(rfq) document for development of four laning of rewa ring road on ...

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RFQ <strong>document</strong> <strong>for</strong> <strong>development</strong> <strong>of</strong> Four Laning <strong>of</strong> Rewa Ring Road on BOT (Toll + Annuity) basis<strong>of</strong> Financial Close in accordance with the Concession Agreement.} $In witness there<strong>of</strong>, I/ we submit this application under and in accordance with theterms <strong>of</strong> the RFQ <strong>document</strong>.Yours faithfully,Date:Place :(Signature, name and designation <strong>of</strong> the AuthorisedSignatory)Name and seal <strong>of</strong> the Applicant/ Lead MemberNote: Paragraphs in square parenthesis may be omitted, if not applicable, ormodified as necessary.__________________________$Omit if the Applicant is not a Consortium.NIT No. MPRDC/BOT (T+A)/PQ/2012/ 7783 Bhopal, dated 27.09.2012 - 46 -
RFQ <strong>document</strong> <strong>for</strong> <strong>development</strong> <strong>of</strong> Four Laning <strong>of</strong> Rewa Ring Road on BOT (Toll + Annuity) basisDetails <strong>of</strong> ApplicantANNEX-I1. (a) Name:(b)(c)(d)Country <strong>of</strong> incorporation:Address <strong>of</strong> the corporate headquarters and its branch <strong>of</strong>fice(s), ifany, in India:Date <strong>of</strong> incorporation and/ or commencement <strong>of</strong> business:2. Brief description <strong>of</strong> the Company including details <strong>of</strong> its mainlines <strong>of</strong> business and proposed role and responsibilities in this Project:3. Details <strong>of</strong> individual(s) who will serve as the point <strong>of</strong> contact/communication <strong>for</strong> the Authority:(a)(b)(c)(d)(e)(f)(g)Name:Designation:Company:Address:Telephone Number:E-Mail Address:Fax Number:4. Particulars <strong>of</strong> the Authorised Signatory <strong>of</strong> the Applicant:(a)Name:(b) Designation:(c)(d)(e)Address:Phone Number:Fax Number:5. In case <strong>of</strong> a Consortium:(a)(b)(c)The in<strong>for</strong>mation above (1-4) should be provided <strong>for</strong> all theMembers <strong>of</strong> the Consortium.A copy <strong>of</strong> the Joint Bidding Agreement, as envisaged in Clause2.2.6(g) should be attached to the Application.In<strong>for</strong>mation regarding the role <strong>of</strong> each Member should beNIT No. MPRDC/BOT (T+A)/PQ/2012/ 7783 Bhopal, dated 27.09.2012 - 47 -
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