or PSU’s etc.

AFFIDAVIT
I Sri Rameshwar Pani S/o. Sri Purna Ch. Pani Proprietor of M/s. Sri Krishna Engineers, aged about 42
barbed wire to wire mesh” at Lakhanpur-OCP of Lakhanpur Area. Against NIT No.MCL/LA/LKP-OCP/Ch.Manager
(E&M)/RE-NIT/15-16/438 Dt.22.07.2015
valid.
Advocate, Lakhanpur NOTARY PUBLIC: Lakhanpur

Advocate, Lakhanpur.
AFFIDAVIT
I Sri Har Charan Singh Proprietor of M/s. Darshan Enterprises S/o.Late Bakhshish Singh aged
about 51 years Occupation Business, resident of Gumadera, Belpahar,Dist Jharsuguda (Odisha), do
barbed wire to wire mesh” at Lakhanpur-OCP of Lakhanpur Area. Against NIT No.MCL/LA/LKP-OCP/Ch.MGR
(E&M)/RE-NIT/15-16/438 Dt.22.07.2015
my firm.
Advocate, Lakhanpur NOTARY PUBLIC, LAKHANPUR

SELF CERTIFICATE
NIT NO: GM/TA/MMD/e-Tender/Cement Capsules/2015/43 Date: 02.07.2015.
Tender ID: 2015_MCL_14805_1”
required.
(Rameshwar Pani)

AFFIDAVIT
I Sri Ranjit Moulick Proprietor of M/s. Ranjit Moulick S/o. Sri Gobind Moulick, aged about 40 years Occupation
Business, resident of Gumadera, Belpahar,Dist Jharsuguda (Odisha), do hereby solemnly affirm & state as
follows:-
1. That, I am submission tender for the work “Making 01 No. new portable shed for nala pump transformer and
replacement of old damaged sheet from nala pump shed at Lakhanpur-OCP of LA ” against NIT no.MCL/LA/LKP-
OCP/Ch.Mgr.(E&M)/15-16/NIT/589 Dt: 18.08.2015
to my firm.


AFFIDAVIT
I Sri Rameshwar Pani S/o. Sri Purna Ch. Pani Proprietor of M/s. Sri Krishna Engineers, aged about 42 years
Occupation Business, resident of Beheramal, Bijunagar, Dist Jharsuguda (Odisha), do hereby solemnly affirm &
state as follows:-
replacement of old damaged sheet from nala pump shed at Lakhanpur-OCP of LA ” against NIT
no.MCL/LA/LKP-OCP/Ch.Mgr.(E&M)/15-16/NIT/589 Dt: 18.08.2015
my firm.
Advocate,Lakhanpur NOTARY PUBLIC: Lakhanpur


AFFIDAVIT
follows:-
replacement of old damaged sheet from nala pump shed at Lakhanpur-OCP of LA ” against NIT no.MCL/LA/LKP-
OCP/Ch.Mgr.(E&M)/15-16/NIT/589 Dt: 18.08.2015
to my firm.


AFFIDAVIT
state as follows:-
replacement of old damaged sheet from nala pump shed at Lakhanpur-OCP of LA ” against NIT
no.MCL/LA/LKP-OCP/Ch.Mgr.(E&M)/15-16/NIT/589 Dt: 18.08.2015
my firm.

AFFIDAVIT
I, Rameshwar Pani S/o. Sri Purna Ch. Pani aged about 43 years Occupation -Business, resident of Beheramal,
Po/ Dist Jharsuguda (Odisha), do hereby solemnly affirm & state as follows:-
1. That, I am the absolute owner and sole proprietor in respect of my firm, namely M/s. Sri Krishna Engineers,
Beheramal, Po/ Dist.-Jharsuguda (Odisha) having its TIN Registration No:21691701872 under the Orissa Sales
Tax Act. and PAN Card No. AKIPP4587B under the Indian Income Tax Act. and I am also in peaceful physical
condition possession over the same in my own right, title and interest without anybody’s interference from any
quarter at any point of time.
2. That, I am swearing this affidavit to produce it before the concerned Mahanadi Coalfields Limited authority in
order to prove my legal status with M/s. Sri Krishna Engineers for all purposes such as Central Government/ State
Government/ Semi Government Organization/ Public and Pvt. Concerned etc.
3. That the facts stated above in this affidavit are all true and correct to the best of my knowledge, belief and
information.
Advocate, NOTARY PUBLIC: LAKHANPUR

SELF CERTIFICATE
YOUR NIT No.MCL/GM/BA/MMD/ET/F-102n103 (13-14)/RS/15-16/17 Dated: 17.07.2015,
Our Bid ID: 39586
We are the manufacturer of the tender items i.e. Modified Portable Rest Shelter, but our
turn over is less than 1.5 corers annually, hence ED is not applicable for us.
SELF CERTIFICATE
Our Bid ID: 39586
required.
(Rameshwar Pani)
SELF CERTIFICATE/PER FORMANCE REPORT

Our Bid ID: 39586
The Item covered in the supply order/s submitted against the tender have been fully
executed without any complaint on account of performance of the products supplied. No
warranty claim as regards to such supplied is/are pending as on the last date of
submission of bid.
DECLERATION

Our Bid ID: 39586
We are hereby declared that we have not been banned or de-listed by any
Government or quasi-Government agencies or PSU’s etc.
For, Sri Krishna Engineers
Guarantee/Warrantee Certificate
We hereby give the guarantee/warrantee period for supply of cement against our
Bill No.- SKE/15-16/33 Dt : 10.09.2015 i.e. 12 months from the date of use/
Commissioning whichever is earlier. If found any defect within this period, material
will be replace by us within 30 days on free of cost and all other physico-mechanical properties and
chemical properties etc. of supply capsules is as per DGMS circular .

To,
The Staff Officer (E&M),
Orient Area, Brajrajnagar,
Dist.: Jharsuguda (Odisha),
Subject: Deposit of ALR.

Reference: Your Work Order No.:MCL/GM/OA/EMD/15-16/WO/88 Dated.30.10.2015.
Dear Sir,
With reference to your above work order, we here with enclosing original documents of Fixed Deposit
amount of Rs.3.0 lakh i.e. vide F.D ref. no.325260 Dt.16.05.2014 of Rs.1.0 lakh and ref. no. 323706
Dt.04.05.2015 of Rs.2.0 lakh which is issued by Central Bank of India, Belpahar Branch. Now the above
F.D amounts deposit towards ALR of Rs.2, 87,196.96 subject to refund the same after completion of
above work.
We hope you will accept and receipt the same at the earliest and oblige.
Thanking you,
Yours faithfully,
For, Sri Krishna Engineers,
(Rameshwar Pani, Prop.)
Enclosed: As above.

AFFIDAVIT
state as follows:-
1. That, I am submission tender for the work “Fabrication 0f 04 Nos. of movable road breakers” at Lakhanpur-OCP
of Lakhanpur area against NIT no.MCL/LA/LKP-OCP/Ch.Mgr.(E&M)/15-/Re/NIT
/973 Dt: 02.12.2015
my firm.



AFFIDAVIT
follows:-
1. That, I am submission tender for the work “Fabrication 0f 04 Nos. of movable road breakers” at Lakhanpur-
OCP of Lakhanpur area against NIT no.MCL/LA/LKP-OCP/Ch.Mgr.(E&M)/15-16/NIT/973 Dt: 02.12.2015
to my firm.


AFFIDAVIT
I Sri Har Charan Singh, Proprietor of M/s. Darshan Enterprises S/o.Late Bakhshish Singh aged
1. That, I am submission tender for the work “Fabrication and fixing of 01 No. Air Cooled System of
6.6KV.300KW make BHEL Induction Motor Sl.No.48296”at Lakhanpur-OCP of Lakhanpur Area. Against NIT
No.MCL/LA/LKP-OCP/E&M/NIT/15-16/1374 Dt.15.03.2016.
my firm.

Advocate.

AFFIDAVIT
1. That, I am submission tender for the work “Replacement of damaged sheet along with painting of old shed
structure at 33KV/6.6KV/3.3KV Sub-Station”at Lakhanpur-OCP of Lakhanpur Area. Against NIT
No.MCL/LA/LKP-OCP/E&M/NIT/15-16/1358 Dt.12.03.2016.
my firm.

Advocate.

AFFIDAVIT
I Sri Rameshwar Pani S/o. Lt. Purna Ch. Pani Proprietor of M/s. Sri Krishna Engineers, aged about 43 years
state as follows:-
1. That, I am submission tender for the work “Fabrication and fixing of 01 No. Air Cooled System of
6.6KV.300KW make BHEL induction Motor Sl.No.48296 at Lakhanpur-OCP of Lakhanpur area against NIT no.
MCL/LA/LKP-OCP/E&M/NIT/15-16/1374 Dt.15.03.2016.
my firm.
Advocate NOTARY PUBLIC: JHARSUGUDA


AFFIDAVIT
I Sri Rameshwar Pani S/o. Lt. Purna Ch. Pani Proprietor of M/s. Sri Krishna Engineers, aged about 43 years
state as follows:-
1. That, I am submission tender for the work “Replacement of damaged sheet along with painting of old shed
structure at 33KV/6.6KV/3.3KV Sub-Station at Lakhanpur-OCP of Lakhanpur area against NIT no.
MCL/LA/LKP-OCP/E&M/NIT/15-16/1358 Dt.12.03.2016.
my firm.
Advocate NOTARY PUBLIC: JHARSUGUDA

Advocate.
AFFIDAVIT
1. I am submitting Tender for Supply of Top Bracket & Stool Post for 1000 mm Belt Conveyor against NIT
No. MCL/GM/OA/PUR/E-Tender /Conveyor Structure/15-16/67 Date: 03/03/2016 vide Bid Id: 43867
Undertaking.

Dated……………………..
Identified by Me.
AFFIDAVIT
I Sri Ranjit Moulick Proprietor of M/s. Ranjit Moulick S/o. Gobind Moulick, aged about 40 years Occupation
follows:-
1. That, I am submission tender for the work “Fabrication of 02 Nos. portable shed for protection of DG sets at
GM Complex and Triveni Club at Bandhabahal, Lakhanpur Area against NIT no. MCL/GM/LKPA/SO (E&M)/TN/16-
17/31 Dt.04.05.2016.
to my firm.

AFFIDAVIT
I Laxmidhar Pani S/o. Lt. Purna Ch. Pani Proprietor of M/s. J.P. Engineers, aged about 40 years Occupation
Business, resident of Beheramal, Near Hanuman Tempul, Dist Jharsuguda (Odisha), do hereby solemnly affirm &
state as follows:-
1. That, I am submission tender for the work “Fabrication and supply of steel sign board for in-motion weigh
bridges” for Lakhanpur-OCP against NIT no. MCLLA/LKPOCP/E&M/NIT/16-17/127 Dt.16.05.2016.
my firm.
Advocate, NOTARY PUBLIC: Jharsuguda


AFFIDAVIT
I Sri Ranjit Moulick Proprietor of M/s. Ranjit Moulick S/o. Gobind Moulick, aged about 41 years
1. That, I am submission tender for the work “Fabrication and supply of steel sign board for in-motion
weigh bridges” for Lakhanpur-OCP against NIT no. MCLLA/LKPOCP/E&M/NIT/16-17/127 Dt.16.05.2016.
valid.

Hence requisite court fee is affixed

AFFIDAVIT
1. That, I am submission tender for the work “Fabrication of one no. portable cycle stand near sub-
station of Lilari-OCP against NIT no. MCL/LKPA/Lilari/E&M/TN/16-17/236 Dt.30.06.2016.
valid.
Advocate, LAKHANPUR NOTARY PUBLIC: LAKHANPUR


AFFIDAVIT
Business, resident of Beheramal, Near Hanuman Temple, Dist Jharsuguda (Odisha), do hereby solemnly affirm &
state as follows:-
1. That, I am submission tender for the work “Fabrication of one no. portable cycle stand near Sub-station, Lilari-
OCP against NIT no. MCL/LKPA/Lilari/E&M/TN/16-17/236 Dt.30.06.2016.
my firm.


AFFIDAVIT
I Sri Jyoti Ranjan Pattnaik, Proprietor of M/s. LUCKY ENGINEERING, Old Rly. Siding, Belpahar, Dist-
Jharsuguda (Odisha), do hereby solemnly affirm & state as follows:-
We are submitting tender for the work “Complete repairing & fitting (Rehabilitation) of 50 nos. coal tubs
at OC -1&2 mine under orient sub area of Orient area, MCL” against tender notice
no.MCL/GM/OA/E&M/@016-17/04 Dated:01.07.2016.
I shall abide by CMPF clause of tender document and ensure implement ion of CMPF and Misc. Provision
Signature of the tenderer.

Dated:
Seal of Notary.

AFFIDAVIT
state as follows:-
1. That, I am submission tender for the work “Preparation of sturdy plastic made road speed breaker for in-motion
Weigh Bridge” at LKP-OCP against NIT no. MCL/LA/LKP-OCP/E&M/NIT/16-17/326 Dt.11.07.2016.
my firm.

Hence requisite court fee is affixed.

AFFIDAVIT
1. That, I am submission tender for the work “Dismantle, modify and erection of old shed structure of nallah pump
of Lilari-OCP, LKPA, Against NIT No.MCL/LA/Lilari/E&M/NIT/16-17/252 Dt.18.07.2016.
my firm.
Advocate, NOTARY PUBLIC, LAKHANPUR


AFFIDAVIT
state as follows:-
1. That, I am submission tender for the work “Dismantle, modify and erection of old shed structure of nallah pump
of Lilari-OCP, LKPA against NIT no. .MCL/LA/Lilari/E&M/NIT/16-17/252 Dt.18.07.2016.
my firm.


AFFIDAVIT
1. That, I am submission tender for the work “Providing & fixing of GI Pipe size: 32mm for watering of earth pits
of switch yard of 33KV/6.6KV/3.3KV substation at LKP-OCP of LKPA, Against NIT
No.MCL/LA/LKPOCP/E&M/16-17/NIT/367 Dt.26.07.2016
my firm.
Advocate, NOTARY PUBLIC, JHARSUGUDA


AFFIDAVIT
state as follows:-
1. That, I am submission tender for the work “Providing and fixing of G.I Pipe size: 32mm for watering of earth
pits of switch yard of 33KV/6.6KV/3.3KV substation at LKP-OCP of LKPA, Against NIT
No.MCL/LA/LKPOCP/E&M/16-17/NIT/367 Dt.26.07.2016
my firm.
Advocate, NOTARY PUBLIC: JHARSUGUDA

AFFIDAVIT
We are submitting tender for the work “Fabrication (excluding Material) of foundation bolt (Size-25mm
diax450mm TMT) for man riding system of mine no.1&2 under Orient Sub Area, Orient Area, MCL”
against tender notice no.MCL/GM/OA/E&M/16-17/08 Dated: 09.08.2016.
I shall abide by CMPF clause of tender document and ensure implementation of CMPF and Misc. Provision

Dated:
Seal of Notary.
AFFIDAVIT
I Sri Rameshwar Pani, Proprietor of M/s. Sri Krishna Engineers, Beheramal, PO/Dist- Jharsuguda
(Odisha), do hereby solemnly declare that:
We are submitting tender for the work “Fabrication (excluding Material) of foundation bolt (Size-
25mm diax450mm TMT) for man riding system of mine no.1&2 under orient sub area, Orient Area,
MCL” against tender notice no.MCL/GM/OA/E&M/16-17/08 Dated: 09.08.2016.

Dated:
Seal of Notary.

AFFIDAVIT
I Sri Laxmidhar Pani, Proprietor of M/s. J.P.Engineers, Near Hanuman Tempul, Beheramal, Dist-
Jharsuguda (Odisha), do hereby solemnly declare that:-
We are submitting tender for the work “Fabrication (excluding Material) of foundation bolt (Size-25mm
diax450mm TMT) for man riding system of mine no.1&2 under orient sub area, Orient Area, MCL”
against tender notice no.MCL/GM/OA/E&M/@016-17/08 Dated: 09.08.2016.

Dated:
Seal of Notary.

AFFIDAVIT
state as follows:-
1. That, I am submission tender for the work “Fabrication of LA Bracket and steel rack” for Lilari-OCP, LKPA,
Against NIT No.MCL/LKPA/Lilari/E&M/TN/16-17/316 Dt.15.09.2016
my firm.


AFFIDAVIT
1. That, I am submission tender for the work “Fabrication of LA Bracket and steel rack” for Lilari-OCP,
LKPA, Against NIT No.MCL/LKPA/Lilari/E&M/TN/16-17/316 Dt.15.09.2016
valid.


AFFIDAVIT
1. That, I am submission tender for the work “Fabrication of 01 No. Portable rest shelter for pump
operation at quarry of BOCM” Against NIT No.MCL/LKPA/BOCM/E&M/16-17/625 Dt.26.09.2016
valid.


AFFIDAVIT
1. That, I am submission tender for the work “Fabrication of 01 No. Portable rest shelter for pump operation at
quarry of BOCM” Against NIT No.MCL/LKPA/BOCM/E&M/16-17/625 Dt.26.09.2016
my firm.
Advocate, NOTARY PUBLIC, LAKHANPUR


AFFIDAVIT
1. That, I am submission tender for the work “Fitting of damaged members of 33KV tower (03Nos.) at
Lakhanpur-OCP” Against NIT No.MCL/LA/LKPOCP/E&M/NIT/16-17/717 Dt.08.10.2016
valid.


AFFIDAVIT
state as follows:-
1. That, I am submission tender for the work “Fitting of damaged members of 33KV tower (03Nos.) at
Lakhanpur-OCP” Against NIT No.MCL/LA/LKPOCP/E&M/NIT/16-17/717 Dt.08.10.2016
my firm.


AFFIDAVIT
We are submitting tender for the work “Complete repairing & fitting (re-habilitation) of 50 nos. Coal
Tubs at OC-1&2 Mine under orient sub area of Orient Area, MCL” against tender notice
no.MCL/GM/OA/E&M/2016-17/16 Dated: 31.10.2016.

Dated:
Seal of Notary

AFFIDAVIT
We are submitting tender for the work “Complete repairing & fitting (re-habilitation) of 50 nos. Coal
Tubs at OC-1&2 Mine under orient sub area of Orient Area, MCL” against tender notice

Dated:
Seal of Notary.
AFFIDAVIT
I Sri Ranjit Moulick Proprietor of M/s. Ranjit Moulick S/o. Lt.Gobind Moulick, aged about 42 years
1. That, I am submission tender for the work “Renovation & repairing ofstatic road weigh bridge no.03
at BOCM” Against NIT No.MCL/LKPA/BOCM/E&M/16-17/948 Dt.24.12.2016
valid.



AFFIDAVIT
I Rameshwar Pani S/o. Lt. Purna Ch. Pani Proprietor of M/s. Sri Krishna Engineers, aged about 44 years
Occupation Business, resident of Beheramal,Bijunagar, Dist Jharsuguda (Odisha), do hereby solemnly affirm &
state as follows:-
1. That, I am submission tender for the work “Renovation & repairing of static road weigh bridge no.03 at BOCM”
Against NIT No.MCL/LKPA/BOCM/E&M/16-17/948 Dt.24.12.2016
my firm.

BEFORE THE NOTARY PUBLIC: LKHANPUR
AFFIDAVIT
state as follows:-
1. That, I am submission tender for the work “Fabrication of Bearing Plates (Size-150*150*8mm with center hole
of 20mm dia) for roof support work in all U/G mines of Orient Area, Against NIT No.MCL/GM/OA/E&M/2016-
17 /20 Dated.06.02.2017
my firm.

AFFIDAVIT
I Rameshwar Pani , Proprietor of M/s. Sri Krishna Engineers, aged about 44 years Occupation Business, resident
of Beheramal,Bijunagar, Dist Jharsuguda (Odisha), do hereby solemnly affirm & state as follows:-
1. That, I am submission tender for the work ““Fabrication of Bearing Plates (Size-150X150X8mm with center
hole of 20mm Dia) for Roof Support work in all U/G mines of Orient Area, Against NIT
No.MCL/GM/OA/E&M/2016-17 /20 Dated.06.02.2017
my firm.


AFFIDAVIT
I Rameshwar Pani , S/o Purna Ch. Pani, Proprietor of M/s. Sri Krishna Engineers, aged about 44 years
state as follows:-
1. That, I am submission tender for the work “Laying of PVC Pipe and installation of Sprinkler system at Project
Office garden” of Lilari-OCP against NIT No.MCL/LKPA/LILARI/&M/2016-17/506 Dated.06.03.2017
my firm.


AFFIDAVIT
1. That, I am submission tender for the work “Laying of PVC Pipe and installation of Sprinkler system at
Project Office garden” of Lilari-OCP against NIT No.MCL/LKPA/LILARI/&M/2016-17/506
Dated.06.03.2017
valid.


AFFIDAVIT
We are submitting tender for the work “Making/Fabrication of stringer for belt conveyor of OC-1&2
Mine under orient sub area of Orient Area-450 Nos.” against tender notice no.MCL/GM/OA/E&M/2016-
17/21 Dated: 02.03.2017.
I shall abide by CMPF clause of tender document and ensure implementation of CMPF and Misc.

Dated:
Seal of Notary

AFFIDAVIT
I Rameshwar Pani, S/O Purna Ch. Pani, Proprietor of M/s. Sri Krishna Engineers resident
of Beheramal, Bijunagar,Dist- Jharsuguda (Odisha), do hereby solemnly declare that:-
We are submitting tender for the work “Making/Fabrication of stringer for belt conveyor
of OC-1&2 Mine under orient sub area of Orient Area-450 Nos.” against tender notice

Dated:
Seal of Notary

AFFIDAVIT
1. That, I am submission tender for the work “Modification of oil storage shed o Unit Store and
replacement of old damaged sheet of diesel filling station” of Lilari-OCP,LKPA against NIT
No.MCL/LKPA/LILARI/E&M/2016-17/524 Dated.27.03.2017
valid.


AFFIDAVIT
I Sri Laxmidhar Pani, S/o Purna Ch. Pani Proprietor of M/s. J.P.Engineers , aged about 41 years
Occupation Business, resident of Beheramal,Po/Dist Jharsuguda (Odisha), do hereby solemnly affirm &
state as follows:-
1. That, I am submission tender for the work “Modification of oil storage shed o Unit Store and
replacement of old damaged sheet of diesel filling station” of Lilari-OCP,LKPA against NIT
No.MCL/LKPA/LILARI/E&M/2016-17/524 Dated.27.03.2017
valid.


AFFIDAVIT
I Laxmidhar Pani, S/O Purna Ch. Pani, Proprietor of M/s. J.P. Engineers resident of
Beheramal, Near Durga Temple, Dist- Jharsuguda (Odisha), do hereby solemnly declare
that:-
We are submitting tender for the work “Fabrication of Bearing Plate Size:150*150*6mm
with center hole of 20mm Dia for roof support work in all U/G mines of Orient Area”
against tender notice no.MCL/GM/OA/E&M/2016-17/23 Dated: 04.03.2017.
Dated:
Seal of Notary

AFFIDAVIT
We are submitting tender for the work “Fabrication of Bearing Plate Size:150x150x6mm with
center hole of 20mm Dia for roof support work in all U/G mines of Orient Area” against tender
notice no.MCL/GM/OA/E&M/2016-17/23 Dated: 04.03.2017.

Dated:
Seal of Notary

AFFIDAVIT
1. That, I am submission tender for the work “Repairing of one no. 72 drums Pontoon for installation of H.T. Pump
at Lilari-OCP,LKPA against NIT No.MCL/LKPA/LILARI/E&M/TN/2017-18/607 Dated.12.05.2017
my firm.


AFFIDAVIT
I Sri Har Charan Singh Proprietor of M/s. Darshan Enterprises S/o.Late Bakhshish Singh aged
1. That, I am submission tender for the work “Repairing of one no. 72 drums Pontoon for installation of H.T. Pump
at Lilari-OCP,LKPA against NIT No.MCL/LKPA/LILARI/E&M/TN/2017-18/607 Dated.12.05.2017
my firm.
Advocate, Lakhanpur NOTARY PUBLIC, LAKHANPUR


AFFIDAVIT
state as follows:-
1. That, I am submission tender for the work “Fabrication of G.I light fitting bracket with U type/O type
clamp for road light” of Lakhanpur-OCP,LKPA against NIT No.MCL/LA/PO/LKPOCP/E&M/17-18/NIT/179
Dated.02.06.2017
valid.


AFFIDAVIT
1. That, I am submission tender for the work “Providing & fixing of flaxy banner, painting and letter writing on
old steel boards at Lakhanpur-OCP of Lakhanpur Area against NIT No.MCL/A/LKPOCP/MGR/Safety/17-18/375
Dated.01.09.2017
my firm.

AFFIDAVIT
state as follows:-
1. That, I am submission tender for the work “ Providing & fixing of flaxy banner, painting and letter writing on
old steel boards at Lakhanpur-OCP of Lakhanpur Area against NIT No.MCL/A/LKPOCP/MGR/Safety/17-18/375
Dated.01.09.2017
my firm.


AFFIDAVIT
Occupation Business, resident of Gumadera, Belpahar,Dist-Jharsuguda (Odisha), do hereby solemnly
1. That, I am submission tender for the work “Fabrication of Portable Lighting Tower for Lilari-OCP of Lakhanpur
Area against NIT No.MCL/LKPA/Lilari/E&M/TN/17-18/710 Dated.15.09.2017
my firm.


AFFIDAVIT
state as follows:-
1. That, I am submission tender for the work “Fabrication of Portable Lighting Tower for Lilari-OCP of Lakhanpur
Area against NIT No.MCL/LKPA/Lilari/E&M/TN/17-18/710 Dated.15.09.2017
my firm.


AFFIDAVIT
state as follows:-
1. That, I am submission tender for the work “Making of bearing bush for maintenance of Mather & Plate Pump
model 10/12 PLURO X 4CHR” at Lakhanpur-OCP , Lakhanpur Area against NIT No.
MCL/LA/LKPOCP/E&M/NIT/17-18/575 Date- 30.09.2017.
my firm.


AFFIDAVIT
1. That, I am submission tender for the work “Making of bearing bush for maintenance of Mather &
Plate Pump model 10/12 PLURO X 4CHR” at Lakhanpur-OCP , Lakhanpur Area against NIT No.
MCL/LA/LKPOCP/E&M/NIT/17-18/575 Date- 30.09.2017.
valid.


AFFIDAVIT
state as follows:-
1. That, I am submission tender for the work “Fabrication & fixing of steel rack for up keeping to materials at
33KV Sub-station and E&M Workshop” at Lakhanpur -OCP of Lakhanpur Area against NIT
No.MCL/LKPA/LKPOCP/E&M/NIT/17-18/742 Dated.23.11.2017
my firm.


AFFIDAVIT
1. That, I am submission tender for the work “Fabrication & fixing of steel rack for up keeping to materials at
33KV Sub-station and E&M Workshop” at Lakhanpur -OCP of Lakhanpur Area against NIT
No.MCL/LKPA/LKPOCP/E&M/NIT/17-18/742 Dated.23.11.2017
my firm.


AFFIDAVIT
1. That, I am submission tender for the work “Repairing & Painting of 09 Nos. Portable Rest Shelter & 04 Nos.
Blasting Shelters “at Lakhanpur -OCP of Lakhanpur Area against NIT No.MCL/LKPA/LKPOCP/E&M/NIT/17-
18/921 Dated.20.01.2018
my firm.


AFFIDAVIT
state as follows:-
1. That, I am submission tender for the work “Repairing and Painting of 09 Nos. Portable Rest Shelters & 04 Nos.
Blasting Shelters “at Lakhanpur -OCP of Lakhanpur Area against NIT No.MCL/LKPA/LKPOCP/E&M/NIT/17-
18/921 Dated.20.01.2018
my firm.


AFFIDAVIT
1. That, I am submission tender for the work “Fabrication, supply & installation of 12 Nos. Glow sign
boards for E&M workshop, sub-station and Weigh Bridge’s for Lakhanpur OCP of LA, against NIT
No.MCL/LKPA/LA /LKPOCP/E&M/NIT/17-18/946 dt. 25.01.2018
valid.


AFFIDAVIT
state as follows:-
1. That, I am submission tender for the work “Fabrication, supply & installation of 12 Nos. Glow sign boards for
E&M workshop, sub-station and Weigh Bridge’s for Lakhanpur OCP of LA, against NIT No.MCL/LKPA/LA/
LKPOCP/E&M/NIT/17-18/946 dt. 25.01.2018
my firm.


AFFIDAVIT
I Laxmidhar Pani, S/O Lt. Purna Ch. Pani, Proprietor of M/s. J.P. Engineers resident of
Beheramal, Near Durga Temple, Dist- Jharsuguda (Odisha), do hereby solemnly declare
that:-
We are submitting tender for the work “Cutting 25mm rod and making V shape with
welding (2 nos. of cut & 1 no. of weld ) for the purpose of repairing of bottom roller
including dismantling- 1000 nos.” Against tender notice no.MCL/GM/OA/E&M/CG/2017-
18/88 Dated: 03.02.2018.

Dated:
Seal of Notary
AFFIDAVIT
I Sri Rameshwar Pani, Proprietor of M/s. Sri Krishna Engineers, S/o. Lt. P.C. Pani, aged about 45 years
Occupation Business, resident of Bijunagar, PO- Industrial Estate,Dist Jharsuguda (Odisha), do hereby
We are submitting tender for the work “Cutting 25mm rod and making V shape with welding (2 nos. of
cut & 1 no. of weld ) for the purpose of repairing of bottom roller including dismantling- 1000 nos.”
Against tender notice no.MCL/GM/OA/E&M/CG/2017-18/88 Dated: 03.02.2018.

Dated:
Seal of Notary
AFFIDAVIT
state as follows:-
1. That, I am submission tender for the work “Making of Sleev bush, neck ring & shaft of Kriloskar make SCT
150/48-2 pump at Lakhanpur-OCP , Lakhanpur Area against NIT No. MCL/LA/LKPOCP/E&M/NIT/18-19/539
Date- 21.08.2018.
my firm.

AFFIDAVIT
I Shankar Lal Mittal, S/O Bhimsen Mittal Proprietor of M/s. OM ENGINEERING , aged about 62 years
Occupation Business, resident of Belpahar, Post- Belpahar, Dist Jharsuguda (Odisha), do hereby
1. That, I am submission tender for the work “Making of Sleev bush, neck ring & shaft of Kriloskar make SCT
150/48-2 pump at Lakhanpur-OCP , Lakhanpur Area against NIT No. MCL/LA/LKPOCP/E&M/NIT/18-19/539
Date- 21.08.2018.
my firm.

AFFIDAVIT
state as follows:-
1. That, I am submission tender for the work “Providing & fixing of Acrylic LED sign board at LKPOCP of LKPA ,
against NIT No.MCL/LKPA/SAM/LKPOCP/CVL/TN/19-20/48 dt.08.05.2019
my firm.


AFFIDAVIT
I Sunil Ku. Singh , S/o Surya Nath Singh, Proprietor of M/s. Singh Enterprises, aged about 56 years Occupation
Business, resident of Jamkani Road, Belpahar, Dist Jharsuguda (Odisha), do hereby solemnly affirm & state as
follows:-
1. That, I am submission tender for the work “Providing & fixing of Acrylic LED sign board at LKPOCP of
LKPA, against NIT No.MCL/LKPA/SAM/LKPOCP/CVL/TN/19-20/48 dt.08.05.2019
my firm.


AFFIDAVIT
state as follows:-
1. That, I am submission tender for the work “Fabrication of 11 nos. portable shed for protection of NGR,
Starter, Capacitor and making of 06 Nos. Bracket for lighting arrestor at 33KV/ 6.6KV main sub-station at
Lakhanpur-OCP, LA, against NIT No.MCL/LA/PO/LKPOCP/E&M//19-20/NIT/152 dt.11.05.2019
my firm.


AFFIDAVIT
follows:-
1. That, I am submission tender for the work “Fabrication of 11 nos. portable shed for protection of NGR, Starter,
Capacitor and making of 06 Nos. Bracket for lighting arrestor at 33KV/ 6.6KV main sub-station at Lakhanpur-
OCP, LA, against NIT No.MCL/LA/PO/LKPOCP/E&M//19-20/NIT/152 dt.11.05.2019
my firm.


AFFIDAVIT
Occupation Business, resident of Beheramal,Bijunagar, Dist Jharsuguda (Odisha), do hereby solemnly
01. That the deponent was awarded with the work “Fabrication of 03 Nos. of float for water supplying
and mines de-watering at B(W)OCP under Basundhara Area, vide work order
no.MCL/GM/BA/E&M/2019-20/02 Date-04.04.2019.
02. That the deponent declares that he had employed any labour for less than 30 days continuously to
work. So also he has not engaged more than 19 labour in a day for the discharges of his contractual work.
03. That the deponent is swearing this affidavit to declare the above facts and to submit the same before
the concerned authority of MCL for reference.
04. That the facts stated above are all true to the best of the knowledge and belief of the deponent.
Advocate, JHARSUGUDA
NOTARY PUBLIC: JHARSUGUDA


AFFIDAVIT
I Prabir Pani, S/o Sri Rameshwar Pani, aged about 17 years resident of Beheramal,Ward
No-11, PO/PS/Dist Jharsuguda (Odisha), do hereby declare that:
01. That the above mentioned information is furnished on best of my knowledge. If

information & declaration is found false, I am liable for prosecution.
02. I do not belong to SC, ST and OBC caste.



AFFIDAVIT
follows:-
1. That, I am submission tender for the work “Making of Shaft Sleeve (SS) of Kriloskar Make SCT 200/58-2
Pump” at Lakhanpur-OCP, LA, against NIT No.MCL/LA/PO/LKPOCP/E&M//NIT/19-20/307 dt.28.06.2019
my firm.


AFFIDAVIT
state as follows:-
1. That, I am submission tender for the work “ Making of Shaft Sleeve (SS) of Kriloskar Make SCT 200/58-2
Pump” at Lakhanpur-OCP, LA, against NIT No.MCL/LA/PO/LKPOCP/E&M//NIT/19-20/307 dt.28.06.2019
my firm.


AFFIDAVIT
state as follows:-
1. That, I am submission tender for the work “Fabrication & Installation of 28 Nos. steel boards along with writing
on 3M radium stickers for Quarry no. 06 of Lakhanpur-OCP of LA, against NIT
No.MCL/LA/PO/LKPOCP/SAF/19-20/NIT/731 dt.13.12.2019
my firm.



AFFIDAVIT
I Laxmidhar Pani, Proprietor of M/s. J.P. Engineers, aged about 43 years Occupation Business, resident of
Beheramal, Near Hanuman Temple, Dist Jharsuguda (Odisha), do hereby solemnly affirm & state as follows:-
1. That, I am submission tender for the work “Fabrication & Installation of 28 Nos. steel boards along with writing
on 3M radium stickers for Quarry no. 06 of Lakhanpur-OCP of LA, against NIT
No.MCL/LA/PO/LKPOCP/SAF/19-20/NIT/731 dt.13.12.2019
my firm.


AFFIDAVIT
state as follows:-
1. That, I am submission tender for the work “Collection & preparation of coal samples from coal seams, pit-head
stock, YCS, MGR siding & running tippers for the purpose of revision of the annual coal grade for the year 2019-
20 of Lakhanpur-OCP against NIT No.MCL/LA/PO/LKPOCP/QC/19-20/STT/322 dt.20.12.2019
my firm.

AFFIDAVIT
follows:-
1. That, I am submission tender for the work “Collection & preparation of coal samples from coal seams, pit-
head stock, YCS, MGR siding & running tippers for the purpose of revision of the annual coal grade for
the year 2019-20 of Lakhanpur-OCP against NIT No.MCL/LKPA/SAM/LKPOCP/PO/NO/QC/19-20/322
dt.20.12.2019
my firm.

AFFIDAVIT
follows:-
1. That, I am submission tender for the work “Making fire fighting arrangement at Sardega Railway Siding
under B(W) OCP of Mahalaxmi Area” against NIT No-MCL/PO/B(W)OCP/Civil/Tender/ 19-20/194
dt.05.03.2020
my firm.

AFFIDAVIT
1. That, I am submission tender for the work “Making fire fighting arrangement at Sardega Railway Siding under
B(W) OCP of Mahalaxmi Area” against NIT No-MCL/PO/B(W)OCP/Civil/Tender/ 19-20/194 dt.05.03.2020
my firm.

AFFIDAVIT
follows:-
1. That, I am submission tender for the work “Providing water Pipeline for supply of water at Sardega
Railway Siding under B(W) OCP of Mahalaxmi Area” against NIT No-MCL/PO/B(W)OCP/Civil/Tender/ 19-
20/197 dt.09.03.2020
my firm.


AFFIDAVIT
1. That, I am submission tender for the work “Providing water pipeline for supply of water at Sardega Railway
Siding under B(W) OCP of Mahalaxmi Area” against NIT No-MCL/PO/B(W)OCP/Civil/Tender/ 19-20/197
dt.09.03.2020
my firm.


AFFIDAVIT
follows:-
1. That, I am submission tender for the work “Fabrication & Installation of 35 Nos. of safety slogan boards
along with pasting and writing on radium sticker” for Lakhanpur OCP of Lakhanpur Area against NIT No-
MCL/LA/PO/LKPOCP/E&M/19-20/NIT/1059 dt.08.03.2020
my firm.


AFFIDAVIT
state as follows:-
1. That, I am submission tender for the work “Fabrication & Installation of 35 Nos. of safety slogan boards along
with pasting and writing on radium sticker” at Lakhanpur OCP of Lakhanpur Area against NIT
No-MCL/LA/PO/LKPOCP/E&M/19-20/NIT/1059 dt.08.03.2020.
my firm.


AFFIDAVIT
state as follows:-
1. That, I am submission tender for the work “Supply & Fixing of MS flanges 100mm, 150mm and 200mm inner
dia pipeline for main sump & Railway siding of B(W) OCP, Mahalaxmi Area, against NIT
No-MCL/MA/PO/B(W)OCP/E&M/TN/19-20/45 dt.09.03.2020.
my firm.


AFFIDAVIT
1. That, I am submission tender for the work “Supply & Fixing of MS flanges 100mm, 150mm and 200mm inner
dia pipeline for main sump & railway siding of B(W) OCP, Mahalaxmi Area, against NIT
No-MCL/MA/PO/B(W)OCP/E&M/TN/19-20/45 dt.09.03.2020.
my firm.


AFFIDAVIT
follows:-
1. That, I am submission tender for the work “Repairing of rear loading bed of Departmental Truck of RCSB
having Regd. No.OD23B6869” against NIT No-MCL/LKPA/E&M/TN/19-20/NIT/337 dt.16.03.2020
my tender and action as deemed fit may be taking against me, including termination of the contact,for feature of all
dues including earnest money and banning/ de-listing of my firm and all partners of the firm for a minimum period
of 01 (One) year.
my firm.


AFFIDAVIT
state as follows:-
1. That, I am submission tender for the work “Repairing of rear loading bed of Departmental Truck of RCSB
having Regd. No.OD-23B-6869” against NIT No-MCL/LKPA/E&M/TN/19-20/NIT/337 dt.16.03.2020
my tender and action as deemed fit may be taking against me, including termination of the contact, for feature of
all dues including earnest money and banning/ de-listing of my firm and all partners of the firm for a minimum
period of 01 (One) year.
my firm.


AFFIDAVIT
I Laxmidhar Pani , S/o Purna Ch. Pani, Proprietor of M/s. J.P. Engineers, aged about 45 years
01. That the deponent was awarded with the work “Fabrication of 01 No. 40 drum float for installation of
diesel pump set (Flow more 100HP 40LPS, 100Mh) at coal face sump of Kulda –OCP, Basundhara Area,
vide work order no.MCL/GM/BA/E&M/WO/2020-21/04 Date-21.04.2020.
02. That the deponent declares that he had employed any labour for less than 30 days continuously to
work. So also he has not engaged more than 19 labour in a day for the discharges of his contractual work.


AFFIDAVIT
follows:-
1. That, I am submission tender for the work “Making of Bearing Bush for M&P make: 10/12 PLURO 4XCHR
Pump” at Lakhanpur OCP,LA” against NIT No-MCL/LKPA/E&M/TN/20-21/NIT/134 dt.01.06.2020
my tender and action as deemed fit may be taking against me, including termination of the contact,for feature of all
dues including earnest money and banning/ de-listing of my firm and all partners of the firm for a minimum period
of 01 (One) year.
my firm.


AFFIDAVIT
I _____________________________, S/o_____________________________, Proprietor of M/s.
________________________________, aged about __________ years Occupation Business, resident of
_________________________________________________, do hereby solemnly affirm & state as follows:-
1. That, I am submission tender for the work
“_____________________________________________________________________________________”
against NIT No-________________________________________ dt.______________
my tender and action as deemed fit may be taking against me, including termination of the contact, for feature of
all dues including earnest money and banning/ de-listing of my firm and all partners of the firm for a minimum
period of 01 (One) year.
my firm.


AFFIDAVIT
01. That the deponent was awarded with the work “Providing tyre inflation room at field section
of Garjanbahal-OCP of BG Area. Vide work order no. MCL/GM/BA/Civil/WO/2020-21/F-02/95
Date-02.05.2020.
02. That the deponent declares that he has not employed any labour for 30 days of work continuously.
Also he has not engaged more than 19 labours in a day for the discharges of his contractual work.


AFFIDAVIT
01. That the deponent was awarded with the work “Lying of 200mm MS Pipe line, 3000 mtr. long
from face sump no. 02 to mid sump no. 01 (Two Fanges) for mine water Pumping” at Kulda- OCP
of BG Area. Vide work order no: MCL/GM/BA/E&M/2020-21/WO/19 Date-21.05.2020.
02. That, the deponent has engaged the own worker from 08.08.2020 to 29.08.2020 from the date of
site handover.
03. That the deponent declares that he has deployed own worker (Brought from their work shop) who are
working less than 30 days also he has not engaged more than 19 labours in a day. So that LPC & CMPF
is not applicable for this work.
That the facts stated above are all true to the best of the knowledge and belief of the deponent.


AFFIDAVIT
01. That the deponent was awarded with the work “Fabrication of Blasting shelter 04 nos. and rest
Shelter 04 nos. and portable shed CGI sheet five nos. for Ht pump motor, Starter and VCB switch”
at Kulda OCP of BG Area. Vide work order no: MCL/GM/BA/E&M/2020-21/WO/59
Date- 26.08.2020.
02. That, the deponent has engaged in his own work shop for doing this job work and after the
Completion of the work as per delivery schedule and deliver the material at site. So that LPC & CMPF is
not applicable for this work.
AFFIDAVIT
01. That the deponent was awarded with the work “MS Pipe line work for firefighting at Coal stock”
at GarjanBahal-OCP of BG Area. Vide work order no MCL/GM/BA/E&M/2020-21/WO/60
dt.26.08.2020


AFFIDAVIT
I Laxmidhar Pani , S/o Purna Ch. Pani, Proprietor of M/s. J.P Engineers, aged about 45 years Occupation
Business, resident of Beheramal, Dist Jharsuguda (Odisha), do hereby solemnly affirm & state as
follows:-
01. That the deponent was awarded with the work “AMC for strengthening, overhauling and
renovation from time to time of all weighbridges including testing of same with test weight as and
when required for a year at Kulda -OCP of Basundhara Area. Vide work order no:
MCL/GM/BA/E&M/2020-21/WO/57 Date- 26.08.2020.
Site handover.
working less than 30 days. So that LPC & CMPF is not applicable for this work.
AFFIDAVIT
state as follows:-
1. That, I am submission tender for the work “Repairing of 01 no. of Kriloskar make 6UP4 pump of Nallah pump”
at Lakhanpur OCP of Lakhanpur Area against NIT No-MCL/LA/PO/LKPOCP/E&M/20-21/NIT/446
dt.06.11.2020.
my firm.

AFFIDAVIT
I Sek Pir Mahammad , S/o Sek Rajak, Proprietor of M/s. Aryan Engineering Works, aged about 38 years
Occupation Business, resident of Bawan Pada, Lamthibahal,,Brajrajnagar, Dist Jharsuguda (Odisha), do hereby
1. That, I am submission tender for the work “Repairing of 01 no. of Kriloskar make 6UP4 pump of Nallah pump”
at Lakhanpur OCP of Lakhanpur Area against NIT No-MCL/LA/PO/LKPOCP/E&M/20-21/NIT/446
dt.06.11.2020.
my firm.

AFFIDAVIT
I Rohit Patel , S/o Labadhar Patel, Proprietor of M/s. Rohit Patel, aged about 49 years Occupation
Business, resident of Tumulia, Goplapur, Dist Sundargarh (Odisha), do hereby solemnly affirm & state
as follows:-
01. That the deponent was awarded with the work “MS Pipeline work for mine dewatering”
at Garjanbahal-OCP of BG Area. Vide work order no. MCL/GM/BA/E&M/WO/2020-21/23
Date-30.05.2020.

AFFIDAVIT
I Rameshwar Pani , S/o Purna Ch. Pani, Proprietor of M/s. Sri Krishna Engineers, aged
about 48 years Occupation Business, resident of Beheramal, Bijunagar, Dist Jharsuguda
01. That, I participated in tender reference no. MCL/LKPOCP/PO/NO/QC/19-

20/STN/322 Dated-28.12.2019.
02. That, I deposited Earnest money of Rs.1170.00, vide cash receipt no.
RCC/5201/2019/000356 dt.02.01.2020.
03. That the original receipt has been missing somewhere.
04. That, I am swearing this affidavit in order to submit it before the concerned authority
of MCL for necessary information and release the same as soon as possible.


AFFIDAVIT
I, Susanta Mahapatra , aged about 32 years, S/o- Gurupada Mahapatra, R/o- Gumadera, PO/PS- Belpahar, Dist.-
01. That, the deponent was awarded with the work “Hiring of one no. covered jeep (Bolero SLE) having Regd. no.
OD23J-1148 and seating capacity 6 plus 1 on 16 hrs. duty basis along with deployment of 2 nos. of driver heaving
staggered rest, max run 3500 km/month, for 02 years (682 days) for Lakhanpur OCP of Lakhanpur Area, MCL”
against work order no. MCL/GM/LKPA/SO (E&M)/WO/19-20/64 Dtd.22.07.2019
02. That, deponent declares that he had not employed any labour for more than 30 days for the contract period
03. That, the deponent swearing this affidavit to declare the above facts and to submit the same before the
concerned authority of MCL authority for necessary information and action.
04. That the facts stated above are all true to the best of my knowledge and belief of the deponent.


AFFIDAVIT
I, Rameshwar Pani , S/o Purna Ch. Pani, Proprietor of M/s. Sri Krishna Engineers, aged about 48 years
state as follows:-
1. That, I am submission tender for the work “Fabrication of portable type CGI Sheet Shed of size (3.4X5.0X3.7)
mtr. For mine view point” at Kulda-OCP of Basundhara Area, against tender notice no.
MCL/BA/PO/KOCP/E&M/202125 Dated.03.03.2021 and I offer to execute the work in accordance with all the
terms, condition and provision of the bid.
my firm.
9. That, I hereby authorized department to seek reference/ clarification from our Bankers.
10. Bid securing declaration: - If I withdraw or modify the bids during the period of validity, or if award the
contract and fail to sign the contract, or to submit a “Performance Security” before the deadline or any other default
which attracts forfeiture of EMD as defined in request for bid documents, we will banned for two years from being
eligible to submit bids in CIL and its subsidiaries. This banning shall be done under the provision the NIT with the
approval of “Tender Accepting Authority” with information to all concerned and online blocking of the bidder
shall be done on receipt of written communication from the “Tender Inviting Authority” by application admin of
CIL e-Procurement Portal.



AFFIDAVIT
I, Sunil Ku. Singh , S/o Surya Nath Singh, Proprietor of M/s. Singh Enterprises, aged about 56 years
Occupation Business, resident of Jamkani Road, Belpahar, Dist Jharsuguda (Odisha), do hereby solemnly affirm
& state as follows:-
1. That, I am submission tender for the work “Fabrication of portable type CGI Sheet Shed of size (3.4X5.0X3.7)
mtr. For mine view point” at Kulda-OCP of Basundhara Area, against tender notice no.
MCL/BA/PO/KOCP/E&M/202125 Dated.03.03.2021 and I offer to execute the work in accordance with all the
terms, condition and provision of the bid.
my firm.
eligible to submit bids in CIL and its subsidiaries. This banning shall be done under the provision the NIT with the
approval of “Tender Accepting Authority” with information to all concerned and online blocking of the bidder
shall be done on receipt of written communication from the “Tender Inviting Authority” by application admin of
CIL e-Procurement Portal.



AFFIDAVIT
I, Laxmidhar Pani S/o. Late Purna Ch. Pani aged about 45 years. Proprietors of M/s. J.P Engineers,
resident of Beheramal, Po/ Dist Jharsuguda (Odisha) 768203, do hereby solemnly affirm & state as
follows:-
1. That, I am the absolute owner and sole proprietor in respect of my firm, namely M/s. J.P Engineers,
bearing my permanent account no. AZYPP5897R and GSTIN No. 21AZYPP5897R1ZV respectively
and I am also in peaceful physical condition possession over the same in my own right, title and interest
without anybody’s interference from any quarter at any point of time.
2. That, I am swearing this affidavit to produce it before the concerned Mahanadi Coalfields Limited
authority in order to prove my legal status with M/s. J.P Engineers for all purposes such as Central
Government/ State Government/ Semi Government Organization/ Public and Pvt. Concerned etc.
3. That the facts stated above in this affidavit are all true and correct to the best of my knowledge, belief
and information.

AFFIDAVIT
I, Bijoy kumar Pani S/o. Lt.Purna Ch. Pani aged about 59 years Occupation -Business, resident of Beheramal,
1. That, I am submission tender for the work “Providing & Pasting Retro reflective Tape2” for all HEMMS at
Lakhanpur- OCP of Lakhanpur Area, against tender notice no. MCL/LA/LKPOCP/MGR/Safety/21-22/511 Dated.
12.11.2021 and I offer to execute the work in accordance with all the terms, condition and provision of the bid.
my firm.
eligible to submit bids in CIL and its subsidiaries.

AFFIDAVIT
01. That the deponent was awarded with the work “Making & Fabrication of steel lighting tower of
height 5.5mtr. For lighting at Garjanbahal OCP of Basundhara Area. Vide work order
no:MCL/GM/BA/E&M/2021-22/WO/85 Date-23.09.2021.
Site handover.
working less than 30 days also he has not engaged more than 19 labours in a day. So that LPC & CMPF
is not applicable for this work.
AFFIDAVIT
I, Bijoy kumar Pani S/o. Sri Purna Ch. Pani aged about 59 years Occupation -Business, resident of Beheramal,
01. That, I am the absolute owner and sole proprietor in respect of my firm, namely M/s. S. N. Enterprises,
Beheramal, Po/ Dist.-Jharsuguda (Odisha) having its GST Registration No:21BAQPP2960K1ZD under the Orissa
Sales Tax Act. and PAN Card No. BAQPP2960K under the Indian Income Tax Act. and I am also in peaceful
physical condition possession over the same in my own right, title and interest without anybody’s interference from
any quarter at any point of time.
02. In DSC/Aadhar card my name is mentioned as BIJAY KUMAR PANI and that the name mentioned in GST
Registration and others i.e. BIJOY KUMAR PANI are name of the same and one person.
03. That, I am swearing this affidavit to produce it before the concerned Mahanadi Coalfields Limited authority in
order to prove my legal status with M/s. S.N. Enterprises for all purposes such as Central Government/ State
Government/ Semi Government Organization/ Public and Pvt. Concerned etc.
04. That the facts stated above in this affidavit are all true and correct to the best of my knowledge, belief and
information.

AFFIDAVIT
I, Bijoy kumar Pani S/o. Lt.Purna Ch. Pani aged about 59 years Occupation -Business, resident of Beheramal,
1. That, I am submission tender for the work “Supply & Fixing of Flex Banner without frame at Lakhanpur- OCP
of Lakhanpur Area, against tender notice no. MCL/LA/LKPOCP/MGR/Safety/21-22/510 Dated. 12.11.2021 and I
offer to execute the work in accordance with all the terms, condition and provision of the bid.
my firm.
eligible to submit bids in CIL and its subsidiaries.

AFFIDAVIT
01. That the deponent was awarded with the work “Fabrication of coupling of Motor & Pump of M&P
Make GST 250/350 and 10/12 PLURO 4XCHR” at LKPOCP of LKPA. Vide work order no:
MCL/LA/LKPOCP/E&M/WO/21-22/30 Dt.05.12.2021.
02. That the deponent declares that he has not employed any labour for 30 days continuously to work,
also he has not engaged more than 19 labour in a day for the discharges of his contractual work.
03. That, the deponent has engaged in his own work shop for doing this job work and after the
Completion of the work as per delivery schedule and deliver the material at site. So that LPC & CMPF is
not applicable for this work.


AFFIDEVIT

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AFFIDAVIT

1. I am submitting Tender for Supply of Blasting Shelters against NIT No.

Signature of the Tendered

Signature & Seal of Notary.

Signature of the Tendered

Signature & Seal of Notary.

Your NIT No: MCL/GM/IBV/MM/ET/F167/15-16/26

For Sri Krishna Engineers.

Your NIT No: MCL/GM/IBV/MM/ET/F167/15-16/26

For Sri Krishna Engineers.

Your NIT No: MCL/GM/IBV/MM/ET/F167/15-16/26

Prop. Of M/s. Sri Krishna Engineers.

Your NIT No: MCL/GM/IBV/MM/ET/F167/15-16/26

For, Sri Krishna Engineers.

For, Sri Krishna Engineers

3. All scanned copy of documents uploaded by me / us in support of the information

I/We have been banned by the organization named “--------- xxxxxxx--------------“for a

5. If any information furnished by me / us online and scanned copy of documents uploaded

Signature of the Tendered

Signature & Seal of Notary

I/We, ----------------------------------------------------, authorized representative of M/s.

1. I/We am/are submitting Tender for supply of ---------------------------------------------

6. If any information furnished by me / us online and scanned copy of documents uploaded in

Signature of the Tendered

BEFORE THE NOTARY PUBLIC: JHARSUGUDA

Identified by Me. DEPONENT

Advocate, Jharsuguda NOTARY PUBLIC: JHARSUGUDA

NB: NJSP worth of Rs.10/- is not available

BEFORE THE NOTARY PUBLIC: LAKHANPUR

Identified by Me. DEPONENT

Advocate, Jharsuguda NOTARY PUBLIC: LAKHANPUR

NB: NJSP worth of Rs.10/- is not available

BEFORE THE NOTARY PUBLIC: LAKHANPUR

I Sri---------------------------------------------------S/o. --------------------------------------------- Proprietor of M/s.

1. That, I am submission tender for the work

Identified by Me. DEPONENT

Advocate, Jharsuguda NOTARY PUBLIC: LAKHANPUR

NB: NJSP worth of Rs.10/- is not available

BEFORE THE NOTARY PUBLIC: JHARSUGUDA

Identified by Me. DEPONENT

Advocate, Jharsuguda NOTARY PUBLIC: JHARSUGUDA

NB: NJSP worth of Rs.10/- is not available

BEFORE THE NOTARY PUBLIC: LAKHANPUR

Identified by Me. DEPONENT

Advocate, Jharsuguda NOTARY PUBLIC: LAKHANPUR

NB: NJSP worth of Rs.10/- is not available

BEFORE THE NOTARY PUBLIC: LAKHANPUR

Identified by Me. DEPONENT

Advocate, Jharsuguda NOTARY PUBLIC: LAKHANPUR

NB: NJSP worth of Rs.10/- is not available

BEFORE THE NOTARY PUBLIC: LAKHANPUR

Identified by Me. DEPONENT

Advocate, Jharsuguda NOTARY PUBLIC: LAKHANPUR

NB: NJSP worth of Rs.10/- is not available

BEFORE THE NOTARY PUBLIC: LAKHANPUR

Identified by Me. DEPONENT

Advocate, Jharsuguda NOTARY PUBLIC: LAKHANPUR

NB: NJSP worth of Rs.10/- is not available