Annexure - A

LIFE INSURANCE CORPORATION OF INDIA,
Divisional Office: Aurangabad,

Jeevan Prakash, Adalat Road
AURANGABAD - 431 005.
Terms and conditions for Empanelment of Vendor
1) The firm/Company/Vendor should be in profession for at least 3 years. (Copy of

registration certificate must be enclosed).
2) If the firm/Company/Vendor is/was on the approved panel of any reputed firms, Public
Sector or Government Undertaking, please attach copy of the same.
3) The firm/Company/Vendor should have a PAN of Income Tax Department and GST
Registration (If Applicable) and Registration with State and Local Authority for
undertaking the possession (copies of State Registration – Shop Establishment Act,
CST/BST/VAT Certificate, I. Tax Clearance Certificate, LBT Registration, PAN Card any
other to be enclosed).
4) The applicant should attach copy of Income Tax Returns for last 3 years.
5) Financial Balance Sheets and P&L account to be enclosed duly attested by Chartered
Accountant.
6) The Firm / Company/Vendor should keep sufficient stock in hand so as to comply with
urgent need without delay.
7) The Firm / Company/Vendor should furnish the specific brand or make. In case of
Authorized Dealer (copy of valid authorized dealership certificate must be enclosed).
8) The firm / Company/Vendor will be empanelled only after positive recommendation of
Committee/Authority, duly constituted to visit and inspect the premises / workshop etc. of
the applicants. Mere submission of Application for Empanelment does not confer the right
of Empanelment.
9) All applicants are required to affix the signature and seal of the Authorized official of the
Firm/company / Vendor on each page of Annexure-A and all enclosed papers.
10) The LIC has right to change the terms and conditions at any point of time.
11) Vendors must give their acceptance to the Terms & Conditions.
12) The completed Application form “Annexure A” and other Documents should be submitted
in Sealed envelope Super –Scribed as “Application for empanelment for Supply of (Category)
________, etc.”
The Manager (Sales),
LIC of India, “Jeevan Prakash”, Adalat Road, Aurangabad.431005
Please note that Separate Form in Annexure –A is required to be submitted.
Last date for receipt of duly completed Application is 24.07.2023 up to 5.30 pm
For any enquiry/Clarifications you may contact during Office Hours on Tel No. (0240)
2344520/2344342.
13) NEFT/RTGS Particulars to be submitted by the Applicant for direct payment to
Beneficiary Account against the Bill Payment.
Page-II
14) The Duration for the Empanelment will be for Period of Two(2) years from the date of
Empanelment
15) At any point of time, If any of the documents furnished by the Applicants are found to be
incorrect or false, It would be deemed to be breach of terms of contract making the firm
concerned liable for legal action besides termination of Empanelment.
16) Incomplete and conditional Applications will be rejected
17) CC Deptt of Divisional Office will call quotations with the selected empanelled vendor as
per requirement and specification.
18) Sending and acknowledgement of the receipt of work order, which is taken as an
acceptance of the work order, is mandatory preferably by email.
19) The supply of printing material should be delivered as per the time frame agreed upon
while taking the work order.
20) The supply should be free of freight charges and according to the instruction given by us.
21) Each and every supply should be accompanied by a delivery challan clearly bearing the
details of the items and titles in supply, their quantity and price.
22) If the Empanelled Vendors/Distributors/suppliers to whom the order has been place fails
to supply the entire order or any part of the order within the stipulated time or as per
specifications, without sending any written communication to the concerned office
regarding delay or its inability to supply the ordered items, the Office reserved the right to
impose penalty of 1% of the work order amount per week subject to maximum of 5%.
23) Thereafter, LIC of India (concerned Office) reserved the right to cancel the order and
place the empanelled Vendors/Distributors/suppliers in its black list after providing them
an opportunity to represent their side.
24) The decision of accepting supply of cancelled orders is at the sole discretion of,
Sr. Divisional Manager and the decision of the Competent Authority shall be final in this
regard.
25) A Vendor‘s empanelment may be Terminated/Dropped/Blacklisted from the panel of
suppliers at the occurrence of any of the following event.
a) LIC of India shall be at liberty to terminate the empanelment of the vendor/supplier

without any prior notice and also reserves the right to claim the amount of loss incurred by
the LIC of India, based on the available invoices submitted by that empanelled
Vendors/Distributors/Suppliers due to breach of any terms of agreement or unsatisfactory/
inefficient working on the part of the Vendors/Distributors/Suppliers.
b) If at any time, found that the information provided by the empanelled vendor in any
form, service and related matters are incorrect and result in losses in any form to LIC of
India.
Senior Divisional Manager.
Page-III
LIFE INSURANCE CORPORATION OF INDIA

Divisional Office Aurangabad,
Jeevan Prakash, Adalat Road,
AURANGABAD - 431 005.
Application Form for Empanelment for (Gift Articles/Prizes/ Trophies & Shields) etc.
Annexure - A
SL Information sought Information provided
1 Name of the Vendor/ Firm
(In Block Letters)
2 Date of Establishment / Incorporation/
3 Correspondence address
and Telephone no. /Contact No. with Mail ID
4 Address of Head Office (If separate) and Tel. No. / Mob. No.
5 Address of local office (at Aurangabad) with Tel. & Mob. No.
6 Status: Proprietary/Partnership/Private Limited Company/ Public
Limited Company.
7 Names of the Partners/ Directors and their Contact/Mob. No.
8 Name of Chief Executive with his present addresses and
Tel.No./ Mob. No.
9 Name of Representative (s) with Designation who would be
calling on us and attending to our job.
10 Name of Bankers with addresses & Tel.No.
11 Is the Firm is registered under the Factory Act? If so, state

a) License No.
b) Date of last renewal of license (copy of license enclosed)
c) PAN.NO (Attach self signed Copy)
d) TAN No./ESIS NO If Nay
e) EPF Registration No. if any.
f) VAT No./Sales Tax No./Service Tax No./ GST
Registration Number/ Any Other Registration no If Any
12 Whether the firm is registered under MSME, order 2012.
If yes please enclose Certificate.
If the owner is from SC/ST Category enclose Caste Certificate.
13 Whether holding certificate under Shops & Establishment Act,
duly Renewed ( copy should be enclosed)
14 State the latest Income Tax Assessed year and the amount of Tax
assessed (copies of last 3 years, IT Returns, Balance Sheets &
Revenue A/c to be enclosed)
15 Turn over for last three Financial Years.
F.Y. 2015-16, 2016-17,2017-18
16 List of Reputed firms, Public Sector, Government undertakings

where you have been empanelled.
17 Are you agreeable to make Deliveries to Corporation’s Offices
within and out of Aurangabad when so directed?
18 Are you agreeable to abide strictly by the Terms and Conditions
of the Tender and Contracts?
19 If your firm is empanelled with any office of LIC of India.
20 Name, Addresses and Tel.No. of some of your most valued
clients ( separate list may be attached).
21 Approximate value of your output per year.
22 Mention if any other specialties of your Establishment.
23 Are You agree to deliver items to All Our Office Located in
Aurangabad/Beed/ Latur/Osmanabad District or as per our
Instructions
Note: Please type this form or fill it legibly in ink. If space provided is insufficient, please type or write the
replies on a separate sheet giving appropriate question number and attach it to the form with proper
authentication.
I/We _______________________________________ Address ____________________
Mobile No.________________ Mail ID_______________________________________________
Request Life Insurance Corporation of India, Divisional Office, “Jeevan Prakash”, Adalat Road, Aurangabad to
consider/ inclusion of my /our firm/company name in the list of approved firms / suppliers / Vendors for Supply
of ____________________________________________________________________________________ etc.
I/WE We agree to abide by all the Rules and Regulations framed by the LIC Of India from time to time & give
full satisfaction to the Corporation in the event of their doing so.
I/WE have read all the terms conditions for empanelment carefully and have understood the contents.
Dated at __________________this___________day of _______________2023.
Signature & Seal of Applicant/Authorized Signatory

Designation:
All the pages of application form and documents must be signed with seal.
Note-
1. Firms/Suppliers/Vendors who are on Divisional Office existing panel should also apply for fresh
empanelment.
2. Firms/Suppliers/Vendors who have been blacklisted / removed earlier by any office of the LIC of India,
should not apply. If applied, their application will not be considered.
3. If any query please get clarification from office before submission of application form.
Note- Eligibility criteria for availing benefits under the Public Procurement Policy:
4. “Those who are willing to get benefit under the Public Procurement Policy for Micro & Small Medium
Enterprises (MSME), Order 2012 “,. It is necessary for the enterprise to be registered with the Director
of Industries acknowledgement of Entrepreneurs memorandum (Part-II) OR are registered with
National Small Industries Corporation (NSIC) under Single point vendor registration scheme. The
relevant copy of the Certificate must be enclosed.
Apart from the benefit given to MSMEs such as issue of Tender Sets free of cost and exemption for payment of
EMD, the Vendors who are registered with NSIC under Single point registration Scheme will additionally be
exempted from submitting the Security Deposit up to be monetary limit for which the unit is registered. Please
submit sealed envelope to the given address.

Annexure - A

Uploaded by

Copyright:

Available Formats

Annexure - A

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Annexure - A

Uploaded by

Copyright:

Available Formats

LIFE INSURANCE CORPORATION OF INDIA,

Divisional Office: Aurangabad,

Terms and conditions for Empanelment of Vendor

1) The firm/Company/Vendor should be in profession for at least 3 years. (Copy of

a) LIC of India shall be at liberty to terminate the empanelment of the vendor/supplier

Senior Divisional Manager.

LIFE INSURANCE CORPORATION OF INDIA

and Telephone no. /Contact No. with Mail ID

11 Is the Firm is registered under the Factory Act? If so, state

16 List of Reputed firms, Public Sector, Government undertakings

I/We ___________________ Address

Mobile No. Mail ID_______________________________

Dated at ____________this_day of ___________2023.

Signature & Seal of Applicant/Authorized Signatory

You might also like

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.