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Draft #63 of File DPMSU-KLM/194/ABMO/2017/DPMSU Approved by District Program Manager on 08-Jul-2020 03:16 PM - Page 17
Draft #63 of File DPMSU-KLM/194/ABMO/2017/DPMSU Approved by District Program Manager on 08-Jul-2020 03:16 PM - Page 18
Date: Place: NHM.the 5 4 3 2 1 RBSK 5 4 3 2 1 Vehicle DPM
Sl. No.
2 1 5 4 3
I hereby agreeprovide to the vehicles as per the terms & conditions mentioned in this tender by
Vehicles should be attached) be should Vehicles ofthe details other and Books ofthe RC (Copies bybidder the No. owned of taxis / Vehicles Total If any certificate), performance ofthe copy (Attach etc Firms Pvt. / agencies /rental Companies / PSU theGovt. from Experience Proof) any(attach Tax Service ______and years Returns ofassessment IT and Proof), (Attach Number(PAN) Account Permanent Tax Income No.) Mobile & No. (Land ofBidder ContactNo. E Address, Name, - Mail ID & ID Mail
QUOTATION FORM FORVEHICLES AIRQUOTATION CONDITIONED FORM DIESEL
Make NATIONAL HEALTH MISSION (NHM), KOLLAM Particulars Registration number, if number, Registration
I Annexure
Capacity Technical Bid (Cover A) (Cover Bid Technical
Seating
Details of Vehicle of Details
Model Contractor/vehicle owner Name & of Address Agencythe / Signature
------Odometer reading Odometer Date of of Date registration & registration Remarks original
years
Registration Number
Draft #63 of File DPMSU-KLM/194/ABMO/2017/DPMSU Approved by District Program Manager on 08-Jul-2020 03:16 PM - Page 19 process and the thereafteraward contract. of /her His isattestedbelow on signature tender the during him/her by undertaken Sri/Smt……………………………………….. …………………………………… my/our behalf participateto the in tender no…………………………………… for on sign and act to attorney, our …………………………………………….As of us position the holding and with employed presently is who address) and ………………………………………………..…(name office) appoint constitute, and dohereby authorize Sri/Smt I/ We I/addressof the and registered We………………………………………………….(name hereby also undertake that I/wehereby responsible alsoall foraction be undertake will thatof : ______: (Name, Address and Title of the Attorney) Date ______(Signature) Accepted
(On aStamp Paper relevantvalue) of POWER OF ATTORNEY
Annexure II
(Name,Address) and Designation For______Dated the___ this
day of 201_ day of
Draft #63 of File DPMSU-KLM/194/ABMO/2017/DPMSU Approved by District Program Manager on 08-Jul-2020 03:16 PM - Page 20
6 5 4 3 2 1
Driver’s Name & Signature & Name Driver’s only) journey Outstation (For Halts Night Number of Place Purpose ofJourney Officer / Staff &Name Designation NHM of the Vehicle of No. Registration Trip sheetNo.……………… Sl.
Time From
Starting Km
TRIP SHEET FORMAT OF Annexure III
Place Date ……………………… Signature of User of Signature
Time
To
Km Closing
Run Kms Total
Draft #63 of File DPMSU-KLM/194/ABMO/2017/DPMSU Approved by District Program Manager on 08-Jul-2020 03:16 PM - Page 21 ______/ Rs. vehicle (as in ten of amount an NHM with deposited has sh and conditions employer any against claim may service that meet have towards to employeesthe of contractor.the The Contractor and benefits their to responsible be shall alone contractor the and NHM the of employees the be to deemed or considered or regarded treated, of signature sheetsindicatingTripkilometer thetime.vehicleusage hoursdrivertheandshallbe for maintainedwith counter required the at available not is driver with vehicle where cases in applicable also is deduction This to alternate liablefor NHM is by incurred contractor expenditure the the to equal vehicle, amount an the compensate of availability non non the or in Alternatively, maintenance/repairs time. of to loss any due without utilized be cannot vehicle suitable a Driver, the of availability case its or In NHM to delay. liability any no without contractor with the by employees, done be shall repairs all accident, any of case In fuels, lubricants, and maintenance of vehiclethe good in condition shall be responsibility of the to requirements,statutory other and taxes Insurance, equal time. required the at available amountnot is driver with vehicle an compensate to liable is arrangemen alternate contractor the for NHM by the met expenditure day, any on vehicle the of availability charging any extr necessary,ifholidays requestshall withoutand vehicle madeat availablebe Theon any also). time, days working on p.m. 5.30 to a.m. 8.00 be will driver the of hours working (normally basis 24X7 on vehiThe vehicle. the fordrivingallottedbe shall drivers Permanent ____/ Rs. Category Rs. km perat vehicle cost noextra of The vehicle be will the kept at disposalof with the terms the utilizing to subjected services, and conditions mentioned hereunde the provide of to agreed has contractor the desirous as where and services, ______is Manager, Programme (type ……………………………. No. providing……… in afteras referred contractor. authorized his (na ……………………………………………. or ______Manager, representative side,here onthe andas one NHM inafter Programme District Agreement Number:
(TO BE TAKEN IN Rs.200 KERALA STAMP PAPER ON AWARDING THECONTRACT) AWARDING ON PAPER STAMP KERALA INRs.200 TAKEN BE (TO Category I
The contractor should pay wages to the Driver for the day he attends duty. In the absence non absence the In duty. attends he day the for Driver the to wages pay should contractor The of rate the at paid be will any if Km Additional of services the out carrying is above mentioned contractor the AS WHERE agreementThis executed ….. on the day of………….. month ……..year between the / a nominated officer of NHM. It is agreed that under no circumstances, the driver shall be shall driver the circumstances, no under that agreed is It NHM. of officer nominated a -
District Programme Manager, ______will be provided be will ______Manager, Programme District (Rupees der der condition), as a cost.a -
-
(Rupees _____ Only) for Category III Category forOnly) _____ (Rupees
Nos., Category II Category Nos.,
replacement vehicle of the same category with Driver shall be provided be shall Driver with category same the of vehicle replacement
AGREEMENT FORMATAGREEMENT Annexure IV
Rs r.
-
______(Rupees
me of the contractor/bidder) on the other side, here here side, other the on contractor/bidder) the of me NHM and the KM usage per per usage KM the and NHM Nos., ts made. This will also be applicable in case where case in applicable be also will This made. ts -
Rpe Fv Tosn ol) e ctgr of category per only) Thousand Five (Rupees
in excellent conditions onain excellent basis. conditions fulltime
of vehicle) on contract basis and District and basis contract on vehicle) of s ___/ Rs. per KM & calculated on half yearly basis. yearly half on calculated & KM per l idmiy n ke idmiid the indemnified keep and indemnify all
cle with driver should be provided be drivershould with cle - - Only) for Category for Only) II,
Rpe _____ Ol) for Only) ______(Rupees Only) for Category for Only) I,and arrangement or transport. or arrangement month will be ______be will month
the Contractor.the
-
Draft #63 of File DPMSU-KLM/194/ABMO/2017/DPMSU Approved by District Program Manager on 08-Jul-2020 03:16 PM - Page 22 on either yearof 1 andwith the same conditions. terms is ______the rate ______issued tothe agency be will valid. be paid to him only he after remitted has the required amount Security of Dep be to liable is contractor ofanysaidpart anyofmoreor provisions. the workpayment Thethe for madecontractor bythe will the by made deposit in NHM security by forfeited Such agreement. this of provisions the of performance full faith and due for tender the of 38 clause the in specified as deposit security the Witness For MissionNational Health
renewable depending upon the satisfactory performance, for a further period or for period for or period further a for performance, satisfactory the upon depending renewable s givens below: This contract of agreement is terminable by the parties by giving one month's notice notice month's one giving by parties the byterminable is agreement of contract This For contractor The above arrangements shall bedeemed to have come into force with effect from (c) (b) (a) For asshallpay mentioned theabove,contractor as services the provided NHM per All side.
:
- ______Only)II,for Category ______Only) for Category Iand Rs. Daily rental charges for 8 hours 80 / Kms usage shall be Rs.______/ used for outsidealso. duty v the Generally Only) for Category III _____/ will II, Category for Only) ______Only) Category for I, and Rs. ______/ Monthly rental charges up ______to km of usage
the other as termsconditions inthe tender contained and no.
be paid at the rate of rate the at paid be - Rpe ___ ny fr aeoy I ad s ______/ Rs. and II, Category for Only) _____ (Rupees the event of the contractor failing duty and faithfully to perform any one or one any perform to faithfully and duty failing contractor the of event the
and shall be operated for a period of ______Months, which Months, ______of period a for operated be shall and ehicle will be used in Kollam district, but if required it shall be shall it required if but district, Kollam in used be will ehicle
per km per vehicle per km calculatedper half ona yearly basis. Rs._____/
-
Witness Contractor (Rupees ______Only) for Category I, Rs. I, Category for Only) ______(Rupees : -
e vhce Adtoa k if km Additional vehicle. per
Rs ______(Rupees ______/ osit. -
Rpe ______(Rupees
- -
-
(Rupees
(Rupees (Rupees
any any
Draft #63 of File DPMSU-KLM/194/ABMO/2017/DPMSU Approved by District Program Manager on 08-Jul-2020 03:16 PM - Page 23 of conditions Tender document including the amendments of the tender, any, if the of conditions and terms all the all accept(s) do I/We and Kollam (NHM), read Mission Health National the carefully have I/We KLM/194/ABMO that declare hereby do ______at business of Office/Place Registered /e______aig t Rsdne / Residence its having I/We,______/2017/DPMSU /2017/DPMSU Dated
22 .06 DECLARATION Annexure V .201 9
for the hiring of Air of hiring the for
published by NHM.
- Conditioned vehicles floated by floated vehicles Conditioned edr No. Tender
DPMSU -