office of the chief commissioner of income-tax, aayakar bhawan ...

6ANNEXURE-1OFFICE OF THECHIEF COMMISSIONER OF INCOME-TAX,AAYAKAR BHAWAN, PAOTA C ROAD, JODHPURTechnical Bid for Providing Security Services1 Name of the concern2 Complete Address of the concern (withtelephone No., Fax & E-mail)3 Complete Names and addresses of thePartners/Directors/Proprietor with mobile no.(in case of firm/ company/ proprietorship)4 Contact person(s) (with mobile number)5 A brief note on the security related contractscarried by your concern6 Whether the concern has experience ofproviding Security services. If yes, kindlyprovide proof.7 Whether the concern has at least one“Satisfactory Performance Certificates” fromGovernment Organizations/ GovernmentUndertakings/Reputed Banks/limitedcompanies, if yes, please provide the same.8 A self signed certificate that the concern is notblacklisted or debarred from participating inthe tenders at any point of time by any of theCentral or State Government/ReputedBanks / limited companies.9 Permanent Account Number10 Copy of Income-tax Returns for F Y 2009-10,2010-11 and 2011-12 along with Balancesheet and Profit & Loss account.10 ST/PF/ESIC Registration Numbers11 Government approval registration number(Copy of certificate to be enclosed)12 Details of Earnest Money DepositDECLARATIONI hereby certify that the information furnished above is true and correct to the best ofmy/our knowledge and belief. In case any deviation /discrepancy is found in the abovestatement at any stage, the contract is liable to be terminated immediately and theconcern may be blacklisted by the competent authority.