Common use of Legal Jurisdiction Clause in Contracts

Legal Jurisdiction. The agreement shall be deemed to have been concluded in Jodhpur, Rajasthan and all obligations hereunder shall be deemed to be located at Jodhpur, Rajasthan and Court within Jodhpur, Rajasthan will have Jurisdiction to the exclusion of other courts. Complete Address, Telephone No. & Email Id Name of Proprietor/Partner/Managing Director/Director. Phone No:- Mobile No:- Email Id:- Whether the firm is a registered firm Yes/No (attached copy of certificate) Whether quoting as manufacturer/ authorised distributor/ authorised dealer PAN No. (enclose the attested copy of PAN Card) (enclose the attested copy of GST Certificate) Whether the firm has enclosed the Bank Draft/Pay Order/Banker‟s cheque as Xxxxxxx Money Deposit Whether the Firm/Agency has signed each and every page of Tender/NIT Bank Details: 1) Accounts No: 2) Bank Name: 3) Branch: 4) IFSC Code: Any other information, if necessary Place: Name: Date: Business Address: Signature of Bidder: Seal of the Bidder: Annexure-B List of Products 1 Alprazolam Tablets 0.25mg 2 Alprazolam Tablets 0.5mg 3 Alprazolam Tablets 1 mg 4 Amitriptyline Tablets 10mg 5 Amitriptyline Tablets 75 mg 6 Amitriptyline Tablets 25 mg 7 Amitriptyline Tablets 50 mg 8 Amitriptyline Tablets 100 mg 9 Amitriptyline Tablets 150 mg 10 Amitriptyline + Chlordiazepoxide Tablets 25 mg + 10mg 11 Amitriptyline + Chlordiazepoxide Tablets 12.5 mg+ 5mg 12 Betahistine Tablets 16mg 13 Betahistine Tablets 24mg 14 Betahistine Tablets 32mg 15 Botulinum Toxid Injection 100 Units 16 Bromocriptine Tablets 5mg 17 Bromocriptine Tablets 2.5mg 18 Bupenorphine +Naloxone Tablets 2 mg + 0.5mg 19 Buprenorphine Tablets 8mg 20 Buprenorphine Tablets 0.4mg 21 Buprenorphine sublingual Tablets 0.2mg 22 Buprenorphine sublingual Tablets 8mg 24 Buprenorphine sublingual Tablets 0.4mg 25 Carbamazepine Tablets 100mg 26 Carbamazepine Tablets 200mg 27 Carbamazepine Tablets 400mg 28 Carbamazepine syrup 100mg/5ml 29 Carbamazepine SR Tablets 200mg 30 Carbamazepine SR Tablets 400mg 31 Carbidopa Tablets 25mg 32 Carbidopa Tablets 50mg 33 Carbidopa Tablets 100mg 34 Chlorpromazine hydrochloride Tablets 25 mg 35 Chlorpromazine hydrochloride Syrup 25mg/5ml 36 Chlorpromazine hydrochloride Injection 25mg/ml 37 Chlorpromazine hydrochloride Tablets 50mg 38 Chlorpromazine hydrochloride Tablets 100mg 39 Cilnidipine Tablets 10mg 40 Cilnidipine Tablets 5 mg 41 Citalopram Tablets 10mg 42 Citalopram Tablets 20mg 43 Citalopram Tablets 40mg 44 Citicholine Tablets 500mg 45 Citicholine Injection 250mg/ml 46 Citicholine + Piracetam Tablets 500mg+800mg 47 Clobazam Tablets 2.5 mg 48 Clobazam Tablets 10 mg 49 Clobazam Tablets 5mg 50 Clonazepam Tablets 0.25mg 51 Clonazepam Tablets 0.5mg 52 Clonazepam Tablets 1 mg 53 Clonazepam Tablets 2mg 54 Clonazepam MD Tablets 2 mg 55 Colchicine Tablets 0.6 mg 56 Colchicine Tablets 0.5 mg 57 Colchicine Tablets 1mg 58 Conivaptan Injection 20mg/100ml 59 Deferasirox Tablets 100mg 60 Deferasirox Tablets 400mg 61 Deferasirox Tablets 250mg 62 Deferasirox Tablets 500mg 63 Deferiprone Capsules 250mg 64 Deferiprone Capsules 500mg 65 Deferiprone Tablets 500 mg 66 Deferiprone Tablets 1000 mg 67 Desvenlafaxine Tablets 50mg 68 Desvenlafaxine Tablets 100mg 69 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+325mg+1 0mg 70 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+500mg+1 0mg 71 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+650mg+1 0mg 72 Diazepam Tablets 2 mg 73 Diazepam Tablets 5mg 74 Diazepam Tablets 10mg 75 Diazepam Rectal Suppository 5mg 76 Diazepam Tablets 3 mg 77 Diazepam Rectal Suppository 2.5 mg 78 Diazepam Injection 10mg/2ml 79 Diazoxide Tablets 50 mg 80 Diethylcarbamazine citrate Tablets 50 mg 81 Diethylcarbamazine citrate Tablets 100 mg 82 Disulfiram Tablets 250mg 83 Disulfiram Tablets 500 mg 84 Divalproex equivalent to valproic acid 250 mg syrup 100 ml 85 Divalproex Sodium Tablets 250mg 86 Divalproex Sodium Tablets 500mg 87 Divalproex Sodium Tablets 125 mg 88 Divalproex Sodium Tablets 250 mg ER 89 Divalproex Sodium Tablets 500 mg ER 90 Divalproex Sodium Tablets 125 mg ER 91 Duloxetine Hydrochloride Tablets 20mg 92 Duloxetine Hydrochloride Tablets 30mg 93 Duloxetine Hydrochloride Tablets 60mg 94 Eperisone hydrochloride Tablets 150 mg 95 Eperisone hydrochloride Tablets 450 mg 96 Escitalopram Tablets 5mg 97 Escitalopram Tablets 10mg 98 Escitalopram Tablets 20mg 99 Escitalopram + Clonazepam Tablets 10mg+0.25mg 100 Escitalopram + Clonazepam Tablets 10mg+0.5mg 101 Fludrocortisone Tablets 0.1mg 102 Flumazenil Injection 0.5 mg / 5ml 103 Flumazenil Injection 1 mg / 10 ml 104 Flunarizine Tablets 5mg 105 Flunarizine Tablets 10mg 106 Fluoxetine Tablets 40mg 107 Fluoxetine Capsules 20mg 108 Fluoxetine Tablets 20mg 109 Fluoxetine Tablets 40mg 110 Fluoxetine Tablets 60mg 111 Fluoxetine Tablets 10mg 112 Fluoxetine Capsules 20mg 113 Fluphenazile decanoate Injection 125mg/5ml 114 Flupiritine Tablets 100mg 115 Flupiritine Tablets 200mg 116 Fosphenytoin Injection 50mg/ml 117 Gabapentin Tablets 400mg 118 Gabapentine Tablets 600mg 119 Gabapentine Tablets 300mg 120 Gabapentine Cap. 300mg 121 Gabapentine + Mecobalamine Tablets 300 mg+ 0.5 mg 122 Gabapentine + Nortriptyline Tablets 400 mg + 10 mg 123 Glycerol Syrup 100ml 124 Glycerol Syrup 500ml 125 Haloperidol Tablets 2mg 126 Haloperidol Tablets 5mg 127 Haloperidol Tablets 10 mg 128 Haloperidol Injection 5mg/ml 129 Hydroxyzine Tablets 10mg 130 Hydroxyzine Tablets 25mg 131 Hydroxyzine Syrup 10mg/5ml 132 Imipramine Tablets 25 mg 133 Imipramine Tablets 75 mg 134 Lacosamide Tablets 50 mg 135 Lacosamide Tablets 100 mg 136 Lacosamide Tablets 150 mg 137 Lacosamide Tablets 200 mg 138 Lacosamide Syrup 50 mg/5ml 139 Lacosamide Injection 10 mg/ml 140 Lamotrigin Tablets 25mg 141 Lamotrigin Tablets 100 mg 142 Lamotrigin Tablets 150mg 143 Lamotrigin Tablets 200 mg 144 Lecithin 30mg+ equivalent to 175 mg of essential Phospholipids (EPL)(phosphatidylcholine,phosphatidylethanolamine,phospha tidylinositol,phosphatidylserine) Capsules (350+175)mg 145 Levetiracetam Tablets 250 mg 146 Levetiracetam Tablets 500 mg 147 Levetiracetam Tablets 750mg 148 Levetiracetam Tablets 1000 mg 149 Levetiracetam Injection 100mg/5 ml. 150 Levetiracetam Syrup 100mg/ml 151 Lithium Carbonate Tablets 450mg 152 Lithium Carbonate Tablets 300mg 153 Lithium Carbonate SR Tablets 400mg 154 Lorazepam Tablets 0.5 mg 155 Lorazepam Tablets 1mg 156 Lorazepam Tablets 2mg 157 Lorazepam 2mg Injection 2 ml 158 Lorazepam 2mg Injection 4 ml 159 Magnesium Sulfate, Urea & Sulphacetamide Sdoium Ointment 75gm 160 Mefloquine Tablets 250mg 161 Melatonin Tablets 0.5mg 162 Melatonin Tablets 3mg 163 Melatonin Tablets 6mg 164 Methyldopa Tablets 250mg 165 Methyldopa Tablets 125 mg 166 Methyldopa Tablets 500 mg 167 Naltrexone Tablets 50mg 168 Naproxen Tablets 250mg 169 Naproxen Tablets 500mg 170 Naproxen Tablets 750mg 171 Naproxen + Domperidone Tablets 500mg+10mg 172 Nevirapine Tablets 200mg 173 Nevirapine syrup 10mg/ml 174 Nicotine Chewing gum Tablets 2mg 175 Nicotine Chewing gum Tablets 4mg 176 Nimodipine Tablets 30mg 177 Nimodipine Injection 10mg/50ml 178 Nitrazepam Tablets 5mg 179 Nitrazepam Tablets 10mg 180 Nortriptyline Tablets 25mg 181 Nortriptyline Tablets 10 mg 182 Olanzapine Tablets 20mg 183 Olanzapine Tablets 2.5mg 184 Olanzapine Tablets 5mg 185 Olanzapine Tablets 7.5mg 186 Olanzapine Tablets 10mg 187 Olanzapine Injection 10mg/ml 188 Oxcarbamazepine Tablets 150mg 189 Oxcarbamazepine Tablets 300mg 190 Oxcarbamazepine Tablets 600mg 191 Oxcarbamazepine 300 mg Syrups 60 ml 192 Paracetamol Injection 150mg/2ml 193 Paracetamol Injection 500mg/50 ml 194 Paracetamol 10mg/ml (PLASTIC BOT ) Injection 1 gm/ 100 ml 195 Paracetamol + Tramadol Tablets 325mg+37.5mg 196 Paracetamol 10mg/ ml (GLASS BOT ) Injection 1 gm/ 100 ml 197 Paroxetine Tablets 12.5mg 198 Paroxetine Tablets 25mg 199 Paroxetine Tablets 37.5mg 200 Pergolide Tablets 0.05mg 201 Pergolide Tablets 0.25mg 202 Pergolide Tablets 1mg 203 Phenobarbitone Tablets 30mg 204 Phenobarbitone Tablets 60mg 205 Phenobarbitone Syrup 20mg/5ml 206 Phenobarbitone Injection 200mg /1ml 207 Phenytoin Sodium Tablets 50 mg 208 Phenytoin Sodium Tablets 100mg 209 Phenytoin Sodium Injection 25mg/ml 210 Phenytoin Sodium Liquids 100ml(25mg/ml) 211 Piperazine Tablets 500 mg 212 Piperazine Syrup 750mg/5ml 213 Piracetam Tablets 800mg 214 Piracetam Syrup 500mg/5ml 215 Praziquantel Tablets 600 mg 216 Pregabaline Tablets 50mg 217 Pregabaline Tablets 75mg 218 Pregabaline Tablets 150mg 219 Pregabaline + Amitriptyline Tablets 75mg+10mg 220 Pregabaline + Amitriptyline Tablets 50mg+10mg 221 Pregabaline + Nortriptyline Tablets 75 mg+10 mg 222 Pregabaline+Methylcobalamine Tablets 75mg+750mcg 223 Pregabaline+Methylcobalamine Tablets 50mg+1500mcg 224 Pregabaline+Methylcobalamine Tablets 75mg+500mcg 225 Pregabaline+Methylcobalamine Tablets 150mg+1500mc g 226 Quetiapine Fumarate Tablets 25mg 227 Quetiapine Fumarate Tablets 100mg 228 Risperidone Tablets 4mg 229 Risperidone Tablets 3mg 230 Risperidone Tablets 2mg 231 Risperidone Tablets 1mg 232 Risperidone Tablets 0.5mg 233 Sertraline HCL Tablets 25mg 234 Sertraline HCL Tablets 50mg 235 Sertraline HCL Tablets 100mg 236 Sildenafil Citrate Tablets 50mg 237 Sildenafil Citrate Tablets 25mg 238 Sodium Valproate Tablets 200mg 239 Sodium Valproate Syrup 200mg/5ml 240 Sodium Valproate Injection 100ml/5ml 241 Sodium Valproate Tablets 300mg 242 Sodium Valproate + Valproic Acid Tablets 300mg 243 Sodium Valproate + Valproic Acid Tablets 500mg 244 Sodium Valproate + Valproic Acid Tablets 200mg 245 Sumatriptan + Naproxen Tablets 85mg+500mg 246 Tolvaptan Tablets 15mg 247 Topiramate Tablets 25 mg 248 Topiramate Tablets 50 mg 249 Topiramate Tablets 100 mg 250 Trihexyphenidyl (Benzhexol) Tablets 2mg 251 Zaleplon Tablets 5mg 252 Zaleplon Tablets 10mg 253 Zidovudine Syrup 50mg/5ml 254 Zidovudine Tablets 100mg 255 Zidovudine Tablets 300mg 256 Zolpidem Tablets 10 mg 257 Zolpidem Tablets 5mg 258 Zolpidem SR Tablets 6.25mg 259 Zolpidem SR Tablets 12.5mg Calculation of Local Content Name of Manufacture Calculation by Manufacturer (Cost per unit of product) Cost Component Cost (Domestic Component) A Cost (Imported Component) B Total Cost (INR/ US $) C=a+b Percentage of Local Content D=(a/c)*100 I. ………… II. ………… III. Total Cost (Excluding tax and duties) Note:- I. Cost (Domestic Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken) which have not been imported directly or through a domestic trader or an intermediary. II. Cost (Imported Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken). I S/o.D/o,W/o , Resident of That I will agree to abide by the terms and conditions of the policy of Government of India issued vide order no. P-45021/2/2017-B.E.-II dated 15/06/2017. That the information furnished hereinafter is correct to best of my knowledge and belief and I undertake to produce relevant records before the procuring entity or any authority so nominated by the Government of India for the purpose of assessing the local content. That the local content for all inputs which constitute the said drugs has been verified by me and I am responsible for the correctness of the claims made therein. That in the event of the domestic valve addition of the product mentioned herein is found to be incorrect and not meeting the prescribed valve-addition norms, based on Government of India for the purpose of assessing the local content, action will be taken against me as per Order No. P-45021/2/2017-B.E.-II dated 15.06.2017. I agree to maintain the following information in the Company‟s record for a period of 8 years and shall make this available for verification to any statutory authorities: i) Name and details of the Domestic Manufacturer (Registered Officer, Manufacturing unit location, nature of legal entity) ii) Date on which this certificate is issued. iii) Medicine for which the certificate is product. iv) Procuring entity to whom the certificate is furnished. v) Percentage of local content claimed. vi) Name and contact details of the unit of the manufacturer. vii) Sale Price of the product. viii) Ex-Factory Price of the product. ix) Freight, insurance and handling. x) Total Bill of Material. xi) List and total cost valve of inputs used for manufacture of the medicine certificates from suppliers, if the input is not in-house to be attached. xii) List and cost of inputs which and imported, directly or indirectly. (Also to be provided in PDF format)

Legal Jurisdiction. The agreement shall be deemed to have been concluded in Jodhpur, Rajasthan and all obligations hereunder shall be deemed to be located at Jodhpur, Rajasthan and Court within Jodhpur, Rajasthan will have Jurisdiction to the exclusion of other courts. Complete Address, Telephone No. & Email Id Name of Proprietor/Partner/Managing Director/Director. Phone No:- Mobile No:- Email Id:- Whether the firm is a registered firm Yes/No (attached copy of certificate) Whether quoting as manufacturer/ authorised distributor/ authorised dealer PAN No. (enclose the attested copy of PAN Card) (enclose the attested copy of GST Certificate) Whether the firm has enclosed the Bank Draft/Pay Order/Banker‟s cheque as Xxxxxxx Money Deposit Whether the Firm/Agency has signed each and every page of Tender/NIT Bank Details: 1) Accounts No: 2) Bank Name: 3) Branch: 4) IFSC Code: Any other information, if necessary Place: Name: Date: Business Address: Signature of Bidder: Seal of the Bidder: Annexure-B List of Products 1 Alprazolam 5 Flurouracil Tablets 0.2550mg 2 Alprazolam 5 Flurouracil Tablets 0.5250mg 3 Alprazolam Tablets 1 5-Fluorouracil Injections 250mg 4 Amitriptyline Tablets 105-Fluorouracil Injections 500mg 5 Amitriptyline Tablets 75 Actinomycin D Injection 0.5 mg 6 Amitriptyline Tablets 25 mg Alpha Interferon Injection 3 million IU 7 Amitriptyline Tablets 50 Amifostine Injections 300mg 8 Amitriptyline Tablets 100 Amifostine Injections 500mg 9 Amitriptyline Anastrazole Tablets 150 1mg 10 Amitriptyline + Chlordiazepoxide Axitinib Tablets 25 mg + 101mg 11 Amitriptyline + Chlordiazepoxide Axitinib Tablets 12.5 mg+ 5mg 12 Betahistine Tablets 16mg Bevacizumab Injection 5mg/ml 13 Betahistine Tablets 24Bevacizumab Injection 100mg 14 Betahistine Tablets 32Bleomycin Injections 15mg. 15 Bortezomib Injection 2mg 15 Botulinum Toxid 16 Bortezomib Injection 100 Units 16 Bromocriptine Tablets 515mg 17 Bromocriptine Tablets 2.5mg 18 Bupenorphine +Naloxone Busulphan Tablets 2 mg + 0.518 Capecitabine Tablets 150mg 19 Buprenorphine Capecitabine Tablets 8500mg 20 Buprenorphine Tablets 0.4Carboplatin Injections 150mg 21 Buprenorphine sublingual Tablets 0.2Carboplatin Injections 450mg 22 Buprenorphine sublingual Tablets 8mg Cisplatin Injections 10mg. 23 Cisplatin Injections 50mg. 24 Buprenorphine sublingual Tablets 0.4Cladribine Injection 10 mg 25 Carbamazepine Tablets Cyclosporine capsules 10mg 26 Cytarabine Injections 100mg 26 Carbamazepine Tablets 200mg 27 Carbamazepine Tablets 400Cytarabine Injections 500mg 28 Carbamazepine syrup 100mg/5ml Cytosine Arabinoside Injections 500mg. 29 Carbamazepine SR Tablets 200mg Cytosine Arabinoside Injections 1GM 30 Carbamazepine SR Tablets 400mg CytosineTarabinoside Injection 100 mg/vial 31 Carbidopa Tablets 25mg CytosineTarabinoside Injection 500 mg/vial 32 Carbidopa Tablets 50mg CytosineTarabinoside Injection 1000 mg/vial 33 Carbidopa Tablets Dacarbazine Injections 100mg 34 Chlorpromazine hydrochloride Tablets Dacarbazine Injections 200mg 35 Dacarbazine Injections 500mg. 36 Dactinomycin Injections 0.5mg 37 Danazol capsules 50 mg 38 Danazol capsules 100 mg 39 Darbopoetin Alfa Prefilled syringe 25 mg 35 Chlorpromazine hydrochloride Syrup 25mg/5ml 36 Chlorpromazine hydrochloride Injection 25mg/ml 37 Chlorpromazine hydrochloride Tablets 50mg 38 Chlorpromazine hydrochloride Tablets 100mg 39 Cilnidipine Tablets 10mg 40 Cilnidipine Tablets 5 Darbopoetin Alfa Prefilled syringe 40 mg 41 Citalopram Tablets 10Darbopoetin Alfa Prefilled syringe 60 mg 42 Citalopram Dastanib Tablets 20mg 43 Citalopram Dastanib Tablets 40mg 50mg. 44 Citicholine Dastanib Tablets 50070mg 45 Citicholine Daunorubicin hydrochloride Injection 250mg/ml 20 mg vial 46 Citicholine + Piracetam Tablets 500mg+800mg Docetaxel Injections 80mg. 47 Clobazam Tablets 2.5 Docetaxel Injections 20mg 48 Clobazam Tablets 10 Docetaxel Injections 120mg 49 Clobazam Tablets 5Doxorubicin Injections 50mg 50 Clonazepam Tablets 0.25Doxorubicin Injections 10mg 51 Clonazepam Entecavir Tablets 0.5mg 52 Clonazepam Entecavir Tablets 1 1mg 53 Clonazepam Epirubicin Injections 10mg. 54 Epirubicin Injections 50mg. 55 Erlotinib Tablets 2100mg 54 Clonazepam MD 56 Erlotinib Tablets 150 mg 57 Etanercept Injection 25mg 58 Etanercept Prefilled pens Injections 100mg 59 Etoposide capsules 100 mg 60 Etoposide Injections 100mg 61 Everolimus Tablets 5mg 62 Everolimus Tablets 10mg 63 Exemestane Tablets 25mg 64 Filgrastim (GCSF) Injections 300mcg 65 Flutamide Injection 250mg 66 Folinic Acid Injection 3 mg / ml 67 Geftinib Tablets 250mg 68 Gemcitabine HCL Injections 200mg 69 Gemcitabine HCL Injections 1gm 70 Gemcitabine HCL Injections 1.4gm 71 Granisterone Injections 3mg 72 Granisterone Injections 1mg 73 Hydroxyurea(Hydroxycarbamide) Tablets 500mg 74 Ifosfamide 1gm.vial + Mesna. COMBIPACK Injections 3x2ml. amp 75 Imatinib Tablets 400mg 76 Imatinib Tablets 100mg 77 Irinotecan Injections 2ml/40mg 78 Irinotecan Injections 5ml/100mg 79 Itolizumab Injection 25mg/5 ml 80 Ixabepilone Injection 15mg 81 Ixabepilone Injection 45mg 82 Lapatinib ditosylate Tablets 50mg 83 L-Asparaginase Injections 5000 IU 84 L-Asparaginase Injections 10000 IU 85 Lenalidomide Tablets 15mg 86 Lenalidomide Tablets 10mg 87 Lenalidomide Tablets 25mg 88 Lenalidomide Tablets 5mg 89 Letrozole Tablets 2.5mg 90 Leucovorin Calcium Tablets 15mg 91 Leucovorin Calcium Injections 15mg 92 Leucovorin Calcium Injections 50mg. 93 Liposomal Doxorubicin Injections 10ml 94 Melphalan Tablets 2 mg 55 Colchicine 95 Melphalan Tablets 0.6 5 mg 56 Colchicine 96 Mercaptopurine Injection 100 mg / ml 97 Mercaptopurine Tablets 0.5 50mg 57 Colchicine 98 Methotrexate Tablets 17.5mg 58 Conivaptan 99 Methotrexate Tablets 10mg 100 Methotrexate Tablets 2.5mg 101 Methotrexate Injections 1gm 102 Methotrexate Injections 15mg. 103 Methotrexate Injections 50mg 104 Methotrexate Injections 500mg 105 Mitomycin C Injection 20mg/100ml 59 Deferasirox 2 mg 106 Mitomycin-C Injection 10 mg 107 Mitoxantrone Injections 2mg. 108 Nanoparticle paclitaxel Injection 300 mg 109 Nanoparticle paclitaxel Injection 100 mg 110 Nilotinib Capsules 150mg 111 Nilotinib Capsules 200mg 112 Nimotuzumab Injections 50mg 113 Octreotide Injections 50mcg 114 Octreotide LAR Injections 10mg 115 Octreotide LAR Injections 20mg 116 Octreotide LAR Injections 30mg 117 Omalizumab Injections 150 mg 118 Oxaliplatin Injections 100mg 119 Oxaliplatin Injections 200mg 120 Oxaliplatin Injections 50mg 121 Paclitaxel Injections 300mg 122 Paclitaxel Injections 200mg 123 Paclitaxel Injections 30mg 124 Paclitaxel Injections 100mg 125 Paclitaxel Injections 260mg. 126 Paclitaxel Multidose Injection 300mg 127 Palonosetron Injection 0.25mg 128 Pemetrexed Disodium Injections 500mg 129 Pemetrexed Disodium Injections 100mg 130 Procarbazine capsules 50 mg 131 Ranibizumab Injection 10mg 132 Ruxolitinib Tablets 5mg 133 Ruxolitinib Tablets 15mg 134 Ruxolitinib Tablets 20mg 135 Sargramostim Injections 500mg 136 Sunitinib Capsules 12.5mg 137 Sunitinib Capsules 25mg 138 Sunitinib Capsules 50mg 139 Tamoxifen Tablets 10mg 140 Tamoxifen Tablets 20mg 141 Temozolomide Tablets 20mg 142 Temozolomide Tablets 100mg 60 Deferasirox Tablets 400mg 61 Deferasirox 143 Temozolomide Tablets 250mg 62 Deferasirox Tablets 500mg 63 Deferiprone Capsules 250mg 64 Deferiprone Capsules 500mg 65 Deferiprone Tablets 500 mg 66 Deferiprone Tablets 1000 mg 67 Desvenlafaxine 144 Thalidomide Tablets 50mg 68 Desvenlafaxine 145 Thalidomide Tablets 100mg 69 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+325mg+1 0mg 70 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+500mg+1 0mg 71 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+650mg+1 0mg 72 Diazepam Tablets 2 mg 73 Diazepam Tablets 5mg 74 Diazepam Tablets 10mg 75 Diazepam Rectal Suppository 5mg 76 Diazepam Tablets 3 mg 77 Diazepam Rectal Suppository 2.5 mg 78 Diazepam Injection 10mg/2ml 79 Diazoxide Tablets 50 mg 80 Diethylcarbamazine citrate Tablets 50 mg 81 Diethylcarbamazine citrate Tablets 100 mg 82 Disulfiram Tablets 250mg 83 Disulfiram Tablets 500 mg 84 Divalproex equivalent to valproic acid 250 mg syrup 100 ml 85 Divalproex Sodium Tablets 250mg 86 Divalproex Sodium Tablets 500mg 87 Divalproex Sodium Tablets 125 mg 88 Divalproex Sodium Tablets 250 mg ER 89 Divalproex Sodium Tablets 500 mg ER 90 Divalproex Sodium Tablets 125 mg ER 91 Duloxetine Hydrochloride Tablets 20mg 92 Duloxetine Hydrochloride Tablets 30mg 93 Duloxetine Hydrochloride Tablets 60mg 94 Eperisone hydrochloride Tablets 150 mg 95 Eperisone hydrochloride Tablets 450 mg 96 Escitalopram Tablets 5mg 97 Escitalopram Tablets 10mg 98 Escitalopram Tablets 20mg 99 Escitalopram + Clonazepam Tablets 10mg+0.25mg 100 Escitalopram + Clonazepam Tablets 10mg+0.5mg 101 Fludrocortisone Tablets 0.1mg 102 Flumazenil Injection 0.5 mg / 5ml 103 Flumazenil Injection 1 mg / 10 ml 104 Flunarizine Tablets 5mg 105 Flunarizine Tablets 10mg 106 Fluoxetine 146 Thioguanine Tablets 40mg 107 Fluoxetine Capsules 20147 Transtu zumab (Herceptin) Injections 440 mg 108 Fluoxetine Tablets 20mg 109 Fluoxetine Tablets 40mg 110 Fluoxetine Tablets 60mg 111 Fluoxetine Tablets 10mg 112 Fluoxetine Capsules 20mg 113 Fluphenazile decanoate Injection 125mg/5ml 114 Flupiritine Tablets 100mg 115 Flupiritine Tablets 200mg 116 Fosphenytoin Injection 50mg/ml 117 Gabapentin Tablets 400mg 118 Gabapentine Tablets 600mg 119 Gabapentine Tablets 300mg 120 Gabapentine Cap. 300mg 121 Gabapentine + Mecobalamine Tablets 300 mg+ 0.5 mg 122 Gabapentine + Nortriptyline Tablets 400 mg + 10 mg 123 Glycerol Syrup 100ml 124 Glycerol Syrup 500ml 125 Haloperidol Tablets 2mg 126 Haloperidol Tablets 5mg 127 Haloperidol Tablets 10 mg 128 Haloperidol Injection 5mg/ml 129 Hydroxyzine Tablets 10mg 130 Hydroxyzine Tablets 25mg 131 Hydroxyzine Syrup 10mg/5ml 132 Imipramine Tablets 25 mg 133 Imipramine Tablets 75 mg 134 Lacosamide Tablets 50 mg 135 Lacosamide Tablets 100 mg 136 Lacosamide Tablets 148 Transtuzumab (Herceptin) Injections 150 mg 137 Lacosamide Tablets 200 mg 138 Lacosamide Syrup 50 mg/5ml 139 Lacosamide Injection 10 149 Vinblastine Injections 10mg/ml 140 Lamotrigin Tablets 25mg 141 Lamotrigin Tablets 100 mg 142 Lamotrigin Tablets 150mg 143 Lamotrigin Tablets 200 mg 144 Lecithin 30mg+ equivalent to 175 mg of essential Phospholipids (EPL)(phosphatidylcholine,phosphatidylethanolamine,phospha tidylinositol,phosphatidylserine) Capsules (350+175)mg 145 Levetiracetam Tablets 250 mg 146 Levetiracetam Tablets 500 mg 147 Levetiracetam Tablets 750mg 148 Levetiracetam Tablets 1000 mg 149 Levetiracetam Injection 100mg/5 ml. 150 Levetiracetam Syrup 100mgVincristine Injections 1mg/ml 151 Lithium Carbonate Tablets 450Vinorelbine Injection 10 mg 152 Lithium Carbonate Tablets 300Vinorelbine Solution Injection 50mg 153 Lithium Carbonate SR Tablets 400Zoledronic acid Injections 4mg 154 Lorazepam Tablets 0.5 mg 155 Lorazepam Tablets 1mg 156 Lorazepam Tablets 2mg 157 Lorazepam 2mg Injection 2 ml 158 Lorazepam 2mg Injection 4 ml 159 Magnesium Sulfate, Urea & Sulphacetamide Sdoium Ointment 75gm 160 Mefloquine Tablets 250mg 161 Melatonin Tablets 0.5mg 162 Melatonin Tablets 3mg 163 Melatonin Tablets 6mg 164 Methyldopa Tablets 250mg 165 Methyldopa Tablets 125 mg 166 Methyldopa Tablets 500 mg 167 Naltrexone Tablets 50mg 168 Naproxen Tablets 250mg 169 Naproxen Tablets 500mg 170 Naproxen Tablets 750mg 171 Naproxen + Domperidone Tablets 500mg+10mg 172 Nevirapine Tablets 200mg 173 Nevirapine syrup 10mg/ml 174 Nicotine Chewing gum Tablets 2mg 175 Nicotine Chewing gum Tablets 4mg 176 Nimodipine Tablets 30mg 177 Nimodipine Injection 10mg/50ml 178 Nitrazepam Tablets Zoledronic acid Injections 5mg 179 Nitrazepam Tablets 10mg 180 Nortriptyline Tablets 25mg 181 Nortriptyline Tablets 10 mg 182 Olanzapine Tablets 20mg 183 Olanzapine Tablets 2.5mg 184 Olanzapine Tablets 5mg 185 Olanzapine Tablets 7.5mg 186 Olanzapine Tablets 10mg 187 Olanzapine Injection 10mg/ml 188 Oxcarbamazepine Tablets 150mg 189 Oxcarbamazepine Tablets 300mg 190 Oxcarbamazepine Tablets 600mg 191 Oxcarbamazepine 300 mg Syrups 60 ml 192 Paracetamol Injection 150mg/2ml 193 Paracetamol Injection 500mg/50 ml 194 Paracetamol 10mg/ml (PLASTIC BOT ) Injection 1 gm/ 100 ml 195 Paracetamol + Tramadol Tablets 325mg+37.5mg 196 Paracetamol 10mg/ ml (GLASS BOT ) Injection 1 gm/ 100 ml 197 Paroxetine Tablets 12.5mg 198 Paroxetine Tablets 25mg 199 Paroxetine Tablets 37.5mg 200 Pergolide Tablets 0.05mg 201 Pergolide Tablets 0.25mg 202 Pergolide Tablets 1mg 203 Phenobarbitone Tablets 30mg 204 Phenobarbitone Tablets 60mg 205 Phenobarbitone Syrup 20mg/5ml 206 Phenobarbitone Injection 200mg /1ml 207 Phenytoin Sodium Tablets 50 mg 208 Phenytoin Sodium Tablets 100mg 209 Phenytoin Sodium Injection 25mg/ml 210 Phenytoin Sodium Liquids 100ml(25mg/ml) 211 Piperazine Tablets 500 mg 212 Piperazine Syrup 750mg/5ml 213 Piracetam Tablets 800mg 214 Piracetam Syrup 500mg/5ml 215 Praziquantel Tablets 600 mg 216 Pregabaline Tablets 50mg 217 Pregabaline Tablets 75mg 218 Pregabaline Tablets 150mg 219 Pregabaline + Amitriptyline Tablets 75mg+10mg 220 Pregabaline + Amitriptyline Tablets 50mg+10mg 221 Pregabaline + Nortriptyline Tablets 75 mg+10 mg 222 Pregabaline+Methylcobalamine Tablets 75mg+750mcg 223 Pregabaline+Methylcobalamine Tablets 50mg+1500mcg 224 Pregabaline+Methylcobalamine Tablets 75mg+500mcg 225 Pregabaline+Methylcobalamine Tablets 150mg+1500mc g 226 Quetiapine Fumarate Tablets 25mg 227 Quetiapine Fumarate Tablets 100mg 228 Risperidone Tablets 4mg 229 Risperidone Tablets 3mg 230 Risperidone Tablets 2mg 231 Risperidone Tablets 1mg 232 Risperidone Tablets 0.5mg 233 Sertraline HCL Tablets 25mg 234 Sertraline HCL Tablets 50mg 235 Sertraline HCL Tablets 100mg 236 Sildenafil Citrate Tablets 50mg 237 Sildenafil Citrate Tablets 25mg 238 Sodium Valproate Tablets 200mg 239 Sodium Valproate Syrup 200mg/5ml 240 Sodium Valproate Injection 100ml/5ml 241 Sodium Valproate Tablets 300mg 242 Sodium Valproate + Valproic Acid Tablets 300mg 243 Sodium Valproate + Valproic Acid Tablets 500mg 244 Sodium Valproate + Valproic Acid Tablets 200mg 245 Sumatriptan + Naproxen Tablets 85mg+500mg 246 Tolvaptan Tablets 15mg 247 Topiramate Tablets 25 mg 248 Topiramate Tablets 50 mg 249 Topiramate Tablets 100 mg 250 Trihexyphenidyl (Benzhexol) Tablets 2mg 251 Zaleplon Tablets 5mg 252 Zaleplon Tablets 10mg 253 Zidovudine Syrup 50mg/5ml 254 Zidovudine Tablets 100mg 255 Zidovudine Tablets 300mg 256 Zolpidem Tablets 10 mg 257 Zolpidem Tablets 5mg 258 Zolpidem SR Tablets 6.25mg 259 Zolpidem SR Tablets 12.5mg Calculation of Local Content Name of Manufacture Calculation by Manufacturer (Cost per unit of product) Cost Component Cost (Domestic Component) A Cost (Imported Component) B Total Cost (INR/ US $) C=a+b Percentage of Local Content D=(a/c)*100 I. ………… II. ………… III. Total Cost (Excluding tax and duties) Note:- I. Cost (Domestic Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken) which have not been imported directly or through a domestic trader or an intermediary. II. Cost (Imported Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken). I S/o.D/o,W/o , Resident of That I will agree to abide by the terms and conditions of the policy of Government of India issued vide order no. P-45021/2/2017-B.E.-II dated 15/06/2017. That the information furnished hereinafter is correct to best of my knowledge and belief and I undertake to produce relevant records before the procuring entity or any authority so nominated by the Government of India for the purpose of assessing the local content. That the local content for all inputs which constitute the said drugs has been verified by me and I am responsible for the correctness of the claims made therein. That in the event of the domestic valve addition of the product mentioned herein is found to be incorrect and not meeting the prescribed valve-addition norms, based on Government of India for the purpose of assessing the local content, action will be taken against me as per Order No. P-45021/2/2017-B.E.-II dated 15.06.2017. I agree to maintain the following information in the Company‟s record for a period of 8 years and shall make this available for verification to any statutory authorities: i) Name and details of the Domestic Manufacturer (Registered Officer, Manufacturing unit location, nature of legal entity) ii) Date on which this certificate is issued. iii) Medicine for which the certificate is product. iv) Procuring entity to whom the certificate is furnished. v) Percentage of local content claimed. vi) Name and contact details of the unit of the manufacturer. vii) Sale Price of the product. viii) Ex-Factory Price of the product. ix) Freight, insurance and handling. x) Total Bill of Material. xi) List and total cost valve of inputs used for manufacture of the medicine certificates from suppliers, if the input is not in-house to be attached. xii) List and cost of inputs which and imported, directly or indirectly. (Also to be provided in PDF format)

Legal Jurisdiction. The agreement shall be deemed to have been concluded in Jodhpur, Rajasthan and all obligations hereunder shall be deemed to be located at Jodhpur, Rajasthan and Court within Jodhpur, Rajasthan will have Jurisdiction to the exclusion of other courts. Complete Address, Telephone No. & Email Id Name of Proprietor/Partner/Managing Director/Director. Phone No:- Mobile No:- Email Id:- Whether the firm is a registered firm Yes/No (attached copy of certificate) Whether quoting as manufacturer/ authorised distributor/ authorised dealer PAN No. (enclose the attested copy of PAN Card) (enclose the attested copy of GST Certificate) Whether the firm has enclosed the Bank Draft/Pay Order/Banker‟s cheque as Xxxxxxx Money Deposit Whether the Firm/Agency has signed each and every page of Tender/NIT Bank Details: 1) Accounts No: 2) Bank Name: 3) Branch: 4) IFSC Code: Any other information, if necessary Place: Name: Date: Business Address: Signature of Bidder: Seal of the Bidder: Annexure-B List of Products 1 Alprazolam Adrenocorticotropic hormone Injection 60unit/ml 2 Acarbose Tablets 0.25mg 2 Alprazolam Tablets 0.550mg 3 Alprazolam Acarbose Tablets 1 25mg 4 Amitriptyline Tablets 10mg Caffeine citrate Syrup 3 ml 5 Amitriptyline Tablets 75 mg Caffeine citrate Injection 20mg/ml 6 Amitriptyline Tablets 25 mg 7 Amitriptyline Tablets 50 mg 8 Amitriptyline Tablets 100 mg 9 Amitriptyline Tablets 150 mg 10 Amitriptyline + Chlordiazepoxide Tablets 25 mg + 10mg 11 Amitriptyline + Chlordiazepoxide Tablets 12.5 mg+ 5mg 12 Betahistine Tablets 16mg 13 Betahistine Tablets 24mg 14 Betahistine Tablets 32mg 15 Botulinum Toxid Injection 100 Units 16 Bromocriptine Carbimazole Tablets 5mg 17 Bromocriptine 7 Carbimazole Tablets 2.510 mg 18 Bupenorphine +Naloxone Tablets 2 mg + 0.5mg 19 Buprenorphine Tablets 8mg 20 Buprenorphine Tablets 0.4mg 21 Buprenorphine sublingual Tablets 0.2mg 22 Buprenorphine sublingual Tablets 8mg 24 Buprenorphine sublingual Tablets 0.4mg 25 Carbamazepine 8 Clomiphene Citrate Tablets 100mg 26 Carbamazepine Tablets 200mg 27 Carbamazepine Tablets 400mg 28 Carbamazepine syrup 100mg/5ml 29 Carbamazepine SR Tablets 200mg 30 Carbamazepine SR Tablets 400mg 31 Carbidopa Tablets 25mg 32 Carbidopa Tablets 50mg 33 Carbidopa Tablets 100mg 34 Chlorpromazine hydrochloride Tablets 25 mg 35 Chlorpromazine hydrochloride Syrup 25mg/5ml 36 Chlorpromazine hydrochloride Injection 25mg/ml 37 Chlorpromazine hydrochloride Tablets 50mg 38 Chlorpromazine hydrochloride Tablets 100mg 39 Cilnidipine Tablets 10mg 40 Cilnidipine Tablets 5 mg 41 Citalopram Tablets 10mg 42 Citalopram Tablets 20mg 43 Citalopram Tablets 40mg 44 Citicholine Tablets 500mg 45 Citicholine Injection 250mg/ml 46 Citicholine + Piracetam Tablets 500mg+800mg 47 Clobazam Tablets 2.5 mg 48 Clobazam Tablets 10 mg 49 Clobazam Tablets 5mg 50 Clonazepam Tablets 0.25mg 51 Clonazepam Tablets 0.5mg 52 Clonazepam Tablets 1 mg 53 Clonazepam Tablets 2mg 54 Clonazepam MD Tablets 2 mg 55 Colchicine Tablets 0.6 mg 56 Colchicine Tablets 0.5 mg 57 Colchicine Tablets 1mg 58 Conivaptan Injection 20mg/100ml 59 Deferasirox Tablets 100mg 60 Deferasirox Tablets 400mg 61 Deferasirox Tablets 250mg 62 Deferasirox Tablets 500mg 63 Deferiprone Capsules 250mg 64 Deferiprone Capsules 500mg 65 Deferiprone Tablets 500 mg 66 Deferiprone Tablets 1000 mg 67 Desvenlafaxine Tablets 50mg 68 Desvenlafaxine Tablets 100mg 69 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+325mg+1 0mg 70 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+500mg+1 0mg 71 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+650mg+1 0mg 72 Diazepam Tablets 2 mg 73 Diazepam Tablets 5mg 74 Diazepam Tablets 10mg 75 Diazepam Rectal Suppository 5mg 76 Diazepam Tablets 3 mg 77 Diazepam Rectal Suppository 2.5 mg 78 Diazepam Injection 10mg/2ml 79 Diazoxide Tablets 50 mg 80 Diethylcarbamazine citrate Tablets 50 mg 81 Diethylcarbamazine citrate Tablets 100 mg 82 Disulfiram Tablets 250mg 83 Disulfiram Tablets 500 mg 84 Divalproex equivalent to valproic acid 250 mg syrup 100 ml 85 Divalproex Sodium Tablets 250mg 86 Divalproex Sodium Tablets 500mg 87 Divalproex Sodium Tablets 125 mg 88 Divalproex Sodium Tablets 250 mg ER 89 Divalproex Sodium Tablets 500 mg ER 90 Divalproex Sodium Tablets 125 mg ER 91 Duloxetine Hydrochloride Tablets 20mg 92 Duloxetine Hydrochloride Tablets 30mg 93 Duloxetine Hydrochloride Tablets 60mg 94 Eperisone hydrochloride Tablets 150 mg 95 Eperisone hydrochloride Tablets 450 mg 96 Escitalopram Tablets 5mg 97 Escitalopram Tablets 10mg 98 Escitalopram Tablets 20mg 99 Escitalopram + Clonazepam Tablets 10mg+0.25mg 100 Escitalopram + Clonazepam Tablets 10mg+0.5mg 101 Fludrocortisone Tablets 0.1mg 102 Flumazenil Injection 0.5 mg / 5ml 103 Flumazenil Injection 1 mg / 10 ml 104 Flunarizine Tablets 5mg 105 Flunarizine Tablets 10mg 106 Fluoxetine Tablets 40mg 107 Fluoxetine Capsules 20mg 108 Fluoxetine Tablets 20mg 109 Fluoxetine Tablets 40mg 110 Fluoxetine Tablets 60mg 111 Fluoxetine Tablets 10mg 112 Fluoxetine Capsules 20mg 113 Fluphenazile decanoate Injection 125mg/5ml 114 Flupiritine Tablets 100mg 115 Flupiritine Tablets 200mg 116 Fosphenytoin Injection 50mg/ml 117 Gabapentin Tablets 400mg 118 Gabapentine Tablets 600mg 119 Gabapentine Tablets 300mg 120 Gabapentine Cap. 300mg 121 Gabapentine + Mecobalamine Tablets 300 mg+ 0.5 mg 122 Gabapentine + Nortriptyline Tablets 400 mg + 10 mg 123 Glycerol Syrup 100ml 124 Glycerol Syrup 500ml 125 Haloperidol Tablets 2mg 126 Haloperidol Tablets 5mg 127 Haloperidol Tablets 10 mg 128 Haloperidol Injection 5mg/ml 129 Hydroxyzine Tablets 10mg 130 Hydroxyzine Tablets 25mg 131 Hydroxyzine Syrup 10mg/5ml 132 Imipramine Tablets 25 mg 133 Imipramine Tablets 75 mg 134 Lacosamide Tablets 50 mg 135 Lacosamide Tablets 100 mg 136 Lacosamide Tablets 150 mg 137 Lacosamide Tablets 200 mg 138 Lacosamide Syrup 50 mg/5ml 139 Lacosamide Injection 10 mg/ml 140 Lamotrigin Tablets 25mg 141 Lamotrigin Tablets 100 mg 142 Lamotrigin Tablets 150mg 143 Lamotrigin Tablets 200 mg 144 Lecithin 30mg+ equivalent to 175 mg of essential Phospholipids (EPL)(phosphatidylcholine,phosphatidylethanolamine,phospha tidylinositol,phosphatidylserine) Capsules (350+175)mg 145 Levetiracetam Tablets 250 mg 146 Levetiracetam Tablets 500 mg 147 Levetiracetam Tablets 750mg 148 Levetiracetam Tablets 1000 mg 149 Levetiracetam Injection 100mg/5 ml. 150 Levetiracetam Syrup 100mg/ml 151 Lithium Carbonate Tablets 450mg 152 Lithium Carbonate Tablets 300mg 153 Lithium Carbonate SR Tablets 400mg 154 Lorazepam Tablets 0.5 mg 155 Lorazepam Tablets 1mg 156 Lorazepam Tablets 2mg 157 Lorazepam 2mg Injection 2 ml 158 Lorazepam 2mg Injection 4 ml 159 Magnesium Sulfate, Urea & Sulphacetamide Sdoium Ointment 75gm 160 Mefloquine Tablets 250mg 161 Melatonin Tablets 0.5mg 162 Melatonin Tablets 3mg 163 Melatonin Tablets 6mg 164 Methyldopa Tablets 250mg 165 Methyldopa Tablets 125 mg 166 Methyldopa Tablets 500 mg 167 Naltrexone Tablets 50mg 168 Naproxen Tablets 250mg 169 Naproxen Tablets 500mg 170 Naproxen Tablets 750mg 171 Naproxen + Domperidone Tablets 500mg+10mg 172 Nevirapine Tablets 200mg 173 Nevirapine syrup 10mg/ml 174 Nicotine Chewing gum Tablets 2mg 175 Nicotine Chewing gum Tablets 4mg 176 Nimodipine Tablets 30mg 177 Nimodipine Injection 10mg/50ml 178 Nitrazepam Tablets 5mg 179 Nitrazepam Tablets 10mg 180 Nortriptyline Tablets 25mg 181 Nortriptyline Tablets 10 mg 182 Olanzapine Tablets 20mg 183 Olanzapine Tablets 2.5mg 184 Olanzapine Tablets 5mg 185 Olanzapine Tablets 7.5mg 186 Olanzapine Tablets 10mg 187 Olanzapine Injection 10mg/ml 188 Oxcarbamazepine Tablets 150mg 189 Oxcarbamazepine Tablets 300mg 190 Oxcarbamazepine Tablets 600mg 191 Oxcarbamazepine 300 mg Syrups 60 ml 192 Paracetamol Injection 150mg/2ml 193 Paracetamol Injection 500mg/50 ml 194 Paracetamol 10mg/ml (PLASTIC BOT ) Injection 1 gm/ 100 ml 195 Paracetamol + Tramadol Tablets 325mg+37.5mg 196 Paracetamol 10mg/ ml (GLASS BOT ) Injection 1 gm/ 100 ml 197 Paroxetine Tablets 12.5mg 198 Paroxetine Tablets 25mg 199 Paroxetine Tablets 37.5mg 200 Pergolide Tablets 0.05mg 201 Pergolide Tablets 0.25mg 202 Pergolide Tablets 1mg 203 Phenobarbitone Tablets 30mg 204 Phenobarbitone Tablets 60mg 205 Phenobarbitone Syrup 20mg/5ml 206 Phenobarbitone Injection 200mg /1ml 207 Phenytoin Sodium Tablets 50 mg 208 Phenytoin Sodium Tablets 100mg 209 Phenytoin Sodium Injection 25mg/ml 210 Phenytoin Sodium Liquids 100ml(25mg/ml) 211 Piperazine Tablets 500 mg 212 Piperazine Syrup 750mg/5ml 213 Piracetam Tablets 800mg 214 Piracetam Syrup 500mg/5ml 215 Praziquantel Tablets 600 mg 216 Pregabaline Tablets 50mg 217 Pregabaline Tablets 75mg 218 Pregabaline Tablets 150mg 219 Pregabaline + Amitriptyline Tablets 75mg+10mg 220 Pregabaline + Amitriptyline Tablets 50mg+10mg 221 Pregabaline + Nortriptyline Tablets 75 mg+10 mg 222 Pregabaline+Methylcobalamine Tablets 75mg+750mcg 223 Pregabaline+Methylcobalamine Tablets 50mg+1500mcg 224 Pregabaline+Methylcobalamine Tablets 75mg+500mcg 225 Pregabaline+Methylcobalamine Tablets 150mg+1500mc g 226 Quetiapine Fumarate Tablets 25mg 227 Quetiapine Fumarate Tablets 100mg 228 Risperidone Tablets 4mg 229 Risperidone Tablets 3mg 230 Risperidone Tablets 2mg 231 Risperidone Tablets 1mg 232 Risperidone Tablets 0.5mg 233 Sertraline HCL Tablets 25mg 234 Sertraline HCL Tablets 50mg 235 Sertraline HCL Tablets 100mg 236 Sildenafil 9 Clomiphene Citrate Tablets 50mg 237 Sildenafil Citrate 10 Danazol Tablets 25100mg 238 Sodium Valproate 11 Danazol Tablets 200mg 239 Sodium Valproate 12 Desmopressin Tablets 0.1mg 13 Desmopressin Injection 4mcg/ml 14 Desmopressin Syrup 200mg/5ml 240 Sodium Valproate 0.001 15 Desmopressin nasal spray Injections 1mcg/ml 16 Ethinylestradiol Tablets 0.01mg 17 Ethinylestradiol Tablets 0.05mg 18 Ethinylestradiol +Levonorgesterol Tablets 0.03 mg +0.15 mg 19 Ethinylestradiol +Norethisterone Tablets 0.035 mg +1.0 mg 20 Glibenclamide Tablets 5mg 21 Glibenclamide Tablets 2.5mg 22 Gliclazide Tablets 80mg 23 Gliclazide modified release Tablets 30mg 24 Gliclazide modified release Tablets 60mg 25 Glimeperide Tablets 1mg 26 Glimeperide Tablets 2mg 27 Glimeperide Tablets 3mg 28 Glimeperide Tablets 4mg 29 Glimeperide + Metformin Tablets 1mg+500mg 30 Glipizide Tablets 5 mg 31 Glipizide Tablets 10mg 32 Glipizide Tablets 40mg 33 Glipizide Tablets 80mg 34 Glipizide + Metformin Tablets 2.5mg+250mg 35 Glipizide + Metformin Tablets 5mg+500mg 36 Glucagon Injection 100ml/5ml 241 Sodium Valproate 1mg/ml 37 Goserelin Injections 11.25mg 38 Human Biphasic Isophane Insulin 50/50 vial, pen & penfill Injection 40 IU / MI 39 Human Biphasic Isophane Insulin 50/50 vial, pen & penfill Injection 100 IU / MI 40 Human growth Hormone Injection 4 iu 41 Human insulin of recombiant DNA origin Injection R(Regular) 100iu/ ml 42 Human insulin of recombiant DNA origin Injection N(NPH) 100iu/ ml 43 Human insulin of recombiant DNA origin Injection 30/70, 100 iu/ ml 44 Human insulin of recombiant DNA origin Injection 50/50 (Biophasic)100iu/ ml 45 Human insulin of recombiant DNA origin 40iu Injection R(Regular) 40iu/ ml 46 Human insulin of recombiant DNA origin 40iu Injection N(NPH) 40iu/ ml 47 Human insulin of recombiant DNA origin 40iu Injection 30/70, 40 iu/ ml 48 Human insulin of recombiant DNA origin 40iu Injection 50/50 (Biophasic)40iu/ ml 49 Human Neutral Soluble insulin 40 I.U.vial & penfill Injection 40 IU / MI 50 Human Neutral Soluble insulin vial & penfill Injection 100 IU / MI 51 Hydroxyprogesterone Injections 250mg/1ml 52 Hydroxyprogesterone Injections 500mg/2ml 53 Insulin Aspart (premix analogue) 30/70 pen & penfill Injection 40 IU / MI 54 Insulin Aspart (premix analogue) 30/70 pen & penfill Injection 100iu / ml 55 Intermediate Acting(Lente/NPH Insulin) Injection 40 IU / ml 56 Leuprolide Injection 3.75mg 57 Leuprolide Injection 11.25 mg 58 Leuprolide Injection 22.5 mg 59 Levothyroxine Tablets 30050µg 60 Levothyroxine Tablets 100µg 61 Linagliptin Tablets 5 mg 242 Sodium Valproate + Valproic Acid 62 Medroxyprogesterone Acetate Tablets 3005mg 243 Sodium Valproate + Valproic Acid 63 Medroxyprogesterone Acetate Tablets 10mg 64 Medroxyprogesterone Acetate Tablets 2.5 mg 65 Medroxyprogesterone Acetate Injection 150mg/ml 66 Metformin Tablets 850mg 67 Metformin Tablets 500mg 244 Sodium Valproate 68 Metformin Tablets 1gm 69 Metformin + Valproic Acid Gliclazide Tablets 200500mg+80mg 245 Sumatriptan + Naproxen 70 Metformin SR Tablets 85mg+5001 gm 71 Metformin SR Tablets 500mg 246 Tolvaptan 72 Norethisterone Tablets 5mg 73 Oxytocin Injection 5 IU/ml,1 ml amp 74 Pioglitazone Tablets 30mg 75 Pioglitazone Tablets 15mg 247 Topiramate 76 Propylthiouracil Tablets 25 100mg 248 Topiramate 77 Propylthiouracil Tablets 200 mg 78 Rapid acting analogue Insulin aspact pen & penfill Injections 40 IU / MI 79 Rapid acting analogue Insulin aspact pen & penfill Injections 100iu / ml 80 Rosigitazone Tablets 4mg 81 Rosiglitazone Tablets 1mg 82 Rosiglitazone Tablets 2mg 83 Sitagliptin Tablets 50 mg 249 Topiramate Tablets 100 mg 250 Trihexyphenidyl (Benzhexol) Tablets 2mg 251 Zaleplon Tablets 5mg 252 Zaleplon Tablets 10mg 253 Zidovudine Syrup 50mg/5ml 254 Zidovudine 84 Sitagliptin Tablets 100mg 255 Zidovudine 85 Somatostatin Injection 3000mcg 86 Somatostatin Injection 250mcg 87 Somatropin Recombinant Injections 16 IU/vial 88 Testosterone Capsules 40mg (asundecanoate) 89 Testosterone Injections 100mg/ml 90 Testosterone Injections 25mg/ml 91 Testosterone Injections 200mg/2ml 92 Thyroxine sodium Tablets 30012.5mcg 93 Thyroxine sodium Tablets 62.5mcg 94 Thyroxine sodium Tablets 75mcg 95 Thyroxine sodium Tablets 112mcg 96 Thyroxine sodium Tablets 137mcg 97 Thyroxine sodium Tablets 88mcg 98 Thyroxine sodium Tablets 25mcg 99 Thyroxine sodium Tablets 50mcg 100 Thyroxine sodium Tablets 100mcg 101 Vasopressin Injection 40 IU 102 Vasopressin Injection 20 IU 103 Vildagliptin Tablets 50mg 256 Zolpidem 104 Vildagliptin+Metformin Tablets 10 mg 257 Zolpidem (50+500)mg 105 Vildagliptin+Metformin Tablets 5mg 258 Zolpidem SR (50+1000)mg 106 Vildagliptine+Metformin Tablets 6.25mg 259 Zolpidem SR Tablets 12.5mg (50+850)mg Calculation of Local Content Name of Manufacture Calculation by Manufacturer (Cost per unit of product) Cost Component Cost (Domestic Component) A Cost (Imported Component) B Total Cost (INR/ US $) C=a+b Percentage of Local Content D=(a/c)*100 I. ………… II. ………… III. Total Cost (Excluding tax and duties) Note:- I. Cost (Domestic Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken) which have not been imported directly or through a domestic trader or an intermediary. II. Cost (Imported Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken). I S/o.D/o,W/o , Resident of That I will agree to abide by the terms and conditions of the policy of Government of India issued vide order no. P-45021/2/2017-B.E.-II dated 15/06/2017. That the information furnished hereinafter is correct to best of my knowledge and belief and I undertake to produce relevant records before the procuring entity or any authority so nominated by the Government of India for the purpose of assessing the local content. That the local content for all inputs which constitute the said drugs has been verified by me and I am responsible for the correctness of the claims made therein. That in the event of the domestic valve addition of the product mentioned herein is found to be incorrect and not meeting the prescribed valve-addition norms, based on Government of India for the purpose of assessing the local content, action will be taken against me as per Order No. P-45021/2/2017-B.E.-II dated 15.06.2017. I agree to maintain the following information in the Company‟s record for a period of 8 years and shall make this available for verification to any statutory authorities: i) Name and details of the Domestic Manufacturer (Registered Officer, Manufacturing unit location, nature of legal entity) ii) Date on which this certificate is issued. iii) Medicine for which the certificate is product. iv) Procuring entity to whom the certificate is furnished. v) Percentage of local content claimed. vi) Name and contact details of the unit of the manufacturer. vii) Sale Price of the product. viii) Ex-Factory Price of the product. ix) Freight, insurance and handling. x) Total Bill of Material. xi) List and total cost valve of inputs used for manufacture of the medicine certificates from suppliers, if the input is not in-house to be attached. xii) List and cost of inputs which and imported, directly or indirectly. (Also to be provided in PDF format)

Legal Jurisdiction. The agreement shall be deemed to have been concluded in Jodhpur, Rajasthan and all obligations hereunder shall be deemed to be located at Jodhpur, Rajasthan and Court within Jodhpur, Rajasthan will have Jurisdiction to the exclusion of other courts. Complete Address, Telephone No. & Email Id Name of Proprietor/Partner/Managing Director/Director. Phone No:- Mobile No:- Email Id:- Whether the firm is a registered firm Yes/No (attached copy of certificate) Whether quoting as manufacturer/ authorised distributor/ authorised dealer PAN No. (enclose the attested copy of PAN Card) (enclose the attested copy of GST Certificate) Whether the firm has enclosed the Bank Draft/Pay Order/Banker‟s cheque as Xxxxxxx Money Deposit Whether the Firm/Agency has signed each and every page of Tender/NIT Bank Details: 1) Accounts No: 2) Bank Name: 3) Branch: 4) IFSC Code: Any other information, if necessary Place: Name: Date: Business Address: Signature of Bidder: Seal of the Bidder: Annexure-B List of Products 1 Alprazolam 1,25 Dihydroxy Cholocholciferol Tablets 0.250.25mcg 2 6% Blanced Hydroxyethyl starch130/.04 in an isotonic Electctrolyte with Sodium chloride 110-112 Mmol osmolarity 285-290 in non PVC dehp free bage 500 ml Injection 500 ml 3 7% Amino Acid Solution for renal patients Injection, 250ml 4 7% Amino Acid Solution for renal patients Injection, 500ml 5 Alendronate Tablets 70mg 2 Alprazolam 6 Alendronic Acid Tablets 0.535mg 3 Alprazolam 7 Alendronic Acid Tablets 70mg 8 Alendronic Acid Tablets 10mg 9 Alfacalcidol Capsules 0.25mcg 10 Alfacalcidol Capsules 1mcg 11 Alpha ketoanalogues of essential amino acid Injection 600mg 13 Amino acid 10 % Injection 100 ml 15 Amino Acid Lipid Dextrose Solution for TPN in Single Bag Injection 1026 ml 16 Amino Acid Lipid Dextrose Solution for TPN in Single Bag Injection 1440 ml 17 Amino Acid Lipid Dextrose Solution for TPN in Single Bag Injection 1540 ml 18 Amino Acid Lipid Dextrose Solution for TPN in Single Bag Injection 1920 ml 20 Amino Acid Lipid Dextrose Solution for TPN in Single Bag (1265 kcal Central Route) Injection 1250 ml 21 Amino Acid Lipid Dextrose Solution for TPN in Single Bag (1435 kcal Peripheral Route) Injection 1875 ml 22 Amino Acid Lipid Dextrose Solution for TPN in Single Bag (1475 kcal Central Route) Injection 1250 ml 25 Amino Acid Lipid Dextrose Solution for TPN in Single Bag (955 kcal Peripheral route) Injection 1250 ml 26 Aminoacids Soln. (5%W/V) Injection 500ml 27 Aminoacids Soln. (5%W/V) Injection 250ml 28 Ascorbic Acid Tablets 100 mg 29 Ascorbic Acid Tablets 500 mg 30 B Complex Capsules 31 Balanced Iso-Caloric Powder (Polymeric diet) for Enteral Tube Feeding Powder 400g 32 Cal.Carbonate with Calcitriol Tablets 250 mg 33 Cal.Carbonate with Calcitriol Tablets 500 mg 34 Cal.Carbonate with Alpha Calcidol Tablets 250mg 35 Cal.Carbonate with Alpha Calcidol Tablets 500 mg 36 Cal.Carbonate with Minanerals Tablets 250mg 37 Cal.Carbonate with Minanerals Tablets 500mg 38 Calcium Carbonate+vitamine D3 Tablets 500 mg 39 Calcium acetate Maleate Tablets 250 mg 40 Calcium acetate Maleate Tablets 667 mg 41 Calcium Aspartemate Tablets 1120mg 42 Calcium Gluconate Injection 10 ml 43 Chlorohexidine body wash body wash 500ml 44 Cholecalciferol (Vitamin D3) Sachet 60000 IU 45 Cyanocobalamin Injection 1 mg/ml, 46 Dextran-40 Injection 10% 47 Dextran-70 Injection 6% 48 Dipeptide of N(2) Alanyl glutamin Injection 50ml 49 Each 100 ml :- Polygeline , polypeptides of degraded gelatin , cross linkage via urea bridges 3.5g( equivalent to 063g nitrogen) sodium chloride I.P 0.85g , potassium chloride I.P 0.038g, calcium chloride i.P 0.070g Water for injuction ip qs Electrolytes in m mol/litre NA+ 145,K+5.1, ca++6.25, Cl-145 Mean molecular Weight 30000 Injection 500 ml 50 Enteral Nutrition Powder for Diabetic Patients Powder 400mg 51 Epoetin beta Prefilled syringe 2000 units 52 Erythropoietin Alpha Injection 3000 IU 53 Erythropoietin Alpha Injection 4000 IU Vial 54 Erythropoietin Alpha Injection 4000 IU Prefil 55 Erythropoietin Alpha Injection 4000 IU Safe 56 Erythropoietin Alpha Injection 2000 IU Safe 57 Erythropoietin Alpha Injection 2000 IU Vial 58 Erythropoietin Alpha Injection 2000 IU Prefil 59 Erythropoietin Alpha Injection 10000 IU 60 Erythropoietin Alpha Injection 10000 IU Safe 61 Erythropoietin Beta Injection 2000IU 62 Erythropoietin Beta Injection 3000IU 63 Erythropoietin Beta Injection 4000IU 64 Erythropoietin Beta Injection 10000IU 65 Erythropoietin Beta Injection 40000IU 66 Factor VIIA Injection 1 mg(50KIU) 67 Factor VIIA Injection 5 mg(250KIU) 68 Factor VIII Injection 250 IU 69 Ferric carboxymaltose Injection 100 mg 70 Ferric carboxymaltose Injection 500 mg 71 Ferrous Ascorbate + Folic Acid Tablets 100mg + 1.5 mg 72 Ferrous Sulphate/Fumrate Oral solution 60mg/ ml 73 Ferrous Sulphate/Fumrate (Tablets equivalent to 60 mg elemental iron25mg elemental iron (assulphate) Tablets 60 mg 74 Folic Acid Tablets 1 mg 4 Amitriptyline 75 Folic Acid Tablets 105mg 5 Amitriptyline 76 Formula Milk Powder for Preterm / Low Birth Weight Newborns Powder 400gm 77 Formula Milk Powder for Term Newborns Powder 400gm 78 Glutamine Powder Powder 15gm 79 Hepatic Protien Powder Powder 200g 80 High Protein Low electrolyte Powder for Enteral Powder 200g Tube Feeding in patients on Dialysis 81 High Protein Powder for Enteral Tube Feeding Powder 400mg 82 Human Albumin 20% Injection 100ml 83 Human Albumin 20% Injection 20 ml 84 Human Albumin 25% Injection 100ml 85 Human Albumin 25% Injection 50 ml 86 Human Albumin 5% Injection 100ml 87 Human Albumin 5% Injection 50 ml 88 Human milk Fortifier Sachet. 1gm 89 Ibandronate Tablets 150mg 90 Ibandronate Injection 3ml 91 Intralipid phospholipid & fat emulsion solu 20% Injection 500ml 92 Intralipid phospholipid & fat emulsion solu. 30% Injection 250ml 93 Intralipid phospholipids & fat emulsion solu 20% Injection 100ml 94 Iron Drops. (1 ml/25 mg) 95 Iron + Folic Acid Syrup 200ml 96 Iron Dextran Injection 50 mg iron/ml 97 Iron Sucrose Injection 20mg/5ml 98 Irone isomaltoside Injection 500 mg 99 Lactobacillus with Vitamin B Complex, C, minerals etc. Liq. 60 ml 100 Lactobasilus acidophylis (Sporolac sachet ) sachet 15gm 101 Methoxy polyethylene glycol-epoetin beta Prefilled syringe 50 mg 102 Methoxy polyethylene glycol-epoetin beta Prefilled syringe 75 mg 6 Amitriptyline 103 Methoxy polyethylene glycol-epoetin beta Prefilled syringe 100 mg 104 Methyl cobalamin Injection 500mg 105 Methyl cobalamin Tablets 25 1500mg 7 Amitriptyline 106 Methyl cobalamin Injection 1gm 107 Methyl cobalamine +Alpha Liporic Acid+Folic Acid+Choline+Pyridoxine Tablets 700mcg+100mg+5mg +30mcg+25mg 108 Multivitamin Injection 10 ml 109 Multivitamin drop Liq 15ml 110 Multivitamin with Vitamin –A Drops. 1100-1200 Unit/ ml 111 Nicotinamide Tablets 50 mg 8 Amitriptyline Tablets 100 mg 9 Amitriptyline Tablets 150 mg 10 Amitriptyline + Chlordiazepoxide Tablets 25 mg + 10mg 11 Amitriptyline + Chlordiazepoxide Tablets 12.5 mg+ 5mg 12 Betahistine Tablets 16mg 13 Betahistine Tablets 24mg 14 Betahistine Tablets 32mg 15 Botulinum Toxid 112 Omega-3-fatty acid Injection 100 Units 16 Bromocriptine Tablets 5mg 17 Bromocriptine Tablets 2.5mg 18 Bupenorphine +Naloxone Tablets 2 mg + 0.5mg 19 Buprenorphine Tablets 8mg 20 Buprenorphine Tablets 0.4mg 21 Buprenorphine sublingual Tablets 0.2mg 22 Buprenorphine sublingual Tablets 8mg 24 Buprenorphine sublingual Tablets 0.4mg 25 Carbamazepine Tablets 100mg 26 Carbamazepine Tablets 50ml 113 Oral iron prepartions containing Ferrous sulphate/Ferrous fumarate/Ferrous gluconate/Ferrous ammonium citrate with/without vitamins (B,C,D) aminoacids,minerals etc. Liq. 200ml 114 Peptide Based semi-elemental powder for Enteral Tube Feeding in adults Powder 200mg 27 Carbamazepine Tablets 115 Peptide Based semi-elemental powder for Enteral Tube Feeding in adults Powder 400mg 28 Carbamazepine syrup 100mg/5ml 29 Carbamazepine SR Tablets 200mg 30 Carbamazepine SR Tablets 400mg 31 Carbidopa Tablets 25mg 32 Carbidopa Tablets 50mg 33 Carbidopa Tablets 100mg 34 Chlorpromazine hydrochloride Tablets 25 mg 35 Chlorpromazine hydrochloride Syrup 25mg/5ml 36 Chlorpromazine hydrochloride Injection 25mg/ml 37 Chlorpromazine hydrochloride Tablets 50mg 38 Chlorpromazine hydrochloride Tablets 100mg 39 Cilnidipine Tablets 10mg 40 Cilnidipine Tablets 5 mg 41 Citalopram Tablets 10mg 42 Citalopram Tablets 20mg 43 Citalopram Tablets 40mg 44 Citicholine Tablets 500mg 45 Citicholine Injection 250mg/ml 46 Citicholine + Piracetam Tablets 500mg+800mg 47 Clobazam Tablets 2.5 mg 48 Clobazam Tablets 10 mg 49 Clobazam Tablets 5mg 50 Clonazepam Tablets 0.25mg 51 Clonazepam Tablets 0.5mg 52 Clonazepam Tablets 1 mg 53 Clonazepam Tablets 2mg 54 Clonazepam MD Tablets 2 mg 55 Colchicine Tablets 0.6 mg 56 Colchicine Tablets 0.5 mg 57 Colchicine Tablets 1mg 58 Conivaptan Injection 20mg/100ml 59 Deferasirox Tablets 100mg 60 Deferasirox Tablets 400mg 61 Deferasirox Tablets 250mg 62 Deferasirox Tablets 500mg 63 Deferiprone Capsules 250mg 64 Deferiprone Capsules 500mg 65 Deferiprone Tablets 500 mg 66 Deferiprone Tablets 1000 mg 67 Desvenlafaxine Tablets 50mg 68 Desvenlafaxine Tablets 100mg 69 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+325mg+1 0mg 70 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+500mg+1 0mg 71 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+650mg+1 0mg 72 Diazepam Tablets 2 mg 73 Diazepam Tablets 5mg 74 Diazepam Tablets 10mg 75 Diazepam Rectal Suppository 5mg 76 Diazepam Tablets 3 mg 77 Diazepam Rectal Suppository 2.5 mg 78 Diazepam Injection 10mg/2ml 79 Diazoxide Tablets 50 mg 80 Diethylcarbamazine citrate Tablets 50 mg 81 Diethylcarbamazine citrate Tablets 100 mg 82 Disulfiram Tablets 250mg 83 Disulfiram Tablets 500 mg 84 Divalproex equivalent to valproic acid 250 mg syrup 100 ml 85 Divalproex Sodium Tablets 250mg 86 Divalproex Sodium Tablets 500mg 87 Divalproex Sodium Tablets 125 mg 88 Divalproex Sodium Tablets 250 mg ER 89 Divalproex Sodium Tablets 500 mg ER 90 Divalproex Sodium Tablets 125 mg ER 91 Duloxetine Hydrochloride Tablets 20mg 92 Duloxetine Hydrochloride Tablets 30mg 93 Duloxetine Hydrochloride Tablets 60mg 94 Eperisone hydrochloride Tablets 150 mg 95 Eperisone hydrochloride Tablets 450 mg 96 Escitalopram Tablets 5mg 97 Escitalopram Tablets 10mg 98 Escitalopram Tablets 20mg 99 Escitalopram + Clonazepam Tablets 10mg+0.25mg 100 Escitalopram + Clonazepam Tablets 10mg+0.5mg 101 Fludrocortisone Tablets 0.1mg 102 Flumazenil Injection 0.5 mg / 5ml 103 Flumazenil Injection 1 mg / 10 ml 104 Flunarizine Tablets 5mg 105 Flunarizine Tablets 10mg 106 Fluoxetine Tablets 40mg 107 Fluoxetine Capsules 20mg 108 Fluoxetine Tablets 20mg 109 Fluoxetine Tablets 40mg 110 Fluoxetine Tablets 60mg 111 Fluoxetine Tablets 10mg 112 Fluoxetine Capsules 20mg 113 Fluphenazile decanoate Injection 125mg/5ml 114 Flupiritine Tablets 100mg 115 Flupiritine Tablets 200mg 116 Fosphenytoin Injection 50mg/ml 117 Gabapentin Tablets 400mg 118 Gabapentine Tablets 600mg 119 Gabapentine Tablets 300mg 120 Gabapentine Cap. 300mg 121 Gabapentine + Mecobalamine Tablets 300 mg+ 0.5 mg 122 Gabapentine + Nortriptyline Tablets 400 mg + 10 mg 123 Glycerol Syrup 100ml 124 Glycerol Syrup 500ml 125 Haloperidol Tablets 2mg 126 Haloperidol Tablets 5mg 127 Haloperidol Tablets 10 mg 128 Haloperidol Injection 5mg/ml 129 Hydroxyzine Tablets 10mg 130 Hydroxyzine Tablets 25mg 131 Hydroxyzine Syrup 10mg/5ml 132 Imipramine Tablets 25 mg 133 Imipramine Tablets 75 mg 134 Lacosamide Tablets 50 mg 135 Lacosamide Tablets 100 mg 136 Lacosamide Tablets 150 mg 137 Lacosamide Tablets 200 mg 138 Lacosamide Syrup 50 mg/5ml 139 Lacosamide Phytomenadione Injection 10 mg/ml 140 Lamotrigin 117 Polygeline Injection 3.50% 118 Polygeline (Polymer from Degraded Gelatin ) Injection 500 ml 119 Pot.Chloride 1.5g per 15ml.syrup Liq. 200ml 120 Potassium Chloride Injection 10 ml 121 Potassium Chloride Syrups 200 ml 122 Pyridoxine Injection 100mg/ml 123 Pyridoxine Tablets 2525 mg 141 Lamotrigin 124 Pyridoxine Tablets 10 mg 125 Renal Protien Powder Powder 200g 126 Resendronate Tablets 35mg 127 Riboflavin Tablets 5 mg 128 Sachet. Probiotic (bifidobacterium+ clactobacillus) Sachet. 1gm 129 Sevalemer Carbonate Tablets 400mg 130 Sevelamer Hydrochloride Tablets 400mg 131 Sevelamer Hydrochloride Tablets 800mg 132 Succinylated Gelatines Injection 500ml 133 Thiamine Tablets 100 mg 142 Lamotrigin 134 Vitamin A Tablets 150mg 143 Lamotrigin Tablets 200 mg 144 Lecithin 30mg+ equivalent to 175 mg of essential Phospholipids (EPL)(phosphatidylcholine,phosphatidylethanolamine,phospha tidylinositol,phosphatidylserine) Capsules (350+175)mg 145 Levetiracetam Tablets 250 mg 146 Levetiracetam Tablets 500 mg 147 Levetiracetam Tablets 750mg 148 Levetiracetam Tablets 1000 mg 149 Levetiracetam 2lac IU 135 Vitamin A Injection 100mg/5 ml. 150 Levetiracetam Syrup 100mg50000 IU/ml 151 Lithium Carbonate Tablets 450136 Vitamin A syrup. 50000 IU/ml 137 Vitamin B complex in combination with vit. C capsules 138 Vitamin B1(Thaimine) Injection 100mg 152 Lithium Carbonate Tablets 300139 Vitamin C 500mg 153 Lithium Carbonate SR Tablets 400mg 154 Lorazepam Tablets 0.5 mg 155 Lorazepam Tablets 1mg 156 Lorazepam Tablets 2mg 157 Lorazepam 2mg Injection 2 ml 158 Lorazepam 2mg Injection 4 ml 159 Magnesium Sulfate, Urea & Sulphacetamide Sdoium Ointment 75gm 160 Mefloquine Tablets 250mg 161 Melatonin Tablets 0.5mg 162 Melatonin Tablets 3mg 163 Melatonin Tablets 6mg 164 Methyldopa Tablets 250mg 165 Methyldopa Tablets 125 mg 166 Methyldopa Tablets 500 mg 167 Naltrexone Tablets 50mg 168 Naproxen Tablets 250mg 169 Naproxen Tablets 500mg 170 Naproxen 140 Vitamin D(Ergocalciferol) capsules 0.25 mg 141 Vitamin D(Ergocalciferol) capsules 1 mg 142 Vitamin. B6(Pyridoxine) Tablets 75040mg 171 Naproxen + Domperidone Tablets 500mg+10mg 172 Nevirapine Tablets 200mg 173 Nevirapine syrup 10mg/ml 174 Nicotine Chewing gum Tablets 2mg 175 Nicotine Chewing gum Tablets 4mg 176 Nimodipine Tablets 30mg 177 Nimodipine Injection 10mg/50ml 178 Nitrazepam Tablets 5mg 179 Nitrazepam Tablets 10mg 180 Nortriptyline Tablets 25mg 181 Nortriptyline Tablets 10 mg 182 Olanzapine Tablets 20mg 183 Olanzapine Tablets 2.5mg 184 Olanzapine Tablets 5mg 185 Olanzapine Tablets 7.5mg 186 Olanzapine Tablets 10mg 187 Olanzapine Injection 10mg/ml 188 Oxcarbamazepine Tablets 150mg 189 Oxcarbamazepine Tablets 300mg 190 Oxcarbamazepine Tablets 600mg 191 Oxcarbamazepine 300 mg Syrups 60 ml 192 Paracetamol Injection 150mg/2ml 193 Paracetamol Injection 500mg/50 ml 194 Paracetamol 10mg/ml (PLASTIC BOT 143 Vitamin. B6(Pyridoxine) Injection 1 gm/ 100 ml 195 Paracetamol + Tramadol Tablets 325mg+37.5mg 196 Paracetamol 10mg/ ml (GLASS BOT ) Injection 1 gm/ 100 ml 197 Paroxetine Tablets 12.5mg 198 Paroxetine Tablets 25mg 199 Paroxetine Tablets 37.5mg 200 Pergolide Tablets 0.05mg 201 Pergolide Tablets 0.25mg 202 Pergolide Tablets 1mg 203 Phenobarbitone Tablets 30mg 204 Phenobarbitone Tablets 60mg 205 Phenobarbitone Syrup 20mg/5ml 206 Phenobarbitone Injection 200mg /1ml 207 Phenytoin Sodium Tablets 50 mg 208 Phenytoin Sodium Tablets 100mg 209 Phenytoin Sodium 144 Vitamin.B1, B6, B12 combination Injection 25mg/ml 210 Phenytoin Sodium Liquids 100ml(25mg/ml) 211 Piperazine Tablets 500 mg 212 Piperazine Syrup 750mg/5ml 213 Piracetam Tablets 800mg 214 Piracetam Syrup 500mg/5ml 215 Praziquantel Tablets 600 mg 216 Pregabaline Tablets 50mg 217 Pregabaline Tablets 75mg 218 Pregabaline Tablets 150mg 219 Pregabaline + Amitriptyline Tablets 75mg+10mg 220 Pregabaline + Amitriptyline Tablets 50mg+10mg 221 Pregabaline + Nortriptyline Tablets 75 mg+10 mg 222 Pregabaline+Methylcobalamine Tablets 75mg+750mcg 223 Pregabaline+Methylcobalamine Tablets 50mg+1500mcg 224 Pregabaline+Methylcobalamine Tablets 75mg+500mcg 225 Pregabaline+Methylcobalamine Tablets 150mg+1500mc g 226 Quetiapine Fumarate Tablets 25mg 227 Quetiapine Fumarate Tablets 100mg 228 Risperidone Tablets 4mg 229 Risperidone Tablets 3mg 230 Risperidone Tablets 2mg 231 Risperidone Tablets 1mg 232 Risperidone Tablets 0.5mg 233 Sertraline HCL Tablets 25mg 234 Sertraline HCL Tablets 50mg 235 Sertraline HCL Tablets 100mg 236 Sildenafil Citrate Tablets 50mg 237 Sildenafil Citrate Tablets 25mg 238 Sodium Valproate Tablets 200mg 239 Sodium Valproate Syrup 200mg/5ml 240 Sodium Valproate Injection 100ml/5ml 241 Sodium Valproate Tablets 300mg 242 Sodium Valproate + Valproic Acid Tablets 300mg 243 Sodium Valproate + Valproic Acid Tablets 500mg 244 Sodium Valproate + Valproic Acid Tablets 200mg 245 Sumatriptan + Naproxen Tablets 85mg+500mg 246 Tolvaptan Tablets 15mg 247 Topiramate Tablets 25 mg 248 Topiramate Tablets 50 mg 249 Topiramate Tablets 100 mg 250 Trihexyphenidyl (Benzhexol) Tablets 2mg 251 Zaleplon Tablets 5mg 252 Zaleplon Tablets 10mg 253 Zidovudine Syrup 50mg/5ml 254 Zidovudine Tablets 100mg 255 Zidovudine Tablets 300mg 256 Zolpidem Tablets 10 mg 257 Zolpidem Tablets 5mg 258 Zolpidem SR Tablets 6.25mg 259 Zolpidem SR Tablets 12.5mg 2ml 145 WHO ORS Powder Sachet Powder Sachet 21.8 gm 146 Zinc Gluconate Liq. 100ml Calculation of Local Content Name of Manufacture Calculation by Manufacturer (Cost per unit of product) Cost Component Cost (Domestic Component) A Cost (Imported Component) B Total Cost (INR/ US $) C=a+b Percentage of Local Content D=(a/c)*100 I. ………… II. ………… III. Total Cost (Excluding tax and duties) Note:- I. Cost (Domestic Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken) which have not been imported directly or through a domestic trader or an intermediary. II. Cost (Imported Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken). I S/o.D/o,W/o , Resident of That I will agree to abide by the terms and conditions of the policy of Government of India issued vide order no. P-45021/2/2017-B.E.-II dated 15/06/2017. That the information furnished hereinafter is correct to best of my knowledge and belief and I undertake to produce relevant records before the procuring entity or any authority so nominated by the Government of India for the purpose of assessing the local content. That the local content for all inputs which constitute the said drugs has been verified by me and I am responsible for the correctness of the claims made therein. That in the event of the domestic valve addition of the product mentioned herein is found to be incorrect and not meeting the prescribed valve-addition norms, based on Government of India for the purpose of assessing the local content, action will be taken against me as per Order No. P-45021/2/2017-B.E.-II dated 15.06.2017. I agree to maintain the following information in the Company‟s record for a period of 8 years and shall make this available for verification to any statutory authorities: i) Name and details of the Domestic Manufacturer (Registered Officer, Manufacturing unit location, nature of legal entity) ii) Date on which this certificate is issued. iii) Medicine for which the certificate is product. iv) Procuring entity to whom the certificate is furnished. v) Percentage of local content claimed. vi) Name and contact details of the unit of the manufacturer. vii) Sale Price of the product. viii) Ex-Factory Price of the product. ix) Freight, insurance and handling. x) Total Bill of Material. xi) List and total cost valve of inputs used for manufacture of the medicine certificates from suppliers, if the input is not in-house to be attached. xii) List and cost of inputs which and imported, directly or indirectly. (Also to be provided in PDF format)

Legal Jurisdiction. The agreement shall be deemed to have been concluded in Jodhpur, Rajasthan and all obligations hereunder shall be deemed to be located at Jodhpur, Rajasthan and Court within Jodhpur, Rajasthan will have Jurisdiction to the exclusion of other courts. Complete Address, Telephone No. & Email Id Name of Proprietor/Partner/Managing Director/Director. Phone No:- Mobile No:- Email Id:- Whether the firm is a registered firm Yes/No (attached copy of certificate) Whether quoting as manufacturer/ authorised distributor/ authorised dealer PAN No. (enclose the attested copy of PAN Card) (enclose the attested copy of GST Certificate) Whether the firm has enclosed the Bank Draft/Pay Order/Banker‟s cheque as Xxxxxxx Money Deposit Whether the Firm/Agency has signed each and every page of Tender/NIT Bank Details: 1) Accounts No: 2) Bank Name: 3) Branch: 4) IFSC Code: Any other information, if necessary Place: Name: Date: Business Address: Signature of Bidder: Seal of the Bidder: Annexure-B List of Products 1 Alprazolam Tablets 0.25mg 2 Alprazolam Tablets 0.5mg 3 Alprazolam Tablets 1 mg 4 Amitriptyline Tablets 10mg 5 Amitriptyline Tablets 75 mg 6 Amitriptyline Tablets 25 mg 7 Amitriptyline Tablets 50 mg 8 Amitriptyline Tablets 100 mg 9 Amitriptyline Tablets 150 mg 10 Amitriptyline + Chlordiazepoxide Tablets 25 mg + 10mg 11 Amitriptyline + Chlordiazepoxide Tablets 12.5 mg+ 5mg 12 Betahistine Tablets 16mg 13 Betahistine Tablets 24mg 14 Betahistine Tablets 32mg 15 Botulinum Toxid Injection 100 Units 16 Bromocriptine Tablets 5mg 17 Bromocriptine Tablets 2.5mg 18 Bupenorphine +Naloxone Tablets 2 mg + 0.5mg 19 Buprenorphine Tablets 8mg 20 Buprenorphine Tablets 0.4mg 21 Buprenorphine sublingual Tablets 0.2mg 22 Buprenorphine sublingual Tablets 8mg 24 Buprenorphine sublingual Tablets 0.4mg 25 Carbamazepine Tablets 100mg 26 Carbamazepine Tablets 200mg 27 Carbamazepine Tablets 400mg 28 Carbamazepine syrup 100mg/5ml 29 Carbamazepine SR Tablets 200mg 30 Carbamazepine SR Tablets 400mg 31 Carbidopa Tablets 25mg 32 Carbidopa Tablets 50mg 33 Carbidopa Tablets 100mg 34 Chlorpromazine hydrochloride Tablets 25 mg 35 Chlorpromazine hydrochloride Syrup 25mg/5ml 36 Chlorpromazine hydrochloride Injection 25mg/ml 37 Chlorpromazine hydrochloride Tablets 50mg 38 Chlorpromazine hydrochloride Tablets 100mg 39 Cilnidipine Tablets 10mg 40 Cilnidipine Tablets 5 mg 41 Citalopram Tablets 10mg 42 Citalopram Tablets 20mg 43 Citalopram Tablets 40mg 44 Citicholine Tablets 500mg 45 Citicholine Injection 250mg/ml 46 Citicholine + Piracetam Tablets 500mg+800mg 47 Clobazam Tablets 2.5 mg 48 Clobazam Tablets 10 mg 49 Clobazam Tablets 5mg 50 Clonazepam Tablets 0.25mg 51 Clonazepam Tablets 0.5mg 52 Clonazepam Tablets 1 mg 53 Clonazepam Tablets 2mg 54 Clonazepam MD Tablets 2 mg 55 Colchicine Tablets 0.6 mg 56 Colchicine Tablets 0.5 mg 57 Colchicine Tablets 1mg 58 Conivaptan Injection 20mg/100ml 59 Deferasirox Tablets 100mg 60 Deferasirox Tablets 400mg 61 Deferasirox Tablets 250mg 62 Deferasirox Tablets 500mg 63 Deferiprone Capsules 250mg 64 Deferiprone Capsules 500mg 65 Deferiprone Tablets 500 mg 66 Deferiprone Tablets 1000 mg 67 Desvenlafaxine Tablets 50mg 68 Desvenlafaxine Tablets 100mg 69 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+325mg+1 0mg 70 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+500mg+1 0mg 71 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+650mg+1 0mg 72 Diazepam Tablets 2 mg 73 Diazepam Tablets 5mg 74 Diazepam Tablets 10mg 75 Diazepam Rectal Suppository 5mg 76 Diazepam Tablets 3 mg 77 Diazepam Rectal Suppository 2.5 mg 78 Diazepam Injection 10mg/2ml 79 Diazoxide Tablets 50 mg 80 Diethylcarbamazine citrate Tablets 50 mg 81 Diethylcarbamazine citrate Tablets 100 mg 82 Disulfiram Tablets 250mg 83 Disulfiram Tablets 500 mg 84 Divalproex equivalent to valproic acid 250 mg syrup 100 ml 85 Divalproex Sodium Tablets 250mg 86 Divalproex Sodium Tablets 500mg 87 Divalproex Sodium Tablets 125 mg 88 Divalproex Sodium Didanosine Tablets 250 mg ER 89 Divalproex Sodium Tablets 500 mg ER 90 Divalproex Sodium Tablets 125 mg ER 91 Duloxetine Hydrochloride Tablets 20mg 92 Duloxetine Hydrochloride Tablets 30mg 93 Duloxetine Hydrochloride Tablets 60mg 94 Eperisone hydrochloride Tablets 150 mg 95 Eperisone hydrochloride Tablets 450 mg 96 Escitalopram Tablets 5mg 97 Escitalopram Tablets 10mg 98 Escitalopram Tablets 20mg 99 Escitalopram + Clonazepam Tablets 10mg+0.25mg 100 Escitalopram + Clonazepam Tablets 10mg+0.5mg 101 Fludrocortisone Tablets 0.1mg 102 Flumazenil Injection 0.5 mg / 5ml 103 Flumazenil Injection 1 mg / 10 ml 104 Flunarizine Tablets 5mg 105 Flunarizine Tablets 10mg 106 Fluoxetine Tablets 40mg 107 Fluoxetine Capsules 20mg 108 Fluoxetine Tablets 20mg 109 Fluoxetine Tablets 40mg 110 Fluoxetine Tablets 60mg 111 Fluoxetine Tablets 10mg 112 Fluoxetine Capsules 20mg 113 Fluphenazile decanoate Injection 125mg/5ml 114 Flupiritine Tablets 100mg 115 Flupiritine Tablets 200mg 116 Fosphenytoin Injection 50mg/ml 117 Gabapentin Tablets 400mg 118 Gabapentine Tablets 600mg 119 Gabapentine Tablets 300mg 120 Gabapentine Cap. 300mg 121 Gabapentine + Mecobalamine Tablets 300 mg+ 0.5 mg 122 Gabapentine + Nortriptyline 2 Didanosine Tablets 400 mg + 10 mg 123 Glycerol Syrup 100ml 124 Glycerol Syrup 500ml 125 Haloperidol Tablets 2mg 126 Haloperidol Tablets 5mg 127 Haloperidol Tablets 10 mg 128 Haloperidol Injection 5mg/ml 129 Hydroxyzine Tablets 10mg 130 Hydroxyzine Tablets 25mg 131 Hydroxyzine Syrup 10mg/5ml 132 Imipramine Tablets 25 mg 133 Imipramine Tablets 75 mg 134 Lacosamide Tablets 50 mg 135 Lacosamide Tablets 100 mg 136 Lacosamide Tablets 150 mg 137 Lacosamide Tablets 200 mg 138 Lacosamide Syrup 50 mg/5ml 139 Lacosamide Injection 10 mg/ml 140 Lamotrigin Tablets 25mg 141 Lamotrigin Tablets 100 mg 142 Lamotrigin Tablets 150mg 143 Lamotrigin Tablets 200 mg 144 Lecithin 30mg+ equivalent to 175 mg of essential Phospholipids (EPL)(phosphatidylcholine,phosphatidylethanolamine,phospha tidylinositol,phosphatidylserine) Capsules (350+175)mg 145 Levetiracetam Tablets 250 mg 146 Levetiracetam Tablets 500 mg 147 Levetiracetam Tablets 750mg 148 Levetiracetam Tablets 1000 mg 149 Levetiracetam Injection 100mg/5 ml. 150 Levetiracetam Syrup 100mg/ml 151 Lithium Carbonate Tablets 450mg 152 Lithium Carbonate Tablets 300mg 153 Lithium Carbonate SR Tablets 400mg 154 Lorazepam Tablets 0.5 mg 155 Lorazepam Tablets 1mg 156 Lorazepam Tablets 2mg 157 Lorazepam 2mg Injection 2 ml 158 Lorazepam 2mg Injection 4 ml 159 Magnesium Sulfate, Urea & Sulphacetamide Sdoium Ointment 75gm 160 Mefloquine Tablets 250mg 161 Melatonin Tablets 0.5mg 162 Melatonin Tablets 3mg 163 Melatonin Tablets 6mg 164 Methyldopa Tablets 250mg 165 Methyldopa Tablets 125 mg 166 Methyldopa Tablets 500 mg 167 Naltrexone Tablets 50mg 168 Naproxen Tablets 250mg 169 Naproxen Tablets 500mg 170 Naproxen Tablets 750mg 171 Naproxen + Domperidone Tablets 500mg+10mg 172 Nevirapine Tablets 200mg 173 Nevirapine 3 Lamivudine syrup 10mg/ml 174 Nicotine Chewing gum 4 Diloxanide Furoate Tablets 2500 mg 175 Nicotine Chewing gum Tablets 45 Indinavir capsules 200 mg 176 Nimodipine Tablets 306 Indinavir capsules 400 mg 177 Nimodipine 7 Nelfinavir capsules 250 mg 8 Nelfinavir capsules 100 mg, 9 Pentamidine Isothionate Injection 10mg/50ml 178 Nitrazepam Tablets 5200 mg 179 Nitrazepam Tablets 1010 Tacrolimus Cap. 0.25mg 180 Nortriptyline 11 Cyclosporin Tablets 25mg 181 Nortriptyline Tablets 10 mg 182 Olanzapine Tablets 20mg 183 Olanzapine Tablets 2.5mg 184 Olanzapine Tablets 5mg 185 Olanzapine Tablets 7.5mg 186 Olanzapine Tablets 10mg 187 Olanzapine Injection 10mg/ml 188 Oxcarbamazepine Tablets 150mg 189 Oxcarbamazepine Tablets 300mg 190 Oxcarbamazepine Tablets 600mg 191 Oxcarbamazepine 300 mg Syrups 60 ml 192 Paracetamol Injection 150mg/2ml 193 Paracetamol Injection 500mg/50 ml 194 Paracetamol 10mg/ml (PLASTIC BOT ) Injection 1 gm/ 100 ml 195 Paracetamol + Tramadol Tablets 325mg+37.5mg 196 Paracetamol 10mg/ ml (GLASS BOT ) Injection 1 gm/ 100 ml 197 Paroxetine Tablets 12.5mg 198 Paroxetine Tablets 25mg 199 Paroxetine Tablets 37.5mg 200 Pergolide Tablets 0.05mg 201 Pergolide Tablets 0.25mg 202 Pergolide Tablets 1mg 203 Phenobarbitone Tablets 30mg 204 Phenobarbitone Tablets 60mg 205 Phenobarbitone Syrup 20mg/5ml 206 Phenobarbitone Injection 200mg /1ml 207 Phenytoin Sodium Tablets 50 mg 208 Phenytoin Sodium Tablets 100mg 209 Phenytoin Sodium Injection 25mg/ml 210 Phenytoin Sodium Liquids 100ml(25mg/ml) 211 Piperazine Tablets 500 mg 212 Piperazine Syrup 750mg/5ml 213 Piracetam Tablets 800mg 214 Piracetam Syrup 500mg/5ml 215 Praziquantel Tablets 600 mg 216 Pregabaline Tablets 50mg 217 Pregabaline Tablets 75mg 218 Pregabaline Tablets 150mg 219 Pregabaline + Amitriptyline Tablets 75mg+10mg 220 Pregabaline + Amitriptyline Tablets 50mg+10mg 221 Pregabaline + Nortriptyline Tablets 75 mg+10 mg 222 Pregabaline+Methylcobalamine Tablets 75mg+750mcg 223 Pregabaline+Methylcobalamine Tablets 50mg+1500mcg 224 Pregabaline+Methylcobalamine Tablets 75mg+500mcg 225 Pregabaline+Methylcobalamine Tablets 150mg+1500mc g 226 Quetiapine Fumarate Tablets 25mg 227 Quetiapine Fumarate Tablets 100mg 228 Risperidone Tablets 4mg 229 Risperidone Tablets 3mg 230 Risperidone Tablets 2mg 231 Risperidone Tablets 1mg 232 Risperidone Tablets 0.5mg 233 Sertraline HCL Tablets 25mg 234 Sertraline HCL Tablets 50mg 235 Sertraline HCL Tablets 100mg 236 Sildenafil Citrate Tablets 50mg 237 Sildenafil Citrate Tablets 25mg 238 Sodium Valproate Tablets 200mg 239 Sodium Valproate Syrup 200mg/5ml 240 Sodium Valproate Injection 100ml/5ml 241 Sodium Valproate Tablets 300mg 242 Sodium Valproate + Valproic Acid Tablets 300mg 243 Sodium Valproate + Valproic Acid Tablets 12 Mycophenolate Mofetil Tablet 500mg 244 Sodium Valproate + Valproic Acid Tablets 200mg 245 Sumatriptan + Naproxen Tablets 85mg+500mg 246 Tolvaptan Tablets 15mg 247 Topiramate Tablets 25 mg 248 Topiramate Tablets 50 mg 249 Topiramate Tablets 100 mg 250 Trihexyphenidyl 13 Anti-Thymocyte globulin (BenzhexolRabbit) Tablets 2mg 251 Zaleplon Tablets 5mg 252 Zaleplon Tablets 10mg 253 Zidovudine Syrup 50mg/5ml 254 Zidovudine Tablets 100mg 255 Zidovudine Tablets 300mg 256 Zolpidem Tablets 10 mg 257 Zolpidem Tablets 5mg 258 Zolpidem SR Tablets 6.25mg 259 Zolpidem SR Tablets 12.5Inj. 25mg Calculation of Local Content Name of Manufacture Calculation by Manufacturer (Cost per unit of product) Cost Component Cost (Domestic Component) A Cost (Imported Component) B Total Cost (INR/ US $) C=a+b Percentage of Local Content D=(a/c)*100 I. ………… II. ………… III. Total Cost (Excluding tax and duties) Note:- I. Cost (Domestic Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken) which have not been imported directly or through a domestic trader or an intermediary. II. Cost (Imported Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken). I S/o.D/o,W/o , Resident of That I will agree to abide by the terms and conditions of the policy of Government of India issued vide order no. P-45021/2/2017-B.E.-II dated 15/06/2017. That the information furnished hereinafter is correct to best of my knowledge and belief and I undertake to produce relevant records before the procuring entity or any authority so nominated by the Government of India for the purpose of assessing the local content. That the local content for all inputs which constitute the said drugs has been verified by me and I am responsible for the correctness of the claims made therein. That in the event of the domestic valve addition of the product mentioned herein is found to be incorrect and not meeting the prescribed valve-addition norms, based on Government of India for the purpose of assessing the local content, action will be taken against me as per Order No. P-45021/2/2017-B.E.-II dated 15.06.2017. I agree to maintain the following information in the Company‟s record for a period of 8 years and shall make this available for verification to any statutory authorities: i) Name and details of the Domestic Manufacturer (Registered Officer, Manufacturing unit location, nature of legal entity) ii) Date on which this certificate is issued. iii) Medicine for which the certificate is product. iv) Procuring entity to whom the certificate is furnished. v) Percentage of local content claimed. vi) Name and contact details of the unit of the manufacturer. vii) Sale Price of the product. viii) Ex-Factory Price of the product. ix) Freight, insurance and handling. x) Total Bill of Material. xi) List and total cost valve of inputs used for manufacture of the medicine certificates from suppliers, if the input is not in-house to be attached. xii) List and cost of inputs which and imported, directly or indirectly. (Also to be provided in PDF format)

Legal Jurisdiction. The agreement shall be deemed to have been concluded in Jodhpur, Rajasthan and all obligations hereunder shall be deemed to be located at Jodhpur, Rajasthan and Court within Jodhpur, Rajasthan will have Jurisdiction to the exclusion of other courts. Complete Address, Telephone No. & Email Id Name of Proprietor/Partner/Managing Director/Director. Phone No:- Mobile No:- Email Id:- Whether the firm is a registered firm Yes/No (attached copy of certificate) Whether quoting as manufacturer/ authorised distributor/ authorised dealer PAN No. (enclose the attested copy of PAN Card) (enclose the attested copy of GST Certificate) Whether the firm has enclosed the Bank Draft/Pay Order/Banker‟s cheque as Xxxxxxx Money Deposit Whether the Firm/Agency has signed each and every page of Tender/NIT Bank Details: 1) Accounts No: 2) Bank Name: 3) Branch: 4) IFSC Code: Any other information, if necessary Place: Name: Date: Business Address: Signature of Bidder: Seal of the Bidder: Annexure-B List of Products 1 Alprazolam Tablets 0.25Abatacept Injection 250mg 2 Alprazolam Accelofenac 100mg + Serratio Peptidase 15mg Tablets 0.5100mg+15mg 3 Alprazolam Aceclofenac Tablets 1 100mg 4 Amitriptyline Aceclofenac Tablets 200mg 5 Aceclofenac + Paracetamol Tablets 100mg+500mg 6 Aceclofenac + Thiocolchicoside Tablets 100mg+ 8mg 7 Aceclofenac +Thiocolchicoside Tablets 100mg+4mg 8 Aceclofenac+Chlorzoxazone+Paracetamol Tablets 100mg+250mg+500mg 9 Ademetionine butanedisulfonate Tablets 400mg 10 Allopurinol Tablets 100mg 11 Baclofen Tablets 5 mg 12 Baclofen Tablets 10mg 5 Amitriptyline 13 Baclofen Tablets 75 20 mg 6 Amitriptyline 14 Camylofin dihydrochloride 25mg/ ml Injection 2 ml 15 Camylofin dihydrochloride+ mefenamic acid Tablet (50+250)mg 16 Cerebroprotein hydrolysate Tablets 30mg 17 Cerebroprotein hydrolysate Tablets 60mg 18 Diacerein Tablets 50mg 19 Diclofenac +Chlorzoxazone + Paracetamol + Tablets 50mg+250mg+325mg 20 Diclofenac Patch Patch 100mg 21 Diclofenac Patch Patch 200mg 22 Diclofenac sodium Injection 25 mg 7 Amitriptyline / ml 23 Diclofenac sodium Injection 75mg/ml 24 Diclofenac sodium Tablets 50 mg 8 Amitriptyline Tablets 100 mg 9 Amitriptyline Tablets 150 mg 10 Amitriptyline + Chlordiazepoxide Tablets 25 mg + 10mg 11 Amitriptyline + Chlordiazepoxide Tablets 12.5 mg+ 5mg 12 Betahistine Tablets 16mg 13 Betahistine Tablets 24mg 14 Betahistine Tablets 32mg 15 Botulinum Toxid Injection 100 Units 16 Bromocriptine Tablets 5mg 17 Bromocriptine Tablets 2.5mg 18 Bupenorphine +Naloxone Tablets 2 mg + 0.5mg 19 Buprenorphine Tablets 8mg 20 Buprenorphine Tablets 0.4mg 21 Buprenorphine sublingual Tablets 0.2mg 22 Buprenorphine sublingual Tablets 8mg 24 Buprenorphine sublingual Tablets 0.450mg 25 Carbamazepine Diclofenac sodium Tablets 100mg 26 Carbamazepine Diclofenac sodium Tablets 75 mg SR 27 Diclofenac sodium+ Paracetamol Tablets 50mg+325mg 28 Diclofenac sodium+ Paracetamol Tablets 50mg+500mg 29 Diclofenac suppository Suppository 12.5mg 30 Diclofenac suppository Suppository 25mg 31 Diclofenac Suppository Suppository 100gm 32 Dothiepin hydrochloride + methylcobalamin Tablets 75mg+1500mcg 33 Etanercept Injection 25mg 34 Etanercept Injections 50mg 35 Etoricoxib Tablets 120mg 36 Etoricoxib Tablets 30 mg 37 Etoricoxib Tablets 60mg 38 Etoricoxib Tablets 90mg 39 Febuxostat Tablets 40mg 40 Febuxostat Tablets 80mg 41 Glucosamine Sulphate +Chondrotin Sulphate Tablets 250mg+200mg 42 Glucosamine Sulphate+Diacerein Tablets 1500mg+ 50mg 43 Hyaluronic acid injectable implant 20mg/ ml Injection 3ml 44 Hyaluronic acid injectable implant 20mg/ ml Injection 6ml 45 Ibuprofen Tablets 200mg 27 Carbamazepine 46 Ibuprofen Tablets 400mg 28 Carbamazepine syrup 100mg/5ml 29 Carbamazepine SR 47 Ibuprofen Liquids 100mg./5ml.60 ml 48 Ibuprofen + Paracetamol Tablets 200400mg+325mg 30 Carbamazepine SR Tablets 40049 Ibuprofen + Paracetamol Syrup 100mg.+ 125mg./ml 50 Ibuprofen + Paracetamol Syrup 100mg+162.5mg/5ml 51 Ibuprofen + Tizanidine Capsules 400mg+2mg 31 Carbidopa 52 Indomethacin Tablets 25mg 32 Carbidopa 53 Indomethacin Tablets 50mg 33 Carbidopa 54 Indomethacin Tablets 10075mg 34 Chlorpromazine hydrochloride Tablets 55 Indomethacin Capsules 25 mg 35 Chlorpromazine hydrochloride Syrup 25mg/5ml 36 Chlorpromazine hydrochloride 56 Indomethacin Capsules 50 mg 57 Indomethacin Capsules 75 mg 58 Indomethacin Injection 25mg25 mg 59 Indomethacin Injection 50 mg 60 Indomethacin Injection 1 mg 61 Ketorolac Injection 15mg/ml 37 Chlorpromazine hydrochloride 62 Ketorolac Injection 60mg/ml 63 Ketorolac Injection 30mg/ ml 64 L-Arginin +L-Lysine Tablets 50500mg+200mg 38 Chlorpromazine hydrochloride Tablets 100mg 39 Cilnidipine 65 Leflunomide Tablets 10mg 40 Cilnidipine 66 Leflunomide Tablets 5 20 mg 41 Citalopram Tablets 10mg 42 Citalopram Tablets 20mg 43 Citalopram Tablets 40mg 44 Citicholine 67 Mefenamic Acid Tablets 500mg 45 Citicholine 68 Mefenamic Acid + Dicyclomine Tablets 250mg+10mg 69 Mefenamic Acid+ Tranexamic acid Tablets 500mg+250mg 70 Mesalamine Sachet 500mg 71 Mesalamine Sachet 1gm 72 Nimesulide +Paracetamol Tablet 100mg+350mg 73 Nimesulide+ camylofin dihydrochloride Tablet (50+100)mg 74 Pancreatin minimicrospheres Capsules 150mg 75 Pancreatin minimicrospheres Capsules 300mg 76 Pancuronium 4mg/2ml Injection 250mg2mg/ml 46 Citicholine + Piracetam 77 Paracetamol Tablets 500mg+800125mg 47 Clobazam Tablets 2.5 mg 48 Clobazam Tablets 10 mg 49 Clobazam Tablets 5mg 50 Clonazepam Tablets 0.25mg 51 Clonazepam Tablets 0.5mg 52 Clonazepam Tablets 1 mg 53 Clonazepam Tablets 2mg 54 Clonazepam MD Tablets 2 mg 55 Colchicine Tablets 0.6 mg 56 Colchicine Tablets 0.5 mg 57 Colchicine Tablets 1mg 58 Conivaptan Injection 20mg/100ml 59 Deferasirox Tablets 100mg 60 Deferasirox Tablets 400mg 61 Deferasirox 78 Paracetamol Tablets 250mg 62 Deferasirox 79 Paracetamol Tablets 300mg 80 Paracetamol Tablets 500mg 63 Deferiprone Capsules 250mg 64 Deferiprone Capsules 500mg 65 Deferiprone 81 Paracetamol Tablets 500 mg 66 Deferiprone Tablets 1000 mg 67 Desvenlafaxine Tablets 50mg 68 Desvenlafaxine Tablets 100mg 69 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+325mg+1 0mg 70 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+500mg+1 0mg 71 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+650mg+1 0mg 72 Diazepam Tablets 2 mg 73 Diazepam Tablets 5mg 74 Diazepam Tablets 10mg 75 Diazepam Rectal Suppository 5mg 76 Diazepam Tablets 3 mg 77 Diazepam Rectal Suppository 2.5 mg 78 Diazepam Injection 10mg/2ml 79 Diazoxide Tablets 50 mg 80 Diethylcarbamazine citrate Tablets 50 mg 81 Diethylcarbamazine citrate Tablets 100 650mg 82 Disulfiram Tablets 250Paracetamol Suppository 80 mg 83 Disulfiram Tablets 500 Paracetamol Suppository 250 mg 84 Divalproex equivalent to valproic acid 250 mg syrup 100 ml Paracetamol Syrup 125mg/5ml 85 Divalproex Sodium Tablets 250mg Paracetamol Syrup 250mg/5ml 86 Divalproex Sodium Tablets 500mg 87 Divalproex Sodium Tablets 125 mg 88 Divalproex Sodium Tablets 250 mg ER 89 Divalproex Sodium Tablets 500 mg ER 90 Divalproex Sodium Tablets 125 mg ER 91 Duloxetine Hydrochloride Tablets 20mg 92 Duloxetine Hydrochloride Tablets 30mg 93 Duloxetine Hydrochloride Tablets 60mg 94 Eperisone hydrochloride Tablets 150 mg 95 Eperisone hydrochloride Tablets 450 mg 96 Escitalopram Tablets 5mg 97 Escitalopram Tablets 10mg 98 Escitalopram Tablets 20mg 99 Escitalopram + Clonazepam Tablets 10mg+0.25mg 100 Escitalopram + Clonazepam Tablets 10mg+0.5mg 101 Fludrocortisone Tablets 0.1mg 102 Flumazenil Injection 0.5 mg / 5ml 103 Flumazenil Injection 1 mg / 10 ml 104 Flunarizine Tablets 5mg 105 Flunarizine Tablets 10mg 106 Fluoxetine Tablets 40mg 107 Fluoxetine Capsules 20mg 108 Fluoxetine Tablets 20mg 109 Fluoxetine Tablets 40mg 110 Fluoxetine Tablets 60mg 111 Fluoxetine Tablets 10mg 112 Fluoxetine Capsules 20mg 113 Fluphenazile decanoate Injection 125mg/5ml 114 Flupiritine Tablets 100mg 115 Flupiritine Tablets 200mg 116 Fosphenytoin Injection 50mg/ml 117 Gabapentin Tablets 400mg 118 Gabapentine Tablets 600mg 119 Gabapentine Tablets 300mg 120 Gabapentine Cap. 300mg 121 Gabapentine + Mecobalamine Tablets 300 mg+ 0.5 mg 122 Gabapentine + Nortriptyline Tablets 400 mg + 10 mg 123 Glycerol Syrup 100ml 124 Glycerol Syrup 500ml 125 Haloperidol Tablets 2mg 126 Haloperidol Tablets 5mg 127 Haloperidol Tablets 10 mg 128 Haloperidol Injection 5mg/ml 129 Hydroxyzine Tablets 10mg 130 Hydroxyzine Tablets 25mg 131 Hydroxyzine Syrup 10mg/5ml 132 Imipramine Tablets 25 mg 133 Imipramine Tablets 75 mg 134 Lacosamide Tablets 50 mg 135 Lacosamide Tablets 100 mg 136 Lacosamide Tablets 150 mg 137 Lacosamide Tablets 200 mg 138 Lacosamide Syrup 50 mg/5ml 139 Lacosamide Injection 10 mg/ml 140 Lamotrigin Tablets 25mg 141 Lamotrigin Tablets 100 mg 142 Lamotrigin Tablets 150mg 143 Lamotrigin Tablets 200 mg 144 Lecithin 30mg+ equivalent to 175 mg of essential Phospholipids (EPL)(phosphatidylcholine,phosphatidylethanolamine,phospha tidylinositol,phosphatidylserine) Capsules (350+175)mg 145 Levetiracetam Tablets 250 mg 146 Levetiracetam Tablets 500 mg 147 Levetiracetam Tablets 750mg 148 Levetiracetam Tablets 1000 mg 149 Levetiracetam Injection 100mg/5 ml. 150 Levetiracetam Syrup 100mg/ml 151 Lithium Carbonate Tablets 450mg 152 Lithium Carbonate Tablets 300mg 153 Lithium Carbonate SR Tablets 400mg 154 Lorazepam Tablets 0.5 mg 155 Lorazepam Tablets 1mg 156 Lorazepam Tablets 2mg 157 Lorazepam 2mg Injection 2 ml 158 Lorazepam 2mg Injection 4 ml 159 Magnesium Sulfate, Urea & Sulphacetamide Sdoium Ointment 75gm 160 Mefloquine Tablets 250mg 161 Melatonin Tablets 0.5mg 162 Melatonin Tablets 3mg 163 Melatonin Tablets 6mg 164 Methyldopa Tablets 250mg 165 Methyldopa Tablets 125 mg 166 Methyldopa Tablets 500 mg 167 Naltrexone Tablets 50mg 168 Naproxen Tablets 250mg 169 Naproxen Tablets 500mg 170 Naproxen Tablets 750mg 171 Naproxen + Domperidone Tablets 500mg+10mg 172 Nevirapine Tablets 200mg 173 Nevirapine syrup 10mg/ml 174 Nicotine Chewing gum Tablets 2mg 175 Nicotine Chewing gum Tablets 4mg 176 Nimodipine Tablets 30mg 177 Nimodipine Injection 10mg/50ml 178 Nitrazepam Tablets 5mg 179 Nitrazepam Tablets 10mg 180 Nortriptyline Tablets 25mg 181 Nortriptyline Tablets 10 mg 182 Olanzapine Tablets 20mg 183 Olanzapine Tablets 2.5mg 184 Olanzapine Tablets 5mg 185 Olanzapine Tablets 7.5mg 186 Olanzapine Tablets 10mg 187 Olanzapine Injection 10mg/ml 188 Oxcarbamazepine Tablets 150mg 189 Oxcarbamazepine Tablets 300mg 190 Oxcarbamazepine Tablets 600mg 191 Oxcarbamazepine 300 mg Syrups 60 ml 192 Paracetamol Injection 150mg/2ml 193 87 Paracetamol Injection 500mg/50 ml 194 + Aceclofenac Tablet 325mg+100 mg 88 Paracetamol 10mg/ml (PLASTIC BOT Plastic bot.) Injection 1 gm/ 100 ml 195 Paracetamol + Tramadol 89 Paracetamol+ Caffiene Tablets 500mg+65mg 90 Paracetamol+serratiopeptidase+diclofenac potassium Tablets 500mg+10mg+50mg 91 Paracetamol+Tramadol Tablets 325mg+37.5mg 196 Paracetamol 10mg/ 92 Pentazocin Injection 30mg/ ml (GLASS BOT ) 93 Pethidine Injection 1 gm/ 50mg/ml 94 Pinaverium bromide Tablet 50mg 95 Piroxicam Tablets 10mg 96 Piroxicam Tablets 20mg 97 Piroxicam Injection 20mg/ml 98 Pralidoxime Injection 500mg/20ml 99 Probenecid Tablets 500mg 100 ml 197 Paroxetine Tablets 12.5mg 198 Paroxetine Tablets 25mg 199 Paroxetine Tablets 37.5mg 200 Pergolide Tablets 0.05mg 201 Pergolide Tablets 0.25mg 202 Pergolide Tablets 1mg 203 Phenobarbitone Tablets 30mg 204 Phenobarbitone Pyridostigmine Tablets 60mg 205 Phenobarbitone Syrup 20mg/5ml 206 Phenobarbitone 101 Rivastigmine Tablets 1.5mg 102 Rivastigmine Tablets 4.5mg 103 Rivastigmine Tablets 3mg 104 Rivastigmine Tablets 6mg 105 Serratiopeptidase Tablets 10mg 106 Serratiopeptidase Tablets 20 mg 107 Teriparatide Injection 20020mcg 108 Thiocolchicoside Tablets 4 mg /1ml 207 Phenytoin Sodium 109 Thiocolchicoside Tablets 50 8 mg 208 Phenytoin Sodium 110 Toleperisone Tablets 100mg 209 Phenytoin Sodium Injection 25mg/ml 210 Phenytoin Sodium Liquids 100ml(25mg/ml) 211 Piperazine Tablets 500 mg 212 Piperazine Syrup 750mg/5ml 213 Piracetam Tablets 800mg 214 Piracetam Syrup 500mg/5ml 215 Praziquantel Tablets 600 mg 216 Pregabaline Tablets 50mg 217 Pregabaline Tablets 75mg 218 Pregabaline 111 Toleperisone Tablets 150mg 219 Pregabaline + Amitriptyline Tablets 75mg+10mg 220 Pregabaline + Amitriptyline Tablets 50mg+10mg 221 Pregabaline + Nortriptyline Tablets 75 mg+10 mg 222 Pregabaline+Methylcobalamine Tablets 75mg+750mcg 223 Pregabaline+Methylcobalamine Tablets 50mg+1500mcg 224 Pregabaline+Methylcobalamine Tablets 75mg+500mcg 225 Pregabaline+Methylcobalamine Tablets 150mg+1500mc g 226 Quetiapine Fumarate Tablets 25mg 227 Quetiapine Fumarate Tablets 100mg 228 Risperidone Tablets 4mg 229 Risperidone Tablets 3mg 230 Risperidone Tablets 2mg 231 Risperidone Tablets 1mg 232 Risperidone Tablets 0.5mg 233 Sertraline HCL Tablets 25mg 234 Sertraline HCL Tablets 50mg 235 Sertraline HCL Tablets 100mg 236 Sildenafil Citrate Tablets 50mg 237 Sildenafil Citrate Tablets 25mg 238 Sodium Valproate Tablets 200mg 239 Sodium Valproate Syrup 200mg/5ml 240 Sodium Valproate Injection 100ml/5ml 241 Sodium Valproate Tablets 300mg 242 Sodium Valproate + Valproic Acid Tablets 300mg 243 Sodium Valproate + Valproic Acid Tablets 500mg 244 Sodium Valproate + Valproic Acid Tablets 200mg 245 Sumatriptan + Naproxen Tablets 85mg+500mg 246 Tolvaptan Tablets 15mg 247 Topiramate Tablets 25 mg 248 Topiramate Tablets 112 Tramadol capsules 50 mg 249 Topiramate Tablets 113 Tramadol capsules 100 mg 250 Trihexyphenidyl (Benzhexol) 114 Tramadol Injection 50mg/ml 115 Trypsin + Bromelain + Rutoside Tablets 248 mg 251 Zaleplon +90mg+100 mg 116 Trypsin/Chymotrypsin Tablets 5mg 252 Zaleplon 2,00,000 AU 117 Trypsin/Chymotrypsin Tablets 10mg 253 Zidovudine Syrup 50mg/5ml 254 Zidovudine 1,00,000AU 118 Trypsin/Chymotrypsin Tablets 100mg 255 Zidovudine Tablets 300mg 256 Zolpidem Tablets 10 mg 257 Zolpidem Tablets 5mg 258 Zolpidem SR Tablets 6.25mg 259 Zolpidem SR Tablets 12.5mg 50,000 IU Calculation of Local Content Name of Manufacture Calculation by Manufacturer (Cost per unit of product) Cost Component Cost (Domestic Component) A Cost (Imported Component) B Total Cost (INR/ US $) C=a+b Percentage of Local Content D=(a/c)*100 I. ………… II. ………… III. Total Cost (Excluding tax and duties) Note:- I. Cost (Domestic Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken) which have not been imported directly or through a domestic trader or an intermediary. II. Cost (Imported Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken). I S/o.D/o,W/o , Resident of That I will agree to abide by the terms and conditions of the policy of Government of India issued vide order no. P-45021/2/2017-B.E.-II dated 15/06/2017. That the information furnished hereinafter is correct to best of my knowledge and belief and I undertake to produce relevant records before the procuring entity or any authority so nominated by the Government of India for the purpose of assessing the local content. That the local content for all inputs which constitute the said drugs has been verified by me and I am responsible for the correctness of the claims made therein. That in the event of the domestic valve addition of the product mentioned herein is found to be incorrect and not meeting the prescribed valve-addition norms, based on Government of India for the purpose of assessing the local content, action will be taken against me as per Order No. P-45021/2/2017-B.E.-II dated 15.06.2017. I agree to maintain the following information in the Company‟s record for a period of 8 years and shall make this available for verification to any statutory authorities: i) Name and details of the Domestic Manufacturer (Registered Officer, Manufacturing unit location, nature of legal entity) ii) Date on which this certificate is issued. iii) Medicine for which the certificate is product. iv) Procuring entity to whom the certificate is furnished. v) Percentage of local content claimed. vi) Name and contact details of the unit of the manufacturer. vii) Sale Price of the product. viii) Ex-Factory Price of the product. ix) Freight, insurance and handling. x) Total Bill of Material. xi) List and total cost valve of inputs used for manufacture of the medicine certificates from suppliers, if the input is not in-house to be attached. xii) List and cost of inputs which and imported, directly or indirectly. (Also to be provided in PDF format)

Legal Jurisdiction. The agreement shall be deemed to have been concluded in Jodhpur, Rajasthan and all obligations hereunder shall be deemed to be located at Jodhpur, Rajasthan and Court within Jodhpur, Rajasthan will have Jurisdiction to the exclusion of other courts. Complete Address, Telephone No. & Email Id Name of Proprietor/Partner/Managing Director/Director. Phone No:- Mobile No:- Email Id:- Whether the firm is a registered firm Yes/No (attached copy of certificate) Whether quoting as manufacturer/ authorised distributor/ authorised dealer PAN No. (enclose the attested copy of PAN Card) (enclose the attested copy of GST Certificate) Whether the firm has enclosed the Bank Draft/Pay Order/Banker‟s cheque as Xxxxxxx Money Deposit Whether the Firm/Agency has signed each and every page of Tender/NIT Bank Details: 1) Accounts No: 2) Bank Name: 3) Branch: 4) IFSC Code: Any other information, if necessary Place: Name: Date: Business Address: Signature of Bidder: Seal of the Bidder: Annexure-B List of Products 1 Alprazolam Tablets 0.25Abciximab 10 mg Injection 5 ml 2 Alprazolam Tablets 0.5Acyclovir Injection 500 mg 3 Alprazolam Acyclovir Suspension 400 mg/5 ml 4 Acyclovir Injection 250mg 5 Acyclovir Tablets 200mg 6 Acyclovir Tablets 400mg 7 Acyclovir Tablets 800mg 8 Albendazole Liquid 200mg 9 Albendazole Tablets 400mg 10 Alendronate Tablets 10mg 11 Amikacin Injection 50mg 12 Amikacin Injection 100mg 13 Amikacin Injection 250mg 14 Amikacin Injection 500mg 15 Amoxycillin Capsules 250 mg 16 Amoxycillin Capsules 500mg 17 Amoxycillin Liquid 125mg/5ml 18 Amoxycillin + Clavulanic Acid Liquid 200+28.5mg 19 Amoxycillin + Clavulanic Acid Tablets 200mg+28.5 mg 20 Amoxycillin + Clavulanic Acid Tablets 625mg 21 Amoxycillin + Clavulanic Acid Tablets 250mg+125mg 22 Amoxycillin + Clavulanic Acid Tablets 1000mg 23 Amoxycillin + Cloxacillin Injection 250mg+250mg 24 Amoxycillin Kid Tablets Tablets 125mg 25 Amoxycillin+ Clavulanic acid Injection 1.2gm 26 Amoxycillin+ Clavulanic acid Injection 300mg 27 Amoxycillin+ Clavulanic acid Injection 600mg 28 Amoxycillin+Cloxacillin Capsules 500mg 29 Amoxycillin+Cloxacillin+LB Capsules 250mg+250mg+60 mill 30 Amphotericin B Lipid complex Injection 50mg 31 Amphotericin B liposomal Injection 50mg 32 Ampicillin Powder for suspension 125 mg / 5 ml 33 Ampicillin Injection 250mg 34 Ampicillin Injection 500mg 35 Ampicillin Injection 100mg 36 Ampicillin Injection 500mg 37 Ampicillin + Cloxacillin Tablets 125mg+125mg 38 Ampicillin + Cloxacillin Capsules 250mg+250mg 39 Anidulafungin 100 mg Injection 30 ml 40 Artemether Injection 80mg 41 Artemether+Lumefantrine Syrup 20mg+120mg 42 Artemether+Lumefantrine Syrup 40mg/240mg 43 Artemether+Lumefantrine Tablets 80mg+480mg 00 Xxxxxxxxxx Xxxxxxx 50mg 45 Artesunate Injection 60mg 46 Artesunate Injection 120mg 47 Artesunate+sulfazdoxine+pyrimethamine Tablets 50mg+500mg+25mg 48 Artesunate+sulfazdoxine+pyrimethamine Tablets 100mg+500mg+25mg 49 Artesunate+sulfazdoxine+pyrimethamine Tablets 200mg+500+25mg 50 Azathioprine Tablets 50mg 51 Azithromycin Liquid 100mg/5ml 52 Azithromycin Liquid 200 mg/5ml 53 Azithromycin Tablets 100 mg 54 Azithromycin Tablets 250mg 55 Azithromycin Tablets 500mg 56 Azithromycin Injection 125mg 57 Azithromycin Injection 500mg 58 Aztreonam Injection 500mg 59 Aztreonam Injection 1gm 60 Aztreonam Injection 250mg 61 Aztreonam Injection 2gm 62 Benzyl Penicillin Injection 10 lakh units 63 Benzyl Penicillin Injection 5 lakh units 64 Benzyl Penicillin Injection 6lakh units 65 Benzyl Penicillin Injection 12lakh units 66 Benzyl Penicillin Injection 24lakh units 67 Cefaclor Tablets 500mg 68 Cefaclor Liq. 125mg 69 Cefadroxil Tablets 250mg 70 Cefadroxil Tablets 500mg 71 Cefazolin Injection 1gm 72 Cefdinir Tablets 300mg 73 Cefepime Injection 500mg 74 Cefepime Injection 1gm. 75 Cefepime + Tazobactam Injection 1gm+125 mg 76 Cefixime Liq. 100mg 77 Cefixime Tablets 100mg 78 Cefixime Tablets 200mg 79 Cefixime Tablets 50mg 80 Cefixime Syrup 50mg 81 Cefoperazone Injection 250mg 82 Cefoperazone Injection 500mg 83 Cefoperazone Injection 2gm 84 Cefoperazone Injection 1gm 85 Cefoperazone + Sulbactam Injection 1gm+1gm 86 Cefoperazone + Sulbactam Injection 1gm+500 mg 87 Cefotaxime Injection 125 mg 88 Cefotaxime Injection 500mg 89 Cefotaxime Injection 250mg 90 Cefotaxime Injection 1gm 91 Cefotaxime + Sulbactam Injection 500mg+250mg 92 Cefotaxime + Sulbactam Injection 1000mg+500mg 93 Cefpirome Injection 1gm 94 Cefpirome Injection 500 mg 95 Cefpirome Injection 250 mg 96 Cefpodoxime Syrup 50mg/5ml 97 Cefpodoxime Liq. 100mg/5ml 98 Cefpodoxime proxetil Tablets 50 mg 99 Cefpodoxime proxetil Tablets 100mg 100 Cefpodoxime proxetil Tablets 200mg 101 Cefprozil Tablets 250mg, 102 Cefprozil Tablets 500mg 103 Ceftazidime Injection 500mg 104 Ceftazidime Injection 1gm 105 Ceftazidime Injection 250gm 106 Ceftriaxone + Tazobactam Injection 1gm+125mg 107 Ceftriaxone Sodium Injection 125mg 108 Ceftriaxone Sodium Injection 250mg 109 Ceftriaxone Sodium Injection 1 gm 110 Ceftriaxone Sodium Injection 2gm 111 Ceftriaxone Sodium Injection 500mg 112 Cefuroxime Syrup 125mg/5ml 113 Cefuroxime Tablets 125mg 114 Cefuroxime Tablets 250 mg 115 Cefuroxime Injection 250 mg 116 Cefuroxime Tablets 500mg 117 Cefuroxime Injection 750mg 118 Cefuroxime Injection 1.5gm 119 Cephalexin Tablets 250mg 120 Cephalexin Liq. 125mg/5ml, 30ml 121 Cephalexin Capsules 250mg 122 Cephalexin Capsules 500mg 123 Chloramphenicol Tablets 250mg 124 Chloramphenicol Tablets 500mg 125 Chloroquine Tablets 250mg 126 Chloroquine phosphate Tablets 150 mg base 127 Chloroquine phosphate Injection 40 mg /ml 128 Chloroquine phosphate Syrup 50 mg / 5 ml 129 Chlorpheniramine maleate Liq. 0.5mg/5ml 130 Cholroquine Tablets 500 mg. 131 Ciprofloxacin Tablets 250mg 132 Ciprofloxacin Tablets 500mg 133 Ciprofloxacin Tablets 1gm 134 Ciprofloxacin Syrup 125mg/5ml 135 Ciprofloxacin + Ornidazole Tablets 500mg+500mg 136 Ciprofloxacin + Tinidazole Tablets 500mg + 600mg 137 Ciprofloxacin 200 mg Injection 100 ml 138 Ciprofloxacin 400mg Injection 100 ml 139 Cisatracurium besylate Injection 2 mg/ml 140 Clarithromycin Injection 50mg 141 Clarithromycin Tablets 250mg 142 Clindamycin Injection 300mg/ml 143 Clindamycin Injection 600mg/ml 144 Clindamycin Capsules 300mg 145 Clindamycin Capsules 600mg 146 Clindamycin Tablets 150mg 147 Clindamycin Tablets 300mg 148 Clofazimine Tablets 50mg 149 Clofazimine Tablets 100mg 150 Clotrimazole Pessaries 100mg 151 Clotrimazole Pessaries 200 mg, 152 Clotrimazole Gel 2% 153 Clotrimazole+ Clindamycin Pessary 100mg+100mg 154 Cloxacillin Injection 500mg 155 Cloxacillin Injection 250mg 156 Cloxacillin Capsules 250mg 157 Cloxacillin Capsules 500mg 158 Cloxacillin Syrup 125mg/5ml 159 Cloxacillin Tablets 250mg 160 Cloxacillin Tablets 500mg 161 Cotrimoxazole (Sulphamethoxazole200mg + Trimethoprim 40mg) per vial Liq. 40 + 200 mg / 5 ml 162 Cotrimoxazole (Sulphamethoxazole + Trimethoprim) Sulphamthoxazole + Trimethoprin Tablets 200mg+40mg, 400 MG + 80 MG 163 Co-Trimoxazole(Trimethoprim +Sulphamethoxazole) Tablets 160+800 mg 164 Crizotinib Capsules 200mg 165 Crizotinib Capsules 250mg 166 Cycloserine Tablets 250mg 167 Cyclosporine Tablets 50mg 168 Cyclosporine Tablets 100mg 169 Cyclosporine Tablets 25mg 170 D - Penicillamine Tablets 125 mg 171 D - Penicillamine Tablets 250 mg 172 D - Penicillamine Tablets 50 mg 173 Dapsone Tablets 50 mg 174 Dapsone Tablets 100mg 175 Daptomycin Injection 350 mg. 176 Dihydroergotamine Tablets 1 mg 4 Amitriptyline Tablets 10mg 5 Amitriptyline Tablets 75 mg 6 Amitriptyline Tablets 25 mg 7 Amitriptyline Tablets 50 mg 8 Amitriptyline Tablets 100 mg 9 Amitriptyline Tablets 150 mg 10 Amitriptyline + Chlordiazepoxide Tablets 25 mg + 10mg 11 Amitriptyline + Chlordiazepoxide Tablets 12.5 mg+ 5mg 12 Betahistine Tablets 16mg 13 Betahistine Tablets 24mg 14 Betahistine Tablets 32mg 15 Botulinum Toxid Injection 100 Units 16 Bromocriptine Tablets 5mg 17 Bromocriptine Tablets 2.5mg 18 Bupenorphine +Naloxone Tablets 2 mg + 0.5mg 19 Buprenorphine Tablets 8mg 20 Buprenorphine Tablets 0.4mg 21 Buprenorphine sublingual Tablets 0.2mg 22 Buprenorphine sublingual Tablets 8mg 24 Buprenorphine sublingual Tablets 0.4mg 25 Carbamazepine Tablets 100mg 26 Carbamazepine Tablets 200mg 27 Carbamazepine Tablets 400mg 28 Carbamazepine syrup 100mg/5ml 29 Carbamazepine SR Tablets 200mg 30 Carbamazepine SR Tablets 400mg 31 Carbidopa Tablets 25mg 32 Carbidopa Tablets 50mg 33 Carbidopa Tablets 100mg 34 Chlorpromazine hydrochloride Tablets 25 mg 35 Chlorpromazine hydrochloride Syrup 25mg/5ml 36 Chlorpromazine hydrochloride Injection 25mg/ml 37 Chlorpromazine hydrochloride Tablets 50mg 38 Chlorpromazine hydrochloride Tablets 100mg 39 Cilnidipine Tablets 10mg 40 Cilnidipine Tablets 5 mg 41 Citalopram Tablets 10mg 42 Citalopram Tablets 20mg 43 Citalopram Tablets 40mg 44 Citicholine Tablets 500mg 45 Citicholine Injection 250mg/ml 46 Citicholine + Piracetam Tablets 500mg+800mg 47 Clobazam Tablets 2.5 mg 48 Clobazam Tablets 10 mg 49 Clobazam Tablets 5mg 50 Clonazepam Tablets 0.25mg 51 Clonazepam Tablets 0.5mg 52 Clonazepam Tablets 1 mg 53 Clonazepam Tablets 2mg 54 Clonazepam MD Tablets 2 mg 55 Colchicine Tablets 0.6 mg 56 Colchicine Tablets 0.5 mg 57 Colchicine Tablets 1mg 58 Conivaptan Injection 20mg/100ml 59 Deferasirox Tablets 100mg 60 Deferasirox Tablets 400mg 61 Deferasirox Tablets 250mg 62 Deferasirox Tablets 500mg 63 Deferiprone Capsules 250mg 64 Deferiprone Capsules 500mg 65 Deferiprone Tablets 500 mg 66 Deferiprone Tablets 1000 mg 67 Desvenlafaxine Tablets 50mg 68 Desvenlafaxine Tablets 100mg 69 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+325mg+1 0mg 70 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+500mg+1 0mg 71 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+650mg+1 0mg 72 Diazepam Tablets 2 mg 73 Diazepam Tablets 5mg 74 Diazepam Tablets 10mg 75 Diazepam Rectal Suppository 5mg 76 Diazepam Tablets 3 mg 77 Diazepam Rectal Suppository 2.5 mg 78 Diazepam Injection 10mg/2ml 79 Diazoxide Tablets 50 mg 80 Diethylcarbamazine citrate Tablets 50 mg 81 Diethylcarbamazine citrate Tablets 100 mg 82 Disulfiram Tablets 250mg 83 Disulfiram Tablets 500 mg 84 Divalproex equivalent to valproic acid 250 mg syrup 100 ml 85 Divalproex Sodium Tablets 250mg 86 Divalproex Sodium Tablets 500mg 87 Divalproex Sodium Tablets 125 mg 88 Divalproex Sodium Tablets 250 mg ER 89 Divalproex Sodium Tablets 500 mg ER 90 Divalproex Sodium Tablets 125 mg ER 91 Duloxetine Hydrochloride Tablets 20mg 92 Duloxetine Hydrochloride Tablets 30mg 93 Duloxetine Hydrochloride Tablets 60mg 94 Eperisone hydrochloride Tablets 150 mg 95 Eperisone hydrochloride Tablets 450 mg 96 Escitalopram Tablets 5mg 97 Escitalopram Tablets 10mg 98 Escitalopram Tablets 20mg 99 Escitalopram + Clonazepam Tablets 10mg+0.25mg 100 Escitalopram + Clonazepam Tablets 10mg+0.5mg 101 Fludrocortisone Tablets 0.1mg 102 Flumazenil Injection 0.5 mg / 5ml 103 Flumazenil Injection 1 mg / 10 ml 104 Flunarizine Tablets 5mg 105 Flunarizine Tablets 10mg 106 Fluoxetine Tablets 40mg 107 Fluoxetine Capsules 20mg 108 Fluoxetine Tablets 20mg 109 Fluoxetine Tablets 40mg 110 Fluoxetine Tablets 60mg 111 Fluoxetine Tablets 10mg 112 Fluoxetine Capsules 20mg 113 Fluphenazile decanoate Injection 125mg/5ml 114 Flupiritine Tablets 100mg 115 Flupiritine Tablets 200mg 116 Fosphenytoin 177 Dimenhydrinate Injection 50mg/ml 117 Gabapentin 178 Doripenem Injection 500 mg 179 Doxycycline Tablets 100mg 180 Doxycycline Syrup 10mg/ml, 10ml 181 Doxycycline +Lactic acid Bacillus capsule 100mg 182 Doxycycline Injection Injection 100 mg 183 Ertapenem Injection 1gm 184 Erythromycin Syrup 250mg/ml 185 Erythromycin Tablets 250mg 186 Estolate Tablets 250 mg 187 Estolate Tablets 500 mg 188 Ethambutol Tablets 800mg 189 Ethambutol Tablets 400mg 118 Gabapentine 190 Ethambutol Tablets 200mg 191 Ethambutol Tablets 600 mg 192 Ethionamide Tablets 250 mg 193 Ethionamide Tablets 500mg 194 Faropenem Tablets 150mg 195 Faropenem Tablets 200mg 196 Fluconazole Injection 2mg/ml 197 Fluconazole Tablets 50mg 198 Fluconazole Tablets 100mg 199 Fluconazole Tablets 150mg 200 Fluconazole Tablets 200mg 201 Fluconazole Tablets 400mg 202 Ganciclovir Injection 500mg 203 Ganciclovir Tablets 250mg 204 Gatifloxacin Tablets 200mg 205 Gatifloxacin Tablets 400mg 206 Gatifloxacin Injection 200 ml 207 Gemifloxacin . Tablets 320mg 208 Gentamicin Injection 40mg./ml 209 Griseofulvin Tablets 125 mg 210 Griseofulvin Capsules 125 mg 211 Griseofulvin Capsules 250 mg 212 Griseofulvin Tablets 250 mg 213 Hydroxychloroquine Tablets 200mg 214 Isoniazid Tablets 50mg 215 Isoniazid Syrup 100 mg/5ml 216 Isoniazid Tablets 200 mg 217 Isoniazid Tablets 300mg 218 Isoniazid Tablets 100mg 219 Isoniazid +Rifampicin Tablets 300mg+450mg 220 Isoniazid +Rifampicin Tablets 300mg+600mg 221 Itraconazole Capsules 100mg 222 Itraconazole Tablets 200mg 223 Ketoconazole Tablets 200mg 224 Lactic Acid Bacillus Tablets 120 million Spores 225 Levofloxacin Injection 500mg 226 Levofloxacin Tablets 500mg 227 Linezolid Injection 600mg 228 Linezolid Tablets 600mg 119 Gabapentine Tablets 300mg 120 Gabapentine Cap. 300mg 121 Gabapentine + Mecobalamine Tablets 300 mg+ 0.5 mg 122 Gabapentine + Nortriptyline Tablets 400 mg + 10 mg 123 Glycerol Syrup 100ml 124 Glycerol Syrup 500ml 125 Haloperidol Tablets 2mg 126 Haloperidol Tablets 5mg 127 Haloperidol Tablets 10 mg 128 Haloperidol Injection 5mg/ml 129 Hydroxyzine Tablets 10mg 130 Hydroxyzine Tablets 25mg 131 Hydroxyzine Syrup 10mg/5ml 132 Imipramine Tablets 25 mg 133 Imipramine Tablets 75 mg 134 Lacosamide Tablets 50 mg 135 Lacosamide Tablets 100 mg 136 Lacosamide Tablets 150 mg 137 Lacosamide Tablets 200 mg 138 Lacosamide Syrup 50 mg/5ml 139 Lacosamide Injection 10 mg/ml 140 Lamotrigin Tablets 25mg 141 Lamotrigin Tablets 100 mg 142 Lamotrigin Tablets 150mg 143 Lamotrigin Tablets 200 mg 144 Lecithin 30mg+ equivalent to 175 mg of essential Phospholipids (EPL)(phosphatidylcholine,phosphatidylethanolamine,phospha tidylinositol,phosphatidylserine) Capsules (350+175)mg 145 Levetiracetam Tablets 250 mg 146 Levetiracetam Tablets 500 mg 147 Levetiracetam Tablets 750mg 148 Levetiracetam Tablets 1000 mg 149 Levetiracetam Injection 100mg/5 ml. 150 Levetiracetam 229 Linezolid Syrup 100mg/ml 151 Lithium Carbonate 230 Mebendazole Syrup 100mg/5ml 231 Mebendazole Tablets 450mg 152 Lithium Carbonate Tablets 300mg 153 Lithium Carbonate SR Tablets 400mg 154 Lorazepam Tablets 0.5 mg 155 Lorazepam Tablets 1mg 156 Lorazepam Tablets 2mg 157 Lorazepam 2mg Injection 2 ml 158 Lorazepam 2mg Injection 4 ml 159 Magnesium Sulfate, Urea & Sulphacetamide Sdoium Ointment 75gm 160 Mefloquine Tablets 250mg 161 Melatonin Tablets 0.5mg 162 Melatonin Tablets 3mg 163 Melatonin Tablets 6mg 164 Methyldopa Tablets 250mg 165 Methyldopa Tablets 125 mg 166 Methyldopa Tablets 500 mg 167 Naltrexone Tablets 50mg 168 Naproxen Tablets 250mg 169 Naproxen Tablets 500mg 170 Naproxen Tablets 750mg 171 Naproxen + Domperidone Tablets 500mg+10mg 172 Nevirapine Tablets 200mg 173 Nevirapine syrup 10mg/ml 174 Nicotine Chewing gum Tablets 2mg 175 Nicotine Chewing gum Tablets 4mg 176 Nimodipine Tablets 30mg 177 Nimodipine Injection 10mg/50ml 178 Nitrazepam Tablets 5mg 179 Nitrazepam Tablets 10mg 180 Nortriptyline Tablets 25mg 181 Nortriptyline Tablets 10 mg 182 Olanzapine Tablets 20mg 183 Olanzapine Tablets 2.5mg 184 Olanzapine Tablets 5mg 185 Olanzapine Tablets 7.5mg 186 Olanzapine Tablets 10mg 187 Olanzapine Injection 10mg/ml 188 Oxcarbamazepine Tablets 150mg 189 Oxcarbamazepine Tablets 300mg 190 Oxcarbamazepine Tablets 600mg 191 Oxcarbamazepine 300 mg Syrups 60 ml 192 Paracetamol Injection 150mg/2ml 193 Paracetamol Injection 500mg/50 ml 194 Paracetamol 10mg/ml (PLASTIC BOT ) Injection 1 gm/ 100 ml 195 Paracetamol + Tramadol Tablets 325mg+37.5mg 196 Paracetamol 10mg/ ml (GLASS BOT ) Injection 1 gm/ 100 ml 197 Paroxetine Tablets 12.5mg 198 Paroxetine Tablets 25mg 199 Paroxetine Tablets 37.5mg 200 Pergolide Tablets 0.05mg 201 Pergolide Tablets 0.25mg 202 Pergolide Tablets 1mg 203 Phenobarbitone Tablets 30mg 204 Phenobarbitone Tablets 60mg 205 Phenobarbitone Syrup 20mg/5ml 206 Phenobarbitone Injection 200mg /1ml 207 Phenytoin Sodium Tablets 50 mg 208 Phenytoin Sodium Tablets 100mg 209 Phenytoin Sodium Injection 25mg/ml 210 Phenytoin Sodium Liquids 100ml(25mg/ml) 211 Piperazine Tablets 500 mg 212 Piperazine Syrup 750mg/5ml 213 Piracetam Tablets 800mg 214 Piracetam Syrup 500mg/5ml 215 Praziquantel Tablets 600 mg 216 Pregabaline Tablets 50mg 217 Pregabaline Tablets 75mg 218 Pregabaline Tablets 150mg 219 Pregabaline + Amitriptyline Tablets 75mg+10mg 220 Pregabaline + Amitriptyline Tablets 50mg+10mg 221 Pregabaline + Nortriptyline Tablets 75 mg+10 mg 222 Pregabaline+Methylcobalamine Tablets 75mg+750mcg 223 Pregabaline+Methylcobalamine Tablets 50mg+1500mcg 224 Pregabaline+Methylcobalamine Tablets 75mg+500mcg 225 Pregabaline+Methylcobalamine Tablets 150mg+1500mc g 226 Quetiapine Fumarate Tablets 25mg 227 Quetiapine Fumarate Tablets 100mg 228 Risperidone Tablets 4mg 229 Risperidone Tablets 3mg 230 Risperidone Tablets 2mg 231 Risperidone Tablets 1mg 232 Risperidone Tablets 0.5mg Meropenem Injection 1gm 233 Sertraline HCL Tablets 25mg Meropenem Injection 500 gm 234 Sertraline HCL Tablets 50mg Meropenem+ Sulbactum Injection 1.5gm 235 Sertraline HCL Minocycline Tablets 100mg 236 Sildenafil Citrate Minocycline Injection 100 mg 237 Moxifloxacin HCL 400mg Injection, 100ml 238 Mycophenolate Mofetil Tablets 180mg 239 Mycophenolate Mofetil Tablets 360mg 240 Netilmicin Injection 200mg 241 Netilmicin Injection 300mg 242 Norfloxacin Tablets 400mg 243 Nystatin Tablets 500,000 IU 244 Nystatin Pessaries 100,000 IU 245 Ofloxacin Injection 200mg 246 Ofloxacin Tablets 100mg(USP) 247 Ofloxacin Tablets 200mg(USP) 248 Ofloxacin Tablets 400mg(USP) 249 Ofloxacin Syrup 50mg/5m l 250 Ofloxacin Syrup 30 ml 251 Oseltamivir Capsules 30mg 252 Oseltamivir Capsules 45mg 253 Oseltamivir Capsules 60mg 254 Oseltamivir Syrup 6mg/ ml 255 Pantaglobin Injection 10ml 256 Pantaglobin Injection 50ml 257 Pantaglobin Injection 100ml 258 Pazufloxacin Injection 500mg 259 Penicillin Tablets 125mg 260 Penicillin Tablets 250mg 261 Phosphomycine 4 mg/iv Injection 4 mg/iv 262 Piperacillin 1gm +Tazobactum 125mg Injection 1gm+125mg 263 Piperacillin 2gm.+Tazobactam 250mg Injection 2.25gm 264 Piperacillin 4gm.+Tazobactam 500mg. Injection 4.5gm 265 Primaquine Tablets 2.5 mg 266 Primaquine Tablets 7.5 mg 267 Primaquine Tablets 15mg 268 Pyrazinamide Tablets 500mg 269 Pyrazinamide Tablets 750mg 270 Pyrazinamide Tablets 1000 mg 271 Pyrazinamide Tablets 1500 mg 273 Pyrimethamine Tablets 25 mg 274 Pyrimethamine Tablets 300 mg 275 Pyrimethamine+sulphadoxine Syrup 12.5mg+250mg/5ml 276 Quinine Sulphate Tablets 300mg 277 Quinine Sulphate Tablets 600mg 278 Rifampicin Tablets 50 mg 279 Rifampicin Capsules 50 mg 280 Rifampicin Capsules 150 mg 281 Rifampicin Capsules 300 mg 282 Rifampicin Capsules 450 mg 283 Rifampicin Liq. 100mg/5ml 284 Rifampicin Tablets 150mg 285 Rifampicin Tablets 300mg 286 Rifampicin Tablets 450mg 287 Rifampicin Tablets 600mg 288 Rifampicin Injection 60 mg Vial 289 Rifampicin+ Isoniazid+ Ethambutol+ Pyrazinamide Tablets 450mg+300mg+800mg+750mg 290 Roxithromycin Liq. 50mg/5ml, 30ml 291 Roxithromycin Tablets 50mg 237 Sildenafil Citrate Tablets 25mg 238 Sodium Valproate Tablets 200mg 239 Sodium Valproate Syrup 200mg/5ml 240 Sodium Valproate Injection 100ml/5ml 241 Sodium Valproate 292 Roxithromycin Tablets 300mg 242 Sodium Valproate + Valproic Acid 293 Roxithromycin Tablets 300150mg 243 Sodium Valproate + Valproic Acid 294 Saccharomyces boulardii Capsules 250mg 295 Saccharomyces boulardii Capsules 750mg 296 Sirolimus Tablets 5001mg 244 Sodium Valproate + Valproic Acid Tablets 200297 Stavudine Capsules 30mg 245 Sumatriptan + Naproxen Tablets 85mg+500mg 246 Tolvaptan 298 Stavudine Tablets 15mg 247 Topiramate 299 Stavudine Tablets 20mg 300 Stavudine Tablets 30mg 301 Stavudine Tablets 40mg 302 Stavudine Syrup 1mg/ml 303 Streptomycin Injection 0.75mg 304 Streptomycin Injection 1gm. 305 Sulbactam Injection 1g 306 Sulbactam Injection 2g 307 Sulfadoxine + Pyrimethamine Tablets 500 mg + 25 mg 248 Topiramate 308 Tacrolimus Tablets 1mg 309 Teicoplanin Injection 200mg 310 Teicoplanin Injection 400mg 311 Thalidomide Capsules 100mg 312 Ticarcillin 3gm+Clavulanic Acid 100mg Injection 3gm+100mg 313 Tigecycline Injection 50 mg 249 Topiramate 314 Tobramycin Injection 80mg/2ml 315 Triamcinolone Acetonide Injection 40mg/ml 316 Vancomycin Hydrochloride Injection 1gm 317 Vancomycin Hydrochloride Injection 500 mg 318 Vancomycin with Factor B purity Injection 500mg 319 Voriconazole Injection 50 mg 320 Voriconazole Tablets 100 200 mg 250 Trihexyphenidyl (Benzhexol) 321 Voriconazole Tablets 250mg 251 Zaleplon Tablets 5mg 252 Zaleplon Tablets 10mg 253 Zidovudine Syrup 50mg/5ml 254 Zidovudine Tablets 100mg 255 Zidovudine Tablets 300mg 256 Zolpidem Tablets 10 mg 257 Zolpidem Tablets 5mg 258 Zolpidem SR Tablets 6.25mg 259 Zolpidem SR Tablets 12.5322 Voriconazole Injection 200 mg Calculation of Local Content Name of Manufacture Calculation by Manufacturer (Cost per unit of product) Cost Component Cost (Domestic Component) A Cost (Imported Component) B Total Cost (INR/ US $) C=a+b Percentage of Local Content D=(a/c)*100 I. ………… II. ………… III. Total Cost (Excluding tax and duties) Note:- I. Cost (Domestic Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken) which have not been imported directly or through a domestic trader or an intermediary. II. Cost (Imported Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken). I S/o.D/o,W/o , Resident of That I will agree to abide by the terms and conditions of the policy of Government of India issued vide order no. P-45021/2/2017-B.E.-II dated 15/06/2017. That the information furnished hereinafter is correct to best of my knowledge and belief and I undertake to produce relevant records before the procuring entity or any authority so nominated by the Government of India for the purpose of assessing the local content. That the local content for all inputs which constitute the said drugs has been verified by me and I am responsible for the correctness of the claims made therein. That in the event of the domestic valve addition of the product mentioned herein is found to be incorrect and not meeting the prescribed valve-addition norms, based on Government of India for the purpose of assessing the local content, action will be taken against me as per Order No. P-45021/2/2017-B.E.-II dated 15.06.2017. I agree to maintain the following information in the Company‟s record for a period of 8 years and shall make this available for verification to any statutory authorities: i) Name and details of the Domestic Manufacturer (Registered Officer, Manufacturing unit location, nature of legal entity) ii) Date on which this certificate is issued. iii) Medicine for which the certificate is product. iv) Procuring entity to whom the certificate is furnished. v) Percentage of local content claimed. vi) Name and contact details of the unit of the manufacturer. vii) Sale Price of the product. viii) Ex-Factory Price of the product. ix) Freight, insurance and handling. x) Total Bill of Material. xi) List and total cost valve of inputs used for manufacture of the medicine certificates from suppliers, if the input is not in-house to be attached. xii) List and cost of inputs which and imported, directly or indirectly. (Also to be provided in PDF format)

Legal Jurisdiction. The agreement shall be deemed to have been concluded in Jodhpur, Rajasthan and all obligations hereunder shall be deemed to be located at Jodhpur, Rajasthan and Court within Jodhpur, Rajasthan will have Jurisdiction to the exclusion of other courts. Complete Address, Telephone No. & Email Id Name of Proprietor/Partner/Managing Director/Director. Phone No:- Mobile No:- Email Id:- Whether the firm is a registered firm Yes/No (attached copy of certificate) Whether quoting as manufacturer/ authorised distributor/ authorised dealer PAN No. (enclose the attested copy of PAN Card) (enclose the attested copy of GST Certificate) Whether the firm has enclosed the Bank Draft/Pay Order/Banker‟s cheque as Xxxxxxx Money Deposit Whether the Firm/Agency has signed each and every page of Tender/NIT Bank Details: 1) Accounts No: 2) Bank Name: 3) Branch: 4) IFSC Code: Any other information, if necessary Place: Name: Date: Business Address: Signature of Bidder: Seal of the Bidder: Annexure-B List of Products 1 Alprazolam Tablets 0.25mg 2 Alprazolam Tablets 0.5mg 3 Alprazolam Tablets Adernaline Injections 1ml 4 Anti Heamophilic Factor VIII Vial Injections (250-400 I.U) 5 Anti Heamophilic Factor VIII Vial Injections (500-650 I.U) 7 Atropine Injections 1 mg 4 Amitriptyline Tablets 10mg 5 Amitriptyline Tablets 75 mg 6 Amitriptyline Tablets 25 mg 7 Amitriptyline ml 8 Bicalutamide Tablets 50 mg 8 Amitriptyline Tablets 9 Cyclosporine bottle Lquid 100mg 10 Dextrose 25% Injections 25ml 11 Dextrose 50% Injections 50 ml 12 Fludarabine Phosphate Injections 50mg 13 Fulbexterant PFS Injections 100 mg 9 Amitriptyline Tablets 150 mg 10 Amitriptyline + Chlordiazepoxide Tablets 25 mg + 10mg 11 Amitriptyline + Chlordiazepoxide Tablets 12.5 mg+ 5mg 12 Betahistine Tablets 16mg 13 Betahistine Tablets 24mg 14 Betahistine Tablets 32Fulbexterant Vial Injections 100 mg 15 Botulinum Toxid Injection 100 Units Gefitinib Capsules 250mg 16 Bromocriptine Tablets 5mg 17 Bromocriptine Tablets 2.5mg 18 Bupenorphine +Naloxone Tablets 2 mg + 0.5mg 19 Buprenorphine Tablets 8mg 20 Buprenorphine Tablets 0.4mg 21 Buprenorphine sublingual Tablets 0.2mg 22 Buprenorphine sublingual Tablets 8mg 24 Buprenorphine sublingual Tablets 0.4mg 25 Carbamazepine Tablets 100mg 26 Carbamazepine Tablets 200mg 27 Carbamazepine Tablets 400mg 28 Carbamazepine syrup 100mg/5ml 29 Carbamazepine SR Tablets 200mg 30 Carbamazepine SR Tablets 400mg 31 Carbidopa Tablets 25mg 32 Carbidopa Ibandornic Acid Tablets 50mg 33 Carbidopa Tablets 10017 Ibandornic Acid Vial Injections 6mg 34 Chlorpromazine hydrochloride Tablets 25 mg 35 Chlorpromazine hydrochloride Syrup 25mg/5ml 36 Chlorpromazine hydrochloride Injection 25mg18 Isoprenaline 2mg/ ml Injections 2ml 19 Magnesium Sulphate 50%w/ml 37 Chlorpromazine hydrochloride Tablets 50mg 38 Chlorpromazine hydrochloride Tablets 100mg 39 Cilnidipine Tablets 10mg 40 Cilnidipine Tablets 5 mg 41 Citalopram Tablets 10mg 42 Citalopram Tablets 20mg 43 Citalopram v Injections 2ml 20 Megestrol Acetate Tablets 40mg 44 Citicholine Tablets 500mg 45 Citicholine Injection 250mg/ml 46 Citicholine + Piracetam Tablets 500mg+800mg 47 Clobazam Tablets 2.5 mg 48 Clobazam Tablets 10 mg 49 Clobazam Tablets 5mg 50 Clonazepam Tablets 0.25mg 51 Clonazepam Tablets 0.5mg 52 Clonazepam Tablets 1 mg 53 Clonazepam Tablets 2mg 54 Clonazepam MD Tablets 2 mg 55 Colchicine Tablets 0.6 mg 56 Colchicine Tablets 0.5 mg 57 Colchicine Tablets 1mg 58 Conivaptan Injection 20mg/100ml 59 Deferasirox Tablets 100mg 60 Deferasirox Tablets 400mg 61 Deferasirox Tablets 250mg 62 Deferasirox Tablets 500mg 63 Deferiprone Capsules 250mg 64 Deferiprone Capsules 500mg 65 Deferiprone Tablets 500 mg 66 Deferiprone Tablets 1000 mg 67 Desvenlafaxine Tablets 50mg 68 Desvenlafaxine Tablets 100mg 69 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+325mg+1 0mg 70 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+500mg+1 0mg 71 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+650mg+1 0mg 72 Diazepam Tablets 2 mg 73 Diazepam Tablets 5mg 74 Diazepam Tablets 21 Nalidixic acid syrup 300mg/5ml 22 Normal Immunoglobin Vial Injections 5gm 23 Phenylephprine Injections 10mg 75 Diazepam Rectal Suppository 5mg 76 Diazepam Tablets 3 mg 77 Diazepam Rectal Suppository 2.5 mg 78 Diazepam Injection 10mg/2ml 79 Diazoxide Tablets 50 mg 80 Diethylcarbamazine citrate Tablets 50 mg 81 Diethylcarbamazine citrate Tablets 100 mg 82 Disulfiram Tablets 250mg 83 Disulfiram Tablets 500 mg 84 Divalproex equivalent to valproic acid 250 mg syrup 100 ml 85 Divalproex Sodium Tablets 250mg 86 Divalproex Sodium Tablets 500mg 87 Divalproex Sodium Tablets 125 mg 88 Divalproex Sodium Tablets 250 mg ER 89 Divalproex Sodium Tablets 500 mg ER 90 Divalproex Sodium Tablets 125 mg ER 91 Duloxetine Hydrochloride Tablets 20mg 92 Duloxetine Hydrochloride Tablets 30mg 93 Duloxetine Hydrochloride Tablets 60mg 94 Eperisone hydrochloride Tablets 150 mg 95 Eperisone hydrochloride Tablets 450 mg 96 Escitalopram Tablets 5mg 97 Escitalopram Tablets 10mg 98 Escitalopram Tablets 20mg 99 Escitalopram + Clonazepam Tablets 10mg+0.25mg 100 Escitalopram + Clonazepam Tablets 10mg+0.5mg 101 Fludrocortisone Tablets 0.1mg 102 Flumazenil Injection 0.5 mg / 5ml 103 Flumazenil Injection 1 mg / 10 ml 104 Flunarizine Tablets 5mg 105 Flunarizine Tablets 10mg 106 Fluoxetine Tablets 40mg 107 Fluoxetine Capsules 20mg 108 Fluoxetine Tablets 20mg 109 Fluoxetine Tablets 40mg 110 Fluoxetine Tablets 60mg 111 Fluoxetine Tablets 10mg 112 Fluoxetine Capsules 20mg 113 Fluphenazile decanoate Injection 125mg/5ml 114 Flupiritine Tablets 100mg 115 Flupiritine Tablets 200mg 116 Fosphenytoin Injection 50mg/ml 117 Gabapentin Tablets 400mg 118 Gabapentine Tablets 600mg 119 Gabapentine Tablets 300mg 120 Gabapentine Cap. 300mg 121 Gabapentine + Mecobalamine Tablets 300 mg+ 0.5 mg 122 Gabapentine + Nortriptyline Tablets 400 mg + 10 mg 123 Glycerol Syrup 100ml 124 Glycerol Syrup 500ml 125 Haloperidol Tablets 2mg 126 Haloperidol Tablets 5mg 127 Haloperidol Tablets 10 mg 128 Haloperidol Injection 5mg/ml 129 Hydroxyzine Tablets 10mg 130 Hydroxyzine Tablets 25mg 131 Hydroxyzine Syrup 10mg/5ml 132 Imipramine Tablets 25 mg 133 Imipramine Tablets 75 mg 134 Lacosamide Tablets 50 mg 135 Lacosamide Tablets 100 mg 136 Lacosamide Tablets 150 mg 137 Lacosamide Tablets 200 mg 138 Lacosamide Syrup 50 mg/5ml 139 Lacosamide Injection 10 mg/ml 140 Lamotrigin Tablets 25mg 141 Lamotrigin Tablets 100 mg 142 Lamotrigin Tablets 24 Potassium Chloride 150mg 143 Lamotrigin Tablets 200 mg 144 Lecithin 30mg+ equivalent to 175 mg of essential Phospholipids (EPL)(phosphatidylcholine,phosphatidylethanolamine,phospha tidylinositol,phosphatidylserine) Capsules (350+175)mg 145 Levetiracetam Tablets 250 mg 146 Levetiracetam Tablets Injections 10ml 25 Potassium Chlorlide syrup 500mg/5ml 26 Purifid Botulinum Toxin Vial Injections 100IU 27 Quinine Injections 2ml 28 Sodium Bicarbonate 7.5% Injections 10ml 29 Sodium Bicarbonate 7.5% Injections 25ml 30 Sterile water Injection 10ml 31 Sterile water Injection 50ml 32 Sterile water Injections 5ml 33 Type A Vial Injections 100IU 34 Vitamin C. Injections 500 mg 147 Levetiracetam Tablets 750mg 148 Levetiracetam Tablets 1000 mg 149 Levetiracetam Injection 100mg/5 ml. 150 Levetiracetam Syrup 100mg/ml 151 Lithium Carbonate Tablets 450mg 152 Lithium Carbonate Tablets 300mg 153 Lithium Carbonate SR Tablets 400mg 154 Lorazepam Tablets 0.5 mg 155 Lorazepam Tablets 1mg 156 Lorazepam Tablets 2mg 157 Lorazepam 2mg Injection 2 ml 158 Lorazepam 2mg Injection 4 ml 159 Magnesium Sulfate, Urea & Sulphacetamide Sdoium Ointment 75gm 160 Mefloquine Tablets 250mg 161 Melatonin Tablets 0.5mg 162 Melatonin Tablets 3mg 163 Melatonin Tablets 6mg 164 Methyldopa Tablets 250mg 165 Methyldopa Tablets 125 mg 166 Methyldopa Tablets 500 mg 167 Naltrexone Tablets 50mg 168 Naproxen Tablets 250mg 169 Naproxen Tablets 500mg 170 Naproxen Tablets 750mg 171 Naproxen + Domperidone Tablets 500mg+10mg 172 Nevirapine Tablets 200mg 173 Nevirapine syrup 10mg/ml 174 Nicotine Chewing gum Tablets 2mg 175 Nicotine Chewing gum Tablets 4mg 176 Nimodipine Tablets 30mg 177 Nimodipine Injection 10mg/50ml 178 Nitrazepam Tablets 5mg 179 Nitrazepam Tablets 10mg 180 Nortriptyline Tablets 25mg 181 Nortriptyline Tablets 10 mg 182 Olanzapine Tablets 20mg 183 Olanzapine Tablets 2.5mg 184 Olanzapine Tablets 5mg 185 Olanzapine Tablets 7.5mg 186 Olanzapine Tablets 10mg 187 Olanzapine Injection 10mg/ml 188 Oxcarbamazepine Tablets 150mg 189 Oxcarbamazepine Tablets 300mg 190 Oxcarbamazepine Tablets 600mg 191 Oxcarbamazepine 300 mg Syrups 60 ml 192 Paracetamol Injection 150mg/2ml 193 Paracetamol Injection 500mg/50 ml 194 Paracetamol 10mg/ml (PLASTIC BOT ) Injection 1 gm/ 100 ml 195 Paracetamol + Tramadol Tablets 325mg+37.5mg 196 Paracetamol 10mg/ ml (GLASS BOT ) Injection 1 gm/ 100 ml 197 Paroxetine Tablets 12.5mg 198 Paroxetine Tablets 25mg 199 Paroxetine Tablets 37.5mg 200 Pergolide Tablets 0.05mg 201 Pergolide Tablets 0.25mg 202 Pergolide Tablets 1mg 203 Phenobarbitone Tablets 30mg 204 Phenobarbitone Tablets 60mg 205 Phenobarbitone Syrup 20mg/5ml 206 Phenobarbitone Injection 200mg /1ml 207 Phenytoin Sodium Tablets 50 mg 208 Phenytoin Sodium Tablets 100mg 209 Phenytoin Sodium Injection 25mg/ml 210 Phenytoin Sodium Liquids 100ml(25mg/ml) 211 Piperazine Tablets 500 mg 212 Piperazine Syrup 750mg/5ml 213 Piracetam Tablets 800mg 214 Piracetam Syrup 500mg/5ml 215 Praziquantel Tablets 600 mg 216 Pregabaline Tablets 50mg 217 Pregabaline Tablets 75mg 218 Pregabaline Tablets 150mg 219 Pregabaline + Amitriptyline Tablets 75mg+10mg 220 Pregabaline + Amitriptyline Tablets 50mg+10mg 221 Pregabaline + Nortriptyline Tablets 75 mg+10 mg 222 Pregabaline+Methylcobalamine Tablets 75mg+750mcg 223 Pregabaline+Methylcobalamine Tablets 50mg+1500mcg 224 Pregabaline+Methylcobalamine Tablets 75mg+500mcg 225 Pregabaline+Methylcobalamine Tablets 150mg+1500mc g 226 Quetiapine Fumarate Tablets 25mg 227 Quetiapine Fumarate Tablets 100mg 228 Risperidone Tablets 4mg 229 Risperidone Tablets 3mg 230 Risperidone Tablets 2mg 231 Risperidone Tablets 1mg 232 Risperidone Tablets 0.5mg 233 Sertraline HCL Tablets 25mg 234 Sertraline HCL Tablets 50mg 235 Sertraline HCL Tablets 100mg 236 Sildenafil Citrate Tablets 50mg 237 Sildenafil Citrate Tablets 25mg 238 Sodium Valproate Tablets 200mg 239 Sodium Valproate Syrup 200mg/5ml 240 Sodium Valproate Injection 100ml/5ml 241 Sodium Valproate Tablets 300mg 242 Sodium Valproate + Valproic Acid Tablets 300mg 243 Sodium Valproate + Valproic Acid Tablets 500mg 244 Sodium Valproate + Valproic Acid Tablets 200mg 245 Sumatriptan + Naproxen Tablets 85mg+500mg 246 Tolvaptan Tablets 15mg 247 Topiramate Tablets 25 mg 248 Topiramate Tablets 50 mg 249 Topiramate Tablets 100 mg 250 Trihexyphenidyl (Benzhexol) Tablets 2mg 251 Zaleplon Tablets 5mg 252 Zaleplon Tablets 10mg 253 Zidovudine Syrup 50mg/5ml 254 Zidovudine Tablets 100mg 255 Zidovudine Tablets 300mg 256 Zolpidem Tablets 10 mg 257 Zolpidem Tablets 5mg 258 Zolpidem SR Tablets 6.25mg 259 Zolpidem SR Tablets 12.5mg Calculation of Local Content Name of Manufacture Calculation by Manufacturer (Cost per unit of product) Cost Component Cost (Domestic Component) A Cost (Imported Component) B Total Cost (INR/ US $) C=a+b Percentage of Local Content D=(a/c)*100 I. ………… II. ………… III. Total Cost (Excluding tax and duties) Note:- I. Cost (Domestic Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken) which have not been imported directly or through a domestic trader or an intermediary. II. Cost (Imported Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken). I S/o.D/o,W/o , Resident of That I will agree to abide by the terms and conditions of the policy of Government of India issued vide order no. P-45021/2/2017-B.E.-II dated 15/06/2017. That the information furnished hereinafter is correct to best of my knowledge and belief and I undertake to produce relevant records before the procuring entity or any authority so nominated by the Government of India for the purpose of assessing the local content. That the local content for all inputs which constitute the said drugs has been verified by me and I am responsible for the correctness of the claims made therein. That in the event of the domestic valve addition of the product mentioned herein is found to be incorrect and not meeting the prescribed valve-addition norms, based on Government of India for the purpose of assessing the local content, action will be taken against me as per Order No. P-45021/2/2017-B.E.-II dated 15.06.2017. I agree to maintain the following information in the Company‟s record for a period of 8 years and shall make this available for verification to any statutory authorities: i) Name and details of the Domestic Manufacturer (Registered Officer, Manufacturing unit location, nature of legal entity) ii) Date on which this certificate is issued. iii) Medicine for which the certificate is product. iv) Procuring entity to whom the certificate is furnished. v) Percentage of local content claimed. vi) Name and contact details of the unit of the manufacturer. vii) Sale Price of the product. viii) Ex-Factory Price of the product. ix) Freight, insurance and handling. x) Total Bill of Material. xi) List and total cost valve of inputs used for manufacture of the medicine certificates from suppliers, if the input is not in-house to be attached. xii) List and cost of inputs which and imported, directly or indirectly. (Also to be provided in PDF format)

Legal Jurisdiction. The agreement shall be deemed to have been concluded in Jodhpur, Rajasthan and all obligations hereunder shall be deemed to be located at Jodhpur, Rajasthan and Court within Jodhpur, Rajasthan will have Jurisdiction to the exclusion of other courts. Complete Address, Telephone No. & Email Id Name of Proprietor/Partner/Managing Director/Director. Phone No:- Mobile No:- Email Id:- Whether the firm is a registered firm Yes/No (attached copy of certificate) Whether quoting as manufacturer/ authorised distributor/ authorised dealer PAN No. (enclose the attested copy of PAN Card) (enclose the attested copy of GST Certificate) Whether the firm has enclosed the Bank Draft/Pay Order/Banker‟s cheque as Xxxxxxx Money Deposit Whether the Firm/Agency has signed each and every page of Tender/NIT Bank Details: 1) Accounts No: 2) Bank Name: 3) Branch: 4) IFSC Code: Any other information, if necessary Place: Name: Date: Business Address: Signature of Bidder: Seal of the Bidder: Annexure-B List of Products 1 Alprazolam Tablets 0.25mg Anti-D Immunoglobulin Injections 150mcg 2 Alprazolam Tablets 0.5mg Anti-D Immunoglobulin Injections 300mcg 3 Alprazolam Tablets Anti-rabies immunoglobulin (Human) Injections 300 IU/ 1 mg ml 4 Amitriptyline Tablets 10mg Anti-rabies immunoglobulin (Human) Injections 750 IU/ 5 Amitriptyline Tablets 75 mg ml 5 Anti-rabies immunoglobulin (Human) Injections 300 IU/ 2 ml 6 Amitriptyline Tablets 25 mg 7 Amitriptyline Tablets 50 mg Anti-Snake Venom (Polyvalent) vial Injections 10ml 8 Amitriptyline Tablets 100 mg 9 Amitriptyline Tablets 150 mg Diptheria Antitoxin Injection 20000IU 10 Amitriptyline + Chlordiazepoxide Tablets 25 mg + 10mg DPT(Diptheria, Pertussis & Tetanus toxoid Vaccine) Injections 0.5ml 11 Amitriptyline + Chlordiazepoxide Tablets 12.5 mg+ 5mg Haemophilus Influenzae B Conjugate Vaccine Injection 0.5ml 12 Betahistine Tablets 16mg Hepatitis A Vaccine 720 Elisa Unit/ml. Injections 720 Elisa Unit/0.5ml. 13 Betahistine Tablets 24mg Hepatitis B Vaccine Multi Dose 20 µg/mL Injection 1 ml 14 Betahistine Tablets 32mg Hepatitis B Vaccine Single Dose 20 µg/mL Injection 0.5ml 15 Botulinum Toxid Hepatitis B Vaccine Single Dose Paed. Injection 100 Units 10mcg/0.5 ml 16 Bromocriptine Tablets 5mg Human IV Gammaglobulins Injection 2.5 gm./50ml 17 Bromocriptine Tablets 2.5mg Human IV Gammaglobulins Injection 5gm/100 ml 18 Bupenorphine +Naloxone Tablets 2 mg + 0.5mg Influenza vaccine Prefilled syringe 0.5ml 19 Buprenorphine Tablets 8mg Influnza Vaccine Injections 0.25 20 Buprenorphine Tablets 0.4mg Influnza Vaccine Injections 0.5ml 21 Buprenorphine sublingual Tablets 0.2mg Measles Vaccine Injections 0.5ml Single Dose 22 Buprenorphine sublingual Tablets 8mg Meningococal Vaccine Injections 0.5ml 23 MMR (Xxxxxxx, Mumps & Rubella vaccine) Injections 0.5ml Single Dose 24 Buprenorphine sublingual Tablets 0.4mg 25 Carbamazepine Tablets 100mg 26 Carbamazepine Tablets 200mg 27 Carbamazepine Tablets 400mg 28 Carbamazepine syrup 100mg/5ml 29 Carbamazepine SR Tablets 200mg 30 Carbamazepine SR Tablets 400mg 31 Carbidopa Tablets 25mg 32 Carbidopa Tablets 50mg 33 Carbidopa Tablets 100mg 34 Chlorpromazine hydrochloride Tablets 25 mg 35 Chlorpromazine hydrochloride Syrup 25mg/5ml 36 Chlorpromazine hydrochloride Injection 25mg/ml 37 Chlorpromazine hydrochloride Tablets 50mg 38 Chlorpromazine hydrochloride Tablets 100mg 39 Cilnidipine Tablets 10mg 40 Cilnidipine Tablets 5 mg 41 Citalopram Tablets 10mg 42 Citalopram Tablets 20mg 43 Citalopram Tablets 40mg 44 Citicholine Tablets 500mg 45 Citicholine Injection 250mg/ml 46 Citicholine + Piracetam Tablets 500mg+800mg 47 Clobazam Tablets 2.5 mg 48 Clobazam Tablets 10 mg 49 Clobazam Tablets 5mg 50 Clonazepam Tablets 0.25mg 51 Clonazepam Tablets 0.5mg 52 Clonazepam Tablets 1 mg 53 Clonazepam Tablets 2mg 54 Clonazepam MD Tablets 2 mg 55 Colchicine Tablets 0.6 mg 56 Colchicine Tablets 0.5 mg 57 Colchicine Tablets 1mg 58 Conivaptan Injection 20mg/100ml 59 Deferasirox Tablets 100mg 60 Deferasirox Tablets 400mg 61 Deferasirox Tablets 250mg 62 Deferasirox Tablets 500mg 63 Deferiprone Capsules 250mg 64 Deferiprone Capsules 500mg 65 Deferiprone Tablets 500 mg 66 Deferiprone Tablets 1000 mg 67 Desvenlafaxine Tablets 50mg 68 Desvenlafaxine Tablets 100mg 69 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+325mg+1 0mg 70 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+500mg+1 0mg 71 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+650mg+1 0mg 72 Diazepam Tablets 2 mg 73 Diazepam Tablets 5mg 74 Diazepam Tablets 10mg 75 Diazepam Rectal Suppository 5mg 76 Diazepam Tablets 3 mg 77 Diazepam Rectal Suppository 2.5 mg 78 Diazepam Injection 10mg/2ml 79 Diazoxide Tablets 50 mg 80 Diethylcarbamazine citrate Tablets 50 mg 81 Diethylcarbamazine citrate Tablets 100 mg 82 Disulfiram Tablets 250mg 83 Disulfiram Tablets 500 mg 84 Divalproex equivalent to valproic acid 250 mg syrup 100 ml 85 Divalproex Sodium Tablets 250mg 86 Divalproex Sodium Tablets 500mg 87 Divalproex Sodium Tablets 125 mg 88 Divalproex Sodium Tablets 250 mg ER 89 Divalproex Sodium Tablets 500 mg ER 90 Divalproex Sodium Tablets 125 mg ER 91 Duloxetine Hydrochloride Tablets 20mg 92 Duloxetine Hydrochloride Tablets 30mg 93 Duloxetine Hydrochloride Tablets 60mg 94 Eperisone hydrochloride Tablets 150 mg 95 Eperisone hydrochloride Tablets 450 mg 96 Escitalopram Tablets 5mg 97 Escitalopram Tablets 10mg 98 Escitalopram Tablets 20mg 99 Escitalopram + Clonazepam Tablets 10mg+0.25mg 100 Escitalopram + Clonazepam Tablets 10mg+0.5mg 101 Fludrocortisone Tablets 0.1mg 102 Flumazenil Pneumococal Vaccine Injection 0.5 mg / 5ml 103 Flumazenil ml 25 Pneumococcal 23- valent Polysaccharide vaccine Prefilled syringe 0.5ml 26 Pneumococcal Vaccine Injection 1 mg / 10 0.5 ml 104 Flunarizine Tablets 5mg 105 Flunarizine Tablets 10mg 106 Fluoxetine Tablets 40mg 107 Fluoxetine Capsules 20mg 108 Fluoxetine Tablets 20mg 109 Fluoxetine Tablets 40mg 110 Fluoxetine Tablets 60mg 111 Fluoxetine Tablets 10mg 112 Fluoxetine Capsules 20mg 113 Fluphenazile decanoate 27 Polymyxin B- Injection 125mg/5ml 114 Flupiritine Tablets 100mg 115 Flupiritine Tablets 200mg 116 Fosphenytoin 5 lacs unit 28 Polymyxine –B Sulphate Injections 500000 IU 29 Rabies Vaccine (Human Diploid Cell) Injections 1ml 30 Rubella Vaccine (Monovatent) Injections 0.5ml Single Dose 31 Tetanus Vaccine Injection 50mg/0.5ml 32 Tetnus Immunoglobulin (Human) vial. Injections 500 IU 33 Tetnus Immunoglobulin (Human) vial Injections 250 IU 34 Tuberculin Purified Protien derivated TU,5TU Injections 0.1ML 35 Typhoid Vaccine. Injection 0.5ml 36 Typhoid Vaccine. Injection 25mcg/0.5ml 37 Ulinastatin 100000 IU Injection 5 ml 117 Gabapentin Tablets 400mg 118 Gabapentine Tablets 600mg 119 Gabapentine Tablets 300mg 120 Gabapentine Cap38 Vericella Vaccine 1vial + 1ml. 300mg 121 Gabapentine + Mecobalamine Tablets 300 mg+ 0.5 mg 122 Gabapentine + Nortriptyline Tablets 400 mg + 10 mg 123 Glycerol Syrup 100ml 124 Glycerol Syrup 500ml 125 Haloperidol Tablets 2mg 126 Haloperidol Tablets 5mg 127 Haloperidol Tablets 10 mg 128 Haloperidol Of diluent Injection 5mg/ml 129 Hydroxyzine Tablets 10mg 130 Hydroxyzine Tablets 25mg 131 Hydroxyzine Syrup 10mg/5ml 132 Imipramine Tablets 25 mg 133 Imipramine Tablets 75 mg 134 Lacosamide Tablets 50 mg 135 Lacosamide Tablets 100 mg 136 Lacosamide Tablets 150 mg 137 Lacosamide Tablets 200 mg 138 Lacosamide Syrup 50 mg/5ml 139 Lacosamide Injection 10 mg/ml 140 Lamotrigin Tablets 25mg 141 Lamotrigin Tablets 100 mg 142 Lamotrigin Tablets 150mg 143 Lamotrigin Tablets 200 mg 144 Lecithin 30mg+ equivalent to 175 mg of essential Phospholipids (EPL)(phosphatidylcholine,phosphatidylethanolamine,phospha tidylinositol,phosphatidylserine) Capsules (350+175)mg 145 Levetiracetam Tablets 250 mg 146 Levetiracetam Tablets 500 mg 147 Levetiracetam Tablets 750mg 148 Levetiracetam Tablets 1000 mg 149 Levetiracetam Injection 100mg/5 ml. 150 Levetiracetam Syrup 100mg/ml 151 Lithium Carbonate Tablets 450mg 152 Lithium Carbonate Tablets 300mg 153 Lithium Carbonate SR Tablets 400mg 154 Lorazepam Tablets 0.5 mg 155 Lorazepam Tablets 1mg 156 Lorazepam Tablets 2mg 157 Lorazepam 2mg Injection 2 ml 158 Lorazepam 2mg Injection 4 ml 159 Magnesium Sulfate, Urea & Sulphacetamide Sdoium Ointment 75gm 160 Mefloquine Tablets 250mg 161 Melatonin Tablets 0.5mg 162 Melatonin Tablets 3mg 163 Melatonin Tablets 6mg 164 Methyldopa Tablets 250mg 165 Methyldopa Tablets 125 mg 166 Methyldopa Tablets 500 mg 167 Naltrexone Tablets 50mg 168 Naproxen Tablets 250mg 169 Naproxen Tablets 500mg 170 Naproxen Tablets 750mg 171 Naproxen + Domperidone Tablets 500mg+10mg 172 Nevirapine Tablets 200mg 173 Nevirapine syrup 10mg/ml 174 Nicotine Chewing gum Tablets 2mg 175 Nicotine Chewing gum Tablets 4mg 176 Nimodipine Tablets 30mg 177 Nimodipine Injection 10mg/50ml 178 Nitrazepam Tablets 5mg 179 Nitrazepam Tablets 10mg 180 Nortriptyline Tablets 25mg 181 Nortriptyline Tablets 10 mg 182 Olanzapine Tablets 20mg 183 Olanzapine Tablets 2.5mg 184 Olanzapine Tablets 5mg 185 Olanzapine Tablets 7.5mg 186 Olanzapine Tablets 10mg 187 Olanzapine Injection 10mg/ml 188 Oxcarbamazepine Tablets 150mg 189 Oxcarbamazepine Tablets 300mg 190 Oxcarbamazepine Tablets 600mg 191 Oxcarbamazepine 300 mg Syrups 60 ml 192 Paracetamol Injection 150mg/2ml 193 Paracetamol Injection 500mg/50 ml 194 Paracetamol 10mg/ml (PLASTIC BOT ) Injection 1 gm/ 100 ml 195 Paracetamol + Tramadol Tablets 325mg+37.5mg 196 Paracetamol 10mg/ ml (GLASS BOT ) Injection 1 gm/ 100 ml 197 Paroxetine Tablets 12.5mg 198 Paroxetine Tablets 25mg 199 Paroxetine Tablets 37.5mg 200 Pergolide Tablets 0.05mg 201 Pergolide Tablets 0.25mg 202 Pergolide Tablets 1mg 203 Phenobarbitone Tablets 30mg 204 Phenobarbitone Tablets 60mg 205 Phenobarbitone Syrup 20mg/5ml 206 Phenobarbitone Injection 200mg /1ml 207 Phenytoin Sodium Tablets 50 mg 208 Phenytoin Sodium Tablets 100mg 209 Phenytoin Sodium Injection 25mg/ml 210 Phenytoin Sodium Liquids 100ml(25mg/ml) 211 Piperazine Tablets 500 mg 212 Piperazine Syrup 750mg/5ml 213 Piracetam Tablets 800mg 214 Piracetam Syrup 500mg/5ml 215 Praziquantel Tablets 600 mg 216 Pregabaline Tablets 50mg 217 Pregabaline Tablets 75mg 218 Pregabaline Tablets 150mg 219 Pregabaline + Amitriptyline Tablets 75mg+10mg 220 Pregabaline + Amitriptyline Tablets 50mg+10mg 221 Pregabaline + Nortriptyline Tablets 75 mg+10 mg 222 Pregabaline+Methylcobalamine Tablets 75mg+750mcg 223 Pregabaline+Methylcobalamine Tablets 50mg+1500mcg 224 Pregabaline+Methylcobalamine Tablets 75mg+500mcg 225 Pregabaline+Methylcobalamine Tablets 150mg+1500mc g 226 Quetiapine Fumarate Tablets 25mg 227 Quetiapine Fumarate Tablets 100mg 228 Risperidone Tablets 4mg 229 Risperidone Tablets 3mg 230 Risperidone Tablets 2mg 231 Risperidone Tablets 1mg 232 Risperidone Tablets 0.5mg 233 Sertraline HCL Tablets 25mg 234 Sertraline HCL Tablets 50mg 235 Sertraline HCL Tablets 100mg 236 Sildenafil Citrate Tablets 50mg 237 Sildenafil Citrate Tablets 25mg 238 Sodium Valproate Tablets 200mg 239 Sodium Valproate Syrup 200mg/5ml 240 Sodium Valproate Injection 100ml/5ml 241 Sodium Valproate Tablets 300mg 242 Sodium Valproate + Valproic Acid Tablets 300mg 243 Sodium Valproate + Valproic Acid Tablets 500mg 244 Sodium Valproate + Valproic Acid Tablets 200mg 245 Sumatriptan + Naproxen Tablets 85mg+500mg 246 Tolvaptan Tablets 15mg 247 Topiramate Tablets 25 mg 248 Topiramate Tablets 50 mg 249 Topiramate Tablets 100 mg 250 Trihexyphenidyl (Benzhexol) Tablets 2mg 251 Zaleplon Tablets 5mg 252 Zaleplon Tablets 10mg 253 Zidovudine Syrup 50mg/5ml 254 Zidovudine Tablets 100mg 255 Zidovudine Tablets 300mg 256 Zolpidem Tablets 10 mg 257 Zolpidem Tablets 5mg 258 Zolpidem SR Tablets 6.25mg 259 Zolpidem SR Tablets 12.5mg 0.5ml Calculation of Local Content Name of Manufacture Calculation by Manufacturer (Cost per unit of product) Cost Component Cost (Domestic Component) A Cost (Imported Component) B Total Cost (INR/ US $) C=a+b Percentage of Local Content D=(a/c)*100 I. ………… II. ………… III. Total Cost (Excluding tax and duties) Note:- I. Cost (Domestic Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken) which have not been imported directly or through a domestic trader or an intermediary. II. Cost (Imported Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken). I S/o.D/o,W/o , Resident of That I will agree to abide by the terms and conditions of the policy of Government of India issued vide order no. P-45021/2/2017-B.E.-II dated 15/06/2017. That the information furnished hereinafter is correct to best of my knowledge and belief and I undertake to produce relevant records before the procuring entity or any authority so nominated by the Government of India for the purpose of assessing the local content. That the local content for all inputs which constitute the said drugs has been verified by me and I am responsible for the correctness of the claims made therein. That in the event of the domestic valve addition of the product mentioned herein is found to be incorrect and not meeting the prescribed valve-addition norms, based on Government of India for the purpose of assessing the local content, action will be taken against me as per Order No. P-45021/2/2017-B.E.-II dated 15.06.2017. I agree to maintain the following information in the Company‟s record for a period of 8 years and shall make this available for verification to any statutory authorities: i) Name and details of the Domestic Manufacturer (Registered Officer, Manufacturing unit location, nature of legal entity) ii) Date on which this certificate is issued. iii) Medicine for which the certificate is product. iv) Procuring entity to whom the certificate is furnished. v) Percentage of local content claimed. vi) Name and contact details of the unit of the manufacturer. vii) Sale Price of the product. viii) Ex-Factory Price of the product. ix) Freight, insurance and handling. x) Total Bill of Material. xi) List and total cost valve of inputs used for manufacture of the medicine certificates from suppliers, if the input is not in-house to be attached. xii) List and cost of inputs which and imported, directly or indirectly. (Also to be provided in PDF format)

Legal Jurisdiction. The agreement shall be deemed to have been concluded in Jodhpur, Rajasthan and all obligations hereunder shall be deemed to be located at Jodhpur, Rajasthan and Court within Jodhpur, Rajasthan will have Jurisdiction to the exclusion of other courts. Complete Address, Telephone No. & Email Id Name of Proprietor/Partner/Managing Director/Director. Phone No:- Mobile No:- Email Id:- Whether the firm is a registered firm Yes/No (attached copy of certificate) Whether quoting as manufacturer/ authorised distributor/ authorised dealer PAN No. (enclose the attested copy of PAN Card) (enclose the attested copy of GST Certificate) Whether the firm has enclosed the Bank Draft/Pay Order/Banker‟s cheque as Xxxxxxx Money Deposit Whether the Firm/Agency has signed each and every page of Tender/NIT Bank Details: 1) Accounts No: 2) Bank Name: 3) Branch: 4) IFSC Code: Any other information, if necessary Place: Name: Date: Business Address: Signature of Bidder: Seal of the Bidder: Annexure-B List of Products 1 Alprazolam Tablets 0.25mg Barium Sulphate Suspension 100% w/v 2 Alprazolam Tablets 0.5mg Barium Sulphate Suspension 250%w/v 3 Alprazolam Tablets 1 mg Calcium Ipodate Injection 3 g 4 Amitriptyline Tablets 10mg Calcium Ipodate Injection 3 g 5 Amitriptyline Tablets 75 mg 6 Amitriptyline Tablets 25 mg 7 Amitriptyline Tablets 50 mg 8 Amitriptyline Tablets 100 mg 9 Amitriptyline Tablets 150 mg 10 Amitriptyline + Chlordiazepoxide Tablets 25 mg + 10mg 11 Amitriptyline + Chlordiazepoxide Tablets 12.5 mg+ 5mg 12 Betahistine Tablets 16mg 13 Betahistine Tablets 24mg 14 Betahistine Tablets 32mg 15 Botulinum Toxid Injection 100 Units 16 Bromocriptine Tablets 5mg 17 Bromocriptine Tablets 2.5mg 18 Bupenorphine +Naloxone Tablets 2 mg + 0.5mg 19 Buprenorphine Tablets 8mg 20 Buprenorphine Tablets 0.4mg 21 Buprenorphine sublingual Tablets 0.2mg 22 Buprenorphine sublingual Tablets 8mg 24 Buprenorphine sublingual Tablets 0.4mg 25 Carbamazepine Tablets 100mg 26 Carbamazepine Tablets 200mg 27 Carbamazepine Tablets 400mg 28 Carbamazepine syrup 100mg/5ml 29 Carbamazepine SR Tablets 200mg 30 Carbamazepine SR Tablets 400mg 31 Carbidopa Tablets 25mg 32 Carbidopa Tablets 50mg 33 Carbidopa Tablets 100mg 34 Chlorpromazine hydrochloride Tablets 25 mg 35 Chlorpromazine hydrochloride Syrup 25mg/5ml 36 Chlorpromazine hydrochloride Injection 25mg/ml 37 Chlorpromazine hydrochloride Tablets 50mg 38 Chlorpromazine hydrochloride Tablets 100mg 39 Cilnidipine Tablets 10mg 40 Cilnidipine Tablets 5 mg 41 Citalopram Tablets 10mg 42 Citalopram Tablets 20mg 43 Citalopram Tablets 40mg 44 Citicholine Tablets 500mg 45 Citicholine Injection 250mg/ml 46 Citicholine + Piracetam Tablets 500mg+800mg 47 Clobazam Tablets 2.5 mg 48 Clobazam Tablets 10 mg 49 Clobazam Tablets 5mg 50 Clonazepam Tablets 0.25mg 51 Clonazepam Tablets 0.5mg 52 Clonazepam Tablets 1 mg 53 Clonazepam Tablets 2mg 54 Clonazepam MD Tablets 2 mg 55 Colchicine Tablets 0.6 mg 56 Colchicine Tablets 0.5 mg 57 Colchicine Tablets 1mg 58 Conivaptan Injection 20mg/100ml 59 Deferasirox Tablets 100mg 60 Deferasirox Tablets 400mg 61 Deferasirox Tablets 250mg 62 Deferasirox Tablets 500mg 63 Deferiprone Capsules 250mg 64 Deferiprone Capsules 500mg 65 Deferiprone Iopanoic Acid Tablets 500 mg 66 Deferiprone Tablets 1000 mg 67 Desvenlafaxine Tablets 50mg 68 Desvenlafaxine Tablets 100mg 69 Dextropropoxyphene + PCM6 Meglumine Iothalamate Injection 60% w/Acetaminophen with or without Dicyclomine Tablets 60mg+325mg+1 0mg 70 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+500mg+1 0mg 71 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+650mg+1 0mg 72 Diazepam Tablets 2 mg 73 Diazepam Tablets 5mg 74 Diazepam Tablets 10mg 75 Diazepam Rectal Suppository 5mg 76 Diazepam Tablets 3 mg 77 Diazepam Rectal Suppository 2.5 mg 78 Diazepam Injection 10mg/2ml 79 Diazoxide Tablets 50 mg 80 Diethylcarbamazine citrate Tablets 50 mg 81 Diethylcarbamazine citrate Tablets 100 mg 82 Disulfiram Tablets 250mg 83 Disulfiram Tablets 500 mg 84 Divalproex equivalent to valproic acid 250 mg syrup 100 ml 85 Divalproex Sodium Tablets 250mg 86 Divalproex Sodium Tablets 500mg 87 Divalproex Sodium Tablets 125 mg 88 Divalproex Sodium Tablets 250 mg ER 89 Divalproex Sodium Tablets 500 mg ER 90 Divalproex Sodium Tablets 125 mg ER 91 Duloxetine Hydrochloride Tablets 20mg 92 Duloxetine Hydrochloride Tablets 30mg 93 Duloxetine Hydrochloride Tablets 60mg 94 Eperisone hydrochloride Tablets 150 mg 95 Eperisone hydrochloride Tablets 450 mg 96 Escitalopram Tablets 5mg 97 Escitalopram Tablets 10mg 98 Escitalopram Tablets 20mg 99 Escitalopram + Clonazepam Tablets 10mg+0.25mg 100 Escitalopram + Clonazepam Tablets 10mg+0.5mg 101 Fludrocortisone Tablets 0.1mg 102 Flumazenil Injection 0.5 v (iodine=280 mg / 5ml 103 Flumazenil Injection 1 ml) 7 Meglumine Iotroxate Solution 5-8 g iodine in 100-250 ml 8 Propyliodone Oily, suspension 500-600 mg / 10 ml 104 Flunarizine Tablets 59 Sodium Iothalamate Injection 70% w/v(Iodine=420 mg 105 Flunarizine Tablets 10mg 106 Fluoxetine Tablets 40mg 107 Fluoxetine Capsules 20mg 108 Fluoxetine Tablets 20mg 109 Fluoxetine Tablets 40mg 110 Fluoxetine Tablets 60mg 111 Fluoxetine Tablets 10mg 112 Fluoxetine Capsules 20mg 113 Fluphenazile decanoate Injection 125mg/5ml 114 Flupiritine Tablets 100mg 115 Flupiritine Tablets 200mg 116 Fosphenytoin Injection 50mg/ml 117 Gabapentin Tablets 400mg 118 Gabapentine Tablets 600mg 119 Gabapentine Tablets 300mg 120 Gabapentine Cap. 300mg 121 Gabapentine + Mecobalamine Tablets 300 mg+ 0.5 mg 122 Gabapentine + Nortriptyline Tablets 400 mg + 10 mg 123 Glycerol Syrup 100ml 124 Glycerol Syrup 500ml 125 Haloperidol Tablets 2mg 126 Haloperidol Tablets 5mg 127 Haloperidol Tablets 10 mg 128 Haloperidol Injection 5mg/ml 129 Hydroxyzine Tablets 10mg 130 Hydroxyzine Tablets 25mg 131 Hydroxyzine Syrup 10mg/5ml 132 Imipramine Tablets 25 mg 133 Imipramine Tablets 75 mg 134 Lacosamide Tablets 50 mg 135 Lacosamide Tablets 100 mg 136 Lacosamide Tablets 150 mg 137 Lacosamide Tablets 200 mg 138 Lacosamide Syrup 50 mg/5ml 139 Lacosamide Injection 10 mg/ml 140 Lamotrigin Tablets 25mg 141 Lamotrigin Tablets 100 mg 142 Lamotrigin Tablets 150mg 143 Lamotrigin Tablets 200 mg 144 Lecithin 30mg+ equivalent to 175 mg of essential Phospholipids (EPL)(phosphatidylcholine,phosphatidylethanolamine,phospha tidylinositol,phosphatidylserine) Capsules (350+175)mg 145 Levetiracetam Tablets 250 mg 146 Levetiracetam Tablets 500 mg 147 Levetiracetam Tablets 750mg 148 Levetiracetam Tablets 1000 mg 149 Levetiracetam Injection 100mg/5 ml. 150 Levetiracetam Syrup 100mg/ml 151 Lithium Carbonate Tablets 450mg 152 Lithium Carbonate Tablets 300mg 153 Lithium Carbonate SR Tablets 400mg 154 Lorazepam Tablets 0.5 mg 155 Lorazepam Tablets 1mg 156 Lorazepam Tablets 2mg 157 Lorazepam 2mg Injection 2 ml 158 Lorazepam 2mg Injection 4 ml 159 Magnesium Sulfate, Urea & Sulphacetamide Sdoium Ointment 75gm 160 Mefloquine Tablets 250mg 161 Melatonin Tablets 0.5mg 162 Melatonin Tablets 3mg 163 Melatonin Tablets 6mg 164 Methyldopa Tablets 250mg 165 Methyldopa Tablets 125 mg 166 Methyldopa Tablets 500 mg 167 Naltrexone Tablets 50mg 168 Naproxen Tablets 250mg 169 Naproxen Tablets 500mg 170 Naproxen Tablets 750mg 171 Naproxen + Domperidone Tablets 500mg+10mg 172 Nevirapine Tablets 200mg 173 Nevirapine syrup 10mg/ml 174 Nicotine Chewing gum Tablets 2mg 175 Nicotine Chewing gum Tablets 4mg 176 Nimodipine Tablets 30mg 177 Nimodipine Injection 10mg/50ml 178 Nitrazepam Tablets 5mg 179 Nitrazepam Tablets 10mg 180 Nortriptyline Tablets 25mg 181 Nortriptyline Tablets 10 mg 182 Olanzapine Tablets 20mg 183 Olanzapine Tablets 2.5mg 184 Olanzapine Tablets 5mg 185 Olanzapine Tablets 7.5mg 186 Olanzapine Tablets 10mg 187 Olanzapine Injection 10mg/ml 188 Oxcarbamazepine Tablets 150mg 189 Oxcarbamazepine Tablets 300mg 190 Oxcarbamazepine Tablets 600mg 191 Oxcarbamazepine 300 mg Syrups 60 ml 192 Paracetamol Injection 150mg/2ml 193 Paracetamol Injection 500mg/50 ml 194 Paracetamol 10mg/ml (PLASTIC BOT ) Injection 1 gm/ 100 ml 195 Paracetamol + Tramadol Tablets 325mg+37.5mg 196 Paracetamol 10mg/ ml (GLASS BOT ) Injection 1 gm/ 100 ml 197 Paroxetine Tablets 12.5mg 198 Paroxetine Tablets 25mg 199 Paroxetine Tablets 37.5mg 200 Pergolide Tablets 0.05mg 201 Pergolide Tablets 0.25mg 202 Pergolide Tablets 1mg 203 Phenobarbitone Tablets 30mg 204 Phenobarbitone Tablets 60mg 205 Phenobarbitone Syrup 20mg/5ml 206 Phenobarbitone Injection 200mg /1ml 207 Phenytoin Sodium Tablets 50 mg 208 Phenytoin Sodium Tablets 100mg 209 Phenytoin Sodium Injection 25mg/ml 210 Phenytoin Sodium Liquids 100ml(25mg// ml) 211 Piperazine Tablets 500 10 Sodium MeglumineDiatrizoate Injection 60% w/v(Iodineconc. =292 mg 212 Piperazine Syrup 750mg/5ml 213 Piracetam Tablets 800/ml), 76% w/v(Iodineconc. =370 mg 214 Piracetam Syrup 500mg/5ml 215 Praziquantel Tablets 600 mg 216 Pregabaline Tablets 50mg 217 Pregabaline Tablets 75mg 218 Pregabaline Tablets 150mg 219 Pregabaline + Amitriptyline Tablets 75mg+10mg 220 Pregabaline + Amitriptyline Tablets 50mg+10mg 221 Pregabaline + Nortriptyline Tablets 75 mg+10 mg 222 Pregabaline+Methylcobalamine Tablets 75mg+750mcg 223 Pregabaline+Methylcobalamine Tablets 50mg+1500mcg 224 Pregabaline+Methylcobalamine Tablets 75mg+500mcg 225 Pregabaline+Methylcobalamine Tablets 150mg+1500mc g 226 Quetiapine Fumarate Tablets 25mg 227 Quetiapine Fumarate Tablets 100mg 228 Risperidone Tablets 4mg 229 Risperidone Tablets 3mg 230 Risperidone Tablets 2mg 231 Risperidone Tablets 1mg 232 Risperidone Tablets 0.5mg 233 Sertraline HCL Tablets 25mg 234 Sertraline HCL Tablets 50mg 235 Sertraline HCL Tablets 100mg 236 Sildenafil Citrate Tablets 50mg 237 Sildenafil Citrate Tablets 25mg 238 Sodium Valproate Tablets 200mg 239 Sodium Valproate Syrup 200mg/5ml 240 Sodium Valproate Injection 100ml/5ml 241 Sodium Valproate Tablets 300mg 242 Sodium Valproate + Valproic Acid Tablets 300mg 243 Sodium Valproate + Valproic Acid Tablets 500mg 244 Sodium Valproate + Valproic Acid Tablets 200mg 245 Sumatriptan + Naproxen Tablets 85mg+500mg 246 Tolvaptan Tablets 15mg 247 Topiramate Tablets 25 mg 248 Topiramate Tablets 50 mg 249 Topiramate Tablets 100 mg 250 Trihexyphenidyl (Benzhexol/ ml) Tablets 2mg 251 Zaleplon Tablets 5mg 252 Zaleplon Tablets 10mg 253 Zidovudine Syrup 50mg/5ml 254 Zidovudine Tablets 100mg 255 Zidovudine Tablets 300mg 256 Zolpidem Tablets 10 mg 257 Zolpidem Tablets 5mg 258 Zolpidem SR Tablets 6.25mg 259 Zolpidem SR Tablets 12.5mg Calculation of Local Content Name of Manufacture Calculation by Manufacturer (Cost per unit of product) Cost Component Cost (Domestic Component) A Cost (Imported Component) B Total Cost (INR/ US $) C=a+b Percentage of Local Content D=(a/c)*100 I. ………… II. ………… III. Total Cost (Excluding tax and duties) Note:- I. Cost (Domestic Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken) which have not been imported directly or through a domestic trader or an intermediary. II. Cost (Imported Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken). I S/o.D/o,W/o , Resident of That I will agree to abide by the terms and conditions of the policy of Government of India issued vide order no. P-45021/2/2017-B.E.-II dated 15/06/2017. That the information furnished hereinafter is correct to best of my knowledge and belief and I undertake to produce relevant records before the procuring entity or any authority so nominated by the Government of India for the purpose of assessing the local content. That the local content for all inputs which constitute the said drugs has been verified by me and I am responsible for the correctness of the claims made therein. That in the event of the domestic valve addition of the product mentioned herein is found to be incorrect and not meeting the prescribed valve-addition norms, based on Government of India for the purpose of assessing the local content, action will be taken against me as per Order No. P-45021/2/2017-B.E.-II dated 15.06.2017. I agree to maintain the following information in the Company‟s record for a period of 8 years and shall make this available for verification to any statutory authorities: i) Name and details of the Domestic Manufacturer (Registered Officer, Manufacturing unit location, nature of legal entity) ii) Date on which this certificate is issued. iii) Medicine for which the certificate is product. iv) Procuring entity to whom the certificate is furnished. v) Percentage of local content claimed. vi) Name and contact details of the unit of the manufacturer. vii) Sale Price of the product. viii) Ex-Factory Price of the product. ix) Freight, insurance and handling. x) Total Bill of Material. xi) List and total cost valve of inputs used for manufacture of the medicine certificates from suppliers, if the input is not in-house to be attached. xii) List and cost of inputs which and imported, directly or indirectly. (Also to be provided in PDF format)

Legal Jurisdiction. The agreement shall be deemed to have been concluded in Jodhpur, Rajasthan and all obligations hereunder shall be deemed to be located at Jodhpur, Rajasthan and Court within Jodhpur, Rajasthan will have Jurisdiction to the exclusion of other courts. Complete Address, Telephone No. & Email Id Name of Proprietor/Partner/Managing Director/Director. Phone No:- Mobile No:- Email Id:- Whether the firm is a registered firm Yes/No (attached copy of certificate) Whether quoting as manufacturer/ authorised distributor/ authorised dealer PAN No. (enclose the attested copy of PAN Card) (enclose the attested copy of GST Certificate) Whether the firm has enclosed the Bank Draft/Pay Order/Banker‟s cheque as Xxxxxxx Money Deposit Whether the Firm/Agency has signed each and every page of Tender/NIT Bank Details: 1) Accounts No: 2) Bank Name: 3) Branch: 4) IFSC Code: Any other information, if necessary Place: Name: Date: Business Address: Signature of Bidder: Seal of the Bidder: Annexure-B List of Products 1 Alprazolam Tablets 0.25Anti Thymocyte Globulin Injection 250mg 2 Alprazolam Basiliximab Injection 20mg 3 Betamethasone Tablets 0.5mg 3 Alprazolam 4 Betamethasone Tablets 1 1mg 4 Amitriptyline 5 Cyclophosphamide Tablets 200mg 6 Cyclophosphamide Tablets 50mg 7 Cyclophosphamide Injection 200mg 8 Cyclophosphamide Injection 500mg 9 Cyclophosphamide Injection 1000mg 10 Cyclosporine Capsules 25mg 11 Cyclosporine Capsules 50mg 12 Cyclosporine Capsules 100mg 13 Daclizumab Injection 25mg 14 Deflazacort Tablets 1mg 15 Deflazacort Tablets 18mg 16 Deflazacort Tablets 30mg 17 Deflazacort Tablets 6mg 18 Infliximab Injection 100mg 19 Levamisole Tablets 50mg 20 Methyl Prednisolone 40mg Injection 1ml 21 Methyl Prednisolone 80mg Injection 2ml 22 Methyl Prednisolone Sodium Succinate Injection 1gm 23 Methyl Prednisolone Sodium Succinate Injection 250mg 24 Methyl Prednisolone Sodium succinate Tablets 8mg 25 Methyl Prednisolone Sodium succinate Tablets 4mg 26 Methyl Prednisolone Sodium succinate Tablets 16mg 27 Methylprednisolone Acetate Injection 40 mg 28 Methylprednisolone Acetate Injection 125mg 29 Methylprednisolone Acetate Injection 500mg 30 Mycophenolate Mofetil Tablets 250mg 31 Mycophenolate Mofetil Injection 500mg 32 Prednisolone Tablets 5mg 33 Prednisolone Tablets 10mg 5 Amitriptyline Tablets 75 mg 6 Amitriptyline Tablets 25 mg 7 Amitriptyline Tablets 50 mg 8 Amitriptyline Tablets 100 mg 9 Amitriptyline Tablets 150 mg 10 Amitriptyline + Chlordiazepoxide Tablets 25 mg + 10mg 11 Amitriptyline + Chlordiazepoxide Tablets 12.5 mg+ 5mg 12 Betahistine Tablets 16mg 13 Betahistine Tablets 24mg 14 Betahistine Tablets 32mg 15 Botulinum Toxid Injection 100 Units 16 Bromocriptine Tablets 5mg 17 Bromocriptine Tablets 2.5mg 18 Bupenorphine +Naloxone Tablets 2 mg + 0.5mg 19 Buprenorphine Tablets 8mg 20 Buprenorphine Tablets 0.4mg 21 Buprenorphine sublingual Tablets 0.2mg 22 Buprenorphine sublingual Tablets 8mg 24 Buprenorphine sublingual Tablets 0.4mg 25 Carbamazepine Tablets 100mg 26 Carbamazepine Tablets 200mg 27 Carbamazepine Tablets 400mg 28 Carbamazepine syrup 100mg/5ml 29 Carbamazepine SR Tablets 200mg 30 Carbamazepine SR Tablets 400mg 31 Carbidopa Tablets 25mg 32 Carbidopa Tablets 50mg 33 Carbidopa Tablets 100mg 34 Chlorpromazine hydrochloride Tablets 25 mg 35 Chlorpromazine hydrochloride Syrup 25mg/5ml 36 Chlorpromazine hydrochloride Injection 25mg/ml 37 Chlorpromazine hydrochloride Tablets 50mg 38 Chlorpromazine hydrochloride Tablets 100mg 39 Cilnidipine Tablets 10mg 40 Cilnidipine Tablets 5 mg 41 Citalopram Tablets 10mg 42 Citalopram Prednisolone Tablets 20mg 43 Citalopram Tablets 4035 Rituximab Injection 100mg 44 Citicholine Tablets 36 Rituximab Injection 500mg 45 Citicholine Injection 250mg/ml 46 Citicholine + Piracetam Tablets 500mg+800mg 47 Clobazam Tablets 2.5 mg 48 Clobazam Tablets 10 mg 49 Clobazam Tablets 5mg 50 Clonazepam Tablets 0.25mg 51 Clonazepam 37 Tacrolimus Tablets 0.5mg 52 Clonazepam Tablets 1 mg 53 Clonazepam Tablets 2mg 54 Clonazepam MD Tablets 2 mg 55 Colchicine Tablets 0.6 mg 56 Colchicine Tablets 0.5 mg 57 Colchicine 38 Tacrolimus Tablets 1mg 58 Conivaptan Injection 20mg/100ml 59 Deferasirox Tablets 100mg 60 Deferasirox Tablets 400mg 61 Deferasirox Tablets 250mg 62 Deferasirox Tablets 500mg 63 Deferiprone Capsules 250mg 64 Deferiprone Capsules 500mg 65 Deferiprone Tablets 500 mg 66 Deferiprone Tablets 1000 mg 67 Desvenlafaxine Tablets 50mg 68 Desvenlafaxine Tablets 100mg 69 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+325mg+1 0mg 70 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+500mg+1 0mg 71 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+650mg+1 0mg 72 Diazepam Tablets 2 mg 73 Diazepam 39 Tacrolimus Tablets 5mg 74 Diazepam Tablets 10mg 75 Diazepam Rectal Suppository 5mg 76 Diazepam Tablets 3 mg 77 Diazepam Rectal Suppository 2.5 mg 78 Diazepam Injection 10mg/2ml 79 Diazoxide Tablets 50 mg 80 Diethylcarbamazine citrate Tablets 50 mg 81 Diethylcarbamazine citrate Tablets 100 mg 82 Disulfiram Tablets 250mg 83 Disulfiram Tablets 500 mg 84 Divalproex equivalent to valproic acid 250 mg syrup 100 ml 85 Divalproex Sodium Tablets 250mg 86 Divalproex Sodium Tablets 500mg 87 Divalproex Sodium Tablets 125 mg 88 Divalproex Sodium Tablets 250 mg ER 89 Divalproex Sodium Tablets 500 mg ER 90 Divalproex Sodium Tablets 125 mg ER 91 Duloxetine Hydrochloride Tablets 20mg 92 Duloxetine Hydrochloride Tablets 30mg 93 Duloxetine Hydrochloride Tablets 60mg 94 Eperisone hydrochloride Tablets 150 mg 95 Eperisone hydrochloride Tablets 450 mg 96 Escitalopram Tablets 5mg 97 Escitalopram Tablets 10mg 98 Escitalopram Tablets 20mg 99 Escitalopram + Clonazepam Tablets 10mg+0.25mg 100 Escitalopram + Clonazepam Tablets 10mg+0.5mg 101 Fludrocortisone Tablets 0.1mg 102 Flumazenil Injection 0.5 mg / 5ml 103 Flumazenil Injection 1 mg / 10 ml 104 Flunarizine Tablets 5mg 105 Flunarizine Tablets 10mg 106 Fluoxetine Tablets 40mg 107 Fluoxetine Capsules 20mg 108 Fluoxetine Tablets 20mg 109 Fluoxetine Tablets 40mg 110 Fluoxetine Tablets 60mg 111 Fluoxetine Tablets 10mg 112 Fluoxetine Capsules 20mg 113 Fluphenazile decanoate Injection 125mg/5ml 114 Flupiritine Tablets 100mg 115 Flupiritine Tablets 200mg 116 Fosphenytoin Injection 50mg/ml 117 Gabapentin Tablets 400mg 118 Gabapentine Tablets 600mg 119 Gabapentine Tablets 300mg 120 Gabapentine Cap. 300mg 121 Gabapentine + Mecobalamine Tablets 300 mg+ 0.5 mg 122 Gabapentine + Nortriptyline Tablets 400 mg + 10 mg 123 Glycerol Syrup 100ml 124 Glycerol Syrup 500ml 125 Haloperidol Tablets 2mg 126 Haloperidol Tablets 5mg 127 Haloperidol Tablets 10 mg 128 Haloperidol Injection 5mg/ml 129 Hydroxyzine Tablets 10mg 130 Hydroxyzine Tablets 25mg 131 Hydroxyzine Syrup 10mg/5ml 132 Imipramine Tablets 25 mg 133 Imipramine Tablets 75 mg 134 Lacosamide Tablets 50 mg 135 Lacosamide Tablets 100 mg 136 Lacosamide Tablets 150 mg 137 Lacosamide Tablets 200 mg 138 Lacosamide Syrup 50 mg/5ml 139 Lacosamide Injection 10 mg/ml 140 Lamotrigin Tablets 25mg 141 Lamotrigin Tablets 100 mg 142 Lamotrigin Tablets 150mg 143 Lamotrigin Tablets 200 mg 144 Lecithin 30mg+ equivalent to 175 mg of essential Phospholipids (EPL)(phosphatidylcholine,phosphatidylethanolamine,phospha tidylinositol,phosphatidylserine) Capsules (350+175)mg 145 Levetiracetam Tablets 250 mg 146 Levetiracetam Tablets 500 mg 147 Levetiracetam Tablets 750mg 148 Levetiracetam Tablets 1000 mg 149 Levetiracetam Injection 100mg/5 ml. 150 Levetiracetam Syrup 100mg/ml 151 Lithium Carbonate Tablets 450mg 152 Lithium Carbonate Tablets 300mg 153 Lithium Carbonate SR Tablets 400mg 154 Lorazepam Tablets 0.5 mg 155 Lorazepam Tablets 1mg 156 Lorazepam Tablets 2mg 157 Lorazepam 2mg Injection 2 ml 158 Lorazepam 2mg Injection 4 ml 159 Magnesium Sulfate, Urea & Sulphacetamide Sdoium Ointment 75gm 160 Mefloquine Tablets 250mg 161 Melatonin Tablets 0.5mg 162 Melatonin Tablets 3mg 163 Melatonin Tablets 6mg 164 Methyldopa Tablets 250mg 165 Methyldopa Tablets 125 mg 166 Methyldopa Tablets 500 mg 167 Naltrexone Tablets 50mg 168 Naproxen Tablets 250mg 169 Naproxen Tablets 500mg 170 Naproxen Tablets 750mg 171 Naproxen + Domperidone Tablets 500mg+10mg 172 Nevirapine Tablets 200mg 173 Nevirapine syrup 10mg/ml 174 Nicotine Chewing gum Tablets 2mg 175 Nicotine Chewing gum Tablets 4mg 176 Nimodipine Tablets 30mg 177 Nimodipine Injection 10mg/50ml 178 Nitrazepam Tablets 5mg 179 Nitrazepam Tablets 10mg 180 Nortriptyline Tablets 25mg 181 Nortriptyline Tablets 10 mg 182 Olanzapine Tablets 20mg 183 Olanzapine Tablets 2.5mg 184 Olanzapine Tablets 5mg 185 Olanzapine Tablets 7.5mg 186 Olanzapine Tablets 10mg 187 Olanzapine Injection 10mg/ml 188 Oxcarbamazepine Tablets 150mg 189 Oxcarbamazepine Tablets 300mg 190 Oxcarbamazepine Tablets 600mg 191 Oxcarbamazepine 300 mg Syrups 60 ml 192 Paracetamol Injection 150mg/2ml 193 Paracetamol Injection 500mg/50 ml 194 Paracetamol 10mg/ml (PLASTIC BOT ) Injection 1 gm/ 100 ml 195 Paracetamol + Tramadol Tablets 325mg+37.5mg 196 Paracetamol 10mg/ ml (GLASS BOT ) Injection 1 gm/ 100 ml 197 Paroxetine Tablets 12.5mg 198 Paroxetine Tablets 25mg 199 Paroxetine Tablets 37.5mg 200 Pergolide Tablets 0.05mg 201 Pergolide Tablets 0.25mg 202 Pergolide Tablets 1mg 203 Phenobarbitone Tablets 30mg 204 Phenobarbitone Tablets 60mg 205 Phenobarbitone Syrup 20mg/5ml 206 Phenobarbitone Injection 200mg /1ml 207 Phenytoin Sodium Tablets 50 mg 208 Phenytoin Sodium Tablets 100mg 209 Phenytoin Sodium Injection 25mg/ml 210 Phenytoin Sodium Liquids 100ml(25mg/ml) 211 Piperazine Tablets 500 mg 212 Piperazine Syrup 750mg/5ml 213 Piracetam Tablets 800mg 214 Piracetam Syrup 500mg/5ml 215 Praziquantel Tablets 600 mg 216 Pregabaline Tablets 50mg 217 Pregabaline Tablets 75mg 218 Pregabaline Tablets 150mg 219 Pregabaline + Amitriptyline Tablets 75mg+10mg 220 Pregabaline + Amitriptyline Tablets 50mg+10mg 221 Pregabaline + Nortriptyline Tablets 75 mg+10 mg 222 Pregabaline+Methylcobalamine Tablets 75mg+750mcg 223 Pregabaline+Methylcobalamine Tablets 50mg+1500mcg 224 Pregabaline+Methylcobalamine Tablets 75mg+500mcg 225 Pregabaline+Methylcobalamine Tablets 150mg+1500mc g 226 Quetiapine Fumarate Tablets 25mg 227 Quetiapine Fumarate Tablets 100mg 228 Risperidone Tablets 4mg 229 Risperidone Tablets 3mg 230 Risperidone Tablets 2mg 231 Risperidone Tablets 1mg 232 Risperidone Tablets 0.5mg 233 Sertraline HCL Tablets 25mg 234 Sertraline HCL Tablets 50mg 235 Sertraline HCL Tablets 100mg 236 Sildenafil Citrate Tablets 50mg 237 Sildenafil Citrate Tablets 25mg 238 Sodium Valproate Tablets 200mg 239 Sodium Valproate Syrup 200mg/5ml 240 Sodium Valproate Injection 100ml/5ml 241 Sodium Valproate Tablets 300mg 242 Sodium Valproate + Valproic Acid Tablets 300mg 243 Sodium Valproate + Valproic Acid Tablets 500mg 244 Sodium Valproate + Valproic Acid Tablets 200mg 245 Sumatriptan + Naproxen Tablets 85mg+500mg 246 Tolvaptan Tablets 15mg 247 Topiramate Tablets 25 mg 248 Topiramate Tablets 50 mg 249 Topiramate Tablets 100 mg 250 Trihexyphenidyl (Benzhexol) Tablets 2mg 251 Zaleplon Tablets 5mg 252 Zaleplon Tablets 10mg 253 Zidovudine Syrup 50mg/5ml 254 Zidovudine Tablets 100mg 255 Zidovudine Tablets 300mg 256 Zolpidem Tablets 10 mg 257 Zolpidem Tablets 5mg 258 Zolpidem SR Tablets 6.25mg 259 Zolpidem SR Tablets 12.5mg Calculation of Local Content Name of Manufacture Calculation by Manufacturer (Cost per unit of product) Cost Component Cost (Domestic Component) A Cost (Imported Component) B Total Cost (INR/ US $) C=a+b Percentage of Local Content D=(a/c)*100 I. ………… II. ………… III. Total Cost (Excluding tax and duties) Note:- I. Cost (Domestic Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken) which have not been imported directly or through a domestic trader or an intermediary. II. Cost (Imported Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken). I S/o.D/o,W/o , Resident of That I will agree to abide by the terms and conditions of the policy of Government of India issued vide order no. P-45021/2/2017-B.E.-II dated 15/06/2017. That the information furnished hereinafter is correct to best of my knowledge and belief and I undertake to produce relevant records before the procuring entity or any authority so nominated by the Government of India for the purpose of assessing the local content. That the local content for all inputs which constitute the said drugs has been verified by me and I am responsible for the correctness of the claims made therein. That in the event of the domestic valve addition of the product mentioned herein is found to be incorrect and not meeting the prescribed valve-addition norms, based on Government of India for the purpose of assessing the local content, action will be taken against me as per Order No. P-45021/2/2017-B.E.-II dated 15.06.2017. I agree to maintain the following information in the Company‟s record for a period of 8 years and shall make this available for verification to any statutory authorities: i) Name and details of the Domestic Manufacturer (Registered Officer, Manufacturing unit location, nature of legal entity) ii) Date on which this certificate is issued. iii) Medicine for which the certificate is product. iv) Procuring entity to whom the certificate is furnished. v) Percentage of local content claimed. vi) Name and contact details of the unit of the manufacturer. vii) Sale Price of the product. viii) Ex-Factory Price of the product. ix) Freight, insurance and handling. x) Total Bill of Material. xi) List and total cost valve of inputs used for manufacture of the medicine certificates from suppliers, if the input is not in-house to be attached. xii) List and cost of inputs which and imported, directly or indirectly. (Also to be provided in PDF format)

Legal Jurisdiction. The agreement shall be deemed to have been concluded in Jodhpur, Rajasthan and all obligations hereunder shall be deemed to be located at Jodhpur, Rajasthan and Court within Jodhpur, Rajasthan will have Jurisdiction to the exclusion of other courts. Complete Address, Telephone No. & Email Id Name of Proprietor/Partner/Managing Director/Director. Phone No:- Mobile No:- Email Id:- Whether the firm is a registered firm Yes/No (attached copy of certificate) Whether quoting as manufacturer/ authorised distributor/ authorised dealer PAN No. (enclose the attested copy of PAN Card) (enclose the attested copy of GST Certificate) Whether the firm has enclosed the Bank Draft/Pay Order/Banker‟s cheque as Xxxxxxx Money Deposit Whether the Firm/Agency has signed each and every page of Tender/NIT Bank Details: 1) Accounts No: 2) Bank Name: 3) Branch: 4) IFSC Code: Any other information, if necessary Place: Name: Date: Business Address: Signature of Bidder: Seal of the Bidder: Annexure-B List of Products 1 Alprazolam Acetazolamide Tablets 0.25250 mg 2 Alprazolam Carboprost Tromethamine Injection 250mcg/ml 3 Darifenacin Tablets 0.5mg 3 Alprazolam Tablets 1 7.5mg 4 Amitriptyline Darifenacin Tablets 15mg 5 Dicyclomine Syrup 100 ml 6 Dicyclomine Injection (10mg/ml) 2ml 7 Dicyclomine Capsules 10 mg 8 Dicyclomine + Chlordizepoxide + clinidium bromide Tablets 10 mg+ 5mg+ 2.5mg 9 Finasteride Tablets 1mg 10 Flavoxate Tablets 200mg 11 Isoxsuprine Tablets 10mg 5 Amitriptyline 12 Methyl ergometrine Injection 0.2mg/ml 13 Methyl ergometrine Tablets 75 mg 6 Amitriptyline Tablets 25 mg 7 Amitriptyline Tablets 50 mg 8 Amitriptyline Tablets 100 mg 9 Amitriptyline Tablets 150 mg 10 Amitriptyline + Chlordiazepoxide Tablets 25 mg + 10mg 11 Amitriptyline + Chlordiazepoxide Tablets 12.5 mg+ 5mg 12 Betahistine Tablets 16mg 13 Betahistine Tablets 240.125mg 14 Betahistine Tablets 32mg 15 Botulinum Toxid Injection 100 Units 16 Bromocriptine Tablets 5mg 17 Bromocriptine Tablets 2.5mg 18 Bupenorphine +Naloxone Tablets 2 mg + 0.5mg 19 Buprenorphine Tablets 8mg 20 Buprenorphine Tablets 0.4mg 21 Buprenorphine sublingual Tablets 0.2mg 22 Buprenorphine sublingual Tablets 8mg 24 Buprenorphine sublingual Tablets 0.4mg 25 Carbamazepine Nitrofurantoin Tablets 100mg 26 Carbamazepine Tablets 200mg 27 Carbamazepine Tablets 400mg 28 Carbamazepine syrup 100mg/5ml 29 Carbamazepine SR Tablets 200mg 30 Carbamazepine SR Tablets 400mg 31 Carbidopa Tablets 25mg 32 Carbidopa 15 Nitrofurantoin Tablets 50mg 33 Carbidopa Tablets 100mg 34 Chlorpromazine hydrochloride Tablets 25 mg 35 Chlorpromazine hydrochloride 16 Nitrofurantoin Syrup 25mg/5ml 36 Chlorpromazine hydrochloride Injection 25mg/ml 37 Chlorpromazine hydrochloride Tablets 50mg 38 Chlorpromazine hydrochloride Tablets 100mg 39 Cilnidipine Tablets 10mg 40 Cilnidipine Tablets 5 mg 41 Citalopram Tablets 10mg 42 Citalopram Tablets 20mg 43 Citalopram Tablets 40mg 44 Citicholine Tablets 500mg 45 Citicholine Injection 250mg/ml 46 Citicholine + Piracetam Tablets 500mg+800mg 47 Clobazam Tablets 2.5 mg 48 Clobazam Tablets 10 mg 49 Clobazam Tablets 5mg 50 Clonazepam Tablets 0.25mg 51 Clonazepam Tablets 0.5mg 52 Clonazepam Tablets 1 mg 53 Clonazepam Tablets 2mg 54 Clonazepam MD Tablets 2 mg 55 Colchicine Tablets 0.6 mg 56 Colchicine Tablets 0.5 mg 57 Colchicine Tablets 1mg 58 Conivaptan Injection 20mg/100ml 59 Deferasirox Tablets 100mg 60 Deferasirox Tablets 400mg 61 Deferasirox Tablets 250mg 62 Deferasirox Tablets 500mg 63 Deferiprone Capsules 250mg 64 Deferiprone Capsules 500mg 65 Deferiprone Tablets 500 mg 66 Deferiprone Tablets 1000 mg 67 Desvenlafaxine Tablets 50mg 68 Desvenlafaxine Tablets 100mg 69 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+325mg+1 0mg 70 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+500mg+1 0mg 71 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+650mg+1 0mg 72 Diazepam Tablets 2 mg 73 Diazepam Tablets 5mg 74 Diazepam Tablets 10mg 75 Diazepam Rectal Suppository 5mg 76 Diazepam Tablets 3 mg 77 Diazepam Rectal Suppository 2.5 mg 78 Diazepam Injection 10mg/2ml 79 Diazoxide Tablets 50 mg 80 Diethylcarbamazine citrate Tablets 50 mg 81 Diethylcarbamazine citrate Tablets 100 mg 82 Disulfiram Tablets 250mg 83 Disulfiram Tablets 500 mg 84 Divalproex 125mg/5ml 17 Triptorelin Pamoate equivalent to valproic acid 250 Triptoreline 3.75 mg syrup 100 ml 85 Divalproex Sodium Tablets 250Injection LA. 3.75mg 86 Divalproex Sodium Tablets 500mg 87 Divalproex Sodium Tablets 125 mg 88 Divalproex Sodium Tablets 250 mg ER 89 Divalproex Sodium Tablets 500 mg ER 90 Divalproex Sodium Tablets 125 mg ER 91 Duloxetine Hydrochloride Tablets 20mg 92 Duloxetine Hydrochloride Tablets 30mg 93 Duloxetine Hydrochloride Tablets 60mg 94 Eperisone hydrochloride Tablets 150 mg 95 Eperisone hydrochloride Tablets 450 mg 96 Escitalopram Tablets 5mg 97 Escitalopram Tablets 10mg 98 Escitalopram Tablets 20mg 99 Escitalopram + Clonazepam Tablets 10mg+0.25mg 100 Escitalopram + Clonazepam Tablets 10mg+0.5mg 101 Fludrocortisone Tablets 0.1mg 102 Flumazenil Injection 0.5 mg / 5ml 103 Flumazenil Injection 1 mg / 10 ml 104 Flunarizine Tablets 5mg 105 Flunarizine Tablets 10mg 106 Fluoxetine Tablets 40mg 107 Fluoxetine Capsules 20mg 108 Fluoxetine Tablets 20mg 109 Fluoxetine Tablets 40mg 110 Fluoxetine Tablets 60mg 111 Fluoxetine Tablets 10mg 112 Fluoxetine Capsules 20mg 113 Fluphenazile decanoate Injection 125mg/5ml 114 Flupiritine Tablets 100mg 115 Flupiritine Tablets 200mg 116 Fosphenytoin Injection 50mg/ml 117 Gabapentin Tablets 400mg 118 Gabapentine Tablets 600mg 119 Gabapentine Tablets 300mg 120 Gabapentine Cap. 300mg 121 Gabapentine + Mecobalamine Tablets 300 mg+ 0.5 mg 122 Gabapentine + Nortriptyline Tablets 400 mg + 10 mg 123 Glycerol Syrup 100ml 124 Glycerol Syrup 500ml 125 Haloperidol Tablets 2mg 126 Haloperidol Tablets 5mg 127 Haloperidol Tablets 10 mg 128 Haloperidol Injection 5mg/ml 129 Hydroxyzine Tablets 10mg 130 Hydroxyzine Tablets 25mg 131 Hydroxyzine Syrup 10mg/5ml 132 Imipramine Tablets 25 mg 133 Imipramine Tablets 75 mg 134 Lacosamide Tablets 50 mg 135 Lacosamide Tablets 100 mg 136 Lacosamide Tablets 150 mg 137 Lacosamide Tablets 200 mg 138 Lacosamide Syrup 50 mg/5ml 139 Lacosamide Injection 10 mg/ml 140 Lamotrigin Tablets 25mg 141 Lamotrigin Tablets 100 mg 142 Lamotrigin Tablets 150mg 143 Lamotrigin Tablets 200 mg 144 Lecithin 30mg+ 18 Triptorelin Pamoate equivalent to 175 mg of essential Phospholipids (EPL)(phosphatidylcholine,phosphatidylethanolamine,phospha tidylinositol,phosphatidylserine) Capsules (350+175)mg 145 Levetiracetam Tablets 250 mg 146 Levetiracetam Tablets 500 mg 147 Levetiracetam Tablets 750mg 148 Levetiracetam Tablets 1000 mg 149 Levetiracetam Injection 100mg/5 ml. 150 Levetiracetam Syrup 100mg/ml 151 Lithium Carbonate Tablets 450mg 152 Lithium Carbonate Tablets 300mg 153 Lithium Carbonate SR Tablets 400mg 154 Lorazepam Tablets 0.5 mg 155 Lorazepam Tablets 1mg 156 Lorazepam Tablets 2mg 157 Lorazepam 2Triptoreline 3.75 mg Injection 2 ml 158 Lorazepam 2mg Injection 4 ml 159 Magnesium Sulfate, Urea & Sulphacetamide Sdoium Ointment 75gm 160 Mefloquine Tablets 250mg 161 Melatonin Tablets 0.5mg 162 Melatonin Tablets 3mg 163 Melatonin Tablets 6mg 164 Methyldopa Tablets 250mg 165 Methyldopa Tablets 125 mg 166 Methyldopa Tablets 500 mg 167 Naltrexone Tablets 50mg 168 Naproxen Tablets 250mg 169 Naproxen Tablets 500mg 170 Naproxen Tablets 750mg 171 Naproxen + Domperidone Tablets 500mg+10mg 172 Nevirapine Tablets 200mg 173 Nevirapine syrup 10mg/ml 174 Nicotine Chewing gum Tablets 2mg 175 Nicotine Chewing gum Tablets 4mg 176 Nimodipine Tablets 30mg 177 Nimodipine Injection 10mg/50ml 178 Nitrazepam Tablets 5mg 179 Nitrazepam Tablets 10mg 180 Nortriptyline Tablets 25mg 181 Nortriptyline Tablets 10 mg 182 Olanzapine Tablets 20mg 183 Olanzapine Tablets 2.5mg 184 Olanzapine Tablets 5mg 185 Olanzapine Tablets 7.5mg 186 Olanzapine Tablets 10mg 187 Olanzapine Injection 10mg/ml 188 Oxcarbamazepine Tablets 150mg 189 Oxcarbamazepine Tablets 300mg 190 Oxcarbamazepine Tablets 600mg 191 Oxcarbamazepine 300 mg Syrups 60 ml 192 Paracetamol Injection 150mg/2ml 193 Paracetamol Injection 500mg/50 ml 194 Paracetamol 10mg/ml (PLASTIC BOT ) Injection 1 gm/ 100 ml 195 Paracetamol + Tramadol Tablets 325mg+37.5mg 196 Paracetamol 10mg/ ml (GLASS BOT ) Injection 1 gm/ 100 ml 197 Paroxetine Tablets 12.5mg 198 Paroxetine Tablets 25mg 199 Paroxetine Tablets 37.5mg 200 Pergolide Tablets 0.05mg 201 Pergolide Tablets 0.25mg 202 Pergolide Tablets 1mg 203 Phenobarbitone Tablets 30mg 204 Phenobarbitone Tablets 60mg 205 Phenobarbitone Syrup 20mg/5ml 206 Phenobarbitone Injection 200mg /1ml 207 Phenytoin Sodium Tablets 50 mg 208 Phenytoin Sodium Tablets 100mg 209 Phenytoin Sodium Injection 25mg/ml 210 Phenytoin Sodium Liquids 100ml(25mg/ml) 211 Piperazine Tablets 500 mg 212 Piperazine Syrup 750mg/5ml 213 Piracetam Tablets 800mg 214 Piracetam Syrup 500mg/5ml 215 Praziquantel Tablets 600 mg 216 Pregabaline Tablets 50mg 217 Pregabaline Tablets 75mg 218 Pregabaline Tablets 150mg 219 Pregabaline + Amitriptyline Tablets 75mg+10mg 220 Pregabaline + Amitriptyline Tablets 50mg+10mg 221 Pregabaline + Nortriptyline Tablets 75 mg+10 mg 222 Pregabaline+Methylcobalamine Tablets 75mg+750mcg 223 Pregabaline+Methylcobalamine Tablets 50mg+1500mcg 224 Pregabaline+Methylcobalamine Tablets 75mg+500mcg 225 Pregabaline+Methylcobalamine Tablets 150mg+1500mc g 226 Quetiapine Fumarate Tablets 25mg 227 Quetiapine Fumarate Tablets 100mg 228 Risperidone Tablets 4mg 229 Risperidone Tablets 3mg 230 Risperidone Tablets 2mg 231 Risperidone Tablets 1mg 232 Risperidone Tablets 0.5mg 233 Sertraline HCL Tablets 25mg 234 Sertraline HCL Tablets 50mg 235 Sertraline HCL Tablets 100mg 236 Sildenafil Citrate Tablets 50mg 237 Sildenafil Citrate Tablets 25mg 238 Sodium Valproate Tablets 200mg 239 Sodium Valproate Syrup 200mg/5ml 240 Sodium Valproate Injection 100ml/5ml 241 Sodium Valproate Tablets 300mg 242 Sodium Valproate + Valproic Acid Tablets 300mg 243 Sodium Valproate + Valproic Acid Tablets 500mg 244 Sodium Valproate + Valproic Acid Tablets 200mg 245 Sumatriptan + Naproxen Tablets 85mg+500mg 246 Tolvaptan Tablets 15mg 247 Topiramate Tablets 25 mg 248 Topiramate Tablets 50 mg 249 Topiramate Tablets 100 mg 250 Trihexyphenidyl (Benzhexol) Tablets 2mg 251 Zaleplon Tablets 5mg 252 Zaleplon Tablets 10mg 253 Zidovudine Syrup 50mg/5ml 254 Zidovudine Tablets 100mg 255 Zidovudine Tablets 300mg 256 Zolpidem Tablets 10 mg 257 Zolpidem Tablets 5mg 258 Zolpidem SR Tablets 6.25mg 259 Zolpidem SR Tablets 12.5LA. 11.25mg Calculation of Local Content Name of Manufacture Calculation by Manufacturer (Cost per unit of product) Cost Component Cost (Domestic Component) A Cost (Imported Component) B Total Cost (INR/ US $) C=a+b Percentage of Local Content D=(a/c)*100 I. ………… II. ………… III. Total Cost (Excluding tax and duties) Note:- I. Cost (Domestic Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken) which have not been imported directly or through a domestic trader or an intermediary. II. Cost (Imported Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken). I S/o.D/o,W/o , Resident of That I will agree to abide by the terms and conditions of the policy of Government of India issued vide order no. P-45021/2/2017-B.E.-II dated 15/06/2017. That the information furnished hereinafter is correct to best of my knowledge and belief and I undertake to produce relevant records before the procuring entity or any authority so nominated by the Government of India for the purpose of assessing the local content. That the local content for all inputs which constitute the said drugs has been verified by me and I am responsible for the correctness of the claims made therein. That in the event of the domestic valve addition of the product mentioned herein is found to be incorrect and not meeting the prescribed valve-addition norms, based on Government of India for the purpose of assessing the local content, action will be taken against me as per Order No. P-45021/2/2017-B.E.-II dated 15.06.2017. I agree to maintain the following information in the Company‟s record for a period of 8 years and shall make this available for verification to any statutory authorities: i) Name and details of the Domestic Manufacturer (Registered Officer, Manufacturing unit location, nature of legal entity) ii) Date on which this certificate is issued. iii) Medicine for which the certificate is product. iv) Procuring entity to whom the certificate is furnished. v) Percentage of local content claimed. vi) Name and contact details of the unit of the manufacturer. vii) Sale Price of the product. viii) Ex-Factory Price of the product. ix) Freight, insurance and handling. x) Total Bill of Material. xi) List and total cost valve of inputs used for manufacture of the medicine certificates from suppliers, if the input is not in-house to be attached. xii) List and cost of inputs which and imported, directly or indirectly. (Also to be provided in PDF format)

Legal Jurisdiction. The agreement shall be deemed to have been concluded in Jodhpur, Rajasthan and all obligations hereunder shall be deemed to be located at Jodhpur, Rajasthan and Court within Jodhpur, Rajasthan will have Jurisdiction to the exclusion of other courts. Complete Address, Telephone No. & Email Id Name of Proprietor/Partner/Managing Director/Director. Phone No:- Mobile No:- Email Id:- Whether the firm is a registered firm Yes/No (attached copy of certificate) Whether quoting as manufacturer/ authorised distributor/ authorised dealer PAN No. (enclose the attested copy of PAN Card) (enclose the attested copy of GST Certificate) Whether the firm has enclosed the Bank Draft/Pay Order/Banker‟s cheque as Xxxxxxx Money Deposit Whether the Firm/Agency has signed each and every page of Tender/NIT Bank Details: 1) Accounts No: 2) Bank Name: 3) Branch: 4) IFSC Code: Any other information, if necessary Place: Name: Date: Business Address: Signature of Bidder: Seal of the Bidder: Annexure-B List of Products 1 Alprazolam Tablets Acyclovir 3% Ointment 5gm 2 Atropine 1% Ointment 5gm 3 Atropine 1% Ointment 5gm 4 Betamethosone 0.1%+ neomycin 0.5% Eye Drop 5ml 5 Betaxolol 5% Eye Drop 5ml 6 Betaxolol 0.25mg 2 Alprazolam Tablets % Eye Drop 5ml 7 Brimonidine tartarate 0.2% Eye Drop 5ml 8 Bromonidine 0.2%+Timolol 0.5mg 3 Alprazolam Tablets 1 mg 4 Amitriptyline Tablets % Eye Drop 5ml 9 Carboxymethylcellulose sodium0.5% Eye Drop 10ml 10 Chloramphenicol syrup 125mg/5ml 11 Chloramphenicol 1% Eye Drop 5ml 12 Chloramphenicol 1% Ointment 5gm 13 Ciprofloxacin 0.3% w/w Eye Drop 5ml 14 Ciprofloxacin 0.3% w/w Ointment 5gm 15 CMC 0.5% + glycerine 0.5% + N-acetyl carnosine 1%. Eye Drop 5 ml 16 Combination of Boric Acid + Sod. Chloride + Chlorbutanol + Naphazoline HCL + Zinc Sulphate + Chlorpheniramine Maleate,Hydropropylmethyl cellulose etc. Eye Drop 5ml 17 Cefazolin 0.5% Eye Drop 5ml 18 Cyclopentolate 1% Eye Drop 5ml 19 Cyclosporine 0.05% Eye Drop 5ml 20 Diclofenac 0.1% Eye Drop 5ml 21 Dorzolamide 2% Eye Drop 5ml 22 Erythromycin Syrup 125mg/5ml 23 Fluconazole 0.3% Eye Drop 5ml 24 Fluorescein 1% Eye Drop 5 ml 25 Fluorescein Sodium 10mg 5 Amitriptyline Tablets 75 mg 6 Amitriptyline Tablets 25 mg 7 Amitriptyline Tablets % Injection 5ml 26 Fluorescein Sodium 20% Injection 3ml 27 Fluoromethalone 0.1% Eye Drop 5ml 28 Flurbiprofen 0.03% Eye Drop 5ml 29 Gatifloxacin 0.3% Eye Drop 5ml 30 Gentamicin 0.30% Eye Drop 5ml 31 Glycerine 0.9% + L. Carlnitine + erythromycin + cmc 0.5% E/d Eye Drop 5ml 32 Homatropine Hydrobromide 2% Eye Drop 3ml 33 Hydroxy propyl methyl cellulose 0.70% Eye Drop 10ml 34 Hydroxyl Propyl Methyl Cellulose 0.3% Eye Drop 10ml 35 Hypromellose 0.3% Eye Drop 5ml 36 Ketorolac 0.5% Eye Drop 5ml 37 Latanoprost 50 mg 8 Amitriptyline Tablets 100 mg 9 Amitriptyline Tablets 150 mg 10 Amitriptyline mcg per ml Eye Drop 2.5ml 38 Latanoprost 50 mcg per ml + Chlordiazepoxide Tablets 25 mg + 10mg 11 Amitriptyline + Chlordiazepoxide Tablets 12.5 mg+ 5mg 12 Betahistine Tablets 16mg 13 Betahistine Tablets 24mg 14 Betahistine Tablets 32mg 15 Botulinum Toxid Injection 100 Units 16 Bromocriptine Tablets 5mg 17 Bromocriptine Tablets 2.5mg 18 Bupenorphine +Naloxone Tablets 2 mg + 0.5mg 19 Buprenorphine Tablets 8mg 20 Buprenorphine Tablets 0.4mg 21 Buprenorphine sublingual Tablets 0.2mg 22 Buprenorphine sublingual Tablets 8mg 24 Buprenorphine sublingual Tablets 0.4mg 25 Carbamazepine Tablets 100mg 26 Carbamazepine Tablets 200mg 27 Carbamazepine Tablets 400mg 28 Carbamazepine syrup 100mg/5ml 29 Carbamazepine SR Tablets 200mg 30 Carbamazepine SR Tablets 400mg 31 Carbidopa Tablets 25mg 32 Carbidopa Tablets 50mg 33 Carbidopa Tablets 100mg 34 Chlorpromazine hydrochloride Tablets 25 mg 35 Chlorpromazine hydrochloride Syrup 25mg/5ml 36 Chlorpromazine hydrochloride Injection 25mg/ml 37 Chlorpromazine hydrochloride Tablets 50mg 38 Chlorpromazine hydrochloride Tablets 100mg 39 Cilnidipine Tablets 10mg 40 Cilnidipine Tablets timolol 5 mg per ml Eye Drop 2.5ml 39 Lignocaine 4% Eye Drop 10 ml 40 Methyl Cellulose 2% Injection 2ml 41 Citalopram Tablets 10mg Miconazole 2% Eye Drop 5ml 42 Citalopram Tablets 20mg Moxifloxacin 0.5% Eye Drop 5ml 43 Citalopram Tablets 40mg Natamycin 5% Eye Drop 5ml 44 Citicholine Tablets 500mg Neomycin+polymyxinB+bacitracin zinc Eye Drop 5ml 45 Citicholine Injection 250mg/Nepafenac ophthalmic suspension Eye Drop 5 ml 46 Citicholine Norfloxacin 0.3% Ointment 5gm 47 Ofloxacin 0.3% Eye Drop 5ml 48 Paracaine Eye Drop 5ml 49 Phenylephrine HCL 5% Eye Drop 5ml 50 Phenylephrine HCL 10% Eye Drop 5ml 51 Pilocarpine 0.25% Eye Drop 5ml 52 Pilocarpine 4% Eye Drop 5ml 53 Pilocarpine 2% Eye Drop 5ml 54 Polyvinyl Alcohol 1.4% + Piracetam Tablets 500mg+800mg 47 Clobazam Tablets 2.5 mg 48 Clobazam Tablets 10 mg 49 Clobazam Tablets Povidone 0.06% + Chlorbutanol 0.5% Eye Drop 10ml 55 Povidone Iodine 0.60% Eye Drop 5ml 56 Povidone Iodine 5mg 50 Clonazepam Tablets 0.25mg 51 Clonazepam Tablets % Eye drop 5ml 57 Prednisolone Acetate 0.01% Eye drop 5ml 58 Prednisolone Sodium Phosphate 1% Eye Drop 5ml 59 Proparacain HCI USP 0.5mg 52 Clonazepam Tablets 1 mg 53 Clonazepam Tablets % Eye Drop 5ml 60 Sodium Cromoglycate 2mg 54 Clonazepam MD Tablets 2 mg 55 Colchicine Tablets 0.6 mg 56 Colchicine Tablets 0.5 mg 57 Colchicine Tablets 1mg 58 Conivaptan Injection 20mg/100ml 59 Deferasirox Tablets 100mg 60 Deferasirox Tablets 400mg % Eye Drop 5ml 61 Deferasirox Tablets 250mg 62 Deferasirox Tablets 500mg 63 Deferiprone Capsules 250mg 64 Deferiprone Capsules 500mg 65 Deferiprone Tablets 500 mg 66 Deferiprone Tablets 1000 mg 67 Desvenlafaxine Tablets 50mg 68 Desvenlafaxine Tablets 100mg 69 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+325mg+1 0mg 70 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+500mg+1 0mg 71 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+650mg+1 0mg 72 Diazepam Tablets 2 mg 73 Diazepam Tablets 5mg 74 Diazepam Tablets 10mg 75 Diazepam Rectal Suppository 5mg 76 Diazepam Tablets 3 mg 77 Diazepam Rectal Suppository 2.5 mg 78 Diazepam Injection 10mg/2ml 79 Diazoxide Tablets 50 mg 80 Diethylcarbamazine citrate Tablets 50 mg 81 Diethylcarbamazine citrate Tablets 100 mg 82 Disulfiram Tablets 250mg 83 Disulfiram Tablets 500 mg 84 Divalproex equivalent to valproic acid 250 mg syrup 100 ml 85 Divalproex Sodium Tablets 250mg 86 Divalproex Sodium Tablets 500mg 87 Divalproex Sodium Tablets 125 mg 88 Divalproex Sodium Tablets 250 mg ER 89 Divalproex Sodium Tablets 500 mg ER 90 Divalproex Sodium Tablets 125 mg ER 91 Duloxetine Hydrochloride Tablets 20mg 92 Duloxetine Hydrochloride Tablets 30mg 93 Duloxetine Hydrochloride Tablets 60mg 94 Eperisone hydrochloride Tablets 150 mg 95 Eperisone hydrochloride Tablets 450 mg 96 Escitalopram Tablets 5mg 97 Escitalopram Tablets 10mg 98 Escitalopram Tablets 20mg 99 Escitalopram + Clonazepam Tablets 10mg+0.25mg 100 Escitalopram + Clonazepam Tablets 10mg+0.5mg 101 Fludrocortisone Tablets 0.1mg 102 Flumazenil Injection 0.5 mg / 5ml 103 Flumazenil Injection 1 mg / 10 ml 104 Flunarizine Tablets 5mg 105 Flunarizine Tablets 10mg 106 Fluoxetine Tablets 40mg 107 Fluoxetine Capsules 20mg 108 Fluoxetine Tablets 20mg 109 Fluoxetine Tablets 40mg 110 Fluoxetine Tablets 60mg 111 Fluoxetine Tablets 10mg 112 Fluoxetine Capsules 20mg 113 Fluphenazile decanoate Injection 125mg/5ml 114 Flupiritine Tablets 100mg 115 Flupiritine Tablets 200mg 116 Fosphenytoin Injection 50mg/ml 117 Gabapentin Tablets 400mg 118 Gabapentine Tablets 600mg 119 Gabapentine Tablets 300mg 120 Gabapentine Cap. 300mg 121 Gabapentine + Mecobalamine Tablets 300 mg+ 0.5 mg 122 Gabapentine + Nortriptyline Tablets 400 mg + 10 mg 123 Glycerol Syrup 100ml 124 Glycerol Syrup 500ml 125 Haloperidol Tablets 2mg 126 Haloperidol Tablets 5mg 127 Haloperidol Tablets 10 mg 128 Haloperidol Injection 5mg/ml 129 Hydroxyzine Tablets 10mg 130 Hydroxyzine Tablets 25mg 131 Hydroxyzine Syrup 10mg/5ml 132 Imipramine Tablets 25 mg 133 Imipramine Tablets 75 mg 134 Lacosamide Tablets 50 mg 135 Lacosamide Tablets 100 mg 136 Lacosamide Tablets 150 mg 137 Lacosamide Tablets 200 mg 138 Lacosamide Syrup 50 mg/5ml 139 Lacosamide Injection 10 mg/ml 140 Lamotrigin Tablets 25mg 141 Lamotrigin Tablets 100 mg 142 Lamotrigin Tablets 150mg 143 Lamotrigin Tablets 200 mg 144 Lecithin 30mg+ equivalent to 175 mg of essential Phospholipids (EPL)(phosphatidylcholine,phosphatidylethanolamine,phospha tidylinositol,phosphatidylserine) Capsules (350+175)mg 145 Levetiracetam Tablets 250 mg 146 Levetiracetam Tablets 500 mg 147 Levetiracetam Tablets 750mg 148 Levetiracetam Tablets 1000 mg 149 Levetiracetam Injection 100mg/5 ml. 150 Levetiracetam Syrup 100mg/ml 151 Lithium Carbonate Tablets 450mg 152 Lithium Carbonate Tablets 300mg 153 Lithium Carbonate SR Tablets 400mg 154 Lorazepam Tablets 0.5 mg 155 Lorazepam Tablets 1mg 156 Lorazepam Tablets 2mg 157 Lorazepam 2mg Injection 2 ml 158 Lorazepam 2mg Injection 4 ml 159 Magnesium Sulfate, Urea & Sulphacetamide Sdoium Ointment 75gm 160 Mefloquine Tablets 250mg 161 Melatonin Tablets 0.5mg 162 Melatonin Tablets 3mg 163 Melatonin Tablets 6mg 164 Methyldopa Tablets 250mg 165 Methyldopa Tablets 125 mg 166 Methyldopa Tablets 500 mg 167 Naltrexone Tablets 50mg 168 Naproxen Tablets 250mg 169 Naproxen Tablets 500mg 170 Naproxen Tablets 750mg 171 Naproxen + Domperidone Tablets 500mg+10mg 172 Nevirapine Tablets 200mg 173 Nevirapine syrup 10mg/ml 174 Nicotine Chewing gum Tablets 2mg 175 Nicotine Chewing gum Tablets 4mg 176 Nimodipine Tablets 30mg 177 Nimodipine Injection 10mg/50ml 178 Nitrazepam Tablets 5mg 179 Nitrazepam Tablets 10mg 180 Nortriptyline Tablets 25mg 181 Nortriptyline Tablets 10 mg 182 Olanzapine Tablets 20mg 183 Olanzapine Tablets 2.5mg 184 Olanzapine Tablets 5mg 185 Olanzapine Tablets 7.5mg 186 Olanzapine Tablets 10mg 187 Olanzapine Hyaluronate PFS Injection 10mg/ml 188 Oxcarbamazepine Tablets 150mg 189 Oxcarbamazepine Tablets 300mg 190 Oxcarbamazepine Tablets 600mg 191 Oxcarbamazepine 300 mg Syrups 60 ml 192 Paracetamol 62 Sodium Hyaluronate PFS Injection 150mg/2ml 193 Paracetamol Injection 500mg/50 ml 194 Paracetamol 10mg20 mg/ml (PLASTIC BOT ) 63 Sodium Hyaluronate PFS Injection 1 gm/ 100 ml 195 Paracetamol + Tramadol Tablets 325mg+37.5mg 196 Paracetamol 10mg/ ml (GLASS BOT ) Injection 1 gm/ 100 ml 197 Paroxetine Tablets 12.5mg 198 Paroxetine Tablets 25mg 199 Paroxetine Tablets 37.5mg 200 Pergolide Tablets 0.05mg 201 Pergolide Tablets 0.25mg 202 Pergolide Tablets 1mg 203 Phenobarbitone Tablets 30mg 204 Phenobarbitone Tablets 60mg 205 Phenobarbitone Syrup 20mg/5ml 206 Phenobarbitone Injection 200mg /1ml 207 Phenytoin Sodium Tablets 50 mg 208 Phenytoin Sodium Tablets 100mg 209 Phenytoin Sodium Injection 25mg14mg/ml 210 Phenytoin Sodium Liquids 100ml(25mg64 Tetracaine Hydrochloride 0.5% Eye Drop 5ml 65 Timolol 0.5% Eye drop 5ml 66 Timolol 0.25% Eye Drop 5ml 67 Tobramycin 0.3% Eye Drop 5ml 68 Tropicamide 0.8%+ Phenylepherine 5% Eye Drop 5ml 69 Tropicamide 0.80% Eye Drop 5ml 70 Tropicamide 1% Eye Drop 5ml 71 Tropicamide+Phenylephrine 1%+5% Eye Drop 5ml 72 Vancomycin 50mg/ml) 211 Piperazine Tablets 500 mg 212 Piperazine Syrup 750mg/5ml 213 Piracetam Tablets 800mg 214 Piracetam Syrup 500mg/5ml 215 Praziquantel Tablets 600 mg 216 Pregabaline Tablets 50mg 217 Pregabaline Tablets 75mg 218 Pregabaline Tablets 150mg 219 Pregabaline + Amitriptyline Tablets 75mg+10mg 220 Pregabaline + Amitriptyline Tablets 50mg+10mg 221 Pregabaline + Nortriptyline Tablets 75 mg+10 mg 222 Pregabaline+Methylcobalamine Tablets 75mg+750mcg 223 Pregabaline+Methylcobalamine Tablets 50mg+1500mcg 224 Pregabaline+Methylcobalamine Tablets 75mg+500mcg 225 Pregabaline+Methylcobalamine Tablets 150mg+1500mc g 226 Quetiapine Fumarate Tablets 25mg 227 Quetiapine Fumarate Tablets 100mg 228 Risperidone Tablets 4mg 229 Risperidone Tablets 3mg 230 Risperidone Tablets 2mg 231 Risperidone Tablets 1mg 232 Risperidone Tablets 0.5mg 233 Sertraline HCL Tablets 25mg 234 Sertraline HCL Tablets 50mg 235 Sertraline HCL Tablets 100mg 236 Sildenafil Citrate Tablets 50mg 237 Sildenafil Citrate Tablets 25mg 238 Sodium Valproate Tablets 200mg 239 Sodium Valproate Syrup 200mg/5ml 240 Sodium Valproate Injection 100ml/5ml 241 Sodium Valproate Tablets 300mg 242 Sodium Valproate + Valproic Acid Tablets 300mg 243 Sodium Valproate + Valproic Acid Tablets 500mg 244 Sodium Valproate + Valproic Acid Tablets 200mg 245 Sumatriptan + Naproxen Tablets 85mg+500mg 246 Tolvaptan Tablets 15mg 247 Topiramate Tablets 25 mg 248 Topiramate Tablets 50 mg 249 Topiramate Tablets 100 mg 250 Trihexyphenidyl (Benzhexol) Tablets 2mg 251 Zaleplon Tablets 5mg 252 Zaleplon Tablets 10mg 253 Zidovudine Syrup 50mg/5ml 254 Zidovudine Tablets 100mg 255 Zidovudine Tablets 300mg 256 Zolpidem Tablets 10 mg 257 Zolpidem Tablets 5mg 258 Zolpidem SR Tablets 6.25mg 259 Zolpidem SR Tablets 12.5mg cc Eye Drop 5ml Calculation of Local Content Name of Manufacture Calculation by Manufacturer (Cost per unit of product) Cost Component Cost (Domestic Component) A Cost (Imported Component) B Total Cost (INR/ US $) C=a+b Percentage of Local Content D=(a/c)*100 I. ………… II. ………… III. Total Cost (Excluding tax and duties) Note:- I. Cost (Domestic Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken) which have not been imported directly or through a domestic trader or an intermediary. II. Cost (Imported Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken). I S/o.D/o,W/o , Resident of That I will agree to abide by the terms and conditions of the policy of Government of India issued vide order no. P-45021/2/2017-B.E.-II dated 15/06/2017. That the information furnished hereinafter is correct to best of my knowledge and belief and I undertake to produce relevant records before the procuring entity or any authority so nominated by the Government of India for the purpose of assessing the local content. That the local content for all inputs which constitute the said drugs has been verified by me and I am responsible for the correctness of the claims made therein. That in the event of the domestic valve addition of the product mentioned herein is found to be incorrect and not meeting the prescribed valve-addition norms, based on Government of India for the purpose of assessing the local content, action will be taken against me as per Order No. P-45021/2/2017-B.E.-II dated 15.06.2017. I agree to maintain the following information in the Company‟s record for a period of 8 years and shall make this available for verification to any statutory authorities: i) Name and details of the Domestic Manufacturer (Registered Officer, Manufacturing unit location, nature of legal entity) ii) Date on which this certificate is issued. iii) Medicine for which the certificate is product. iv) Procuring entity to whom the certificate is furnished. v) Percentage of local content claimed. vi) Name and contact details of the unit of the manufacturer. vii) Sale Price of the product. viii) Ex-Factory Price of the product. ix) Freight, insurance and handling. x) Total Bill of Material. xi) List and total cost valve of inputs used for manufacture of the medicine certificates from suppliers, if the input is not in-house to be attached. xii) List and cost of inputs which and imported, directly or indirectly. (Also to be provided in PDF format)

Legal Jurisdiction. The agreement shall be deemed to have been concluded in Jodhpur, Rajasthan and all obligations hereunder shall be deemed to be located at Jodhpur, Rajasthan and Court within Jodhpur, Rajasthan will have Jurisdiction to the exclusion of other courts. Complete Address, Telephone No. & Email Id Name of Proprietor/Partner/Managing Director/Director. Phone No:- Mobile No:- Email Id:- Whether the firm is a registered firm Yes/No (attached copy of certificate) Whether quoting as manufacturer/ authorised distributor/ authorised dealer PAN No. (enclose the attested copy of PAN Card) (enclose the attested copy of GST Certificate) Whether the firm has enclosed the Bank Draft/Pay Order/Banker‟s cheque as Xxxxxxx Money Deposit Whether the Firm/Agency has signed each and every page of Tender/NIT Bank Details: 1) Accounts No: 2) Bank Name: 3) Branch: 4) IFSC Code: Any other information, if necessary Place: Name: Date: Business Address: Signature of Bidder: Seal of the Bidder: Annexure-B List of Products 1 Alprazolam Tablets 0.25mg Acyclovir 5% Ointment 5gm 2 Alprazolam Tablets Adapalene Gel 0.1% Ointment 15gm 3 Benzoyl peroxide 2.5% Ointment 20gm 4 Benzoyl peroxide 5% Ointment 20gm 5 Benzyl benzoate Lotion 25% 6 Benzyl benzoate Cream 5% 7 Betamethasone Dipropionate Ointment 0.05% 8 Betamethasone dipropionate 0.1% + Salicyclic acid 3% Ointment 20g 9 Betamethasone valerate 0.01% Cream 20gm 10 Betamethasone valerate 0.12% + clioquinol 3% Cream 20gm 11 Betamethasone valerate 0.12% + neomycin 0.5mg 3 Alprazolam Tablets 1 mg 4 Amitriptyline Tablets % Cream 20gm 12 Calamine+Diphenhydramine Hydrochloride + Ethanol Lotion 100 ml 13 Clindamycin 1% Lotion 25ml 14 Clindamycin 1% Gel 10gm 15 Clobetasol 0.05% Ointment 10gm 16 Clobetasol 0.05% Ointment 15gm 17 Clobetasol 0.05% + Gentamicin 0.1% Ointment 10mg 18 Clobetasol 0.05% + Gentamicin 0.1% Ointment 15gm 19 Clobetasol 0.05%+ Micanozole 2% Ointment 20gm 20 Clotrimazole 1% + Betamethasone Ointment 5gm 21 Clotrimazole cream Ointment 10gm 22 Clotrimazole cream Ointment 15gm 23 Clotrimazole Lotion 1% Solution 15ml 24 Clotrimazole Powder 1% Powder 75gm 25 Coal Tar 5% Solution 500ml 26 Dithranol 0.1-2% Ointment 30gm 27 Fluocinolone + Miconazole Nitrate Ointment 15gm 28 Fluocinolone + Neomycin Ointment 20gm 29 Fluocinolone 0.025% Ointment 15gm 30 Fluocinolone Acetonide 0.1% Ointment 20gm 31 Fluticasone Propionate 0.05% Ointment 10gm 32 Framycetin 1% Ointment 30gm 33 Framycetin 1% Ointment 100gm 34 Framycetin Sulphate Cream 0.50% 35 Fusidic Acid 2% Cream 15gm 36 Gamabenzene lotion Hexachloride 1% Ointment 100ml 37 Heparin Ointment 30gm 38 Hydroquinone Ointment 25gm 39 Ketoconazole 2% shampoo 50ml 40 Liposomal Dithranol 0.5% w/w Ointment 30gm 41 Methylrosanilinium Chloride (GentianViolet) Aqueous solution 0.50% 42 Metronidazole Gel Ointment 30gm 43 Miconazole 2% Ointment or 15gm Cream 44 Minoxidil 2% Solution 60ml 45 Minoxidil 5% Solution 60ml 46 Mometasone 0.1% Lotion 15ml 47 Mometasone 0.1% Ointment 15gm 48 Mometasone Furoate N/spray 50mcg 49 Mupirocin + Betamethasone Ointment 5gm 50 Mupirocin 2% Ointment 5gm 51 Neomycin +Bacitracin Ointment 5 Amitriptyline Tablets 75 mg 6 Amitriptyline Tablets 25 mg 7 Amitriptyline Tablets 50 mg 8 Amitriptyline Tablets 100 mg 9 Amitriptyline Tablets 150 mg 10 Amitriptyline + Chlordiazepoxide Tablets 25 mg + 10mg 11 Amitriptyline 500 IU / g 52 Ointment/Gel containig Diclofenadiethylamine Linseed methyl Salicylate & Menthol Ointment 30gm 53 Ointment/Gel containing Etoricoxib +Menthol+Lincid oil+Methyl salycylate Ointment 30gm 54 Permethrin 1% Ointment 30gm 55 Permethrin 5% Lotion 30ml 56 Pimecrolimus 1% Ointment 10gm 57 Polymyxin B Sulph.5000 IU + Chlordiazepoxide Tablets 12.5 mg+ Neomycin 3400 IU per gm powder Powder 10gm 58 Polymyxin B Sulph.5000IU equivalent to neomycin 1700IU per gm Ointment 2.5GM 59 PolymyxinBSulp.5000IU+Neomycin 3400IU per gm Ointment 5gm 60 Povidone Iodine5% + Metronidazole 1% Ointment 15gm 61 Povidone Iodine 5mg 12 Betahistine Tablets 16mg 13 Betahistine Tablets 24mg 14 Betahistine Tablets 32mg 15 Botulinum Toxid Injection 100 Units 16 Bromocriptine Tablets 5mg 17 Bromocriptine Tablets 2.5mg 18 Bupenorphine +Naloxone Tablets 2 mg % Ointment 15gm 62 Salicyclic acid + 0.5mg 19 Buprenorphine Tablets 8mg 20 Buprenorphine Tablets 0.4mg 21 Buprenorphine sublingual Tablets 0.2mg 22 Buprenorphine sublingual Tablets 8mg 24 Buprenorphine sublingual Tablets 0.4mg 25 Carbamazepine Tablets 100mg 26 Carbamazepine Tablets 200mg 27 Carbamazepine Tablets 400mg 28 Carbamazepine syrup 100mg/5ml 29 Carbamazepine SR Tablets 200mg 30 Carbamazepine SR Tablets 400mg 31 Carbidopa Tablets 25mg 32 Carbidopa Tablets 50mg 33 Carbidopa Tablets 100mg 34 Chlorpromazine hydrochloride Tablets 25 mg 35 Chlorpromazine hydrochloride Syrup 25mg/5ml 36 Chlorpromazine hydrochloride Injection 25mgCoaltar 1%+5% W/ml 37 Chlorpromazine hydrochloride Tablets 50mg 38 Chlorpromazine hydrochloride Tablets 100mg 39 Cilnidipine Tablets 10mg 40 Cilnidipine Tablets 5 mg 41 Citalopram Tablets 10mg 42 Citalopram Tablets 20mg 43 Citalopram Tablets 40mg 44 Citicholine Tablets 500mg 45 Citicholine Injection 250mg/ml 46 Citicholine + Piracetam Tablets 500mg+800mg 47 Clobazam Tablets 2.5 mg 48 Clobazam Tablets 10 mg 49 Clobazam Tablets 5mg 50 Clonazepam Tablets 0.25mg 51 Clonazepam Tablets 0.5mg 52 Clonazepam Tablets 1 mg 53 Clonazepam Tablets 2mg 54 Clonazepam MD Tablets 2 mg 55 Colchicine Tablets 0.6 mg 56 Colchicine Tablets 0.5 mg 57 Colchicine Tablets 1mg 58 Conivaptan Injection 20mg/100ml 59 Deferasirox Tablets 100mg 60 Deferasirox Tablets 400mg 61 Deferasirox Tablets 250mg 62 Deferasirox Tablets 500V Ointment 15mg 63 Deferiprone Capsules 250mg Salicyclic acid 1.15/1.5% + Coaltar extract/Urea 5% with other ingredients Ointment 30gm 64 Deferiprone Capsules 500mg Salicylic Acid 5% Solution 30ml 65 Deferiprone Tablets 500 mg Silver Sulfadiazine 1% Cream 25gm 66 Deferiprone Tablets 1000 mg Silver Sulfadiazine+Chlorhexidine Ointment 100gm 67 Desvenlafaxine Tablets 50mg Silver Sulfadiazine+Chlorhexidine Ointment 25gm 68 Desvenlafaxine Tablets 100mg Silver Sulfadiazine+Chlorhexidine Ointment 250gm 69 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+325mg+1 0mg Sodium fusidate 2% Ointment 5gm 70 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+500mg+1 0mg Tretinoin 0.05% Ointment 20gm 71 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+650mg+1 0mg Tretinoin 0.025% Ointment 20gm 72 Diazepam Tablets 2 mg 73 Diazepam Tablets 5mg 74 Diazepam Tablets 10mg 75 Diazepam Rectal Suppository 5mg 76 Diazepam Tablets 3 mg 77 Diazepam Rectal Suppository 2.5 mg 78 Diazepam Injection 10mg/2ml 79 Diazoxide Tablets 50 mg 80 Diethylcarbamazine citrate Tablets 50 mg 81 Diethylcarbamazine citrate Tablets 100 mg 82 Disulfiram Tablets 250mg 83 Disulfiram Tablets 500 mg 84 Divalproex equivalent to valproic acid 250 mg syrup 100 ml 85 Divalproex Sodium Tablets 250mg 86 Divalproex Sodium Tablets 500mg 87 Divalproex Sodium Tablets 125 mg 88 Divalproex Sodium Tablets 250 mg ER 89 Divalproex Sodium Tablets 500 mg ER 90 Divalproex Sodium Tablets 125 mg ER 91 Duloxetine Hydrochloride Tablets 20mg 92 Duloxetine Hydrochloride Tablets 30mg 93 Duloxetine Hydrochloride Tablets 60mg 94 Eperisone hydrochloride Tablets 150 mg 95 Eperisone hydrochloride Tablets 450 mg 96 Escitalopram Tablets 5mg 97 Escitalopram Tablets 10mg 98 Escitalopram Tablets 20mg 99 Escitalopram + Clonazepam Tablets 10mg+0.25mg 100 Escitalopram + Clonazepam Tablets 10mg+0.5mg 101 Fludrocortisone Tablets 0.1mg 102 Flumazenil Injection 0.5 mg / 5ml 103 Flumazenil Injection 1 mg / 10 ml 104 Flunarizine Tablets 5mg 105 Flunarizine Tablets 10mg 106 Fluoxetine Tablets 40mg 107 Fluoxetine Capsules 20mg 108 Fluoxetine Tablets 20mg 109 Fluoxetine Tablets 40mg 110 Fluoxetine Tablets 60mg 111 Fluoxetine Tablets 10mg 112 Fluoxetine Capsules 20mg 113 Fluphenazile decanoate Injection 125mg/5ml 114 Flupiritine Tablets 100mg 115 Flupiritine Tablets 200mg 116 Fosphenytoin Injection 50mg/ml 117 Gabapentin Tablets 400mg 118 Gabapentine Tablets 600mg 119 Gabapentine Tablets 300mg 120 Gabapentine Cap. 300mg 121 Gabapentine + Mecobalamine Tablets 300 mg+ 0.5 mg 122 Gabapentine + Nortriptyline Tablets 400 mg + 10 mg 123 Glycerol Syrup 100ml 124 Glycerol Syrup 500ml 125 Haloperidol Tablets 2mg 126 Haloperidol Tablets 5mg 127 Haloperidol Tablets 10 mg 128 Haloperidol Injection 5mg/ml 129 Hydroxyzine Tablets 10mg 130 Hydroxyzine Tablets 25mg 131 Hydroxyzine Syrup 10mg/5ml 132 Imipramine Tablets 25 mg 133 Imipramine Tablets 75 mg 134 Lacosamide Tablets 50 mg 135 Lacosamide Tablets 100 mg 136 Lacosamide Tablets 150 mg 137 Lacosamide Tablets 200 mg 138 Lacosamide Syrup 50 mg/5ml 139 Lacosamide Injection 10 mg/ml 140 Lamotrigin Tablets 25mg 141 Lamotrigin Tablets 100 mg 142 Lamotrigin Tablets 150mg 143 Lamotrigin Tablets 200 mg 144 Lecithin 30mg+ equivalent to 175 mg of essential Phospholipids (EPL)(phosphatidylcholine,phosphatidylethanolamine,phospha tidylinositol,phosphatidylserine) Capsules (350+175)mg 145 Levetiracetam Tablets 250 mg 146 Levetiracetam Tablets 500 mg 147 Levetiracetam Tablets 750mg 148 Levetiracetam Tablets 1000 mg 149 Levetiracetam Injection 100mg/5 ml. 150 Levetiracetam Syrup 100mg/ml 151 Lithium Carbonate Tablets 450mg 152 Lithium Carbonate Tablets 300mg 153 Lithium Carbonate SR Tablets 400mg 154 Lorazepam Tablets 0.5 mg 155 Lorazepam Tablets 1mg 156 Lorazepam Tablets 2mg 157 Lorazepam 2mg Injection 2 ml 158 Lorazepam 2mg Injection 4 ml 159 Magnesium Sulfate, Urea & Sulphacetamide Sdoium Ointment 75gm 160 Mefloquine Tablets 250mg 161 Melatonin Tablets 0.5mg 162 Melatonin Tablets 3mg 163 Melatonin Tablets 6mg 164 Methyldopa Tablets 250mg 165 Methyldopa Tablets 125 mg 166 Methyldopa Tablets 500 mg 167 Naltrexone Tablets 50mg 168 Naproxen Tablets 250mg 169 Naproxen Tablets 500mg 170 Naproxen Tablets 750mg 171 Naproxen + Domperidone Tablets 500mg+10mg 172 Nevirapine Tablets 200mg 173 Nevirapine syrup 10mg/ml 174 Nicotine Chewing gum Tablets 2mg 175 Nicotine Chewing gum Tablets 4mg 176 Nimodipine Tablets 30mg 177 Nimodipine Injection 10mg/50ml 178 Nitrazepam Tablets 5mg 179 Nitrazepam Tablets 10mg 180 Nortriptyline Tablets 25mg 181 Nortriptyline Tablets 10 mg 182 Olanzapine Tablets 20mg 183 Olanzapine Tablets 2.5mg 184 Olanzapine Tablets 5mg 185 Olanzapine Tablets 7.5mg 186 Olanzapine Tablets 10mg 187 Olanzapine Injection 10mg/ml 188 Oxcarbamazepine Tablets 150mg 189 Oxcarbamazepine Tablets 300mg 190 Oxcarbamazepine Tablets 600mg 191 Oxcarbamazepine 300 mg Syrups 60 ml 192 Paracetamol Injection 150mg/2ml 193 Paracetamol Injection 500mg/50 ml 194 Paracetamol 10mg/ml (PLASTIC BOT ) Injection 1 gm/ 100 ml 195 Paracetamol + Tramadol Tablets 325mg+37.5mg 196 Paracetamol 10mg/ ml (GLASS BOT ) Injection 1 gm/ 100 ml 197 Paroxetine Tablets 12.5mg 198 Paroxetine Tablets 25mg 199 Paroxetine Tablets 37.5mg 200 Pergolide Tablets 0.05mg 201 Pergolide Tablets 0.25mg 202 Pergolide Tablets 1mg 203 Phenobarbitone Tablets 30mg 204 Phenobarbitone Tablets 60mg 205 Phenobarbitone Syrup 20mg/5ml 206 Phenobarbitone Injection 200mg /1ml 207 Phenytoin Sodium Tablets 50 mg 208 Phenytoin Sodium Tablets 100mg 209 Phenytoin Sodium Injection 25mg/ml 210 Phenytoin Sodium Liquids 100ml(25mg/ml) 211 Piperazine Tablets 500 mg 212 Piperazine Syrup 750mg/5ml 213 Piracetam Tablets 800mg 214 Piracetam Syrup 500mg/5ml 215 Praziquantel Tablets 600 mg 216 Pregabaline Tablets 50mg 217 Pregabaline Tablets 75mg 218 Pregabaline Tablets 150mg 219 Pregabaline + Amitriptyline Tablets 75mg+10mg 220 Pregabaline + Amitriptyline Tablets 50mg+10mg 221 Pregabaline + Nortriptyline Tablets 75 mg+10 mg 222 Pregabaline+Methylcobalamine Tablets 75mg+750mcg 223 Pregabaline+Methylcobalamine Tablets 50mg+1500mcg 224 Pregabaline+Methylcobalamine Tablets 75mg+500mcg 225 Pregabaline+Methylcobalamine Tablets 150mg+1500mc g 226 Quetiapine Fumarate Tablets 25mg 227 Quetiapine Fumarate Tablets 100mg 228 Risperidone Tablets 4mg 229 Risperidone Tablets 3mg 230 Risperidone Tablets 2mg 231 Risperidone Tablets 1mg 232 Risperidone Tablets 0.5mg 233 Sertraline HCL Tablets 25mg 234 Sertraline HCL Tablets 50mg 235 Sertraline HCL Tablets 100mg 236 Sildenafil Citrate Tablets 50mg 237 Sildenafil Citrate Tablets 25mg 238 Sodium Valproate Tablets 200mg 239 Sodium Valproate Syrup 200mg/5ml 240 Sodium Valproate Injection 100ml/5ml 241 Sodium Valproate Tablets 300mg 242 Sodium Valproate + Valproic Acid Tablets 300mg 243 Sodium Valproate + Valproic Acid Tablets 500mg 244 Sodium Valproate + Valproic Acid Tablets 200mg 245 Sumatriptan + Naproxen Tablets 85mg+500mg 246 Tolvaptan Tablets 15mg 247 Topiramate Tablets 25 mg 248 Topiramate Tablets 50 mg 249 Topiramate Tablets 100 mg 250 Trihexyphenidyl (Benzhexol) Tablets 2mg 251 Zaleplon Tablets 5mg 252 Zaleplon Tablets 10mg 253 Zidovudine Syrup 50mg/5ml 254 Zidovudine Tablets 100mg 255 Zidovudine Tablets 300mg 256 Zolpidem Tablets 10 mg 257 Zolpidem Tablets 5mg 258 Zolpidem SR Tablets 6.25mg 259 Zolpidem SR Tablets 12.5mg Zinc Oxide Dusting Powder 25gm Calculation of Local Content Name of Manufacture Calculation by Manufacturer (Cost per unit of product) Cost Component Cost (Domestic Component) A Cost (Imported Component) B Total Cost (INR/ US $) C=a+b Percentage of Local Content D=(a/c)*100 I. ………… II. ………… III. Total Cost (Excluding tax and duties) Note:- I. Cost (Domestic Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken) which have not been imported directly or through a domestic trader or an intermediary. II. Cost (Imported Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken). I S/o.D/o,W/o , Resident of That I will agree to abide by the terms and conditions of the policy of Government of India issued vide order no. P-45021/2/2017-B.E.-II dated 15/06/2017. That the information furnished hereinafter is correct to best of my knowledge and belief and I undertake to produce relevant records before the procuring entity or any authority so nominated by the Government of India for the purpose of assessing the local content. That the local content for all inputs which constitute the said drugs has been verified by me and I am responsible for the correctness of the claims made therein. That in the event of the domestic valve addition of the product mentioned herein is found to be incorrect and not meeting the prescribed valve-addition norms, based on Government of India for the purpose of assessing the local content, action will be taken against me as per Order No. P-45021/2/2017-B.E.-II dated 15.06.2017. I agree to maintain the following information in the Company‟s record for a period of 8 years and shall make this available for verification to any statutory authorities: i) Name and details of the Domestic Manufacturer (Registered Officer, Manufacturing unit location, nature of legal entity) ii) Date on which this certificate is issued. iii) Medicine for which the certificate is product. iv) Procuring entity to whom the certificate is furnished. v) Percentage of local content claimed. vi) Name and contact details of the unit of the manufacturer. vii) Sale Price of the product. viii) Ex-Factory Price of the product. ix) Freight, insurance and handling. x) Total Bill of Material. xi) List and total cost valve of inputs used for manufacture of the medicine certificates from suppliers, if the input is not in-house to be attached. xii) List and cost of inputs which and imported, directly or indirectly. (Also to be provided in PDF format)

Legal Jurisdiction. The agreement shall be deemed to have been concluded in Jodhpur, Rajasthan and all obligations hereunder shall be deemed to be located at Jodhpur, Rajasthan and Court within Jodhpur, Rajasthan will have Jurisdiction to the exclusion of other courts. Complete Address, Telephone No. & Email Id Name of Proprietor/Partner/Managing Director/Director. Phone No:- Mobile No:- Email Id:- Whether the firm is a registered firm Yes/No (attached copy of certificate) Whether quoting as manufacturer/ authorised distributor/ authorised dealer PAN No. (enclose the attested copy of PAN Card) (enclose the attested copy of GST Certificate) Whether the firm has enclosed the Bank Draft/Pay Order/Banker‟s cheque as Xxxxxxx Money Deposit Whether the Firm/Agency has signed each and every page of Tender/NIT Bank Details: 1) Accounts No: 2) Bank Name: 3) Branch: 4) IFSC Code: Any other information, if necessary Place: Name: Date: Business Address: Signature of Bidder: Seal of the Bidder: Annexure-B List of Products 1 Alprazolam Tablets 0.25Norfloxacin 100mg + Metronidazole 100mg per 5ml Liquid 30ml 2 Alprazolam Tablets 0.5mg 3 Alprazolam Tablets 1 mg 4 Amitriptyline Adefovir Tablets 10mg 3 Antacid [Magnesiumtrisilicate+ Alluminium Hydroxide] syrup 200 ml. 4 Bisacodyl Tablets 5 Amitriptyline Tablets 75 mg 5 Bisacodyl Suppository 10mg 6 Amitriptyline Dicyclomine Injection 10mg/2ml 7 Dicyclomine Tablets 25 mg 7 Amitriptyline Tablets 50 10mg 8 Amitriptyline Dicyclomine Tablets 20mg 9 Dicyclomine Drops 10mg/ml 10 Dicyclomine Drops 10mg/5ml 11 Dicyclomine syrup 100mg/5ml 12 Digene Aluminium Hydroxide+Magnesium Aluminium Silicate+Magnesium Hydroxide+Simethicone Tablets 300mg+25mg+25 mg+25mg 13 Domperidone Tablets 5mg 14 Domperidone Tablets 10mg 15 Domperidone Liquid 5mg/5ml 16 Domperidone + Omeprazole Tablets 10 mg+20 mg 17 Domperidone +Omeprazole capsules 10 mg+20 mg 18 Drotaverine HCL Injection 40 mg/ 2ml 19 Esomeprazole capsules 20mg 20 Esomeprazole capsules 40mg 21 Esomeprazole Injection 40mg 22 Euphorbia prostrata dry extract Tablets 100 mg 9 Amitriptyline 23 Famotidine Tablets 150 mg 10 Amitriptyline + Chlordiazepoxide Tablets 25 mg + 10mg 11 Amitriptyline + Chlordiazepoxide Tablets 12.5 mg+ 5mg 12 Betahistine Tablets 16mg 13 Betahistine Tablets 24mg 14 Betahistine Tablets 32mg 15 Botulinum Toxid Injection 100 Units 16 Bromocriptine Tablets 5mg 17 Bromocriptine Tablets 2.5mg 18 Bupenorphine +Naloxone Tablets 2 mg + 0.5mg 19 Buprenorphine Tablets 8mg 20 Buprenorphine Tablets 0.4mg 21 Buprenorphine sublingual Tablets 0.2mg 22 Buprenorphine sublingual Tablets 8mg 24 Buprenorphine sublingual Tablets 0.4mg Fungal diastase in combination with Lactic acid Bacillus/Pepsin/papain, vit B Com. and/or any other ingredients Liquid 200ml 25 Carbamazepine Furazolidone Tablets 100mg 26 Carbamazepine Hydrocortisone rectal cream 20 gm 27 Hydrocortisone rectal Ointment 20 gm 28 Hyoscine Butyl Bromide Tablets 20010mg 27 Carbamazepine 29 Hyoscine Butyl Bromide Injection 20 mg/ 1ml 30 Ispaghula husk Powder 100gm 31 Itopride Tablets 50mg 32 Itopride Tablets 150mg 33 L- Ornithine L - Aspartate Injection 10 ml 34 Lactulose 3.3335g Liquid 300 ml 35 Lamividune Tablets 100mg 36 Lansoprazole Tablets 15mg 37 Lansoprazole Tablets 30mg 38 Lansoprazole Syrup 15mg/5ml 39 Levosulpiride Tablets 25mg 40 Levosulpiride Tablets 50mg 41 Levosulpiride Tablets 75mg 42 Liquid paraffin +Milk of magnesia with or without Phenolphthalein Liquid 200ML 43 Loperamide Capsule 2mg 44 Mesalazine Enema 1gm 45 Mesalazine Tablets 400mg 28 Carbamazepine syrup 100mg/5ml 29 Carbamazepine SR Tablets 200mg 30 Carbamazepine SR Tablets 400mg 31 Carbidopa Tablets 25mg 32 Carbidopa Tablets 50mg 33 Carbidopa Tablets 100mg 34 Chlorpromazine hydrochloride Tablets 25 mg 35 Chlorpromazine hydrochloride 46 Metoclopramide Injection 2 ml 47 Metoclopramide Injection 10 ml 48 Metoclopramide Syrup 25mg/5ml 36 Chlorpromazine hydrochloride Injection 25mg/ml 37 Chlorpromazine hydrochloride Tablets 50mg 38 Chlorpromazine hydrochloride Tablets 100mg 39 Cilnidipine Tablets 10mg 40 Cilnidipine Tablets 5 mg 41 Citalopram Tablets 10mg 42 Citalopram Tablets 20mg 43 Citalopram Tablets 40mg 44 Citicholine Tablets 500mg 45 Citicholine Injection 250mg/ml 46 Citicholine + Piracetam Tablets 500mg+800mg 47 Clobazam Tablets 2.5 mg 48 Clobazam Tablets 10 mg /5ml 49 Clobazam Metoclopramide Tablets 5mg 50 Clonazepam Metoclopramide Tablets 0.2510 mg 51 Clonazepam Metoclopramide Tablets 0.525 mg 52 Clonazepam Metronidazole Tablets 1 200mg 53 Clonazepam Tablets 2mg 54 Clonazepam MD Tablets 2 mg 55 Colchicine Tablets 0.6 mg 56 Colchicine Tablets 0.5 mg 57 Colchicine Tablets 1mg 58 Conivaptan Injection 20mg/100ml 59 Deferasirox Tablets 100mg 60 Deferasirox Metronidazole Tablets 400mg 54 Metronidazole Syrup 10mg/5 ml 55 Metronidazole Injection 500mg/100ml 56 Metronidazole+Furazolidone Tablets (400+100)mg 57 Mosapride Tablets 5mg 58 N-Acetylcysteine Tablets 600 mg 59 N-Acetylcysteine Injection 200 mg/2ml 60 N-Acetylcysteine Injection 200 mg/5ml 61 Deferasirox Tablets 250Omeprazole Injection 40mg 62 Deferasirox Omeprazole capsules 40 mg 63 Omeprazole capsules 10mg 64 Omeprazole capsules 20mg 65 Ondansetron Tablets 8 mg 66 Ondansetron Syrup 2mg/5ml 67 Ondansetron Injection 2mg/2ml 68 Ondansetron Injection 2mg/4ml 69 Ondansetron MD Tablets 4 mg 70 Ornidazole Tablets 500mg 63 Deferiprone Capsules 250mg 64 Deferiprone Capsules 71 Ornidazole 500mg 65 Deferiprone + Ofloxacin 200mg Injection 100 ml 72 Ornidazole + Ofloxacin Tablets 500 mg+200 mg 66 Deferiprone Tablets 1000 73 Ornidazole 125mg 67 Desvenlafaxine Tablets + Ofloxacin 50mg 68 Desvenlafaxine Syrup 30ml 74 Oxethazaine + Antacid Gel Liquid 200 ml 75 Pantoprazole Injection 40mg 76 Pantoprazole Tablets 10040mg 69 Dextropropoxyphene 77 Pantoprazole Tablets 20mg 78 Pantoprazole + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+325mg+1 0Domperidone capsules 40mg+10mg 70 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+500mg+1 0mg 71 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+650mg+1 0mg 72 Diazepam Tablets 2 mg 73 Diazepam Tablets 5mg 74 Diazepam 79 Pantoprazole+Domperidone capsules (40mg+10mg)sr 80 Peginterferon alfa 2b Injection 50 mcg/0.5 ml 81 Peginterferon alfa 2b Injection 80 mcg/0.5 ml 82 Peginterferon alfa 2b Injection 120 mcg/0.5 ml 83 Peginterferon alfa 2b Injection 150 mcg/0.5 ml 84 Polyethylene glycol Powder one pack 85 Proctoclysis Enema Enema 20 ml 86 Proctoclysis Enema Enema 30 ml 87 Proctoclysis Enema Enema 100 ml 88 Promethazine Tablets 10mg 75 Diazepam Rectal Suppository 589 Promethazine Tablets 25mg 76 Diazepam Tablets 3 mg 77 Diazepam Rectal Suppository 2.5 mg 78 Diazepam 90 Promethazine Liquid 5mg/5ml 91 Promethazine Injection 10mg/2ml 79 Diazoxide Tablets 50 mg 80 Diethylcarbamazine citrate Tablets 50 mg 81 Diethylcarbamazine citrate Tablets 100 mg 82 Disulfiram Tablets 250mg 83 Disulfiram Tablets 500 mg 84 Divalproex equivalent to valproic acid 250 mg syrup 100 25 mg/ ml 85 Divalproex 92 Rabeprazole + Domperidone capsules (20+10)mg 93 Rabeprazole + Domperidone capsules (20+30)mgSR 94 Rabeprazole Sodium Tablets 25040mg 86 Divalproex 95 Rabeprazole Sodium Tablets 20mg 96 Rabeprazole+Domperidone Tablets (20+30)mg SR 97 Ranitidine Tablets 150mg 98 Ranitidine Tablets 75 mg 99 Ranitidine Tablets 300 mg 100 Ranitidine Injection 15mg/ml 101 Ranitidine Injection 50mg/2ml 102 Rifaximin Tablets, 200 mg 103 Rifaximin Tablets, 400 mg 104 Rifaximin Tablets, 550mg 105 Secnidazole Tablets 40mg 106 Secnidazole Tablets 500mg 87 Divalproex Sodium 107 Secnidazole Tablets 125 mg 88 Divalproex Sodium 1 gm 108 Sucralfate Tablets 250 mg ER 89 Divalproex Sodium 1 gm 109 Sucralfate Liquid 200ml 110 Sucralfate Syrup 100ml 111 Sulfasalazine Tablets 500 mg ER 90 Divalproex Sodium Tablets 125 mg ER 91 Duloxetine Hydrochloride Tablets 20mg 92 Duloxetine Hydrochloride Tablets 30mg 93 Duloxetine Hydrochloride Tablets 60mg 94 Eperisone hydrochloride Tablets 150 mg 95 Eperisone hydrochloride Tablets 450 mg 96 Escitalopram Tablets 5mg 97 Escitalopram Tablets 10mg 98 Escitalopram Tablets 20mg 99 Escitalopram + Clonazepam Tablets 10mg+0.25mg 100 Escitalopram + Clonazepam Tablets 10mg+0.5mg 101 Fludrocortisone Tablets 0.1mg 102 Flumazenil Injection 0.5 mg / 5ml 103 Flumazenil Injection 1 mg / 10 ml 104 Flunarizine Tablets 5mg 105 Flunarizine Tablets 10mg 106 Fluoxetine Tablets 40mg 107 Fluoxetine Capsules 20mg 108 Fluoxetine Tablets 20mg 109 Fluoxetine Tablets 40mg 110 Fluoxetine Tablets 60mg 111 Fluoxetine Tablets 101000mg 112 Fluoxetine Capsules 20Sulfasalazine Tablets 500mg 113 Fluphenazile decanoate Tenecteplase Injection 125mg/5ml 40 mg 114 Flupiritine Tablets 100Tenecteplase Injection 30 mg 115 Flupiritine Tablets 200Terlipressin Injection 1mg 116 Fosphenytoin Tinidazole syrup 300mg/5ml 117 Tinidazole Injection 50mg/400 ml 117 Gabapentin 118 Tinidazole + Norfloxacin Tablets 400mg 118 Gabapentine (600+400)mg 119 Tinidazole I.P. Tablets 600mg 119 Gabapentine Tablets 300150mg 120 Gabapentine Cap. 300Tinidazole I.P. Tablets 300 mg 121 Gabapentine + Mecobalamine Tinidazole I.P. Tablets 300 mg+ 0.5 500mg 122 Gabapentine + Nortriptyline Tablets 400 mg + 10 mg 123 Glycerol Syrup 100ml 124 Glycerol Syrup 500ml 125 Haloperidol Tablets 2mg 126 Haloperidol Tablets 5mg 127 Haloperidol Tablets 10 mg 128 Haloperidol Injection 5mg/ml 129 Hydroxyzine Tablets 10mg 130 Hydroxyzine Tablets 25mg 131 Hydroxyzine Syrup 10mg/5ml 132 Imipramine Tablets 25 mg 133 Imipramine Ursodeoxycholic Acid Tablets 75 mg 134 Lacosamide Tablets 50 mg 135 Lacosamide Tablets 100 mg 136 Lacosamide Tablets 150 mg 137 Lacosamide Tablets 200 mg 138 Lacosamide Syrup 50 mg/5ml 139 Lacosamide Injection 10 mg/ml 140 Lamotrigin Tablets 25mg 141 Lamotrigin Tablets 100 mg 142 Lamotrigin 123 Ursodeoxycholic Acid Tablets 150mg 143 Lamotrigin Tablets 200 mg 144 Lecithin 30mg+ equivalent to 175 mg of essential Phospholipids (EPL)(phosphatidylcholine,phosphatidylethanolamine,phospha tidylinositol,phosphatidylserine) Capsules (350+175)mg 145 Levetiracetam Tablets 250 mg 146 Levetiracetam Tablets 500 mg 147 Levetiracetam Tablets 750mg 148 Levetiracetam Tablets 1000 mg 149 Levetiracetam Injection 100mg/5 ml. 150 Levetiracetam Syrup 100mg/ml 151 Lithium Carbonate Tablets 450mg 152 Lithium Carbonate Tablets 300mg 153 Lithium Carbonate SR Tablets 400mg 154 Lorazepam Tablets 0.5 mg 155 Lorazepam Tablets 1mg 156 Lorazepam Tablets 2mg 157 Lorazepam 2mg Injection 2 ml 158 Lorazepam 2mg Injection 4 ml 159 Magnesium Sulfate, Urea & Sulphacetamide Sdoium Ointment 75gm 160 Mefloquine Tablets 250mg 161 Melatonin Tablets 0.5mg 162 Melatonin Tablets 3mg 163 Melatonin Tablets 6mg 164 Methyldopa Tablets 250mg 165 Methyldopa Tablets 125 mg 166 Methyldopa Tablets 500 mg 167 Naltrexone Tablets 50mg 168 Naproxen Tablets 250mg 169 Naproxen Tablets 500mg 170 Naproxen Tablets 750mg 171 Naproxen + Domperidone Tablets 500mg+10mg 172 Nevirapine Tablets 200mg 173 Nevirapine syrup 10mg/ml 174 Nicotine Chewing gum Tablets 2mg 175 Nicotine Chewing gum Tablets 4mg 176 Nimodipine Tablets 30mg 177 Nimodipine Injection 10mg/50ml 178 Nitrazepam Tablets 5mg 179 Nitrazepam Tablets 10mg 180 Nortriptyline Tablets 25mg 181 Nortriptyline Tablets 10 mg 182 Olanzapine Tablets 20mg 183 Olanzapine Tablets 2.5mg 184 Olanzapine Tablets 5mg 185 Olanzapine Tablets 7.5mg 186 Olanzapine Tablets 10mg 187 Olanzapine Injection 10mg/ml 188 Oxcarbamazepine Tablets 150mg 189 Oxcarbamazepine Tablets 300mg 190 Oxcarbamazepine Tablets 600mg 191 Oxcarbamazepine 300 mg Syrups 60 ml 192 Paracetamol Injection 150mg/2ml 193 Paracetamol Injection 500mg/50 ml 194 Paracetamol 10mg/ml (PLASTIC BOT ) Injection 1 gm/ 100 ml 195 Paracetamol + Tramadol Tablets 325mg+37.5mg 196 Paracetamol 10mg/ ml (GLASS BOT ) Injection 1 gm/ 100 ml 197 Paroxetine Tablets 12.5mg 198 Paroxetine Tablets 25mg 199 Paroxetine Tablets 37.5mg 200 Pergolide Tablets 0.05mg 201 Pergolide Tablets 0.25mg 202 Pergolide Tablets 1mg 203 Phenobarbitone Tablets 30mg 204 Phenobarbitone Tablets 60mg 205 Phenobarbitone Syrup 20mg/5ml 206 Phenobarbitone Injection 200mg /1ml 207 Phenytoin Sodium Tablets 50 mg 208 Phenytoin Sodium Tablets 100mg 209 Phenytoin Sodium Injection 25mg/ml 210 Phenytoin Sodium Liquids 100ml(25mg/ml) 211 Piperazine Tablets 500 mg 212 Piperazine Syrup 750mg/5ml 213 Piracetam Tablets 800mg 214 Piracetam Syrup 500mg/5ml 215 Praziquantel Tablets 600 mg 216 Pregabaline Tablets 50mg 217 Pregabaline Tablets 75mg 218 Pregabaline Tablets 150mg 219 Pregabaline + Amitriptyline Tablets 75mg+10mg 220 Pregabaline + Amitriptyline Tablets 50mg+10mg 221 Pregabaline + Nortriptyline Tablets 75 mg+10 mg 222 Pregabaline+Methylcobalamine Tablets 75mg+750mcg 223 Pregabaline+Methylcobalamine Tablets 50mg+1500mcg 224 Pregabaline+Methylcobalamine Tablets 75mg+500mcg 225 Pregabaline+Methylcobalamine Tablets 150mg+1500mc g 226 Quetiapine Fumarate Tablets 25mg 227 Quetiapine Fumarate Tablets 100mg 228 Risperidone Tablets 4mg 229 Risperidone Tablets 3mg 230 Risperidone Tablets 2mg 231 Risperidone Tablets 1mg 232 Risperidone Tablets 0.5mg 233 Sertraline HCL Tablets 25mg 234 Sertraline HCL Tablets 50mg 235 Sertraline HCL Tablets 100mg 236 Sildenafil Citrate Tablets 50mg 237 Sildenafil Citrate Tablets 25mg 238 Sodium Valproate Tablets 200mg 239 Sodium Valproate Syrup 200mg/5ml 240 Sodium Valproate Injection 100ml/5ml 241 Sodium Valproate Tablets 300mg 242 Sodium Valproate + Valproic 124 Ursodeoxycholic Acid Tablets 300mg 243 Sodium Valproate + Valproic 125 Ursodeoxycholic Acid Tablets 500mg 244 Sodium Valproate + Valproic Acid Tablets 200mg 245 Sumatriptan + Naproxen Tablets 85mg+500mg 246 Tolvaptan Tablets 15mg 247 Topiramate Tablets 25 mg 248 Topiramate Tablets 50 mg 249 Topiramate Tablets 100 mg 250 Trihexyphenidyl (Benzhexol) Tablets 2mg 251 Zaleplon Tablets 5mg 252 Zaleplon Tablets 10mg 253 Zidovudine Syrup 50mg/5ml 254 Zidovudine Tablets 100mg 255 Zidovudine Tablets 300mg 256 Zolpidem Tablets 10 mg 257 Zolpidem Tablets 5mg 258 Zolpidem SR Tablets 6.25mg 259 Zolpidem SR Tablets 12.5600mg Calculation of Local Content Name of Manufacture Calculation by Manufacturer (Cost per unit of product) Cost Component Cost (Domestic Component) A Cost (Imported Component) B Total Cost (INR/ US $) C=a+b Percentage of Local Content D=(a/c)*100 I. ………… II. ………… III. Total Cost (Excluding tax and duties) Note:- I. Cost (Domestic Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken) which have not been imported directly or through a domestic trader or an intermediary. II. Cost (Imported Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken). I S/o.D/o,W/o , Resident of That I will agree to abide by the terms and conditions of the policy of Government of India issued vide order no. P-45021/2/2017-B.E.-II dated 15/06/2017. That the information furnished hereinafter is correct to best of my knowledge and belief and I undertake to produce relevant records before the procuring entity or any authority so nominated by the Government of India for the purpose of assessing the local content. That the local content for all inputs which constitute the said drugs has been verified by me and I am responsible for the correctness of the claims made therein. That in the event of the domestic valve addition of the product mentioned herein is found to be incorrect and not meeting the prescribed valve-addition norms, based on Government of India for the purpose of assessing the local content, action will be taken against me as per Order No. P-45021/2/2017-B.E.-II dated 15.06.2017. I agree to maintain the following information in the Company‟s record for a period of 8 years and shall make this available for verification to any statutory authorities: i) Name and details of the Domestic Manufacturer (Registered Officer, Manufacturing unit location, nature of legal entity) ii) Date on which this certificate is issued. iii) Medicine for which the certificate is product. iv) Procuring entity to whom the certificate is furnished. v) Percentage of local content claimed. vi) Name and contact details of the unit of the manufacturer. vii) Sale Price of the product. viii) Ex-Factory Price of the product. ix) Freight, insurance and handling. x) Total Bill of Material. xi) List and total cost valve of inputs used for manufacture of the medicine certificates from suppliers, if the input is not in-house to be attached. xii) List and cost of inputs which and imported, directly or indirectly. (Also to be provided in PDF format)

Legal Jurisdiction. The agreement shall be deemed to have been concluded in Jodhpur, Rajasthan and all obligations hereunder shall be deemed to be located at Jodhpur, Rajasthan and Court within Jodhpur, Rajasthan will have Jurisdiction to the exclusion of other courts. Complete Address, Telephone No. & Email Id Name of Proprietor/Partner/Managing Director/Director. Phone No:- Mobile No:- Email Id:- Whether the firm is a registered firm Yes/No (attached copy of certificate) Whether quoting as manufacturer/ authorised distributor/ authorised dealer PAN No. (enclose the attested copy of PAN Card) (enclose the attested copy of GST Certificate) Whether the firm has enclosed the Bank Draft/Pay Order/Banker‟s cheque as Xxxxxxx Money Deposit Whether the Firm/Agency has signed each and every page of Tender/NIT Bank Details: 1) Accounts No: 2) Bank Name: 3) Branch: 4) IFSC Code: Any other information, if necessary Place: Name: Date: Business Address: Signature of Bidder: Seal of the Bidder: Annexure-B List of Products 1 Alprazolam Tablets 0.25mg Barium Sulphate Suspension 100% w/v 2 Alprazolam Tablets 0.5mg Barium Sulphate Suspension 250%w/v 3 Alprazolam Tablets 1 mg Calcium Ipodate Injection 3 g 4 Amitriptyline Tablets 10mg Gadobenate Acid dimeglumine Injections 10ml 5 Amitriptyline Tablets 75 mg Gadobenate Acid dimeglumine Injections 20ml 6 Amitriptyline Tablets 25 mg Gadodiamide Injections 20ml 7 Amitriptyline Tablets 50 mg 8 Amitriptyline Tablets 100 mg 9 Amitriptyline Tablets 150 mg 10 Amitriptyline + Chlordiazepoxide Tablets 25 mg + 10mg 11 Amitriptyline + Chlordiazepoxide Tablets 12.5 mg+ 5mg 12 Betahistine Tablets 16mg 13 Betahistine Tablets 24mg 14 Betahistine Tablets 32mg 15 Botulinum Toxid Gastrovedeo (Diatriozoate sod 41.7% w/v) Injection 100 Units 16 Bromocriptine Tablets 5ml 8 Iodixanol USP Injection 320mg 17 Bromocriptine Tablets 2.5mg 18 Bupenorphine +Naloxone Tablets 2 mg + 0.5mg 19 Buprenorphine Tablets 8mg 20 Buprenorphine Tablets 0.4mg 21 Buprenorphine sublingual Tablets 0.2mg 22 Buprenorphine sublingual Tablets 8mg 24 Buprenorphine sublingual Tablets 0.4mg 25 Carbamazepine Tablets 100mg 26 Carbamazepine Tablets 200mg 27 Carbamazepine Tablets /50ml 9 Iohexol 000xx.xx 347mg./ml Injections 10ml 10 Iohexol 000xx.xx 347mg./ml Injections 20ml 11 Iohexol 000xx.xx 347mg./ml Injections 40ml 12 Iohexol 000xx.xx 347mg./ml Injections 50ml 13 Iohexol 000xx.xx 347mg./ml Injections 100ml 14 Iohexol 000xx.xx 755mg./ml Injections 50ml 15 Iomeprol 400mg 28 Carbamazepine syrup 100mg/5ml 29 Carbamazepine SR Tablets 200mg 30 Carbamazepine SR Tablets Injections 50ml 16 Iomeprol 400mg 31 Carbidopa Tablets 25Injections 75ml 17 Iopamidol 300mg 32 Carbidopa Tablets 50Injections 100ml 18 Iopamidol 370mg 33 Carbidopa Tablets 100mg 34 Chlorpromazine hydrochloride Tablets 25 mg 35 Chlorpromazine hydrochloride Syrup 25mg/5ml 36 Chlorpromazine hydrochloride Injection 25mg/ml 37 Chlorpromazine hydrochloride Tablets 50mg 38 Chlorpromazine hydrochloride Tablets 100mg 39 Cilnidipine Tablets 10mg 40 Cilnidipine Tablets 5 mg 41 Citalopram Tablets 10mg 42 Citalopram Tablets 20mg 43 Citalopram Tablets 40mg 44 Citicholine Tablets 500mg 45 Citicholine Injection 250mg/ml 46 Citicholine + Piracetam Tablets 500mg+800mg 47 Clobazam Tablets 2.5 mg 48 Clobazam Tablets 10 mg 49 Clobazam Tablets 5mg 50 Clonazepam Tablets 0.25mg 51 Clonazepam Tablets 0.5mg 52 Clonazepam Tablets 1 mg 53 Clonazepam Tablets 2mg 54 Clonazepam MD Tablets 2 mg 55 Colchicine Tablets 0.6 mg 56 Colchicine Tablets 0.5 mg 57 Colchicine Tablets 1mg 58 Conivaptan Injection 20mg/100ml 59 Deferasirox Tablets 100mg 60 Deferasirox Tablets 400mg 61 Deferasirox Tablets 250mg 62 Deferasirox Tablets 500mg 63 Deferiprone Capsules 250mg 64 Deferiprone Capsules 500mg 65 Deferiprone Injections 100ml 19 Iopanoic Acid Tablets 500 mg 66 Deferiprone Tablets 1000 mg 67 Desvenlafaxine Tablets 50mg 68 Desvenlafaxine Tablets 20 Iopromide 000xx.xx 0.623g./ml Injections 50ml 21 Iopromide 000xx.xx 0.623g./ml Injections 100ml 22 Iopromide 000xx.xx 0.769g./ml Injections 50ml 23 Iopromide 000xx.xx 0.769g./ml Injections 100ml 24 Meglumine diatrizoate 0.65mg./ml. Injections 20ml 25 Meglumine Iothalamate 60% & Iodine 280mg/ml Injection 20ml 26 Meglumine Iotroxate Solution 5-8 g iodine in 100mg 69 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+325mg+1 0mg 70 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+500mg+1 0mg 71 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+650mg+1 0mg 72 Diazepam Tablets 2 mg 73 Diazepam Tablets 5mg 74 Diazepam Tablets 10mg 75 Diazepam Rectal Suppository 5mg 76 Diazepam Tablets 3 mg 77 Diazepam Rectal Suppository 2.5 mg 78 Diazepam Injection 10mg/2ml 79 Diazoxide Tablets 50 mg 80 Diethylcarbamazine citrate Tablets 50 mg 81 Diethylcarbamazine citrate Tablets 100 mg 82 Disulfiram Tablets 250mg 83 Disulfiram Tablets 500 mg 84 Divalproex equivalent to valproic acid -250 mg syrup 100 ml 85 Divalproex Sodium Tablets 250mg 86 Divalproex Sodium Tablets 27 Oral C.7. Contrast 30ml vial Injections 30ml 28 Propyliodone Oily, suspension 500mg 87 Divalproex Sodium Tablets 125 mg 88 Divalproex Sodium Tablets 250 mg ER 89 Divalproex Sodium Tablets 500 mg ER 90 Divalproex Sodium Tablets 125 mg ER 91 Duloxetine Hydrochloride Tablets 20mg 92 Duloxetine Hydrochloride Tablets 30mg 93 Duloxetine Hydrochloride Tablets 60mg 94 Eperisone hydrochloride Tablets 150 mg 95 Eperisone hydrochloride Tablets 450 mg 96 Escitalopram Tablets 5mg 97 Escitalopram Tablets 10mg 98 Escitalopram Tablets 20mg 99 Escitalopram + Clonazepam Tablets 10mg+0.25mg 100 Escitalopram + Clonazepam Tablets 10mg+0.5mg 101 Fludrocortisone Tablets 0.1mg 102 Flumazenil Injection 0.5 -600 mg / 5ml 103 Flumazenil Injection 1 mg / 10 ml 104 Flunarizine Tablets 5mg 105 Flunarizine Tablets 10mg 106 Fluoxetine Tablets 40mg 107 Fluoxetine Capsules 20mg 108 Fluoxetine Tablets 20mg 109 Fluoxetine Tablets 40mg 110 Fluoxetine Tablets 29 Sod. Diatrizoate & Meglumine Diatrizoate 60mg 111 Fluoxetine Tablets 10mg 112 Fluoxetine Capsules 20mg 113 Fluphenazile decanoate Injection 125mg/5ml 114 Flupiritine Tablets 100mg 115 Flupiritine Tablets 200mg 116 Fosphenytoin Injection 50mg% xx.xx 292mg./ml. Injections 20ml 30 Sod. Diatrizoate & Meglumine Diatrizoate 76% xx.xx 370mg./ml Injections 20ml 31 Sod. Diatrizoate & Meglumine Diatrizoate 76% xx.xx 370mg./ml Injections 50ml 32 Sod. Diatrizoate & Meglumine Diatrizoate 76% xx.xx 370mg./ml Injections 100ml 33 Sodium Iothalamate 70% & Iodine 420mg/ml 117 Gabapentin Tablets 400mg 118 Gabapentine Tablets 600mg 119 Gabapentine Tablets 300mg 120 Gabapentine CapInjection 20ml 34 Subtrigonal bulking agent (dextranomer and sod. 300mg 121 Gabapentine + Mecobalamine Tablets 300 mg+ 0.5 mg 122 Gabapentine + Nortriptyline Tablets 400 mg + 10 mg 123 Glycerol Syrup 100ml 124 Glycerol Syrup 500ml 125 Haloperidol Tablets 2mg 126 Haloperidol Tablets 5mg 127 Haloperidol Tablets 10 mg 128 Haloperidol Injection 5mg/ml 129 Hydroxyzine Tablets 10mg 130 Hydroxyzine Tablets 25mg 131 Hydroxyzine Syrup 10mg/5ml 132 Imipramine Tablets 25 mg 133 Imipramine Tablets 75 mg 134 Lacosamide Tablets 50 mg 135 Lacosamide Tablets 100 mg 136 Lacosamide Tablets 150 mg 137 Lacosamide Tablets 200 mg 138 Lacosamide Syrup 50 mg/5ml 139 Lacosamide Injection 10 mg/ml 140 Lamotrigin Tablets 25mg 141 Lamotrigin Tablets 100 mg 142 Lamotrigin Tablets 150mg 143 Lamotrigin Tablets 200 mg 144 Lecithin 30mg+ equivalent to 175 mg of essential Phospholipids (EPL)(phosphatidylcholine,phosphatidylethanolamine,phospha tidylinositol,phosphatidylserine) Capsules (350+175)mg 145 Levetiracetam Tablets 250 mg 146 Levetiracetam Tablets 500 mg 147 Levetiracetam Tablets 750mg 148 Levetiracetam Tablets 1000 mg 149 Levetiracetam Injection 100mg/5 ml. 150 Levetiracetam Syrup 100mg/ml 151 Lithium Carbonate Tablets 450mg 152 Lithium Carbonate Tablets 300mg 153 Lithium Carbonate SR Tablets 400mg 154 Lorazepam Tablets 0.5 mg 155 Lorazepam Tablets 1mg 156 Lorazepam Tablets 2mg 157 Lorazepam 2mg Injection 2 ml 158 Lorazepam 2mg Injection 4 ml 159 Magnesium Sulfate, Urea & Sulphacetamide Sdoium Ointment 75gm 160 Mefloquine Tablets 250mg 161 Melatonin Tablets 0.5mg 162 Melatonin Tablets 3mg 163 Melatonin Tablets 6mg 164 Methyldopa Tablets 250mg 165 Methyldopa Tablets 125 mg 166 Methyldopa Tablets 500 mg 167 Naltrexone Tablets 50mg 168 Naproxen Tablets 250mg 169 Naproxen Tablets 500mg 170 Naproxen Tablets 750mg 171 Naproxen + Domperidone Tablets 500mg+10mg 172 Nevirapine Tablets 200mg 173 Nevirapine syrup 10mg/ml 174 Nicotine Chewing gum Tablets 2mg 175 Nicotine Chewing gum Tablets 4mg 176 Nimodipine Tablets 30mg 177 Nimodipine Injection 10mg/50ml 178 Nitrazepam Tablets 5mg 179 Nitrazepam Tablets 10mg 180 Nortriptyline Tablets 25mg 181 Nortriptyline Tablets 10 mg 182 Olanzapine Tablets 20mg 183 Olanzapine Tablets 2.5mg 184 Olanzapine Tablets 5mg 185 Olanzapine Tablets 7.5mg 186 Olanzapine Tablets 10mg 187 Olanzapine Injection 10mg/ml 188 Oxcarbamazepine Tablets 150mg 189 Oxcarbamazepine Tablets 300mg 190 Oxcarbamazepine Tablets 600mg 191 Oxcarbamazepine 300 mg Syrups 60 ml 192 Paracetamol Injection 150mg/2ml 193 Paracetamol Injection 500mg/50 ml 194 Paracetamol 10mg/ml (PLASTIC BOT hyaluronate) Injection 1 gm/ 100 ml 195 Paracetamol + Tramadol Tablets 325mg+37.5mg 196 Paracetamol 10mg/ ml (GLASS BOT ) Injection 1 gm/ 100 ml 197 Paroxetine Tablets 12.5mg 198 Paroxetine Tablets 25mg 199 Paroxetine Tablets 37.5mg 200 Pergolide Tablets 0.05mg 201 Pergolide Tablets 0.25mg 202 Pergolide Tablets 1mg 203 Phenobarbitone Tablets 30mg 204 Phenobarbitone Tablets 60mg 205 Phenobarbitone Syrup 20mg/5ml 206 Phenobarbitone Injection 200mg /1ml 207 Phenytoin Sodium Tablets 50 mg 208 Phenytoin Sodium Tablets 100mg 209 Phenytoin Sodium Injection 25mg/ml 210 Phenytoin Sodium Liquids 100ml(25mg/ml) 211 Piperazine Tablets 500 mg 212 Piperazine Syrup 750mg/5ml 213 Piracetam Tablets 800mg 214 Piracetam Syrup 500mg/5ml 215 Praziquantel Tablets 600 mg 216 Pregabaline Tablets 50mg 217 Pregabaline Tablets 75mg 218 Pregabaline Tablets 150mg 219 Pregabaline + Amitriptyline Tablets 75mg+10mg 220 Pregabaline + Amitriptyline Tablets 50mg+10mg 221 Pregabaline + Nortriptyline Tablets 75 mg+10 mg 222 Pregabaline+Methylcobalamine Tablets 75mg+750mcg 223 Pregabaline+Methylcobalamine Tablets 50mg+1500mcg 224 Pregabaline+Methylcobalamine Tablets 75mg+500mcg 225 Pregabaline+Methylcobalamine Tablets 150mg+1500mc g 226 Quetiapine Fumarate Tablets 25mg 227 Quetiapine Fumarate Tablets 100mg 228 Risperidone Tablets 4mg 229 Risperidone Tablets 3mg 230 Risperidone Tablets 2mg 231 Risperidone Tablets 1mg 232 Risperidone Tablets 0.5mg 233 Sertraline HCL Tablets 25mg 234 Sertraline HCL Tablets 50mg 235 Sertraline HCL Tablets 100mg 236 Sildenafil Citrate Tablets 50mg 237 Sildenafil Citrate Tablets 25mg 238 Sodium Valproate Tablets 200mg 239 Sodium Valproate Syrup 200mg/5ml 240 Sodium Valproate Injection 100ml/5ml 241 Sodium Valproate Tablets 300mg 242 Sodium Valproate + Valproic Acid Tablets 300mg 243 Sodium Valproate + Valproic Acid Tablets 500mg 244 Sodium Valproate + Valproic Acid Tablets 200mg 245 Sumatriptan + Naproxen Tablets 85mg+500mg 246 Tolvaptan Tablets 15mg 247 Topiramate Tablets 25 mg 248 Topiramate Tablets 50 mg 249 Topiramate Tablets 100 mg 250 Trihexyphenidyl (Benzhexol) Tablets 2mg 251 Zaleplon Tablets 5mg 252 Zaleplon Tablets 10mg 253 Zidovudine Syrup 50mg/5ml 254 Zidovudine Tablets 100mg 255 Zidovudine Tablets 300mg 256 Zolpidem Tablets 10 mg 257 Zolpidem Tablets 5mg 258 Zolpidem SR Tablets 6.25mg 259 Zolpidem SR Tablets 12.5mg 1ml Calculation of Local Content Name of Manufacture Calculation by Manufacturer (Cost per unit of product) Cost Component Cost (Domestic Component) A Cost (Imported Component) B Total Cost (INR/ US $) C=a+b Percentage of Local Content D=(a/c)*100 I. ………… II. ………… III. Total Cost (Excluding tax and duties) Note:- I. Cost (Domestic Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken) which have not been imported directly or through a domestic trader or an intermediary. II. Cost (Imported Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken). I S/o.D/o,W/o , Resident of That I will agree to abide by the terms and conditions of the policy of Government of India issued vide order no. P-45021/2/2017-B.E.-II dated 15/06/2017. That the information furnished hereinafter is correct to best of my knowledge and belief and I undertake to produce relevant records before the procuring entity or any authority so nominated by the Government of India for the purpose of assessing the local content. That the local content for all inputs which constitute the said drugs has been verified by me and I am responsible for the correctness of the claims made therein. That in the event of the domestic valve addition of the product mentioned herein is found to be incorrect and not meeting the prescribed valve-addition norms, based on Government of India for the purpose of assessing the local content, action will be taken against me as per Order No. P-45021/2/2017-B.E.-II dated 15.06.2017. I agree to maintain the following information in the Company‟s record for a period of 8 years and shall make this available for verification to any statutory authorities: i) Name and details of the Domestic Manufacturer (Registered Officer, Manufacturing unit location, nature of legal entity) ii) Date on which this certificate is issued. iii) Medicine for which the certificate is product. iv) Procuring entity to whom the certificate is furnished. v) Percentage of local content claimed. vi) Name and contact details of the unit of the manufacturer. vii) Sale Price of the product. viii) Ex-Factory Price of the product. ix) Freight, insurance and handling. x) Total Bill of Material. xi) List and total cost valve of inputs used for manufacture of the medicine certificates from suppliers, if the input is not in-house to be attached. xii) List and cost of inputs which and imported, directly or indirectly. (Also to be provided in PDF format)

Legal Jurisdiction. The agreement shall be deemed to have been concluded in Jodhpur, Rajasthan and all obligations hereunder shall be deemed to be located at Jodhpur, Rajasthan and Court within Jodhpur, Rajasthan will have Jurisdiction to the exclusion of other courts. Complete Address, Telephone No. & Email Id Name of Proprietor/Partner/Managing Director/Director. Phone No:- Mobile No:- Email Id:- Whether the firm is a registered firm Yes/No (attached copy of certificate) Whether quoting as manufacturer/ authorised distributor/ authorised dealer PAN No. (enclose the attested copy of PAN Card) (enclose the attested copy of GST Certificate) Whether the firm has enclosed the Bank Draft/Pay Order/Banker‟s cheque as Xxxxxxx Money Deposit Whether the Firm/Agency has signed each and every page of Tender/NIT Bank Details: 1) Accounts No: 2) Bank Name: 3) Branch: 4) IFSC Code: Any other information, if necessary Place: Name: Date: Business Address: Signature of Bidder: Seal of the Bidder: Annexure-B List of Products 1 Alprazolam Tablets 0.25mg Acetic Acid 2% w/v Liquid 15ml 2 Alprazolam Tablets Bismuth Iodine Paraffin paste (BIPP) Paste 30gm 3 Budesonide 32mcg Nasal Spary 7.5ml 4 Chloramphenicol 5% + Beclomethasone Dipropionate 0.025% +Clotrimazole 1% + Lignocaine 2% Ear drop 5ml 5 Chlorhexidine Gluconate 2% Mouth wash Nasal Spary 160ml 6 Chlorhexidine Mouth wash Liquid 100ml 7 Chlorine water 0.5mg 3 Alprazolam Tablets 1 mg 4 Amitriptyline Tablets 10mg 5 Amitriptyline Tablets 75 mg 6 Amitriptyline Tablets 25 mg 7 Amitriptyline Tablets 50 mg % Solution 1000ml 8 Amitriptyline Tablets 100 Clotrimazole Tablets/Lozenge 100mg 9 Amitriptyline Tablets 150 mg Clotrimazole 1% Ear drop 10ml 10 Amitriptyline + Chlordiazepoxide Tablets 25 mg + 10mg Feracrylum (Hemolok) 1% w/v Solution 20ml 11 Amitriptyline + Chlordiazepoxide Tablets 12.5 mg+ Fluticasone 0.05% Nasal Spary 10ml 12 Fluticasone Furoate 50mcg Nasal Spary 12ml 13 Liquid parafffin Nasal drop 10ml 14 Medicated Toothpaste containing Potassium Nitrate 50mg. Medicated Toothpaste 50gm 15 Medicated Toothpaste containing Strontium Chloride, Potassium Nitrate, Formalin etc. Medicated Toothpaste 50gm 16 Medicated Toothpaste containing Strontium Chloride, Pottassium Nitrate, Formaline etc Medicated Toothpaste 100gm 17 Neomycin+Bacitracin+Hydrocortisone Ointment 5mg 12 Betahistine Tablets 16mg 13 Betahistine Tablets 24mg 14 Betahistine Tablets 32mg 15 Botulinum Toxid Injection 100 Units 16 Bromocriptine Tablets 5mg 17 Bromocriptine Tablets 2.5mg 18 Bupenorphine +Naloxone Tablets 2 mg + 0.5mg Neomycin+Bacitracin+Hydrocortisone Ear drop 5 ml 19 Buprenorphine Tablets 8mg Neomycin+Bacitracin+polymyxin B Powder 10gm 20 Buprenorphine Tablets 0.4mg Neomycin+Polymyxin B Sulfates+Bacitracin zinc Ointment 5gm 21 Buprenorphine sublingual Tablets 0.2mg Neomycin+Polymyxin B Sulfates+Bacitracin zinc Ointment 20 gm 22 Buprenorphine sublingual Tablets 8mg 24 Buprenorphine sublingual Tablets 0.4mg 25 Carbamazepine Tablets 100mg 26 Carbamazepine Tablets 200mg 27 Carbamazepine Tablets 400mg 28 Carbamazepine syrup 100mg/5ml 29 Carbamazepine SR Tablets 200mg 30 Carbamazepine SR Tablets 400mg 31 Carbidopa Tablets 25mg 32 Carbidopa Tablets 50mg 33 Carbidopa Tablets 100mg 34 Chlorpromazine hydrochloride Tablets 25 mg 35 Chlorpromazine hydrochloride Syrup 25mg/5ml 36 Chlorpromazine hydrochloride Injection 25mg/ml 37 Chlorpromazine hydrochloride Tablets 50mg 38 Chlorpromazine hydrochloride Tablets 100mg 39 Cilnidipine Tablets 10mg 40 Cilnidipine Tablets 5 mg 41 Citalopram Tablets 10mg 42 Citalopram Tablets 20mg 43 Citalopram Tablets 40mg 44 Citicholine Tablets 500mg 45 Citicholine Injection 250mg/ml 46 Citicholine + Piracetam Tablets 500mg+800mg 47 Clobazam Tablets 2.5 mg 48 Clobazam Tablets 10 mg 49 Clobazam Tablets 5mg 50 Clonazepam Tablets 0.25mg 51 Clonazepam Tablets 0.5mg 52 Clonazepam Tablets 1 mg 53 Clonazepam Tablets 2mg 54 Clonazepam MD Tablets 2 mg 55 Colchicine Tablets 0.6 mg 56 Colchicine Tablets 0.5 mg 57 Colchicine Tablets 1mg 58 Conivaptan Injection 20mg/100ml 59 Deferasirox Tablets 100mg 60 Deferasirox Tablets 400mg 61 Deferasirox Tablets 250mg 62 Deferasirox Tablets 500mg 63 Deferiprone Capsules 250mg 64 Deferiprone Capsules 500mg 65 Deferiprone Tablets 500 mg 66 Deferiprone Tablets 1000 mg 67 Desvenlafaxine Tablets 50mg 68 Desvenlafaxine Tablets 100mg 69 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+325mg+1 0mg 70 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+500mg+1 0mg 71 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+650mg+1 0mg 72 Diazepam Tablets 2 mg 73 Diazepam Tablets 5mg 74 Diazepam Tablets 10mg 75 Diazepam Rectal Suppository 5mg 76 Diazepam Tablets 3 mg 77 Diazepam Rectal Suppository 2.5 mg 78 Diazepam Injection 10mg/2ml 79 Diazoxide Tablets 50 mg 80 Diethylcarbamazine citrate Tablets 50 mg 81 Diethylcarbamazine citrate Tablets 100 mg 82 Disulfiram Tablets 250mg 83 Disulfiram Tablets 500 mg 84 Divalproex equivalent to valproic acid 250 mg syrup 100 ml 85 Divalproex Sodium Tablets 250mg 86 Divalproex Sodium Tablets 500mg 87 Divalproex Sodium Tablets 125 mg 88 Divalproex Sodium Tablets 250 mg ER 89 Divalproex Sodium Tablets 500 mg ER 90 Divalproex Sodium Tablets 125 mg ER 91 Duloxetine Hydrochloride Tablets 20mg 92 Duloxetine Hydrochloride Tablets 30mg 93 Duloxetine Hydrochloride Tablets 60mg 94 Eperisone hydrochloride Tablets 150 mg 95 Eperisone hydrochloride Tablets 450 mg 96 Escitalopram Tablets 5mg 97 Escitalopram Tablets 10mg 98 Escitalopram Tablets 20mg 99 Escitalopram + Clonazepam Tablets 10mg+0.25mg 100 Escitalopram + Clonazepam Tablets 10mg+0.5mg 101 Fludrocortisone Tablets 0.1mg 102 Flumazenil Injection 0.5 mg / 5ml 103 Flumazenil Injection 1 mg / Normal saline Drop Liquid 10 ml 104 Flunarizine Tablets 23 Paradichlorobenzene 2%+ Benzocaine 2.7% + Chlorbutol 5mg 105 Flunarizine Tablets 10mg 106 Fluoxetine Tablets 40mg 107 Fluoxetine Capsules 20mg 108 Fluoxetine Tablets 20mg 109 Fluoxetine Tablets 40mg 110 Fluoxetine Tablets 60mg 111 Fluoxetine Tablets 10mg 112 Fluoxetine Capsules 20mg 113 Fluphenazile decanoate Injection 125mg/5ml 114 Flupiritine Tablets 100mg 115 Flupiritine Tablets 200mg 116 Fosphenytoin Injection 50mg% + Turpentine oil 15% + Butylated hydroxyanisole 0.05% w/ml 117 Gabapentin Tablets 400mg 118 Gabapentine Tablets 600mg 119 Gabapentine Tablets 300mg 120 Gabapentine Cap. 300mg 121 Gabapentine + Mecobalamine Tablets 300 mg+ 0.5 mg 122 Gabapentine + Nortriptyline Tablets 400 mg + 10 mg 123 Glycerol Syrup v Ear drop 10ml 24 Povidone-Iodine Mouthwash/Gargle 1% Liquid 100ml 124 Glycerol Syrup 500ml 125 Haloperidol Tablets 2mg 126 Haloperidol Tablets 5mg 127 Haloperidol Tablets 10 mg 128 Haloperidol Injection 5mg/ml 129 Hydroxyzine Tablets 10mg 130 Hydroxyzine Tablets 25mg 131 Hydroxyzine Syrup 10mg/5ml 132 Imipramine Tablets 25 mg 133 Imipramine Tablets 75 mg 134 Lacosamide Tablets 50 mg 135 Lacosamide Tablets 100 mg 136 Lacosamide Tablets 150 mg 137 Lacosamide Tablets 200 mg 138 Lacosamide Syrup 50 mg/5ml 139 Lacosamide Injection 10 mg/ml 140 Lamotrigin Tablets 25mg 141 Lamotrigin Tablets 100 mg 142 Lamotrigin Tablets 150mg 143 Lamotrigin Tablets 200 mg 144 Lecithin 30mg+ equivalent to 175 mg of essential Phospholipids (EPL)(phosphatidylcholine,phosphatidylethanolamine,phospha tidylinositol,phosphatidylserine) Capsules (350+175)mg 145 Levetiracetam Tablets 250 mg 146 Levetiracetam Tablets 500 mg 147 Levetiracetam Tablets 750mg 148 Levetiracetam Tablets 1000 mg 149 Levetiracetam Injection 100mg/5 ml. 150 Levetiracetam Syrup 100mg/ml 151 Lithium Carbonate Tablets 450mg 152 Lithium Carbonate Tablets 300mg 153 Lithium Carbonate SR Tablets 400mg 154 Lorazepam Tablets 0.5 mg 155 Lorazepam Tablets Sodium Chloride 0.65% Nasal drop 10ml 26 Wax Softener Liquid 10ml 27 Xylometazoline 0.05% Nasal Spary 10ml 28 Xylometazoline 1mg 156 Lorazepam Tablets 2mg 157 Lorazepam 2mg Injection 2 ml 158 Lorazepam 2mg Injection 4 ml 159 Magnesium Sulfate, Urea & Sulphacetamide Sdoium Ointment 75gm 160 Mefloquine Tablets 250mg 161 Melatonin Tablets 0.5mg 162 Melatonin Tablets 3mg 163 Melatonin Tablets 6mg 164 Methyldopa Tablets 250mg 165 Methyldopa Tablets 125 mg 166 Methyldopa Tablets 500 mg 167 Naltrexone Tablets 50mg 168 Naproxen Tablets 250mg 169 Naproxen Tablets 500mg 170 Naproxen Tablets 750mg 171 Naproxen + Domperidone Tablets 500mg+10mg 172 Nevirapine Tablets 200mg 173 Nevirapine syrup 10mg/ml 174 Nicotine Chewing gum Tablets 2mg 175 Nicotine Chewing gum Tablets 4mg 176 Nimodipine Tablets 30mg 177 Nimodipine Injection 10mg/50ml 178 Nitrazepam Tablets 5mg 179 Nitrazepam Tablets 10mg 180 Nortriptyline Tablets 25mg 181 Nortriptyline Tablets 10 mg 182 Olanzapine Tablets 20mg 183 Olanzapine Tablets 2.5mg 184 Olanzapine Tablets 5mg 185 Olanzapine Tablets 7.5mg 186 Olanzapine Tablets 10mg 187 Olanzapine Injection 10mg/ml 188 Oxcarbamazepine Tablets 150mg 189 Oxcarbamazepine Tablets 300mg 190 Oxcarbamazepine Tablets 600mg 191 Oxcarbamazepine 300 mg Syrups 60 ml 192 Paracetamol Injection 150mg/2ml 193 Paracetamol Injection 500mg/50 ml 194 Paracetamol 10mg/ml (PLASTIC BOT ) Injection 1 gm/ 100 ml 195 Paracetamol + Tramadol Tablets 325mg+37.5mg 196 Paracetamol 10mg/ ml (GLASS BOT ) Injection 1 gm/ 100 ml 197 Paroxetine Tablets 12.5mg 198 Paroxetine Tablets 25mg 199 Paroxetine Tablets 37.5mg 200 Pergolide Tablets 0.05mg 201 Pergolide Tablets 0.25mg 202 Pergolide Tablets 1mg 203 Phenobarbitone Tablets 30mg 204 Phenobarbitone Tablets 60mg 205 Phenobarbitone Syrup 20mg/5ml 206 Phenobarbitone Injection 200mg /1ml 207 Phenytoin Sodium Tablets 50 mg 208 Phenytoin Sodium Tablets 100mg 209 Phenytoin Sodium Injection 25mg/ml 210 Phenytoin Sodium Liquids 100ml(25mg/ml) 211 Piperazine Tablets 500 mg 212 Piperazine Syrup 750mg/5ml 213 Piracetam Tablets 800mg 214 Piracetam Syrup 500mg/5ml 215 Praziquantel Tablets 600 mg 216 Pregabaline Tablets 50mg 217 Pregabaline Tablets 75mg 218 Pregabaline Tablets 150mg 219 Pregabaline + Amitriptyline Tablets 75mg+10mg 220 Pregabaline + Amitriptyline Tablets 50mg+10mg 221 Pregabaline + Nortriptyline Tablets 75 mg+10 mg 222 Pregabaline+Methylcobalamine Tablets 75mg+750mcg 223 Pregabaline+Methylcobalamine Tablets 50mg+1500mcg 224 Pregabaline+Methylcobalamine Tablets 75mg+500mcg 225 Pregabaline+Methylcobalamine Tablets 150mg+1500mc g 226 Quetiapine Fumarate Tablets 25mg 227 Quetiapine Fumarate Tablets 100mg 228 Risperidone Tablets 4mg 229 Risperidone Tablets 3mg 230 Risperidone Tablets 2mg 231 Risperidone Tablets 1mg 232 Risperidone Tablets 0.5mg 233 Sertraline HCL Tablets 25mg 234 Sertraline HCL Tablets 50mg 235 Sertraline HCL Tablets 100mg 236 Sildenafil Citrate Tablets 50mg 237 Sildenafil Citrate Tablets 25mg 238 Sodium Valproate Tablets 200mg 239 Sodium Valproate Syrup 200mg/5ml 240 Sodium Valproate Injection 100ml/5ml 241 Sodium Valproate Tablets 300mg 242 Sodium Valproate + Valproic Acid Tablets 300mg 243 Sodium Valproate + Valproic Acid Tablets 500mg 244 Sodium Valproate + Valproic Acid Tablets 200mg 245 Sumatriptan + Naproxen Tablets 85mg+500mg 246 Tolvaptan Tablets 15mg 247 Topiramate Tablets 25 mg 248 Topiramate Tablets 50 mg 249 Topiramate Tablets 100 mg 250 Trihexyphenidyl (Benzhexol) Tablets 2mg 251 Zaleplon Tablets 5mg 252 Zaleplon Tablets 10mg 253 Zidovudine Syrup 50mg/5ml 254 Zidovudine Tablets 100mg 255 Zidovudine Tablets 300mg 256 Zolpidem Tablets 10 mg 257 Zolpidem Tablets 5mg 258 Zolpidem SR Tablets 6.25mg 259 Zolpidem SR Tablets 12.5mg % Nasal Spary 10ml Calculation of Local Content Name of Manufacture Calculation by Manufacturer (Cost per unit of product) Cost Component Cost (Domestic Component) A Cost (Imported Component) B Total Cost (INR/ US $) C=a+b Percentage of Local Content D=(a/c)*100 I. ………… II. ………… III. Total Cost (Excluding tax and duties) Note:- I. Cost (Domestic Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken) which have not been imported directly or through a domestic trader or an intermediary. II. Cost (Imported Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken). I S/o.D/o,W/o , Resident of That I will agree to abide by the terms and conditions of the policy of Government of India issued vide order no. P-45021/2/2017-B.E.-II dated 15/06/2017. That the information furnished hereinafter is correct to best of my knowledge and belief and I undertake to produce relevant records before the procuring entity or any authority so nominated by the Government of India for the purpose of assessing the local content. That the local content for all inputs which constitute the said drugs has been verified by me and I am responsible for the correctness of the claims made therein. That in the event of the domestic valve addition of the product mentioned herein is found to be incorrect and not meeting the prescribed valve-addition norms, based on Government of India for the purpose of assessing the local content, action will be taken against me as per Order No. P-45021/2/2017-B.E.-II dated 15.06.2017. I agree to maintain the following information in the Company‟s record for a period of 8 years and shall make this available for verification to any statutory authorities: i) Name and details of the Domestic Manufacturer (Registered Officer, Manufacturing unit location, nature of legal entity) ii) Date on which this certificate is issued. iii) Medicine for which the certificate is product. iv) Procuring entity to whom the certificate is furnished. v) Percentage of local content claimed. vi) Name and contact details of the unit of the manufacturer. vii) Sale Price of the product. viii) Ex-Factory Price of the product. ix) Freight, insurance and handling. x) Total Bill of Material. xi) List and total cost valve of inputs used for manufacture of the medicine certificates from suppliers, if the input is not in-house to be attached. xii) List and cost of inputs which and imported, directly or indirectly. (Also to be provided in PDF format)

Legal Jurisdiction. The agreement shall be deemed to have been concluded in Jodhpur, Rajasthan and all obligations hereunder shall be deemed to be located at Jodhpur, Rajasthan and Court within Jodhpur, Rajasthan will have Jurisdiction to the exclusion of other courts. Complete Address, Telephone No. & Email Id Name of Proprietor/Partner/Managing Director/Director. Phone No:- Mobile No:- Email Id:- Whether the firm is a registered firm Yes/No (attached copy of certificate) Whether quoting as manufacturer/ authorised distributor/ authorised dealer PAN No. (enclose the attested copy of PAN Card) (enclose the attested copy of GST Certificate) Whether the firm has enclosed the Bank Draft/Pay Order/Banker‟s cheque as Xxxxxxx Money Deposit Whether the Firm/Agency has signed each and every page of Tender/NIT Bank Details: 1) Accounts No: 2) Bank Name: 3) Branch: 4) IFSC Code: Any other information, if necessary Place: Name: Date: Business Address: Signature of Bidder: Seal of the Bidder: Annexure-B List of Products 1 Alprazolam Aminophylline Tablets 0.25100 mg 2 Alprazolam Tablets 0.5mg Aminophylline Injection 250 mg/2 ml 3 Alprazolam Tablets 1 mg Beclomethasone DPI 200mcg 4 Amitriptyline Beclomethasone Dipropionate Inhalation 50µg/dose 5 Beclomethasone Dipropionate Inhalation 250µg/dose 6 Budesonide MDI 400mcg 7 Budesonide DPI 100mcg 8 Budesonide DPI 200mcg 9 Budesonide MDI 100mcg 10 Budesonide MDI 200mcg 11 Budesonide Resp. 0.5mg/2 ml 12 Codeine phosphate Tablets 10mg 13 Codeine phosphate + Chlorpheniramine Maleate Liquid 10mg/5ml 14 Dextromethorphan Tablets 30mg 15 Dextromethorphan hydrochloride ,5 Amitriptyline mg Chlorpheniramine maleate 2.5 mg, Guaifenesin 50mg, Ammonium Chloride 60 mg/ 5ml Syprup 100 ml 16 Doxophylline Tablets 75 400mg 17 Doxophylline Injection 100mg/10ml 18 Fluticasone + Salmeterol MDI 125mcg+25mcg 19 Fluticasone + Salmeterol MDI 250mcg + 25mcg 20 Fluticasone + Salmetrol DPI 100mcg + 50mcg 22 Formoterol + budesonide MDI 6mcg + 200mcg 23 Formoterol + budesonide MDI 6mcg+ 400mcg 24 Formoterol + budesonide MDI 6mcg + 100mcg 25 Formoterol + budesonide DPI 6mcg + 100mcg 26 Formoterol + budesonide DPI 6mcg + 200mcg 27 Formoterol + budesonide DPI 6mcg + 400mcg 28 Formoterol + Triotropium DPI 12mcg + 18mcg 29 Formoterol + Triotropium MDI 6 Amitriptyline Tablets 25 mg 7 Amitriptyline Tablets 50 mg 8 Amitriptyline Tablets 100 mg 9 Amitriptyline Tablets 150 mg 10 Amitriptyline + Chlordiazepoxide Tablets 25 mcg+ 9mcg 30 Guaiphenesin+Dextromethorphan +Chlorpheniramine maleate (Sugar free) Liquid 10mg + 10mg 11 Amitriptyline 31 Guaiphenesin+Dextromethorphan H Br+Chlorphenrmine Mal.(Syrup base) Liquid 100ml 32 Hydrocortisone sodium succinate Injection 100mg 33 Hydrocortisone sodium succinate Injection 200mg 34 Hydrocortisone sodium succinate Injection 400 mg, 35 Indacaterol maleate+Indacaterol+glycopyrrronium bromide Capsule 143mcg+110mcg+63mcg 36 Ipratropium Br + Chlordiazepoxide Tablets 12.5 mg+ 5Levosalbutamol Respules 500mcg + 1.25mg 12 Betahistine Tablets 1637 Ipratropium Br + Salbutamol MDI 20mcg/mg 13 Betahistine Tablets 24+ 100mcg/mg 14 Betahistine Tablets 3238 Ipratropium Bromide Inhalation 20µg/metered dose 39 Ipratropium Respirator solu. for nebulisers Respuls 250mcg/1ml 40 Ipratropium Respirator solu. for nebulisers Respuls 500mcg/2ml 41 Levosalbutamol 1.25mg 15 Botulinum Toxid Injection 100 Units 16 Bromocriptine Resp. 2.5 ml 42 Montelukast Tablets 5mg 17 Bromocriptine 43 Montelukast Tablets 10mg 44 Montelukast + Levocetrizine Tablets 10mg+5mg 45 Montelukast +Fexofenadine Tablets 10mg+120mg 46 Phenyephrine + Chlorpheniramine Maleate Liquid (5mg+2mg)60ml 47 Promethazine Hydrochloride 1.5mg + Pholcodine 1.5mg Liquid 60ml 48 Salbutamol DPI 200mcg 49 Xxxxxxxxxx MDI 100mcg 50 Salbutamol +Ipratropium Bromide Resp. 205 mg+ 500mcg/2.5 ml 51 Salbutamol + Theophylline Tablets 2mg+200mg 52 Salbutamol + Theophylline Tablets 2mg+100mg 53 Salbutamol +Ipratropium Bromide MDI 100mcg + 20mcg 54 Salbutamol 2 mg/5 ml Liquid 100ml 55 Salbutamol 5mg/ml Resp. 2.5 ml 56 Salbutamol Sulphate Tablets 2 mg 57 Salbutamol Sulphate Tablets 4mg 58 Salmetrol + Fluticasone DPI 50mcg + 250mcg 59 Salmetrol + Fluticasone DPI 50mcg + 250mcg 60 Salmetrol + Fluticasone DPI 50mcg+250mcg 61 Salmetrol + Fluticasone with accuhaler device MDI 50mcg+500mcg 62 Salmetrol + Fluticasone with accuhaler device MDI 50mcg+250mcg 63 Salmetrol+Fluticasone DPI 50mcg+250mcg 64 Surfactant Injection 4ml 65 Surfactant Injection 8ml 66 Terbutaline Tablets 2.5mg 18 Bupenorphine +Naloxone Tablets 2 mg + 0.5mg 19 Buprenorphine Tablets 8mg 20 Buprenorphine Tablets 0.4mg 21 Buprenorphine sublingual Tablets 0.2mg 22 Buprenorphine sublingual Tablets 8mg 24 Buprenorphine sublingual Tablets 0.4mg 25 Carbamazepine Tablets 100mg 26 Carbamazepine Tablets 200mg 27 Carbamazepine Tablets 400mg 28 Carbamazepine syrup 100mg/5ml 29 Carbamazepine SR Tablets 200mg 30 Carbamazepine SR Tablets 400mg 31 Carbidopa Tablets 25mg 32 Carbidopa Tablets 50mg 33 Carbidopa Tablets 100mg 34 Chlorpromazine hydrochloride Tablets 25 mg 35 Chlorpromazine hydrochloride Syrup 25mg/5ml 36 Chlorpromazine hydrochloride Injection 25mg/ml 37 Chlorpromazine hydrochloride Tablets 50mg 38 Chlorpromazine hydrochloride Tablets 100mg 39 Cilnidipine Tablets 10mg 40 Cilnidipine Tablets 5 mg 41 Citalopram Tablets 10mg 42 Citalopram Tablets 20mg 43 Citalopram Tablets 40mg 44 Citicholine Tablets 500mg 45 Citicholine Injection 250mg/ml 46 Citicholine + Piracetam Tablets 500mg+800mg 47 Clobazam Tablets 2.5 mg 48 Clobazam Tablets 10 mg 49 Clobazam 67 Terbutaline Tablets 5mg 50 Clonazepam 68 Terbutaline Injection 0.5mg/ml 69 Terbutaline + Bromhexine HCR Liquid 30 ml 70 Terbutaline 1.5mg/5ml Liquid 100 ml 71 Terbutaline Nebulising solution 0.5mg/ml Resp. Solution 10ml 72 Terbutaline Sulphate + Brohexine Hydrochloride + Guaiphenesin + Menthol Syrup 100 ml 73 Theophylline + Etophylline Injection (25.3 mg+84.7mg) 2ml 74 Theophylline + Etophylline Liquid 100ml 75 Theophylline 35 mg + Etophylline 115mg Tablets 0.25mg 51 Clonazepam Tablets 0.5mg 52 Clonazepam Tablets 1 mg 53 Clonazepam Tablets 2mg 54 Clonazepam MD Tablets 2 mg 55 Colchicine Tablets 0.6 mg 56 Colchicine Tablets 0.5 mg 57 Colchicine Tablets 1mg 58 Conivaptan Injection 20mg/100ml 59 Deferasirox Tablets 100mg 60 Deferasirox Tablets 400mg 61 Deferasirox Tablets 250mg 62 Deferasirox Tablets 500mg 63 Deferiprone Capsules 250mg 64 Deferiprone Capsules 500mg 65 Deferiprone Tablets 500 mg 66 Deferiprone Tablets 1000 mg 67 Desvenlafaxine Tablets 50mg 68 Desvenlafaxine Tablets 100mg 69 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+325mg+1 0mg 70 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+500mg+1 0mg 71 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+650mg+1 0mg 72 Diazepam Tablets 2 mg 73 Diazepam Tablets 5mg 74 Diazepam Tablets 10mg 75 Diazepam Rectal Suppository 5150mg 76 Diazepam Tablets 3 Theophylline 70 mg 77 Diazepam Rectal Suppository 2.5 + Etophylline 231mg 78 Diazepam Injection 10mg/2ml 79 Diazoxide Tablets 50 mg 80 Diethylcarbamazine citrate Tablets 50 mg 81 Diethylcarbamazine citrate Tablets 100 mg 82 Disulfiram Tablets 250mg 83 Disulfiram Tablets 500 mg 84 Divalproex equivalent to valproic acid 250 mg syrup 100 ml 85 Divalproex Sodium Tablets 250mg 86 Divalproex Sodium Tablets 500mg 87 Divalproex Sodium Tablets 125 mg 88 Divalproex Sodium Tablets 250 mg ER 89 Divalproex Sodium Tablets 500 mg ER 90 Divalproex Sodium Tablets 125 mg ER 91 Duloxetine Hydrochloride Tablets 20mg 92 Duloxetine Hydrochloride Tablets 30mg 93 Duloxetine Hydrochloride Tablets 60mg 94 Eperisone hydrochloride Tablets 150 mg 95 Eperisone hydrochloride Tablets 450 mg 96 Escitalopram Tablets 5mg 97 Escitalopram Tablets 10mg 98 Escitalopram Tablets 20mg 99 Escitalopram + Clonazepam Tablets 10mg+0.25mg 100 Escitalopram + Clonazepam Tablets 10mg+0.5mg 101 Fludrocortisone Tablets 0.1mg 102 Flumazenil Injection 0.5 mg / 5ml 103 Flumazenil Injection 1 mg / 10 ml 104 Flunarizine Tablets 5mg 105 Flunarizine Tablets 10mg 106 Fluoxetine Tablets 40mg 107 Fluoxetine Capsules 20mg 108 Fluoxetine Tablets 20mg 109 Fluoxetine Tablets 40mg 110 Fluoxetine Tablets 60mg 111 Fluoxetine Tablets 10mg 112 Fluoxetine Capsules 20mg 113 Fluphenazile decanoate Injection 125mg/5ml 114 Flupiritine Tablets 100mg 115 Flupiritine Tablets 200mg 116 Fosphenytoin Injection 50mg/ml 117 Gabapentin Tablets 400mg 118 Gabapentine Tablets 600mg 119 Gabapentine Tablets 300mg 120 Gabapentine Cap. 300mg 121 Gabapentine + Mecobalamine Tablets 300 mg+ 0.5 mg 122 Gabapentine + Nortriptyline Tablets 400 mg + 10 mg 123 Glycerol Syrup 100ml 124 Glycerol Syrup 500ml 125 Haloperidol Tablets 2mg 126 Haloperidol Tablets 5mg 127 Haloperidol Tablets 10 mg 128 Haloperidol Injection 5mg/ml 129 Hydroxyzine Tablets 10mg 130 Hydroxyzine Tablets 25mg 131 Hydroxyzine Syrup 10mg/5ml 132 Imipramine Tablets 25 mg 133 Imipramine Tablets 75 mg 134 Lacosamide Tablets 50 mg 135 Lacosamide Tablets 100 mg 136 Lacosamide Tablets 150 mg 137 Lacosamide Tablets 200 mg 138 Lacosamide Syrup 50 mg/5ml 139 Lacosamide Injection 10 mg/ml 140 Lamotrigin Tablets 25mg 141 Lamotrigin Tablets 100 mg 142 Lamotrigin Tablets 150mg 143 Lamotrigin Tablets 200 mg 144 Lecithin 30mg+ equivalent to 175 mg of essential Phospholipids (EPL)(phosphatidylcholine,phosphatidylethanolamine,phospha tidylinositol,phosphatidylserine) Capsules (350+175)mg 145 Levetiracetam Tablets 250 mg 146 Levetiracetam Tablets 500 mg 147 Levetiracetam Tablets 750mg 148 Levetiracetam Tablets 1000 mg 149 Levetiracetam Injection 100mg/5 ml. 150 Levetiracetam Syrup 100mg/ml 151 Lithium Carbonate Tablets 450mg 152 Lithium Carbonate Tablets 300mg 153 Lithium Carbonate SR Tablets 400mg 154 Lorazepam Tablets 0.5 mg 155 Lorazepam Tablets 1mg 156 Lorazepam Tablets 2mg 157 Lorazepam 2mg Injection 2 ml 158 Lorazepam 2mg Injection 4 ml 159 Magnesium Sulfate, Urea & Sulphacetamide Sdoium Ointment 75gm 160 Mefloquine Tablets 250mg 161 Melatonin Tablets 0.5mg 162 Melatonin Tablets 3mg 163 Melatonin Tablets 6mg 164 Methyldopa Tablets 250mg 165 Methyldopa Tablets 125 mg 166 Methyldopa Tablets 500 mg 167 Naltrexone Tablets 50mg 168 Naproxen Tablets 250mg 169 Naproxen Tablets 500mg 170 Naproxen Tablets 750mg 171 Naproxen + Domperidone Tablets 500mg+10mg 172 Nevirapine Tablets 200mg 173 Nevirapine syrup 10mg/ml 174 Nicotine Chewing gum Tablets 2mg 175 Nicotine Chewing gum Tablets 4mg 176 Nimodipine Tablets 30mg 177 Nimodipine Injection 10mg/50ml 178 Nitrazepam Tablets 5mg 179 Nitrazepam Tablets 10mg 180 Nortriptyline Tablets 25mg 181 Nortriptyline Tablets 10 mg 182 Olanzapine Tablets 20mg 183 Olanzapine Tablets 2.5mg 184 Olanzapine Tablets 5mg 185 Olanzapine Tablets 7.5mg 186 Olanzapine Tablets 10mg 187 Olanzapine Injection 10mg/ml 188 Oxcarbamazepine Tablets 150mg 189 Oxcarbamazepine Tablets 300mg 190 Oxcarbamazepine Tablets 600mg 191 Oxcarbamazepine 300 mg Syrups 60 ml 192 Paracetamol Injection 150mg/2ml 193 Paracetamol Injection 500mg/50 ml 194 Paracetamol 10mg/ml (PLASTIC BOT ) Injection 1 gm/ 100 ml 195 Paracetamol + Tramadol Tablets 325mg+37.5mg 196 Paracetamol 10mg/ ml (GLASS BOT ) Injection 1 gm/ 100 ml 197 Paroxetine Tablets 12.5mg 198 Paroxetine Tablets 25mg 199 Paroxetine Tablets 37.5mg 200 Pergolide Tablets 0.05mg 201 Pergolide Tablets 0.25mg 202 Pergolide Tablets 1mg 203 Phenobarbitone Tablets 30mg 204 Phenobarbitone Tablets 60mg 205 Phenobarbitone Syrup 20mg/5ml 206 Phenobarbitone Injection 200mg /1ml 207 Phenytoin Sodium Tablets 50 mg 208 Phenytoin Sodium Tablets 100mg 209 Phenytoin Sodium Injection 25mg/ml 210 Phenytoin Sodium Liquids 100ml(25mg/ml) 211 Piperazine Tablets 500 mg 212 Piperazine Syrup 750mg/5ml 213 Piracetam Tablets 800mg 214 Piracetam Syrup 500mg/5ml 215 Praziquantel Tablets 600 mg 216 Pregabaline Tablets 50mg 217 Pregabaline Tablets 75mg 218 Pregabaline Tablets 150mg 219 Pregabaline + Amitriptyline Tablets 75mg+10mg 220 Pregabaline + Amitriptyline Tablets 50mg+10mg 221 Pregabaline + Nortriptyline Tablets 75 mg+10 mg 222 Pregabaline+Methylcobalamine Tablets 75mg+750mcg 223 Pregabaline+Methylcobalamine Tablets 50mg+1500mcg 224 Pregabaline+Methylcobalamine Tablets 75mg+500mcg 225 Pregabaline+Methylcobalamine Tablets 150mg+1500mc g 226 Quetiapine Fumarate Tablets 25mg 227 Quetiapine Fumarate Tablets 100mg 228 Risperidone Tablets 4mg 229 Risperidone Tablets 3mg 230 Risperidone Tablets 2mg 231 Risperidone Tablets 1mg 232 Risperidone Tablets 0.5mg 233 Sertraline HCL Tablets 25mg 234 Sertraline HCL Tablets 50mg 235 Sertraline HCL Tablets 100mg 236 Sildenafil Citrate Tablets 50mg 237 Sildenafil Citrate Tablets 25mg 238 Sodium Valproate Tablets 200mg 239 Sodium Valproate Syrup 200mg/5ml 240 Sodium Valproate Injection 100ml/5ml 241 Sodium Valproate Tablets 300mg 242 Sodium Valproate + Valproic Acid Tablets 300mg 243 Sodium Valproate + Valproic Acid Tablets 500mg 244 Sodium Valproate + Valproic Acid Tablets 200mg 245 Sumatriptan + Naproxen Tablets 85mg+500mg 246 Tolvaptan Tablets 15mg 247 Topiramate Tablets 25 mg 248 Topiramate Tablets 50 mg 249 Topiramate Tablets 100 mg 250 Trihexyphenidyl (Benzhexol) Tablets 2mg 251 Zaleplon Tablets 5mg 252 Zaleplon Tablets 10mg 253 Zidovudine Syrup 50mg/5ml 254 Zidovudine Tablets 100mg 255 Zidovudine Tablets 300mg 256 Zolpidem Tablets 10 mg 257 Zolpidem Tablets 5mg 258 Zolpidem SR Tablets 6.25mg 259 Zolpidem SR Tablets 12.5mg 77 Tiotropium DPI 18mcg Calculation of Local Content Name of Manufacture Calculation by Manufacturer (Cost per unit of product) Cost Component Cost (Domestic Component) A Cost (Imported Component) B Total Cost (INR/ US $) C=a+b Percentage of Local Content D=(a/c)*100 I. ………… II. ………… III. Total Cost (Excluding tax and duties) Note:- I. Cost (Domestic Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken) which have not been imported directly or through a domestic trader or an intermediary. II. Cost (Imported Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken). I S/o.D/o,W/o , Resident of That I will agree to abide by the terms and conditions of the policy of Government of India issued vide order no. P-45021/2/2017-B.E.-II dated 15/06/2017. That the information furnished hereinafter is correct to best of my knowledge and belief and I undertake to produce relevant records before the procuring entity or any authority so nominated by the Government of India for the purpose of assessing the local content. That the local content for all inputs which constitute the said drugs has been verified by me and I am responsible for the correctness of the claims made therein. That in the event of the domestic valve addition of the product mentioned herein is found to be incorrect and not meeting the prescribed valve-addition norms, based on Government of India for the purpose of assessing the local content, action will be taken against me as per Order No. P-45021/2/2017-B.E.-II dated 15.06.2017. I agree to maintain the following information in the Company‟s record for a period of 8 years and shall make this available for verification to any statutory authorities: i) Name and details of the Domestic Manufacturer (Registered Officer, Manufacturing unit location, nature of legal entity) ii) Date on which this certificate is issued. iii) Medicine for which the certificate is product. iv) Procuring entity to whom the certificate is furnished. v) Percentage of local content claimed. vi) Name and contact details of the unit of the manufacturer. vii) Sale Price of the product. viii) Ex-Factory Price of the product. ix) Freight, insurance and handling. x) Total Bill of Material. xi) List and total cost valve of inputs used for manufacture of the medicine certificates from suppliers, if the input is not in-house to be attached. xii) List and cost of inputs which and imported, directly or indirectly. (Also to be provided in PDF format)

Legal Jurisdiction. The agreement shall be deemed to have been concluded in Jodhpur, Rajasthan and all obligations hereunder shall be deemed to be located at Jodhpur, Rajasthan and Court within Jodhpur, Rajasthan will have Jurisdiction to the exclusion of other courts. Complete Address, Telephone No. & Email Id Name of Proprietor/Partner/Managing Director/Director. Phone No:- Mobile No:- Email Id:- Whether the firm is a registered firm Yes/No (attached copy of certificate) Whether quoting as manufacturer/ authorised distributor/ authorised dealer PAN No. (enclose the attested copy of PAN Card) (enclose the attested copy of GST Certificate) Whether the firm has enclosed the Bank Draft/Pay Order/Banker‟s cheque as Xxxxxxx Money Deposit Whether the Firm/Agency has signed each and every page of Tender/NIT Bank Details: 1) Accounts No: 2) Bank Name: 3) Branch: 4) IFSC Code: Any other information, if necessary Place: Name: Date: Business Address: Signature of Bidder: Seal of the Bidder: Annexure-B List of Products 1 Alprazolam Tablets 0.25mg Acriflavin powder 100gm 2 Alprazolam Tablets 0.5mg Boric Acid powder 400gm 3 Alprazolam Tablets 1 mg Boric Acid powder 500gm 4 Amitriptyline Tablets 10mg Carbolic Acid powder 400gm 5 Amitriptyline Tablets 75 mg Gentian Violet solution 100gm 6 Amitriptyline Tablets 25 mg Glycerin LIQUID 25Kg. 7 Amitriptyline Tablets 50 mg Glycerol solution LIQUID 500 ml 8 Amitriptyline Tablets 100 mg Hydrogen Peroxide LIQUID 400ml 9 Amitriptyline Tablets 150 mg Hydrogen Peroxide LIQUID 500ml 10 Amitriptyline + Chlordiazepoxide Tablets 25 mg + 10mg Icthamol solu. solution 11 Amitriptyline + Chlordiazepoxide Tablets 12.5 mg+ 5mg Liquid Paraffin Heavy LIQUID 400ml 12 Betahistine Tablets 16mg Mercurochrome crystals powder 100gm 13 Betahistine Tablets 24mg Methylene Blue powder powder 14 Betahistine Tablets 32mg Potassium Permanganate powder 400gm 15 Botulinum Toxid Injection 100 Units Potassium Permanganate powder 500gm 16 Bromocriptine Tablets 5mg Potassium Permanganate sachet 400gm 17 Bromocriptine Tablets 2.5mg Potassium Permanganate sachet 500gm 18 Bupenorphine +Naloxone Tablets 2 mg + 0.5mg Tannic Acid LIQUID 500gm 19 Buprenorphine Tablets 8mg Tincture Benzoin LIQUID 500ml 20 Buprenorphine Tablets 0.4mg Tincture Iodine LIQUID 500ml 21 Buprenorphine sublingual Tablets 0.2mg 22 Buprenorphine sublingual Tablets 8mg 24 Buprenorphine sublingual Tablets 0.4mg 25 Carbamazepine Tablets 100mg 26 Carbamazepine Tablets 200mg 27 Carbamazepine Tablets 400mg 28 Carbamazepine syrup 100mg/5ml 29 Carbamazepine SR Tablets 200mg 30 Carbamazepine SR Tablets 400mg 31 Carbidopa Tablets 25mg 32 Carbidopa Tablets 50mg 33 Carbidopa Tablets 100mg 34 Chlorpromazine hydrochloride Tablets 25 mg 35 Chlorpromazine hydrochloride Syrup 25mg/5ml 36 Chlorpromazine hydrochloride Injection 25mg/ml 37 Chlorpromazine hydrochloride Tablets 50mg 38 Chlorpromazine hydrochloride Tablets 100mg 39 Cilnidipine Tablets 10mg 40 Cilnidipine Tablets 5 mg 41 Citalopram Tablets 10mg 42 Citalopram Tablets 20mg 43 Citalopram Tablets 40mg 44 Citicholine Tablets 500mg 45 Citicholine Injection 250mg/ml 46 Citicholine + Piracetam Tablets 500mg+800mg 47 Clobazam Tablets 2.5 mg 48 Clobazam Tablets 10 mg 49 Clobazam Tablets 5mg 50 Clonazepam Tablets 0.25mg 51 Clonazepam Tablets 0.5mg 52 Clonazepam Tablets 1 mg 53 Clonazepam Tablets 2mg 54 Clonazepam MD Tablets 2 mg 55 Colchicine Tablets 0.6 mg 56 Colchicine Tablets 0.5 mg 57 Colchicine Tablets 1mg 58 Conivaptan Injection 20mg/100ml 59 Deferasirox Tablets 100mg 60 Deferasirox Tablets 400mg 61 Deferasirox Tablets 250mg 62 Deferasirox Tablets 500mg 63 Deferiprone Capsules 250mg 64 Deferiprone Capsules 500mg 65 Deferiprone Tablets 500 mg 66 Deferiprone Tablets 1000 mg 67 Desvenlafaxine Tablets 50mg 68 Desvenlafaxine Tablets 100mg 69 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+325mg+1 0mg 70 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+500mg+1 0mg 71 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+650mg+1 0mg 72 Diazepam Tablets 2 mg 73 Diazepam Tablets 5mg 74 Diazepam Tablets 10mg 75 Diazepam Rectal Suppository 5mg 76 Diazepam Tablets 3 mg 77 Diazepam Rectal Suppository 2.5 mg 78 Diazepam Injection 10mg/2ml 79 Diazoxide Tablets 50 mg 80 Diethylcarbamazine citrate Tablets 50 mg 81 Diethylcarbamazine citrate Tablets 100 mg 82 Disulfiram Tablets 250mg 83 Disulfiram Tablets 500 mg 84 Divalproex equivalent to valproic acid 250 mg syrup 100 ml 85 Divalproex Sodium Tablets 250mg 86 Divalproex Sodium Tablets 500mg 87 Divalproex Sodium Tablets 125 mg 88 Divalproex Sodium Tablets 250 mg ER 89 Divalproex Sodium Tablets 500 mg ER 90 Divalproex Sodium Tablets 125 mg ER 91 Duloxetine Hydrochloride Tablets 20mg 92 Duloxetine Hydrochloride Tablets 30mg 93 Duloxetine Hydrochloride Tablets 60mg 94 Eperisone hydrochloride Tablets 150 mg 95 Eperisone hydrochloride Tablets 450 mg 96 Escitalopram Tablets 5mg 97 Escitalopram Tablets 10mg 98 Escitalopram Tablets 20mg 99 Escitalopram + Clonazepam Tablets 10mg+0.25mg 100 Escitalopram + Clonazepam Tablets 10mg+0.5mg 101 Fludrocortisone Tablets 0.1mg 102 Flumazenil Injection 0.5 mg / 5ml 103 Flumazenil Injection 1 mg / 10 ml 104 Flunarizine Tablets 5mg 105 Flunarizine Tablets 10mg 106 Fluoxetine Tablets 40mg 107 Fluoxetine Capsules 20mg 108 Fluoxetine Tablets 20mg 109 Fluoxetine Tablets 40mg 110 Fluoxetine Tablets 60mg 111 Fluoxetine Tablets 10mg 112 Fluoxetine Capsules 20mg 113 Fluphenazile decanoate Injection 125mg/5ml 114 Flupiritine Tablets 100mg 115 Flupiritine Tablets 200mg 116 Fosphenytoin Injection 50mg/ml 117 Gabapentin Tablets 400mg 118 Gabapentine Tablets 600mg 119 Gabapentine Tablets 300mg 120 Gabapentine Cap. 300mg 121 Gabapentine + Mecobalamine Tablets 300 mg+ 0.5 mg 122 Gabapentine + Nortriptyline Tablets 400 mg + 10 mg 123 Glycerol Syrup 100ml 124 Glycerol Syrup 500ml 125 Haloperidol Tablets 2mg 126 Haloperidol Tablets 5mg 127 Haloperidol Tablets 10 mg 128 Haloperidol Injection 5mg/ml 129 Hydroxyzine Tablets 10mg 130 Hydroxyzine Tablets 25mg 131 Hydroxyzine Syrup 10mg/5ml 132 Imipramine Tablets 25 mg 133 Imipramine Tablets 75 mg 134 Lacosamide Tablets 50 mg 135 Lacosamide Tablets 100 mg 136 Lacosamide Tablets 150 mg 137 Lacosamide Tablets 200 mg 138 Lacosamide Syrup 50 mg/5ml 139 Lacosamide Injection 10 mg/ml 140 Lamotrigin Tablets 25mg 141 Lamotrigin Tablets 100 mg 142 Lamotrigin Tablets 150mg 143 Lamotrigin Tablets 200 mg 144 Lecithin 30mg+ equivalent to 175 mg of essential Phospholipids (EPL)(phosphatidylcholine,phosphatidylethanolamine,phospha tidylinositol,phosphatidylserine) Capsules (350+175)mg 145 Levetiracetam Tablets 250 mg 146 Levetiracetam Tablets 500 mg 147 Levetiracetam Tablets 750mg 148 Levetiracetam Tablets 1000 mg 149 Levetiracetam Injection 100mg/5 ml. 150 Levetiracetam Syrup 100mg/ml 151 Lithium Carbonate Tablets 450mg 152 Lithium Carbonate Tablets 300mg 153 Lithium Carbonate SR Tablets 400mg 154 Lorazepam Tablets 0.5 mg 155 Lorazepam Tablets 1mg 156 Lorazepam Tablets 2mg 157 Lorazepam 2mg Injection 2 ml 158 Lorazepam 2mg Injection 4 ml 159 Magnesium Sulfate, Urea & Sulphacetamide Sdoium Ointment 75gm 160 Mefloquine Tablets 250mg 161 Melatonin Tablets 0.5mg 162 Melatonin Tablets 3mg 163 Melatonin Tablets 6mg 164 Methyldopa Tablets 250mg 165 Methyldopa Tablets 125 mg 166 Methyldopa Tablets 500 mg 167 Naltrexone Tablets 50mg 168 Naproxen Tablets 250mg 169 Naproxen Tablets 500mg 170 Naproxen Tablets 750mg 171 Naproxen + Domperidone Tablets 500mg+10mg 172 Nevirapine Tablets 200mg 173 Nevirapine syrup 10mg/ml 174 Nicotine Chewing gum Tablets 2mg 175 Nicotine Chewing gum Tablets 4mg 176 Nimodipine Tablets 30mg 177 Nimodipine Injection 10mg/50ml 178 Nitrazepam Tablets 5mg 179 Nitrazepam Tablets 10mg 180 Nortriptyline Tablets 25mg 181 Nortriptyline Tablets 10 mg 182 Olanzapine Tablets 20mg 183 Olanzapine Tablets 2.5mg 184 Olanzapine Tablets 5mg 185 Olanzapine Tablets 7.5mg 186 Olanzapine Tablets 10mg 187 Olanzapine Injection 10mg/ml 188 Oxcarbamazepine Tablets 150mg 189 Oxcarbamazepine Tablets 300mg 190 Oxcarbamazepine Tablets 600mg 191 Oxcarbamazepine 300 mg Syrups 60 ml 192 Paracetamol Injection 150mg/2ml 193 Paracetamol Injection 500mg/50 ml 194 Paracetamol 10mg/ml (PLASTIC BOT ) Injection 1 gm/ 100 ml 195 Paracetamol + Tramadol Tablets 325mg+37.5mg 196 Paracetamol 10mg/ ml (GLASS BOT ) Injection 1 gm/ 100 ml 197 Paroxetine Tablets 12.5mg 198 Paroxetine Tablets 25mg 199 Paroxetine Tablets 37.5mg 200 Pergolide Tablets 0.05mg 201 Pergolide Tablets 0.25mg 202 Pergolide Tablets 1mg 203 Phenobarbitone Tablets 30mg 204 Phenobarbitone Tablets 60mg 205 Phenobarbitone Syrup 20mg/5ml 206 Phenobarbitone Injection 200mg /1ml 207 Phenytoin Sodium Tablets 50 mg 208 Phenytoin Sodium Tablets 100mg 209 Phenytoin Sodium Injection 25mg/ml 210 Phenytoin Sodium Liquids 100ml(25mg/ml) 211 Piperazine Tablets 500 mg 212 Piperazine Syrup 750mg/5ml 213 Piracetam Tablets 800mg 214 Piracetam Syrup 500mg/5ml 215 Praziquantel Tablets 600 mg 216 Pregabaline Tablets 50mg 217 Pregabaline Tablets 75mg 218 Pregabaline Tablets 150mg 219 Pregabaline + Amitriptyline Tablets 75mg+10mg 220 Pregabaline + Amitriptyline Tablets 50mg+10mg 221 Pregabaline + Nortriptyline Tablets 75 mg+10 mg 222 Pregabaline+Methylcobalamine Tablets 75mg+750mcg 223 Pregabaline+Methylcobalamine Tablets 50mg+1500mcg 224 Pregabaline+Methylcobalamine Tablets 75mg+500mcg 225 Pregabaline+Methylcobalamine Tablets 150mg+1500mc g 226 Quetiapine Fumarate Tablets 25mg 227 Quetiapine Fumarate Tablets 100mg 228 Risperidone Tablets 4mg 229 Risperidone Tablets 3mg 230 Risperidone Tablets 2mg 231 Risperidone Tablets 1mg 232 Risperidone Tablets 0.5mg 233 Sertraline HCL Tablets 25mg 234 Sertraline HCL Tablets 50mg 235 Sertraline HCL Tablets 100mg 236 Sildenafil Citrate Tablets 50mg 237 Sildenafil Citrate Tablets 25mg 238 Sodium Valproate Tablets 200mg 239 Sodium Valproate Syrup 200mg/5ml 240 Sodium Valproate Injection 100ml/5ml 241 Sodium Valproate Tablets 300mg 242 Sodium Valproate + Valproic Acid Tablets 300mg 243 Sodium Valproate + Valproic Acid Tablets 500mg 244 Sodium Valproate + Valproic Acid Tablets 200mg 245 Sumatriptan + Naproxen Tablets 85mg+500mg 246 Tolvaptan Tablets 15mg 247 Topiramate Tablets 25 mg 248 Topiramate Tablets 50 mg 249 Topiramate Tablets 100 mg 250 Trihexyphenidyl (Benzhexol) Tablets 2mg 251 Zaleplon Tablets 5mg 252 Zaleplon Tablets 10mg 253 Zidovudine Syrup 50mg/5ml 254 Zidovudine Tablets 100mg 255 Zidovudine Tablets 300mg 256 Zolpidem Tablets 10 mg 257 Zolpidem Tablets 5mg 258 Zolpidem SR Tablets 6.25mg 259 Zolpidem SR Tablets 12.5mg White Petrolium Jelly Jelly 1KG Calculation of Local Content Name of Manufacture Calculation by Manufacturer (Cost per unit of product) Cost Component Cost (Domestic Component) A Cost (Imported Component) B Total Cost (INR/ US $) C=a+b Percentage of Local Content D=(a/c)*100 I. ………… II. ………… III. Total Cost (Excluding tax and duties) Note:- I. Cost (Domestic Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken) which have not been imported directly or through a domestic trader or an intermediary. II. Cost (Imported Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken). I S/o.D/o,W/o , Resident of That I will agree to abide by the terms and conditions of the policy of Government of India issued vide order no. P-45021/2/2017-B.E.-II dated 15/06/2017. That the information furnished hereinafter is correct to best of my knowledge and belief and I undertake to produce relevant records before the procuring entity or any authority so nominated by the Government of India for the purpose of assessing the local content. That the local content for all inputs which constitute the said drugs has been verified by me and I am responsible for the correctness of the claims made therein. That in the event of the domestic valve addition of the product mentioned herein is found to be incorrect and not meeting the prescribed valve-addition norms, based on Government of India for the purpose of assessing the local content, action will be taken against me as per Order No. P-45021/2/2017-B.E.-II dated 15.06.2017. I agree to maintain the following information in the Company‟s record for a period of 8 years and shall make this available for verification to any statutory authorities: i) Name and details of the Domestic Manufacturer (Registered Officer, Manufacturing unit location, nature of legal entity) ii) Date on which this certificate is issued. iii) Medicine for which the certificate is product. iv) Procuring entity to whom the certificate is furnished. v) Percentage of local content claimed. vi) Name and contact details of the unit of the manufacturer. vii) Sale Price of the product. viii) Ex-Factory Price of the product. ix) Freight, insurance and handling. x) Total Bill of Material. xi) List and total cost valve of inputs used for manufacture of the medicine certificates from suppliers, if the input is not in-house to be attached. xii) List and cost of inputs which and imported, directly or indirectly. (Also to be provided in PDF format)

Legal Jurisdiction. The agreement shall be deemed to have been concluded in Jodhpur, Rajasthan and all obligations hereunder shall be deemed to be located at Jodhpur, Rajasthan and Court within Jodhpur, Rajasthan will have Jurisdiction to the exclusion of other courts. Complete Address, Telephone No. & Email Id Name of Proprietor/Partner/Managing Director/Director. Phone No:- Mobile No:- Email Id:- Whether the firm is a registered firm Yes/No (attached copy of certificate) Whether quoting as manufacturer/ authorised distributor/ authorised dealer PAN No. (enclose the attested copy of PAN Card) (enclose the attested copy of GST Certificate) Whether the firm has enclosed the Bank Draft/Pay Order/Banker‟s cheque as Xxxxxxx Money Deposit Whether the Firm/Agency has signed each and every page of Tender/NIT Bank Details: 1) Accounts No: 2) Bank Name: 3) Branch: 4) IFSC Code: Any other information, if necessary Place: Name: Date: Business Address: Signature of Bidder: Seal of the Bidder: Annexure-B List of Products 1 Alprazolam Tablets 0.25mg Acriflavine + Glycerine Solution 20 ml 2 Alprazolam Tablets 0.5mg Acriflavine + Glycerine Solution 400 ml 3 Alprazolam Tablets 1 mg Antimicrobial skin gel with Ethyl alcohol >60% Liquid 1000ml 4 Amitriptyline Tablets 10mg Benzoin Compound Tincture 150ml 5 Amitriptyline Tablets 75 mg Cedepol (Teepol) Liquid 5ltr 6 Amitriptyline Tablets 25 mg Cetrimide Solution 20% (conc. for dilution) 7 Amitriptyline Tablets 50 mg Cetrimide 15%+Chlorhexidine 7.5% Liquid 1000ml 8 Amitriptyline Tablets 100 mg 9 Amitriptyline Tablets 150 mg 10 Amitriptyline + Chlordiazepoxide Tablets 25 mg + 10mg 11 Amitriptyline + Chlordiazepoxide Tablets 12.5 mg+ 5mg 12 Betahistine Tablets 16mg 13 Betahistine Tablets 24mg 14 Betahistine Tablets 32mg 15 Botulinum Toxid Injection 100 Units 16 Bromocriptine Tablets 5mg 17 Bromocriptine Tablets 2.5mg 18 Bupenorphine +Naloxone Tablets 2 mg + 0.5mg 19 Buprenorphine Tablets 8mg 20 Buprenorphine Tablets 0.4mg 21 Buprenorphine sublingual Tablets 0.2mg 22 Buprenorphine sublingual Tablets 8mg 24 Buprenorphine sublingual Tablets 0.4mg 25 Carbamazepine Tablets 100mg 26 Carbamazepine Tablets 200mg 27 Carbamazepine Tablets 400mg 28 Carbamazepine syrup 100mg/5ml 29 Carbamazepine SR Tablets 200mg 30 Carbamazepine SR Tablets 400mg 31 Carbidopa Tablets 25mg 32 Carbidopa Tablets 50mg 33 Carbidopa Tablets 100mg 34 Chlorpromazine hydrochloride Tablets 25 mg 35 Chlorpromazine hydrochloride Syrup 25mg/5ml 36 Chlorpromazine hydrochloride Injection 25mg/ml 37 Chlorpromazine hydrochloride Tablets 50mg 38 Chlorpromazine hydrochloride Tablets 100mg 39 Cilnidipine Tablets 10mg 40 Cilnidipine Tablets 5 mg 41 Citalopram Tablets 10mg 42 Citalopram Tablets 20mg 43 Citalopram Tablets 40mg 44 Citicholine Tablets 500mg 45 Citicholine Injection 250mg/ml 46 Citicholine + Piracetam Tablets 500mg+800mg 47 Clobazam Tablets 2.5 mg 48 Clobazam Tablets 10 mg 49 Clobazam Tablets 5mg 50 Clonazepam Tablets 0.25mg 51 Clonazepam Tablets 0.5mg 52 Clonazepam Tablets 1 mg 53 Clonazepam Tablets 2mg 54 Clonazepam MD Tablets 2 mg 55 Colchicine Tablets 0.6 mg 56 Colchicine Tablets Chlorhexidine 0.5 mg 57 Colchicine Tablets 1mg 58 Conivaptan Injection 20mg/100ml 59 Deferasirox Tablets 100mg 60 Deferasirox Tablets 400mg 61 Deferasirox Tablets 250mg 62 Deferasirox Tablets 500mg 63 Deferiprone Capsules 250mg 64 Deferiprone Capsules 500mg 65 Deferiprone Tablets 500 mg 66 Deferiprone Tablets 1000 mg 67 Desvenlafaxine Tablets 50mg 68 Desvenlafaxine Tablets 100mg 69 Dextropropoxyphene + PCM/Acetaminophen %( with 70% ethanol) sol. With or without Dicyclomine surfactants, emollients & moisturerisers. Liquid 500ml 9 Chlorhexidine 4% sol. With surfactants, emollients & moisturerisers. Liquid 500ml 10 Chlorhexidine Gluconate 2% wet wipes 24 x 30 cm 11 Combination of sodium laureth sulphate +Nacl+ Peg 7 +peg 120 + Glycerine Liquid 500ml 12 Combination of Undecylenamidopropyl-trimonium methosulphate + Phenoxyethanol + Skin care addictives Liquid 500ml 13 Diethyl Ether (Solvent ether) for synthesis Liquid 500ml 14 Ehtanol 30% with 1% Triclosan Solution Liquid 30 ml 15 Enzymatic detergent solution with neutral ph Liquid 1000ml 16 Ethanol 80% with butan.2-one, macrogolglycerolococoate Liquid 500ml 17 Ethyl Alcohol 60% W/v Based Hand Sanitizer with Moisturiser. Liquid 500 ml 18 Formaldehyde Solution (Formalin) 37-41%W/V for synthesis Solution 5ltr 19 Gentian Violet 0.5% Paint 30ml 20 Gentian Violet 1% Paint 30ml 21 Gluteraldehyde (Acidic Medium 2% ) Liquid 500ml 22 Gluteraldehyde (Alkaline Medium) 2.45% with powder rust inhibitors Liquid 5ltr 23 Hydrogen peroxide 11% and 0.01% sliver nitrate with micro jet. Liquid 1000ml 24 Isopropyl alcohol (1, 2, Propanol) 75% + Macetronium + Skin emollients & moisturizers Liquid 500ml 25 Octenidine Dihydrochloride 0.1 % Liquid 150 ml 26 Povidone Iodine 10% Liquid 500ml 27 Povidone Iodine 10% Liquid 100ml 28 Povidone Iodine 7.5% Liquid 500ml 29 Povidone Iodine 5% Liquid 100ml 30 Povidone Iodine 5% Liquid 500ml 31 Silver sulfadiazine 1%, Chlorhexidine Gluconate 0.2% Ointment 10 gm 32 Sodalime Granules Tablets 60mg+325mg+1 0mg 70 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine 500gm 33 Sodium diehloroisocyanurate surfactant free Tablets 60mg+500mg+1 0mg 71 Dextropropoxyphene + PCM/Acetaminophen with or without Dicyclomine Tablets 60mg+650mg+1 0mg 72 Diazepam Tablets 2 mg 73 Diazepam Tablets 5mg 74 Diazepam Tablets 10mg 75 Diazepam Rectal Suppository 5mg 76 Diazepam Tablets 3 mg 77 Diazepam Rectal Suppository 2.5 mg 78 Diazepam Injection 10mg/2ml 79 Diazoxide Tablets 50 mg 80 Diethylcarbamazine citrate Tablets 50 mg 81 Diethylcarbamazine citrate Tablets 100 mg 82 Disulfiram Tablets 250mg 83 Disulfiram Tablets 30gm 39 Sodium hychlorite 0.002% hypochlorous acid 0.008% electrolysed water 97.64% ( hydrogel ) Gel 120 gm 40 Sodium hychlorite 0.002% hypochlorous acid 0.008% electrolysed water 97.64% Liquid 100ml 41 Sodium hychlorite 0.002% hypochlorous acid 0.008% electrolysed water 97.64% Liquid 500 mg 84 Divalproex equivalent to valproic ml 42 Sodium hychlorite 0.002% hypochlorous acid 250 mg syrup 100 0.008% electrolysed water 97.64% Liquid 1000 ml 85 Divalproex Sodium Tablets 250mg 86 Divalproex Sodium Tablets 500mg 87 Divalproex Sodium Tablets 125 mg 88 Divalproex Sodium Tablets 250 mg ER 89 Divalproex Sodium Tablets 500 mg ER 90 Divalproex Sodium Tablets 125 mg ER 91 Duloxetine Hydrochloride Tablets 20mg 92 Duloxetine Hydrochloride Tablets 30mg 93 Duloxetine Hydrochloride Tablets 60mg 94 Eperisone hydrochloride Tablets 150 mg 95 Eperisone hydrochloride Tablets 450 mg 96 Escitalopram Tablets 5mg 97 Escitalopram Tablets 10mg 98 Escitalopram Tablets 20mg 99 Escitalopram + Clonazepam Tablets 10mg+0.25mg 100 Escitalopram + Clonazepam Tablets 10mg+0.5mg 101 Fludrocortisone Tablets 0.1mg 102 Flumazenil Injection 0.5 mg / 5ml 103 Flumazenil Injection 1 mg / 10 ml 104 Flunarizine Tablets 5mg 105 Flunarizine Tablets 10mg 106 Fluoxetine Tablets 40mg 107 Fluoxetine Capsules 20mg 108 Fluoxetine Tablets 20mg 109 Fluoxetine Tablets 40mg 110 Fluoxetine Tablets 60mg 111 Fluoxetine Tablets 10mg 112 Fluoxetine Capsules 20mg 113 Fluphenazile decanoate Injection 125mg/5ml 114 Flupiritine Tablets 100mg 115 Flupiritine Tablets 200mg 116 Fosphenytoin Injection 50mg/ml 117 Gabapentin Tablets 400mg 118 Gabapentine Tablets 600mg 119 Gabapentine Tablets 300mg 120 Gabapentine Cap. 300mg 121 Gabapentine + Mecobalamine Tablets 300 mg+ 0.5 mg 122 Gabapentine + Nortriptyline Tablets 400 mg + 10 mg 123 Glycerol Syrup 100ml 124 Glycerol Syrup 500ml 125 Haloperidol Tablets 2mg 126 Haloperidol Tablets 5mg 127 Haloperidol Tablets 10 mg 128 Haloperidol Injection 5mg/ml 129 Hydroxyzine Tablets 10mg 130 Hydroxyzine Tablets 25mg 131 Hydroxyzine Syrup 10mg/5ml 132 Imipramine Tablets 25 mg 133 Imipramine Tablets 75 mg 134 Lacosamide Tablets 50 mg 135 Lacosamide Tablets 100 mg 136 Lacosamide Tablets 150 mg 137 Lacosamide Tablets 200 mg 138 Lacosamide Syrup 50 mg/5ml 139 Lacosamide Injection 10 mg/ml 140 Lamotrigin Tablets 25mg 141 Lamotrigin Tablets 100 mg 142 Lamotrigin Tablets 150mg 143 Lamotrigin Tablets 200 mg 144 Lecithin 30mg+ equivalent to 175 mg of essential Phospholipids (EPL)(phosphatidylcholine,phosphatidylethanolamine,phospha tidylinositol,phosphatidylserine) Capsules (350+175)mg 145 Levetiracetam Tablets 250 mg 146 Levetiracetam Tablets 500 mg 147 Levetiracetam Tablets 750mg 148 Levetiracetam Tablets 1000 mg 149 Levetiracetam Injection 100mg/5 ml. 150 Levetiracetam Syrup 100mg/ml 151 Lithium Carbonate Tablets 450mg 152 Lithium Carbonate Tablets 300mg 153 Lithium Carbonate SR Tablets 400mg 154 Lorazepam Tablets 0.5 mg 155 Lorazepam Tablets 1mg 156 Lorazepam Tablets 2mg 157 Lorazepam 2mg Injection 2 ml 158 Lorazepam 2mg Injection 4 ml 159 Magnesium Sulfate, Urea & Sulphacetamide Sdoium Ointment 75gm 160 Mefloquine Tablets 250mg 161 Melatonin Tablets 0.5mg 162 Melatonin Tablets 3mg 163 Melatonin Tablets 6mg 164 Methyldopa Tablets 250mg 165 Methyldopa Tablets 125 mg 166 Methyldopa Tablets 500 mg 167 Naltrexone Tablets 50mg 168 Naproxen Tablets 250mg 169 Naproxen Tablets 500mg 170 Naproxen Tablets 750mg 171 Naproxen + Domperidone Tablets 500mg+10mg 172 Nevirapine Tablets 200mg 173 Nevirapine syrup 10mg/ml 174 Nicotine Chewing gum Tablets 2mg 175 Nicotine Chewing gum Tablets 4mg 176 Nimodipine Tablets 30mg 177 Nimodipine Injection 10mg/50ml 178 Nitrazepam Tablets 5mg 179 Nitrazepam Tablets 10mg 180 Nortriptyline Tablets 25mg 181 Nortriptyline Tablets 10 mg 182 Olanzapine Tablets 20mg 183 Olanzapine Tablets 2.5mg 184 Olanzapine Tablets 5mg 185 Olanzapine Tablets 7.5mg 186 Olanzapine Tablets 10mg 187 Olanzapine Injection 10mg/ml 188 Oxcarbamazepine Tablets 150mg 189 Oxcarbamazepine Tablets 300mg 190 Oxcarbamazepine Tablets 600mg 191 Oxcarbamazepine 300 mg Syrups 60 ml 192 Paracetamol Injection 150mg/2ml 193 Paracetamol Injection 500mg/50 ml 194 Paracetamol 10mg/ml (PLASTIC BOT ) Injection 1 gm/ 100 ml 195 Paracetamol + Tramadol Tablets 325mg+37.5mg 196 Paracetamol 10mg/ ml (GLASS BOT ) Injection 1 gm/ 100 ml 197 Paroxetine Tablets 12.5mg 198 Paroxetine Tablets 25mg 199 Paroxetine Tablets 37.5mg 200 Pergolide Tablets 0.05mg 201 Pergolide Tablets 0.25mg 202 Pergolide Tablets 1mg 203 Phenobarbitone Tablets 30mg 204 Phenobarbitone Tablets 60mg 205 Phenobarbitone Syrup 20mg/5ml 206 Phenobarbitone Injection 200mg /1ml 207 Phenytoin Sodium Tablets 50 mg 208 Phenytoin Sodium Tablets 100mg 209 Phenytoin Sodium Injection 25mg/ml 210 Phenytoin Sodium Liquids 100ml(25mg/ml) 211 Piperazine Tablets 500 mg 212 Piperazine Syrup 750mg/5ml 213 Piracetam Tablets 800mg 214 Piracetam Syrup 500mg/5ml 215 Praziquantel Tablets 600 mg 216 Pregabaline Tablets 50mg 217 Pregabaline Tablets 75mg 218 Pregabaline Tablets 150mg 219 Pregabaline + Amitriptyline Tablets 75mg+10mg 220 Pregabaline + Amitriptyline Tablets 50mg+10mg 221 Pregabaline + Nortriptyline Tablets 75 mg+10 mg 222 Pregabaline+Methylcobalamine Tablets 75mg+750mcg 223 Pregabaline+Methylcobalamine Tablets 50mg+1500mcg 224 Pregabaline+Methylcobalamine Tablets 75mg+500mcg 225 Pregabaline+Methylcobalamine Tablets 150mg+1500mc g 226 Quetiapine Fumarate Tablets 25mg 227 Quetiapine Fumarate Tablets 100mg 228 Risperidone Tablets 4mg 229 Risperidone Tablets 3mg 230 Risperidone Tablets 2mg 231 Risperidone Tablets 1mg 232 Risperidone Tablets 0.5mg 233 Sertraline HCL Tablets 25mg 234 Sertraline HCL Tablets 50mg 235 Sertraline HCL Tablets 100mg 236 Sildenafil Citrate Tablets 50mg 237 Sildenafil Citrate Tablets 25mg 238 Sodium Valproate Tablets 200mg 239 Sodium Valproate Syrup 200mg/5ml 240 Sodium Valproate Injection 100ml/5ml 241 Sodium Valproate Tablets 300mg 242 Sodium Valproate + Valproic Acid Tablets 300mg 243 Sodium Valproate + Valproic Acid Tablets 500mg 244 Sodium Valproate + Valproic Acid Tablets 200mg 245 Sumatriptan + Naproxen Tablets 85mg+500mg 246 Tolvaptan Tablets 15mg 247 Topiramate Tablets 25 mg 248 Topiramate Tablets 50 mg 249 Topiramate Tablets 100 mg 250 Trihexyphenidyl (Benzhexol) Tablets 2mg 251 Zaleplon Tablets 5mg 252 Zaleplon Tablets 10mg 253 Zidovudine Syrup 50mg/5ml 254 Zidovudine Tablets 100mg 255 Zidovudine Tablets 300mg 256 Zolpidem Tablets 10 mg 257 Zolpidem Tablets 5mg 258 Zolpidem SR Tablets 6.25mg 259 Zolpidem SR Tablets 12.5mg Calculation of Local Content Name of Manufacture Calculation by Manufacturer (Cost per unit of product) Cost Component Cost (Domestic Component) A Cost (Imported Component) B Total Cost (INR/ US $) C=a+b Percentage of Local Content D=(a/c)*100 I. ………… II. ………… III. Total Cost (Excluding tax and duties) Note:- I. Cost (Domestic Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken) which have not been imported directly or through a domestic trader or an intermediary. II. Cost (Imported Component): Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken). I S/o.D/o,W/o , Resident of That I will agree to abide by the terms and conditions of the policy of Government of India issued vide order no. P-45021/2/2017-B.E.-II dated 15/06/2017. That the information furnished hereinafter is correct to best of my knowledge and belief and I undertake to produce relevant records before the procuring entity or any authority so nominated by the Government of India for the purpose of assessing the local content. That the local content for all inputs which constitute the said drugs has been verified by me and I am responsible for the correctness of the claims made therein. That in the event of the domestic valve addition of the product mentioned herein is found to be incorrect and not meeting the prescribed valve-addition norms, based on Government of India for the purpose of assessing the local content, action will be taken against me as per Order No. P-45021/2/2017-B.E.-II dated 15.06.2017. I agree to maintain the following information in the Company‟s record for a period of 8 years and shall make this available for verification to any statutory authorities: i) Name and details of the Domestic Manufacturer (Registered Officer, Manufacturing unit location, nature of legal entity) ii) Date on which this certificate is issued. iii) Medicine for which the certificate is product. iv) Procuring entity to whom the certificate is furnished. v) Percentage of local content claimed. vi) Name and contact details of the unit of the manufacturer. vii) Sale Price of the product. viii) Ex-Factory Price of the product. ix) Freight, insurance and handling. x) Total Bill of Material. xi) List and total cost valve of inputs used for manufacture of the medicine certificates from suppliers, if the input is not in-house to be attached. xii) List and cost of inputs which and imported, directly or indirectly. (Also to be provided in PDF format)