Odisha Livelihoods Mission

Panchayati Raj Department

Government of

EOI NO: OLM/NRLP/16-17/ 09 Dated:23.03.2017

REQUEST FOR EXPRESSION OF INTEREST (CONSULTING SERVICES– FIRMS SELECTION) Odisha Livelihoods Mission National Rural Livelihoods Project (NRLP) Credit No: 4978. IN Assignment Title: “hiring of CA Firm to conduct GPLF (Gram Panchayat Level Federation) Statutory Audit in 3 different Zone”

1. The Government of India has availed a credit from International Development Association (IDA), towards the National Rural Livelihoods Project which aims to support the National Rural Livelihoods Mission under the Ministry of Rural Development, Government of India; and intends to apply part of the loan proceeds to make payments under the contract for the following services:

The consulting services conduct GPLF (Gram Panchayat Level Federation) Statutory Audit in 3 different Zone” ”) include following; 2. Background. Odisha Livelihoods Mission (OLM) is a registered society working under the Panchayati Raj Dept. of Govt. of Odisha for enhancing the socio-economic condition of the rural poor through promotion of sustainable livelihoods. The society is implementing the centrally sponsored scheme of Govt. of India called “National Rural Livelihoods Mission” (NRLM). The scheme aim at enhancing social and economic status of the rural poor through development of self-sustained and community managed institutions. The main focus of project activities will be on strengthening SHGs and promoting sustainable and inclusive federation at the GP level. The project will also invest in building the capacity of public and private agencies for the promotion of a range of social and economic service delivery for these institutions of the poor. 3. Objectives: 1. Enable the auditor to express an independent opinion as to whether GPLFs are being formed as per OLM guidelines and they are operating properly as per the standard operating procedures. 2. Enable the auditor to express a professional opinion on the annual financial statement of GPLF; these would include receipt and Payment account, income and expenditure account, balance sheet, bank reconciliation statement, statement of expenditure and utilization of concerned GPLF. 3. Comment on the effectiveness of the overall financial management arrangements including the system of internal controls as documented in the fund management guidelines, MOU’s and various guidelines for specific funds. 4. Specific opinion that the grant from the project has been used for the intended purpose and bring to the projects attention any fraud related issues and activities including diversion of funds from intended purpose or misuse of funds. 5. Comment on the effectives of internal control and internal check.

SIRD Campus, Unit VIII, 751012, Odisha Tel: 0674 2560169, Mail: [email protected]/[email protected]

Odisha Livelihoods Mission

Panchayati Raj Department

Government of Odisha

4. Scope/ Deliverables: Initial Age of GP. collection of Component wise fund transferred to the GP (CIF, Livelihoods fund, IB and information startup fund etc). about the GP Utilization certificate submitted to BMMU Comment on Ensure that GPLFs are conducting regular meeting of GB, RGB, EC and Sub- performance committee. (Frequency of meeting of GB, RGB, EC and Sub-committee are of GP annually, half yearly, monthly and monthly respectively) Verify whether regular saving, lending and repayments are followed by GPLFs. Ascertain the quantum of lending to SHG out of the funds given to that GPLF. Ascertain whether loan has been disbursed as per approved MIP, based on the priority of needs. Ensure that the loans given to members are utilized properly. Ascertain whether CRP/MBK/Bank Mitra are placed and getting their remuneration regularly. Report of any other innovative work taken by the GPLF on discussion with Executive Committee.

Maintenance of Books of Accounts Ascertain whether proper books of accounts have been maintained (A check list have been prepared which may be refereed, Checklist to be signed by GPLF office bearer) Vouching Verification of cash book, pass book & cheque issue register. Verification of payment details with supporting vouchers. All expenditure made must have been passed for payment in minutes book. Grant received from BMMU has been utilized under the head for which it was Verification of sanctioned and as per the approved conditions. Books of Whether procurement procedures have been followed. (whether procured Accounts and from lowest quoted supplier, budget, community procurement manual) records. Whether loan recovered (Both principal and interest) with in prescribed time

limit. Whether expenditure as mentioned in the cash book is in conformity with the UC submitted to BMMU. Last but not least, audit has to verify any fraud, deviation from standard operating procedure etc. Preparation of Financial Statement Receipt & Payment Account Income and expenditure Account Balance sheet

SIRD Campus, Unit VIII, Bhubaneswar 751012, Odisha Tel: 0674 2560169, Mail: [email protected]/[email protected]

Odisha Livelihoods Mission

Panchayati Raj Department

Government of Odisha

Others The auditor may prepare a management letter (GPLF wise and Zone wise) containing recommendations for improvement in internal control and other matters coming to the attention of the auditor during the audit examination, possibly including the following matters; Observations on the accounting systems and controls that were examined during the course of audit. Deficiencies and weakness in the systems and controls, together with specific recommendations for improvement. Compliances with financial covenants. Matters that might have significant impact on the implementation of the project. Any other matter that the auditor consider pertinent.

5. Eligibility: Only firms fulfilling the following conditions may apply:-

1) A Chartered Accountant firm based at Odisha and on the approved panel of Comptroller and Auditor General of India (CAG of India) of the year 2016-2017. 2) Last three years average annual turnover of the firm should not be less than Rs.20.00 lakhs. (proof of turnover to be attached and service tax return to be submitted) 3) The firm or any partner of the firm should not have been black listed by any Government or any other organization in respect of any assignment or behaviour. Authorized signatory(s) of the firm shall submit an undertaking to this effect.( Annexure-4) 4) The firm should have on team leader / audit partner with at least 5 years of post qualification experience in external audit and four teams comprising of following personnel in each team. 1. One semi qualified auditor(CA Inter) and 2. One support staff 5) The Chartered Accountant firm having statutory/ concurrent audit experience of at least one externally aided project in Odisha. Having more any externally aide projects shall be given preferences. 6) The firm must have conducted statutory/ concurrent audit of at least 5 Nos assignment in Government sector. The preference shall be given to the firm having more assignments. Each assignment value below Rs.5.00 lakhs shall not be considered. 7) One firm can apply for the entire three Zone, however only one zone will be allotted to one firm on the basis of lowest bidding firm. 8) Preference shall be given to the firm having branch office in the applied zone. 9) The firm shall submit relevant documents duly signed by the authorized signatory, in support of the eligible criteria given above. (Check list of documents to be submitted is given in Annexure-2). 10) The firm already been assigned for Statutory Audit/Internal Audit/concurrent Audit in SMMU, Odisha Livelihoods Mission shall not be considered for this assignment.

SIRD Campus, Unit VIII, Bhubaneswar 751012, Odisha Tel: 0674 2560169, Mail: [email protected]/[email protected]

Odisha Livelihoods Mission

Panchayati Raj Department

Government of Odisha

i) A firm shall meet all the minimum eligibility criteria otherwise their proposal shall not be considered for further evaluation. ii) Incomplete assignments or ongoing assignments shall not be considered.

6. The Odisha Livelihoods Mission (OLM) now invites eligible CA firms to indicate their interest in providing the Services. Interested Firms should provide information demonstrating that they have the required qualifications and relevant experience to perform the Services in the prescribed format at Annexure-1.

7. Period of Contract: The audit shall be completed within three months from the date of Commencement 8. "The attention of interested Consultants is drawn to paragraph 1.9 of the World Bank’s Guidelines: Selection and Employment of Consultants [under IBRD Loans and IDA Credits & Grants] by World Bank Borrowers “Consultants Selection Guidelines of the World Bank dated January 2011” (“Consultant Guidelines”), setting forth the World Bank’s policy on conflict of interest. " "The Guidelines are available at www.worldbank.org/procurement."

9. Joint Venture firm shall not considered for the assignment.

10. Firm will be selected in accordance with the Least Cost Selection (LCS) method set out in the Consultant Guidelines ( NRLM Procurement Manual)

11. Further information can be obtained at the address below during office hours i.e. 10.00 to 17.00 hours and the details ToR and NRLM Procurement Manual can be seen and downloaded in OLM website www.olm.nic.in

12. In case of any Addendum/Clarification/Corrigendum/Extension regarding this EOI, the same will be published in the above websites only.

13. Expressions of interest in sealed envelope must be delivered in a written form to the address below (in person, or by post ) latest by 10.04.2017 ,17.00 Hours (IST). The interested firm must submit the EOI proposal separately for 3 different zones.

State Mission Director-Cum-CEO Odisha Livelihoods Mission (OLM) SIRD Campus, Unit-8, Bhubaneswar Contact Person- Goutam Mohanty Manager (Procurement),0674-2560169

Sd/- State Mission Director-Cum-CEO

SIRD Campus, Unit VIII, Bhubaneswar 751012, Odisha Tel: 0674 2560169, Mail: [email protected]/[email protected] Terms of Reference For hiring of agencies to conduct GPLF (Gram Panchayat Level Federation) Statutory Audit in 3 different Zones

Introduction Odisha Livelihoods Mission (OLM) is a registered society working under the Panchayati Raj Dept. of Govt. of Odisha for enhancing the socio-economic condition of the rural poor through promotion of sustainable livelihoods. The society is implementing the centrally sponsored scheme of Govt. of India called “National Rural Livelihoods Mission” (NRLM). The scheme aim at enhancing social and economic status of the rural poor through development of self- sustained and community managed institutions. The main focus of project activities will be on strengthening SHGs and promoting sustainable and inclusive federation at the GP level. The project will also invest in building the capacity of public and private agencies for the promotion of a range of social and economic service delivery for these institutions of the poor. The key components of the project are:

(1) Community institution building, which improves the capacity of the community based organizations of the poor and vulnerable in management of their own institutions and livelihood activities; (2) Community Investment Fund, which helps households plan and meet their credit demands for household and investment plans; (3) Livelihood Fund, which increase the share of the poor in the value chain leading to enhanced incomes; and (4) Implementation support and monitoring, which supports effective project and knowledge management. The state project management unit (SPMU) is responsible for overall management, coordination and implementation of the project. The district project unit based at the district head quarter shall be the nodal agency for project execution. At the block level the facilitation team shall provide necessary techno managerial support services for effective implementation of the project. The federation of the SHGs at the Panchayat Level Federation (GPLF) is a single unit and cluster level forum (CLF) at village level consisting of 5-15 SHGs are the key stake holders of the project who will be responsible for planning, implementation & evaluation of the project activity from time to time with due support of Block Level Facilitation Team (BLFT). The project presence is in all 30 districts of Odisha. GPLFs are enabled to manage and govern their institutions and its need of the hour to streamline their financial management system at institutional level. The project is planning to support GPLFs by hiring three auditing firm for conducting statutory external audit of GPLFs.

A: Objective:

1. Enable the auditor to express an independent opinion as to whether GPLFs are being formed as per OLM guidelines and they are operating properly as per the standard operating procedures. 2. Enable the auditor to express a professional opinion on the annual financial statement of GPLF; these would include receipt and Payment account, income and expenditure account, balance sheet, bank reconciliation statement, statement of expenditure and utilization of concerned GPLF. 3. Comment on the effectiveness of the overall financial management arrangements including the system of internal controls as documented in the fund management guidelines, MOU’s and various guidelines for specific funds. 4. Specific opinion that the grant from the project has been used for the intended purpose and bring to the projects attention any fraud related issues and activities including diversion of funds from intended purpose or misuse of funds. 5. Comment on the effectives of internal control and internal check.

B: Audit Standard

The audit shall be carried out in accordance with the “Standards on Audit” promulgated by the Institute of Chartered Accountants of India. The auditor should accordingly consider methodology when planning and performing the audit to reduce audit risk to an acceptable level that is consistent with the objective of audit. Although the responsibility for preventing irregularity, fraud or the use of fund for the intended purpose remains with the mission, the audit should be carried out in such a way that a clear opinion can be formed regarding any material misstatement in the mission financial statement.

C: Audit Scope:

Initial collection of  Age of GP. information about the GP  Component wise fund transferred to the GP (CIF, Livelihoods fund, IB and startup fund etc).  Utilization certificate submitted to BMMU Comment on performance of  Ensure that GPLFs are conducting regular meeting of GB, RGB, GP EC and Sub-committee. (Frequency of meeting of GB, RGB, EC and Sub-committee are annually, half yearly, monthly and monthly respectively)  Verify whether regular saving, lending and repayments are followed by GPLFs.  Ascertain the quantum of lending to SHG out of the funds given to that GPLF.  Ascertain whether loan has been disbursed as per approved MIP, based on the priority of needs.  Ensure that the loans given to members are utilized properly.  Ascertain whether CRP/MBK/Bank Mitra are placed and getting their remuneration regularly.  Report of any other innovative work taken by the GPLF on discussion with Executive Committee. Maintenance of Books of Accounts Ascertain whether proper books of accounts have been maintained (A check list have been prepared which may be refereed, Checklist to be signed by GPLF office bearer) Vouching  Verification of cash book, pass book & cheque issue register.  Verification of payment details with supporting vouchers.  All expenditure made must have been passed for payment in minutes book.  Grant received from BMMU has been utilized under the head Verification of Books of for which it was sanctioned and as per the approved conditions. Accounts and records.  Whether procurement procedures have been followed. (whether procured from lowest quoted supplier, budget, community procurement manual)  Whether loan recovered (Both principal and interest) with in prescribed time limit.  Whether expenditure as mentioned in the cash book is in conformity with the UC submitted to BMMU.  Last but not least, audit has to verify any fraud, deviation from standard operating procedure etc. Preparation of Financial Statement  Receipt & Payment Account  Income and expenditure Account  Balance sheet Others  The auditor may prepare a management letter (GPLF wise and Zone wise) containing recommendations for improvement in internal control and other matters coming to the attention of the auditor during the audit examination, possibly including the following matters; 1. Observations on the accounting systems and controls that were examined during the course of audit. 2. Deficiencies and weakness in the systems and controls, together with specific recommendations for improvement. 3. Compliances with financial covenants. 4. Matters that might have significant impact on the implementation of the project. 5. Any other matter that the auditor consider pertinent. D: Details procedures to be followed during audit During the course of GPLF audit, if the auditor notices any defalcations or misappropriation of fund, the auditor shall immediately bring the fact to the notice of the block and District office for necessary action. E: Deliverables and reporting: Before submission of final report, the audit report and finding may be discussed with the auditable units including president and secretary of the GPLF and their views are obtained and discussions are recorded in the minutes of that GPLF. The report should be structured in a manner giving observations, the implications of the observations, recommendations and the management comments and agreed actions. The audit observation should be supported by instances and quantified, as far as practicable. 1. Filled in check list of performance audit of GPLF. 2. Filled in check list on maintenance of books of accounts. 3. Individual audit report 4. Annual Financial statement 5. Observations on audit and final reporting. E: Division of Zone For timely completion of audit, 20 districts covered under audit have been divided into 3 zones keeping on view the geographical distribution. (Annexure-1) F: Audit period to be covered The audit of GPLF will be for the period from the date of incorporation by funding start up fund from the project of GPLF to 31st March 2017. F: Time Schedule The audit shall be completed within three months from the date of Commencement.. G: Audit Fee The minimum audit fee shall be Rs.2000/- per GPLF per year which will be asked during RFP ( Request For Proposal ) stage. H: Eligibility Criteria/Evaluation criteria The auditing firm shall fulfill the following minimum eligibility criteria: 1) A Chartered Accountant firm based at Odisha and on the approved panel of Comptroller and Auditor General of India (CAG of India) of the year 2016-2017. 2) Last three years average annual turnover of the firm should not be less than Rs.20.00 lakhs. (proof of turnover to be attached and service tax return to be submitted) 3) The firm or any partner of the firm should not have been black listed by any Government or any other organization in respect of any assignment or behavior. Authorized signatory(s) of the firm shall submit an undertaking to this effect.( Annexure-4) 4) The firm should have on team leader / audit partner with at least 5 years of post qualification experience in external audit and four teams comprising of following personnel in each team. 1. One semi qualified auditor(CA Inter) and 2. One support staff 5) The Chartered Accountant firm having statutory/ concurrent audit experience of at least one externally aided project in Odisha. Having more any externally aide projects shall be given preferences. 6) The firm must have conducted statutory/ concurrent audit of at least 5 Nos assignment in Government sector. The preference shall be given to the firm having more assignments. Each assignment value below Rs.5.00 lakhs shall not be considered. 7) One firm can apply for the entire three Zone, however only one zone will be allotted to one firm on the basis of lowest bidding firm. 8) Preference shall be given to the firm having branch office in the applied zone. 9) The firm shall submit relevant documents duly signed by the authorized signatory, in support of the eligible criteria given above. (Check list of documents to be submitted is given in Annexure-2). 10) The firm already been assigned for Statutory Audit/Internal Audit/concurrent Audit in SMMU, Odisha Livelihoods Mission shall not be considered for this assignment. 11) Joint venture firm shall be not be considered for the assignment.

i) A firm shall meet all the minimum eligibility criteria otherwise their proposal shall not be considered for further evaluation. ii) Incomplete assignments or ongoing assignments shall not be considered. I. Reporting The firms will submit its report to SMD-Cum-CEO, Odisha Livelihoods Mission, Panchayati Raj Department, Government of Odisha. Further the bidder is required to submit the soft copy of the report written in a CD to Odisha Livelihoods Mission. J. Payment Schedule On signing of contract and completion 50% report of atleast 3 district in the prescribed format Rest Final District Report Submission in 50% the prescribed format.

Annexure-1

Segregation of Zone Nos South Name of District Total No of GPLF Malkanagiri 44 Koraput 58 Gajapati 56 Rayagada 48 Nabarangapur 1 Kalahandi 12 Total GPs 219 Central 10 Balangir 32 Kandhamal 51 Ganjam 95 Bargarh 1 Sonepur 12 Boudh 2 Jharsuguda 2 Total GPs 205 North Sambalpur 72 Sundargarh 49 Deogarh 60 Dhenkanal 2 Keonjhar 5 Mayurbhanj 61 Total GPs 249

Equivalent Intensive/Non District Block GPLFs 2013-14 2014-15 2015-16 2016-17 Total number of Intensive Years

Bargarh Bhatli 1 Non Intensive 0 0 1 1 1

Bolangir Bongamunda 14 Intensive 0 6 0 8 14 26

Bolangir Muribahal 14 Intensive 0 6 0 8 14 26

Bolangir Saintala 3 Non Intensive 0 0 0 3 3 3

Bolangir Deogaon 1 Non Intensive 0 0 0 1 1 1

Boudh Harbhanga 2 Intensive 0 0 2 2 2

Deogarh Barkot 22 Intensive 8 6 0 8 22 58

Deogarh Tileibani 16 Intensive 6 6 0 4 16 46

Deogarh Reamal 22 Intensive 0 6 0 16 22 34

Dhenkanal Kankadahad 2 Intensive 0 0 2 2 2

Gajapati Nuagarh 14 Intensive 6 6 0 2 14 44

Gajapati Rayagada 16 Intensive 6 6 0 4 16 46

Gajapati R.Udaygiri 13 Intensive 0 13 0 0 13 39

Gajapati Guma 11 Intensive 0 6 0 5 11 23

Gajapati Mohana 2 Intensive 0 0 2 2 2

Ganjam Beguniapada 14 Intensive 0 14 0 0 14 42

Ganjam Patrapur 14 Intensive 6 6 0 2 14 44

Ganjam Sorada 14 Intensive 0 12 2 0 14 40

Ganjam Shergarh 6 Intensive 0 6 0 0 6 18

Ganjam Chhatrapur 14 Intensive 0 6 0 8 14 26

Ganjam Ganjam 8 Intensive 0 6 0 2 8 20

Ganjam Chikiti 8 Intensive 0 6 0 2 8 20

Ganjam Rengeilunda 10 Intensive 0 6 0 4 10 22

Ganjam Khallikote 7 Intensive 0 6 0 1 7 19

Jharsuguda Kirmira 2 Intensive 0 0 2 2 2

Kalahandi Thuamulrampur 10 Intensive 0 6 0 4 10 22

Kalahandi Langigarh 1 Intensive 0 0 1 1 1

Kalahandi M.Rampur 1 Intensive 0 0 1 1 1

Kandhamal Baliguda 14 Intensive 0 12 0 2 14 38

Kandhamal Chakapad 11 Intensive 6 5 0 0 11 39

Kandhamal Daringibadi 15 Intensive 6 7 0 2 15 47

Kandhamal Phulbani 8 Intensive 0 6 0 2 8 20 Kandhamal Kotagarh 2 Intensive 0 0 2 2 2

Kandhamal Khajuripada 1 Non Intensive 0 0 1 1 1

Keonjhar Bansapal 2 Intensive 0 0 2 2 2

Keonjhar Telkoi 2 Intensive 0 0 2 2 2

Keonjhar Ghasipura 1 Non Intensive 0 0 1 1 1

Koraput Boriguma 18 Intensive 6 8 0 4 18 52

Koraput Kotpad 15 Intensive 6 6 0 3 15 45

Koraput Laxmipur 13 Intensive 6 7 0 0 13 45

Koraput Koraput 9 Intensive 0 6 0 3 9 21

Koraput Boipariguda 2 Intensive 0 0 2 2 2

Koraput Semiliguda 1 Non Intensive 0 1 0 1 2

Makangiri Khariput 9 Intensive 6 3 0 0 9 33

Makangiri Kudmulguma 11 Intensive 6 5 0 0 11 39

Makangiri Malkangiri 13 Intensive 6 7 0 0 13 45

Makangiri Matheli 11 Intensive 0 6 0 5 11 23

Mayurbhanj Bangiriposi 14 Intensive 0 12 0 2 14 38

Mayurbhanj Jashipur 14 Intensive 6 0 6 2 14 38

Mayurbhanj Kusumi 12 Intensive 0 12 0 0 12 36

Mayurbhanj Morada 13 Intensive 0 12 0 1 13 37

Mayurbhanj Karanjia 7 Intensive 0 6 0 1 7 19

Mayurbhanj Tiring 1 Intensive 0 0 1 1 1

Nabarangpur Umerkote 1 Intensive 0 0 1 1 1

Rayagada Chandrapur 7 Intensive 7 0 0 0 7 28

Rayagada Kasipur 14 Intensive 6 6 0 2 14 44

Rayagada Muniguda 14 Intensive 0 12 0 2 14 38

Rayagada Bisam cuttack 11 Intensive 0 6 0 5 11 23

Rayagada Kalyansinghpur 2 Intensive 0 0 2 2 2

Sambalpur Bamra 17 Intensive 0 12 0 5 17 41

Sambalpur Jamankira 21 Intensive 0 12 0 9 21 45

Sambalpur Kuchinda 17 Intensive 0 12 0 5 17 41

Sambalpur Jujumura 17 Intensive 0 6 0 11 17 29

Sonepur Tarava 10 Intensive 0 6 0 4 10 22

Sonepur Birmaharajpur 2 Intensive 0 0 2 2 2

Sundargarh Boneigarh 13 Intensive 13 0 0 0 13 52

Sundargarh Kuanrmund 14 Intensive 12 0 0 2 14 50 Sundargarh Tangarpalli 13 Intensive 13 0 0 0 13 52

Sundargarh Balisankara 8 Intensive 0 6 0 2 8 20

Sundargarh Gurundia 1 Intensive 0 0 1 1 1

Nuapada Sinapali 8 Intensive 0 6 0 2 8 20

Nuapada Nuapada 2 Intensive 0 0 2 2 2

673 137 339 9 188 673 1771 No of Years to be 4 3 2 1 audited Equivalent no of Years to be 548 1017 18 188 1771 audited South Zone Central Zone North Zone No of Equivalent Name of No of Equivalent Name of No of Equivalent Name of District GPLF No of Years District GPLF No of Years District GPLF No of Years Malkanagiri 44 140 Kalahandi 12 24 Jharsuguda 2 2 Koraput 58 167 Nuapada 10 22 Bargarh 1 1 Gajapati 56 154 Balangir 32 56 Sambalpur 72 156 Rayagada 48 135 Kandhamal 51 147 Sundargarh 49 175 Nabarangapu r 1 1 Ganjam 95 251 Deogarh 60 138 Sonepur 12 24 Dhenkanal 2 2 Boudh 2 2 Keonjhar 5 5 Mayurbhanj 61 169 Total GPs 207 597 Total GPs 214 526 Total GPs 252 648

Annexure-2

Check list for submission of documents

Sl Description Yes/No Remarks

No

1 Copy of CAG empanelled Certificate

2 Certificate of Establishment of Firm

3 Undertaking by authorized signatory.

Last three year Financial statement in support of Turnover 4 achieved (2013-14, 2014-15 and 2015-16)

Last two half yearly service tax return(for the half yearly 5 ending 31st March 2016 and 30th September 2016)

6 Certificate that the firm have not been black listed.

7 Proof of address of branch office in the applied zone if any

Experience of government audit and externally aided 8 project.

Annexure-3

Name of the Assignment:

Date of advertisement:

A – Consultant’s Profile

1. Name of the Organization

2. Postal Address

3. Telephone: Mobile /

Fax/ E-mail/ Website;

4. Contact Person name and

designation with contract details

5 Registration Details: Provide copy of the registration certificate, PAN , Board of

Registered on (Date) Directors, Executive Committee Members, General Body

Legal status ( for profit members, brief profile and latest annual report company; not for profit company; registered trust;

registered trust; others (specify)

6. Details of Branch State/Location of Name of the partners

Offices (provide details of branch offices if any). office

7. Financial Capacity: Provide the turnover of organization (on the basis of the

audited accounts) in the last three financial years in Indian

Average Annual Turnover of

Rupees. consultant must be more than Rs.20 lakh annual turn over

during each year in last three financial years.

(Enclose Audited financial reports).

2015-16 2014-15 2013-14 Total

B- Consultant’s Experience

Name of the Name of the Duration of Assignment and Status as on June 2016 Value of Project Client Contract( in INR) Effective date of Closure date Date of Whether original of contract acceptance of contract contract final closed or not deliverables by the Client

Signature of the authorised representative.

Annexure -4

Declaration Date:……………. To whom so ever it may be concern

I/We hereby solemnly take oath that I/We am/are authorized signatory in the firms/ Agency/ Institute/ Company and hereby declare that "Our firms/ Agency/ Institute/ Company do not face any sanction or any pending disciplinary action from any authority against our firms/ Agency/ Institute/ Company or partners." Further, it is also certified that our firm has not been blacklisted by any government or any other donor/partner organization in past.

In case of any further changes which affect of this declaration at a later date; we would inform the mission accordingly.

Authorized Signatory

(with seal)