ANNEXURE-I

EXPERIENCE OF THE BIDDER

Sl. Name of the Ordering Authority Value of Date of Remarks

No. relevant the work Completion
Assignment

(*) Documentary evidence in form of Purchase Order/ Work Order and Citation from clients
stating completion of the project to be submitted.

Signed By:……………………………………………………………………………………
Name:…………………………………………………………………………………………
Designation:………………………………………………………………………………….
Organization:…………………………………………………………………………………
Date & Place:…………………………………………………………………………………
Phone/Fax/Mobile/Email:……………………………………………………………………
Bidder’s Stamp & Seal:……………………………………………………………………...

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 ANNEXURE-II

Undertaking/Self-Declaration

1. I,......................................................Son/Daughter/Wife of Shri……………………………
Proprietor/firm/Agency/Company/Contractor /authorized signatory of the Service Provider
mentioned above, am competent to sign this declaration and execute this tender document.
2. I/We,......................................................................................................(Name of the Bidder)
Proprietor/Agency/Company/Contractor incorporated under the provisions of the Indian
Companies Act/ Proprietorship Firm registered under Indian Partnership Act/ Sole
Proprietor/Registered under Govt. having its office at………………………………..and
represented through Sh ……………………………………………….duly authorized person
(…………………………….. Designation) hereby solemnly declares & affirms that
We,……………………………………………….….(Name of the Bidder) have not been
blacklisted/debarred/disqualified by any Govt. or any of its agencies or PSU etc. from the
date of its inception till date.

3. I have carefully read and understood all the terms and conditions of the tender and
undertake to abide by them.

4. The information/documents furnished along with the above application are true and
authentic to the best of my knowledge and belief. I am well aware of the fact that furnishing
of any false information/fabricated document would lead to rejection of my tender at any
stage besides liabilities towards prosecution under appropriate law.

Signature of the Tenderer

Name/Seal:-
Address:

Place:

Date:

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 ANNEXURE-III

NO RELATION CERTIFICATE

I, Sri________________________, GEN/OBC/ST/SC (mark √ where is applicable), class

“_____” Contractor, son of ________________residing at my present
address____________________ ________________________ and participating in the tender
for the work“___________________________________________________________

_________________________________ vide e-Procurement Notice No-

___________________

of the Unit Head, BHEP, Balimela, Malkangiri do hereby declare that I have no relation
with any officer of Balimela Hydro Electric Project/OHPC LTD., Govt. Of Odisha by which the
tender process will be affected.

Signature:-

Name of Tenderer:-

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 ANNEXURE-IV
PERFORMANCE BANK GUARANTEE FORMAT

This Guarantee Bond is executed this …………… day …………of ……….2021

by us, the …………………………………(Bank) At …………….
P.O…………………………….…P.S…………………..…… Dist. ……………………….
State……………..WHEREAS the Odisha Hydro Power Corporation Ltd., a body
corporate constituted under the Odisha Electricity Reform Act, 1995 (hereinafter called
the OHPC) has placed work orders No. ………dt. …………….(Hereinafter called “the
agreement” on M/s………………………….....……………………………………………
(Hereinafter called “the firm”) for Construction of Cable Trench work AND

WHEREAS the firm has agreed to undertake the above maintenance services as per
scope of work indicated in the work order, AND WHEREAS OHPC has agreed (1) to
release payment to the firm as per the said agreement and, (2) The firm is agreed to
furnish Performance Bank Guarantee to OHPC of the value of 10% (ten percentage) of
the value of the said agreement.

NOW THEREFORE in consideration of the above we, the

………………………………………….... Bank (hereinafter referred to as ‘the bank’) do
hereby undertake to pay to the OHPC an amount not exceeding Rs……………….
(Rupees.…………………………………………………….) against any loss or damage
caused to or suffered by or would be caused to or suffered by the OHPC by reason of
any breach of contractual obligation by the said firm or violation of any of the terms &
conditions contained in the said agreement.

2. We, (the ...……………………………………Bank) do hereby undertake to pay the

amounts due and payable under this guarantee without any demur, merely on a
demand from the OHPC stating that the amount claimed is due by way of loss or
damage caused to or suffered by the OHPC by reason of any breach by
the said firm of any of the terms & conditions contained in the said agreement or
by reason of the firm (s) failure to perform as per the said agreement. Any such
demand made on the Bank shall be conclusive as regards to the amount due and
payable by the Bank under this guarantee. However, our liability under this
guarantee shall be restricted to an amount not exceeding Rs……………..
(Rupees ………………………………………...) only.

3. We, the ……………………………………………… Bank also undertake to pay to

the OHPC any money so demanded not withstanding any dispute or disputes
raised by the firm (s) in any suit or proceeding instituted / pending before any
Court or Tribunal relating thereto, our liability under this being absolute &
unequivocal. The payment so made by us under this Bond shall be a valid
discharge of our liability for payment hereunder and the firm (s) shall have no
claim against us for making such payment.

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4. We, .…………..…………………………………………………. further agree that the
guarantee herein contained shall remain in full force and effect during the period
that would be taken for the performance of the said agreement and that it shall
continue to be so enforceable till all the dues of the OHPC under or by virtue of
the said agreement have been fully paid and its claims satisfied or discharged or
till Sr. General Manager, BHEP, Odisha Hydro Power Corporation Ltd., Balimela
certifies that the terms and conditions of the said agreement have been fully and
properly carried out by the said firm and accordingly discharges this guarantee.

5. Unless a demand or claim under this guarantee is made on us in writing on or

before, ……………………………………………….. we shall be discharged from all
liability under this guarantee thereafter.

6. WE, (……………………………………………………………) further agree that the

OHPC shall have the fullest liberty without our consent and without affecting in
any manner our obligations hereunder to vary any of the terms and conditions of
the said agreement or to extend time period of performance by the said firm and
we shall not be relieved from our liability by reason of any such variations or
extension being granted to the said or for any forbearance, act or omission on
the part of the OHPC or any indulgence by the OHPC to the said firm (s) by any
such matter or thing whatsoever which under the law relating to sureties would,
but for this provisions, have effect of so relieving us.

7. This guarantee will not be discharged due to the change in the name, style and
constitution of the bank or the firm.

8. WE, (………………………………………………………) lastly undertake not to

revoke this guarantee during its currency except with the prior consent of the
OHPC in writing.

For & on behalf of

Signature of the constituent Authority of the Bank with Seal.

WITNESS: (1)

WITNESS: (2)

2. Name of the Firm 3. No. & Date of Performance Bank

Guarantee:

4. Name of the Bank: 5. Validity period or date up to which the

guarantee is valid

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