For Individual Bidder(s). The E-bidder’s need to key in their personal information (correspondence address & telephone contact number) accurately for online registration and upload the bidder’s NRIC (both sides) to ESZAM AUCTIONEER SDN BHD website.

For Individual Bidder(s). 1.1 Constitution or legal status of Bidder Place of registration: Principal place of business: Power of attorney of signatory of Bid

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For Individual Bidder(s). Principal place of business:

For Individual Bidder(s). Constitution or legal status of Bidder [Attach Copy] Place of Registration: Principal Place of Business: Power of Attorney of Signatory of Bid [Attach] Total value of Civil Engineering construction work performed in the last Five years 2008 - 2009 (In Rs. Million) 2009 - 2010 (Attach Certificate from 2010 - 2011 Chartered Accountant) 2011 - 2012 2012 – 2013 1.4.1 Work performed as prime contractor, work performed in the past as a nominated sub-contractor will also be considered provided the sub-contract involved execution of all main items of work described in the bid document, provided further that all other qualification criteria are satisfied (in the same name) on works of a similar nature over the last five years. Sl. No. Name of the Employer Description of Work Contract No. Value of Contract (Rs. in Crore) Date of Issue of work order Stipula xxx period of compl etion Actual Date of Complet ion (Attach Certifica te from Enginee r-In- Charge) Remarks explaining reasons for delay & work completed 1.3.2 Quantities of work executed as prime contractor, work performed in the past as a nominated sub-contractor, will also be considered provided the sub-contract involved execution of all main items of work described in the bid document, provided further that all other qualification criteria are satisfied (in the same name and style) in the last five years. Year Name of the Work Name of the Employer Quantity of Work performed (Cu m) Remarks Steel Reinfo rceme nt Remarks (indicate contract Ref) (Attach Certificate from Engineer- In-Charge) Cement Concrete (including RCC & PCC) Brick Work 2008- 2009 2009- 2010 2010- 2011 2011- 2012 2012- 2013

For Individual Bidder(s). 1.1 Constitution or legal status of Bidder (Attach Copy) Place of registration: Principal place of business: (Power of attorney of signatory of Bid) (A) Value of work Completed during the last five years (in Rs. Lakh) Total value of Work Executed in the last five years** 2015-16 ** Immediately preceding the financial year in which bids are received. Attach certificate from Chartered accountant. (B) Existing commitments and on-going works: (format for clause 3.7) I. Financial Analysis-Details to be furnished duly supported by figures in balance sheet/profit & loss account for the last five years duly certified by the Chartered Accountant, as submitted by the applicant to the Income tax Department (Copies to be attached.) II. Financial arrangements for carrying out the proposed work. III. Solvency Certificate from Bankers of the bidder in the prescribed Form” I” Signature of the Manager Seal of Bank Note :This certificate should be issued on the letter head and addressed to the DIRECTOR , Main Building, Xx. XXXX XXXXXXX ROAD, IISER, PUNE – 411 008 in a Sealed Cover SIGNATURE OF BIDDER(S)

For Individual Bidder(s). 1.1 Constitution or legal status of Bidder Place of registration: Principal place of business: Power of attorney of signatory of Bid 1.2 Total value of Civil Engineering construction 2004-2005  work executed and payments received in the last five years** 200 (in Rs. Million) 2006-2007 2007-2008 2008-2009 1.3.1 Work performed as prime contractor (in the same name) on works of a similar nature over the last five years. ** Project Name Name of the Employer* Descrip- tion of work Contrac t No. Value of contract (Rs. Million) Date of issue of work order Stipulate d period of completi on Actual date of completion * Remarks explainin g reasons for delay and work completed 1.3.2 Quantities of work executed as prime contractor (in the same name and style) in the last five years: ** Year Name Name Quantity of work performed (cum) @ Remarks * 2004-2005 2005-2006 2006-2007 2007-2008 2008-2009 of the Work Cement concrete (including RCC&PCC) E/works *Attach certificate(s) from the Engineer(s)-in-Charge @The item of work for which data is requested should tally with that specified in ITB clause 4.5A(c). ** immediately preceding the financial year in which bids are received. XXX.XX/W-2 1.4 Information on Bid Capacity (works for which bids have been submitted and works which are yet to be completed) as on the date of this bid. (A) Existing commitments and on-going works: Description Place Contract No. Name Value of Stipulated Value of works* Anticipated of & & Date and Contract period of remaining to be date of Work State Address (Rs. million) completion completed completion of Employer (Rs. million) (1) (2) (3) (4) (5) (6) (7) (8) (B) Works for which bids already submitted: Description Place Name and Estimated Stipulated Date when Remarks of & Address of value of works period of decision is if any Work State Employer (Rs. million) completion expected (1) (2) (3) (4) (5) (6) (7) * Attach certificate(s) from the Engineer(s)-in-Charge.

For Individual Bidder(s). 1.1 Constitution or legal status of Bidder Place of registration: Principal place of business: Power of attorney of signatory of Bid 1.2 Total value of Civil Engineering construction Work executed and payments received in the last five years** (In Rs. Million) 2005- 2006 β 2006- 2007 2007- 2008 2008- 2009 2009- 2010 1.3.1 Work performed as prime contractor (in the same name) on works of a similar nature (STP, ETP, Sewerage Collection System, Sewage Pumping Stations only) over the last five years. ** Project Name Name of the Employer Descripti on of work Contract No. Value of contract (Rs. Date of issue of work order Stipulated period of completion Actual date of completion Remarks explaining reasons for delay and work completed ** (List all STP / ETP designed / constructed by the firm in the last 5 years with details.) 1.3.2 Quantities of work executed as prime contractor (in the same name and style) in the last five years: i.e., 2005-06 to 2009-10 Year Name Name Quantity of work performed (MLD) Remarks * 2005-2006 2006-2007 2007-2008 2008-2009 2009-2010 of the Work of the * STP/ETP Capacity not less than 2 mld (indicate contract Ref) Design Construction 1.3 Information on Bid Capacity (works for which bids have been submitted and works which are yet to be completed) as on the date of this bid. Existing commitments and on-going works: Description of work Place & State Contract No. & date Name and address of Employer Value of Contract Rs. In Million Stipulated Period of completion Value of Remaining work to be completed Anticipated date of completion (1) (2) (3) (4) (5) (6) (7) (8)

For Individual Bidder(s). 1.1 Constitution or legal status of Bidder Place of registration: _______________________________ Principal place of business: _______________________________ Power of attorney of signatory of Bid 1.2 Total value of Civil Engineering construction 19-----19______________ work executed and payments received in the last five years** 19-----19______________ (in Rs. Million) 2000-2001______________ 2001-2002______________ 2002-2003______________

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