Annex XI
Annex XI
Annex XI
Category of Registration
GENERAL INFORMATION:
Name
Head Office/Registered Office:
Address/ City/ State/Pin Code
Telephone
Fax
E-Mail
Telephone
Fax
E-Mail
PAN No.
Central Sales Tax No.
VAT TIN No.
PF Registration No.
Service Tax Registration No.
ESIC Registration No. .
Pre-Qualification Questionnaire
1 Nature of past jobs done Exactly same as applied for
/ similar to what applied for
2 Value of atleast one single job done during Yes / No
lasts years is greater than 70% of the class
upper limit applied for
3 Total turnover of the past 3 years is atleast Yes / No
equal to the upper limit of class applied for
4 The maximum value of similar work done in Rs.
the past three years.
5 The minimum value of works that you shall Rs.
be interested in.
6 Does your organization follow any quality Yes / No
plans / programs?
7 Does your organization have laid down any Yes / No
safety policy?
8 Does your organization have ISO/ISRS Yes / No
Certification
Past Performance
1. Details of works Furnish the Work Order Copy & Completion Certificate
executed during (For a few jobs against each category for which
last 3 years. registration is sought)
2. Details of works Furnish the Work Order Copies for a few jobs
in progress
3. Time schedule Furnish status with respect to contractual completion
period.
4. Detail of any works executed in the past for ONGC ?
Order No.
Name of Work :
Value:
Balance Sheet
2. Maximum Value of similar Past Works: (In the order of highest value
first)
Organization Details
Constitution:
Type of Organization Document to be enclosed
(Strike out those not
applicable)
Sole Proprietorship Registration Certificate
Partnership Partnership deed
Private Ltd. Prospectus, Memorandum of Association, Articles of
Association
Public Sector/Public Ltd. Prospectus, Memorandum of Association, Articles of
Association
Manpower Employed:
Sr. No. Particulars Nos. Documents
Submitted
1. Total no. in permanent
employment
2. Number of Graduate / Diploma
Engineers
3. Nos. in Safety/Inspn./QC
4. Others
5. For Electrical Contractors, whether the
applicant possesses:
- Valid Electrical Licenses
For LT / HT Works?
- Valid Electrical
Contractors License
- Valid Electrical
Supervisor License
Nos. of Licensed Electricians
Financial Details
Banker’s Details:
Name
Branch
Address / City / State
Pin code
PLACE :__________________
DATE :___________________