440 021 REGISTRATION FORM FOR

Ministry of DefenceOrdnance Factory AmbajhariNAGPUR - 440 021REGISTRATION FORM FOR CIVIL & ELECTRICAL WORKSInterested contractors who are working in Civil Works (Building & Road) / Electrical Workswith Central Government Departments / Central PSUs/ Ordnance Factories may download &submit (by hand/post) the Registration form so as to reach the Central Office of this factory onor before 31.11.2012 duly filled in along with demand draft of $ 1000/- ($ One Thousand only/-)non refundable as processing fee drawn in favour of General Manager, Ordnance FactoryAmbajhari, Nagpur – 440 021. Name of the firm must be clearly mentioned on the reverse ofDemand Draft.ClassUpper Tendering limit($ In lakhs)Value of Standing SecurityDeposit($ In Lakhs)Limit of minimum reserves/total ofmovable or immovable property orfixed assets (in case of companies)(80% of minimum reserves/assetsshall be in shape of immovableproperty) ($ In Lakhs)(1) (2) (3) (4)A 750.00 7.00 75.00B 300.00 4.00 60.00C 100.00 1.75 25.00D 50.00 1.00 12.50E 25.00 0.50 8.00Proposed Registration is for period of 03 years.*********************************************************************************************To,The General ManagerOrdnance Factory Ambajhari,Nagpur - 440 021Sir,I / We …………………………………………………………………am/ are desirous of being registered for a period of 03 years on the list of Contractors for theOrdnance Factory Ambajhari, Nagpur under Class …… (A/B/C/D/E) to undertake thefollowing categories of work (delete those not applicable) :(a) Building & Road Works and their Maintenance, Periodical Services etc.(b) Specialized jobs of Tar-felting/ Water proofing/ Anti-termite treatment.(c) Civil Engineering (Reinforced Concrete, Steel Structural work, Water Supply, SewageDisposal and Internal Sanitary Installation)(d) Supply, Fabrication and Installation of Storage Tanks and laying pipes etc..(e) Architectural and Land- Escaping work.(f) Sanitation, Sweeping and De-jungling work.(g) Industrial & Domestic Electrical wiring.(h) Laying of underground cables, Lightning Protection & Earth-pits.(i) Repair/ Replacement of HT/LT overheads line and sub-stations.(j) Lifts and Electrically operated cranesUpto a value of Rs…………………and given below a statement of my / our capabilitiesand resources.Contd...2

2 //Note: For participation in tender enquiries, it is essential to get online vendor approvalfrom e-procurement portal of OFB https://ofbeproc.gov.in after purchasing ‘Class 3’Digital Signature Certificate. List of Certifying Authorities in India, which issues‘Class 3’ Digital Signature Certificate is given on the above mentioned website.1. PARTICULARS OF CONTRACTOR :Name : ..……………………………………………………………..………………..…….Proprietors / Partners : ………………………………………………………...…..………..Address for Assessment of Income Tax ………………..……………………….……….…………………………………………………………..……………………………………..Address of Business Premise:…………………………………………………...…………………………………………………………………………………………..……………2. PARTICULARS OF PROPERTY :a) Movable(Attach bankers reference / affidavit)b) Immovable(attach certificate from D.C./Collector or a First Class Magistrate/ valuation report fromRegistered Valuer and Affidavit).c) Limited Liability Companies(Copy of last balance sheet audited by Chartered Accountants)d) List of T & P/Machinery/Transport in various categories held in possession.3. PARTICULARS OF EXPERIENCE(a) Work carried out for the past 7 years including highest value work done in single order.(Note: - Attach a list showing clearly that name of the work, work order No.,Amount, Agency and the completion date along with performance certificate fromthe office not below the rank of Executive Engineer)Please submit information in the following format using extra sheets & enclose copies ofthe supporting documents.(a) Details Of Works Completed in Last Five Years :Sl.NoContractPlacingAgencyContractNo. & dateValueof workLocationof WorkDescription &Nature of WorkCompletionAmountDt. ofCompletionContd….3

Sl.No// 3 //(b) Details Of Current /Ongoing Contracts/ Works :Contract PlacingAgencyContractNo. & dateValueof workLocationof WorkDescription &Nature of WorkStatus4. PARTICULARS OF THE FIRM :Head Office……………………………………….………Telephone No……………………………… Local Office………….……………………e-mail address……………………Workshop……………………………………………………………………………….Plant…………………………………………………………………………………….…Transport……………………………………………………………...……………………(a) Particulars of persons holding power of Attorney …………………...…………………..(b) Principal Banker……………………………………………………………….• Type Of Account………………………………………………..……………..• Account No……………………………………………………….……………• Credit & Overdraft Facility & Limit…………………………………..………(c) Particulars of all Companies/ Firms /Association in which the applicant is substantiallyinterested in his individual or fiduciary capacity……………...………………………….………………………………………………………………………………………………………………………………………………………………………………………….(d) Weather enrolled as a member of any Builder’s Association? If so give the name of theAssociation and the date of enrolment….………………………………………………...………………………………………………………………………………………………………………………………………………………………………………………….(e) No. of monthly paid persons employee by you and their capacity ……………………….(f) Possessions of PAN No., TAN No. & TIN No. (copies to be enclosed).(g) Valid State/ VAT / Central Sales Tax Registration Certificate (copies to be enclosed).(h) E.P.F. Registration No. & Other Details (copies to be enclosed).(i) Annual turnover certificate from CA/ Income tax deduction at source (TDS) certificatesfrom authority in support of annual turnover during last three years (copies to beenclosed).(j) Income Tax Returns for Three Years (copies to be enclosed).(k) Balance sheet of last three years in case of limited companies. (copies to be enclosed)(l) Affidavit that no litigation is pending against the Contractor/ Firm.(m) Character Certificate/ verification of antecedents issued by the Police Authority.(copies to be enclosed)Contd….4

4 //5. PARTICULARS OF TECHNICALS / SUPERVISING STAFF :(Separate sheet to be enclosed given following particulars)Name and permanent addresses of persons employedQualification: Engineer graduate/ Diploma/ Matriculation/ GraduationWork Experience………………………………6. SOLVENCY CERTIFICATE :Name of Bank / Court / Corporate / Undertakings………….………Amount Rs………….(Certificate to be enclosed).7. DETAILS OF REGISTRATION WITH CENTRAL GOVT. DEPTTS./CPSUs/ORDNANCE FACTORIES(i) Name of formation : …………………………………………………………………(ii) Category, limit and Index No. ………………………………………………………….(iii) Locality or area for which enlisted …………………………………………………….(iv) State weather you were ever debarred/ blacklisted or banned for the tender enquiry.(Submit in affidavit with verification).(v) Contractors applying for registration of electrical works must also attach the copies ofthe following documents:• Electrical Contractor License.• Electrical Supervisory Competency Certificate issued by the competent authority forelectrical works.8. Details of Construction / Testing / Quality Control Equipments owned by the Firm :(attach separate sheet if required)________________________________________________________________________Sl. No. Name of Equipment Date of Purchase________________________________________________________________________9. Detail of Important Facilities & Infrastructure: (attach separate sheet if required)________________________________________________________________________________________________________________________________________________10. Bank Account Details :1. Name of Account Holder(s) :________________________________________2. Name of the Bank :________________________________________3. Branch Address :________________________________________4. Account No. :________________________________________5. IFSC/RTGS Code :________________________________________6. MICR Code :________________________________________Contd…5

11. DECLARATION :// 5 //a) Contractor/Corporation wishing to be registered as an approved contractor shallsubmit a list of those persons who are working with him/it in any capacity and whoare ‘near relatives’ of any gazetted / commissioned officer in the OFAJ or of anygazetted officer of the Ministry of Defence. The Contractor / Corporation shall alsointimate names of such persons if they are subsequently employed by him / it.(Note: - By the term “near relative” is meant wife, husband, parents, children,brothers, sisters, brother/ sister– in– law, Son / Daughter– in–law, uncle, first cousinand father / mother –in-law).b) I / We agree to notify the officer accepting this application and registering my / ournames on the OFAJ list of contractors of any changes if the foregoing particularsas they occur and to verify and confirm these particulars, annually on 1 st January.c) I / We agree to execute a BOND in favour of the President of India in the form and tothe amount prescribed as security against proper performance of work entrusted to me/ us for execution in accordance with the applicable conditions of contract, as acondition precedent to my / our name being registered on the OFAJ list of contractors.d) I / way understand and agree that the appropriate OFAJ Authority has the right as hemay decide, so, to issue tender form in any particular case and also to suspend,remove or black - list my / our name from the OFAJ list of contractors if the event ofmy / our submission of non-bonafide tenders or for technical of other delinquency inregard to which the decision of the appropriate OFAJ Authority shall be finial andconclusive.e) I / We certify that the above particulars are correct and that should it be found that I /We have given a false certificate, or that if I / We fail it to notify the fact of my / oursubsequent amalgamation with another contractor of firm, My / Our name will beremoved from the OFAJ list of contractors and any contract the I / may be holding atthe time is liable to be rescinded.f) I / We undertake not to employ directly or indirectly any Army personnel dismissedfrom service in my/our business.(The term "Army Personnel” is intended to include Government Servant also)g) I/We note that registration, as contractor does not carry with it the right to tender for0works.Yours faithfully,Date:(Signature of Authorised Signatory of firm with Name & seal)Place:DECLARATIONI/we confirm that the information furnished above is correct to the best of my knowledge& belief. In the event of any information given by me/us is found in-correct/false at any time or ifI / we fail to notify the fact of my/our subsequent amalgamation with another contractor or firm,I/we understand our registration will be cancelled without notice, besides any other appropriateaction against me/us.DATEPLACE(Signature of Authorised Signatory of firm with Name & seal)Contd…6

6//Documents Submission Check ListImportatnt :The following documents are required to be submitted by the firm (with proper binding) forconsideration of Registration in applied category. The documents must be enclosed as perthe following sequence by confirming the tick mark on (Yes/No/NA) failing which theirapplication is liable to be rejected.1. Application (Processing) Fee in the form of Demand Draft (Non-refundable) of $ 1000/- (Yes/No)($ One Thousand only) from any Nationalised / Scheduled Bank.2. Two Photographs of Proprietor / Partners / Directors (stappled on Registration form) (Yes/No)3. Work Done Certificates for works carried out during last 07 years showing clearly (Yes/No)the name of the work, work order No., Amount, Agency and the completion datealong with performance certificate from the office not below the rank of Executive Engineer.4. Copy of PAN No. (Yes/No)5. Copy of VAT No. (Yes/No)6. Copy of TIN No. (Yes/No)7. Copy of E.P.F. Registration No. (Yes/NA)8. Income Tax Returns for last Three Years / Balance sheet from CA of annual turnover (Yes/No)during last three years in support of Working Capital.9. Details of registration with central govt. deptts./ Central PSUs/Ordnance Factories. (Yes/No)For Electrical Works : Contractors applying for registration of electrical works must also attach theadditional copies of the following documents: -(i) Electrical Contractor License. (Yes/NA)(ii) Electrical Supervisory Competency Certificate issued by the competent authority (Yes/NA)(Central Govt. Dept./Central PSUs) for electrical works.(Yes/No)10. Character Certificate/ verification of antecedents issued by the Police Authority. (Yes/No)11. Solvency Certificate from Nationalized / Scheduled Bank as per specimen given. (Yes/No)ORWorking capital certificate from the Scheduled Bank/CA as per specimen given.(Yes/No)12. Immovable Property Valuation report from Registered (with any Government body) valuer (Yes/No)clearly indicating ownership details. Alternatively the Contractor may submit certificate fromthe Deputy Commissioner/Collector/ Judicial Magistrate or assessment of wealth tax authorities.13. Copy of agreement deed for Partnership / Pvt. Ltd firm. (Yes/No)14. Copy of power of attorney given to any person/partner/director by the Contractor. (Yes/NA)15. Experience and Degree/Diploma certificates of Engineers. (Yes/No)16. Memorandum and Articles of Association in case of Limited Companies. (Yes/NA)Contd…7

7 //17. Affidavits :(a) Affidavit for immovable properties indicating present market value and containing followingendorsements:(Yes/No)(i)That the immovable property is free from mortages, hypothecation or any other disputes andencumbrances and clearly belongs to the Contractor.OrThat the immovable property is free from any disputes and encumbrances and clearly belongsto the Contractor. The immovable property has been mortgaged / hypothecated for $ _______,Market value of immovable property as per valuation report No. _______ given by Registeredvaluer _______ is $ _____, Therefore balance market value of property i.e $ ___ (Market valueminus mortgaged value) is free from any mortgage/hypothecation.(ii)That the said immovable property has not been shown for seeking enlistment of otherordnance factory.That the said immovable property will not be sold, transferred, gifted or otherwise disposed off withoutprior intimation to the registering authority in OFAj. While giving such prior intimation, new affidavit foralternate immovable property of value at least equal to minimum requirement as per scales along withvaluation report from registered valuer shall also be submitted; failing which the Registering Authority maydeclare the contractor un-enlisted or may take action as deemed fit acquiring alternate immovable propertyby the Contractor.Note :(iii)In case of partnership firm, the partner having immovable property in his name, shall also endorsethe following in addition to above :“Irrespective of any share in partnership firm, my whole property may be utilized by theGovernment for realizing their dues/recovery, if the firm fails to deposit the same”(b) Affidavit for T & P, machinery, transport etc.(c) Affidavit that the firm is not debarred/ blacklisted or banned for the tender enquiry.(d) Affidavit that no near relative(s) of the contractor is/are working as Gazetted/CommissionedOfficer / Junior Engineer in Ordnance Factory Ambajhari. If his near relative(s) is / areworking in such capacity, the contractor shall furnish details.(Yes/No)(Yes/No)(Yes/No)(e) Affidavit from Contractor for employment of Engineers.(f) Affidavit from contractor that there is no Government dues/recovery outstanding against him.(If there is any Government dues / recovery outstanding from the Contractor, enlistment/up-gradation shall not be done).(Yes/No)(Yes/No)(g) Affidavit from Contractor that he is not involved in any arbitration/litigation cases.(Yes/No)Notes : (i) All the documents submitted by the Contractor shall be signed by him.(ii) Photo copies of documents shall be attested by the Gazetted Officer/Notary Public.(iii) All the affidavit shall be given on non-judicial stamp paper of appropriate value duly signed by thecontractor and attested by the Magistrate/notary public.On receipt of letter from enlisting authority, the contractor shall furnish the following:(a) Standing security deposit of appropriate value.(b) Standing security bond (Bond to secure performance) on non-judicial stamp paper of appropriate value dulysigned by Contractor and attested by Magistrate/Notary Public.

FORMAT OF SOLVENCY CERTIFICATE FRON NATIONALISED / SCHEDULEDBANKThis is certified that to the best of our knowledge and information M/s / Shri / Smt.…………………………… having address, a customer of our bank are/ is respectable and can beconsidered solvent upto $ …………………… (Rupees……………………………….)/financially sound for any engagement upto ($ …………………………….). This certificate isissued without any guarantee or responsibility on the bank or any of the officers.Signature of Authorised Signatory of firm with Name & seal)Note : In case of partnership firm, certificate to include names of all partners as recorded withthe bank.

FORM OF WORKING CAPITAL CERTIFICATE FROMNATIONALISED/SCHEDULED BANKThis is certified that M/s / Shri / Smt ………………………… having address……………………………………… has/ have been maintaining a saving bank account/ currentaccount/ fixed deposit account with this branch of bank since ………………………. and the firmis having working capital of approximately $ ………………………… and /or the firm isenjoying overdraft/ credit facilities upto limit of $ ……………………This certificate is issuedwithout any guarantee or responsibility on the bank or any of the officers.Signature of Authorised Signatory of firm with Name & seal)