Office of the Chief Engineer(R&B),

Administration & Quality Control,

Erramunzil, Hyderabad.

Eligibility Criteria and Documents required for Registration of Contractors in

Class-I (Electrical /PHE) / Class-II (Electrical /PHE) in Telangana State.

1. Application in the format appended (Annexure-I) with Rs.2/- Court Fee Stamp affixed.
2. Bio-Data in the format appended Two (2) Sets in Hard Copies and One (1) set Soft Copy (CD/DVD) (Annexure-II)
3. Registration Fee in the shape of DD/BC in favour of “PAO, R.R. District, Hyderabad” for
Class-I Class-II
(Electrical / PHE) (Electrical / PHE)
Rs.20,000/- Rs.10,000/-

4. Solvency Certificate issued by the Scheduled Bank in the format appended (Annexure-III) for
Class-I Class-II
(Electrical / PHE) (Electrical / PHE)
Rs.2.00 Lakhs Rs.1.00 Lakhs

5. Experience Certificate issued by the Executive Engineer and Counter Signed by the Superintending Engineer in the particular
category i.e., Electrical/PHE, in a particular year during the last five (5) financial years as below
Class-I Class-II
(Electrical / PHE) (Electrical / PHE)
Single work of Rs.2.50 Lakhs and Single work of Rs.1.25 Lakhs and
Rs.5.00 Lakhs for Group of works Rs.2.50 Lakhs for Group of works

6. Other Requirements:
In the case of Electrical

• Valid Electrical License Certificate (A-Grade / B-Grade).

The Contractor himself shall be licensed Electrician or at least have a licensed Electrician in his employment i.e.,
certificate issued by the Electrical License Board in Telangana State.

In the case of PHE

• Plumber Certificate.
The application shall either be a licensed plumber or at least have a licensed plumber in his employment or plumber
certificate issued by Individual Training Institute (ITI) or National Academy of Construction (NAC).

• Declaration from the Plumber (in case of a licenced Plumber is employed) (Annexure-IX)
• Declaration on Letter Head from the employer / Contractor that the Plumber is working under him. (Annexure-X)
[

7. Copy of Existing registration in Civil/Electrical/PHE/Transport/F&ESS and in other category if any.

8. Copy of Pan Card.

9. Copy of latest Income Tax Return submitted along with proof of receipt.

10. Copy of GST Registration in Telangana State.

11. Copy of Partnership Deed (in case of Firms)

12. a) In Case of Firms: Copy of Form-C & Latest certified copy of Form-A issued by the Registrar of Firms or Issued by the
Meeseva Centre (Original duly signed with issuing date).

b) In Case of Companies: Memorandum of Articles, Form-32, DIR-12 and any other applicable Documents.
13. Declaration on Rs.100/- Non-Judicial Stamp Paper
a) Declaration on genuineness of certificates and on blacklisting duly Notarized. (Annexure-IV)
b) Declaration that there are no Criminal Cases during the last Ten (10) years duly Notarized. (Annexure-V).
c) Declaration that there are no other Contractor Registration either in individual name or as a sole Proprietor/Managing
Partner / Partner / Managing Director / Director of any Firm / Company duly Notarized. (Annexure-VI).

d) Undertaking for the Different Names duly Notarized. (Annexure-VIII).

14. Declaration on Letter Head for the different Addresses mentioned in the Documents submitted (Annexure-XI)
15. Copy of Aadhaar Card in case of Individuals.

Note:
(i) The Agency / Contractor is requested to Sign on all Pages and and alsoonCD/DVD.
(ii) Rs. 100/- Non Judicial Stamp Papers should be purchased in Telangana State only.
(iii) Annexure - VII : Applicable incase of change of Contractor Registration i.e, from
a. Individual to Proprietor firm/ Partnership Firm/ Company
b. Partnership firm to Company/ Individual/ Proprietor firm
c. Company to Partnership Firm/ Individual / Proprietor firm)

The above Details and formats are available at www.roadbuild.telangana.gov.in

 INDEX
Sl. Description of Documents Reference
No. to Page No.
1 Existing Registration Certificate

2 Bio – Data (Hard Copy in Duplicate & Soft Copy in CD/DVD)

(Annexure-II)

3 Demand Draft (D.D) / Bankers Cheque (B.C)

4 Solvency Certificate (Annexure-III)

5 Pan Card

6 Latest IT Return

7 GST Registration in Telangana State

8 Valid Electrical License/Plumbing Certificate

9 Registration of firm Form “C”, Latest Form “A” and all

Partnership Deeds (In Case of Firm)

10 Memorandum of Articles, Form 32/DIR-12/Any other

Documents (In Case of Company)

11 Self Declaration (Annexure-IV)

12 Declaration for Criminal Cases (Annexure-V)

13 Declaration on Existing registrations (Annexure-VI)

14 Undertaking on Different Names (Annexure-VIII)

15 Plumber Declaration (Annexure-IX)

16 Contractor / Employer Declaration (Annexure-X)

17 Declaration on Different Addresses (Annexure-XI)

18 Copy of Aadhaar Card in Case of Individual

19 Experience Certificate

20 Other Documents (Mention the name of the Document enclosed)

 ANNEXURE - I

APPLICATION FOR REGISTRATION OF CONTRACTORS IN TELANGANA STATE

To
The Commissioner,
O/o the Commissionerate of
Tenders, 1st Floor, Ground Water
Buildings, Opp: to Govt., Degree
College, Chintal Basthi,
Khairatabad, Hyderabad, Telangana
State-500004.

Sir,

Sub:- Registration of Contractors – Application for Class-I under the

category of Electrical / PHE – Contractor–Submitted – Regarding.

*****
I/We, request
to kindly register my name / our firm name/our company name as Class-I
contractor in the Category of Electrical / PHE Contractors as per G.O.Ms.No.94, I&CAD
(PW-COD) Department, Dated: 01-07-2003, G.O.Ms.No.130, I&CAD (PW-Reforms),
Department, Dt: 22.05.2007, G.O.Ms.No.4, I&CAD (Reforms) Dept., Dated 15.07.2014,
G.O.Ms.No.14, I&CAD (reforms) Dept., Dated: 31.01.2015, G.O.Ms.No.66, I&CAD (reforms)
Dept., Dated: 20.04.2015, G.O.Ms.No.67, I&CAD (reforms) Dept., Dated: 20.04.2015, GO
Ms No.149, I& CAD(Reforms)Dept, Dated.15.10.2015, GO Ms No.46 I&CAD (Reforms) Dept,
Dated.28.06.2016 and GO Ms No.6 , I&CAD(Reforms)Dept, Dated.23.01.2017.

1. Bankers Cheque / Demand Draft No. dated: for

Rs. ( Rupees ) in
Favour of PAO ., R.R District, Hyderabad towards
registration fee.

2. BIO-DATA in the formats prescribed in hard and soft copy.

3. Solvency certificate for Rs……………..Lakhs, Dt………………
issued by…………………………………………………………………………..
(the solvency certificate shall not be more than One year old)

4. Copy of GST Registration.

5. Latest Income Tax Returns.
6. Self Declaration & Undertaking on Rs.100/- Non-Judicial Stamp Papers-……Nos.
7. Experience Certificate.

8. Copy of Registration of firm Form “C”, Latest Form “A” and all Partnership Deeds
in case of Partnership firm / Memorandum of Articles and Form-32 / DIR-12 in
case of Company.

9. Electrical License / Plumber Certificate.

10. Aadhar

P.T.O
 I/We _

solemnly declare that the information furnished by me/us along with this application is

correct and I/We personally take responsibility for the correctness of the information

furnished.

I/We also declare that I am/we are aware of the fact that if any of the information

Furnished along with this application is found to be in-correct, false, fabricated and

suppresses My Name/Our Firm Name/Our company name is liable for blacklisting.

Yours faithfully,
Place:
Date:
 ANNEXURE – II

BIO-DATA

Of
 1. Name of the Contractor/Firm/ :
Company as registered

Photograph of
2. Address :
the proprietor /
Managing Partner/
Managing Director
Phones :
(Authorised Mobile :
Signatory) Fax :
E-mail :
Website : ……………………………..

3 Details of Registration with registrar :

of firms)
a Reference No. & date :
b Designation and Addressof the :
Registering authority

c Details of renewals, changes etc. :

4 Category of Firm :

a Managing Partners Authorized :

Signatory)

b Educational Qualification of :
Managing Director

c Details of all the Partners (as per :

Registered Partnershipdeed/
Articles of Association.

Name of the Directors Educational Occupation Status in the Firm % Share

Qualification

5 Details of Registration of Partnership :

deed/ Articles of Association etc:

a Date of Partnership deed :

b Reference No. & date of :
Registration
c Designation and address of the :
Registering Authority
6 Details of Registration with :
Commercial Tax department.

a Reference No. & date :

b Designation and Address of the :
Registering Authority

c Registration number :
d Authority where the sales tax :
returns are being filed now.
e Date of issue of latest Sales Tax :
Clearance certificate.
f Designation and Address of :
Issuing Authority of clearance certificate
7 PAN allotted by Income Tax Dept :

a) For the firm (as a whole) :

b) individual

c) All other Directors as individual

Name of the Partner PAN

8 a) Name of the Chartered Accountant

Firm, Address, Phone / Fax.

b) Registration No.

9 a) Financial year up to which income

firm
b Designation and address of
Income Tax Authority who
assessed
c) Date of latest IT assessment order

10. Designation and Address of Mines &

Geology Department where returns
are Being filed by the Firm.

11. Details of Registration as Civil

Contractor with Government of TS
a. Class in which Registered
b. Specialization
c. Designation and Address of the
Registering authority
d. Proceedings No. / Date

e. Regd. Number
f. Valid up to
g. Details of renewals
 12. Details of Registration as
Civil Contractor is other
states

Designation & Address of Proceedings No.

Registered As Valid Upto
Registering Authority & Date
1 2 3 4

13. Details of Partnership in other

firms/ Companies. (As per
Registered Partnership deed of
the other firm).

Nature of
Name of the Partner (having Name, Address of the other %of
business of the
partnership in Other firms firm in which he is a partner share
other firm.
1 2 3 4
a. Firm (in question) as a whole
b. Proprietor / Managing
Partner/Managing Director (in
individual capacity)
c. Other partners (in individual
capacity)

14 Membership in professional bodies

a. Builders Association of India

b. Institution of Engineers

c. National Academy of Construction

15. Name/Address of Bankers

a. Maximum Solvency /Credit facility/

Liquid Assets of the firm in Rs.
Lakhs
b. Ref. No and date, Name of the
Issuing Bank

16. Specimen Signature of the proprietor/

Managing Partner/Managing Director
(Authorized Signatory).
 Statement. I
Annual turnover on the Civil Engineering Public Works executed during the last 5 years
A) Firm as its own name:-
Annual Financial Turnover
Financial Year If authority to whom is filed
(As per IT Returns
2011-12
2012-13
2013-14
2014-15
2015-16

B) Firm as a Registered Partner in other firms:

Rs. In Lakhs
Whether
Proportionat
Total turnover of the % share included
Financial Name of other e turnover
other firm as furnished to of the in IT
year Firm/company of the firm in
IT department firm return of
question
the firm
1 2 3 4 5 6

c) Firm as a sub-contractor (with the approval of department) : -No-

Rs. In Lakhs
Value of
Whether
Name of the Main work done
Financial Name of the Agreement Agreement included in
contractor/Firm/C by the firm
year work Amount Authority IT return of
ompany as sub-
the firm
contractor
1 2 3 4 5 6

1. The figures furnished should not be more than the figures indicated in Income
tax clearance certificate.
2. The turnover on private (Non-Government works should not be
included
 Statement II.
Details of Civil Eng.. Public Works completed during the last 5 years i.e ………………. to …………….
A) In the Name of the Firm: (In Lakhs).
Year wise
Designation,
Total Target/actual Total value break up value
Sl. address of Agreement No. &
Name of the work contract date of Of work as work executed
No. Agreement Date
value completion completed Amount
Authority
Year
1 2 3 4 5 6 7 8

B) As Joint Venture with other Registered Co-partner Firm (s) : Rs. InLakhs.
Designation, Value of Year wise Breakup Value of work
Agreeme Name Total Target/actu Total value
Sl.N Name of the address of Share in work done done under JV
nt No. & of JV Contract al date of of work as
o. work Agreement JV by thefirm Amoun Amoun Amount
Date firm value completion completed
Authority under JV t year t year year
1 2 3 4 5 6 7 8 9 10 11 12 13

C) As a Sub-Contract (with the approval of department): Rs. InLakhs.

Firms Total value Value of Year wise Breakup Value of work
Designation,
Name of share Total Target/actu of work as work as executed as sub contractor
Sl.N Name of the address of Agreement
main as sub- Contract al date of completed subcontract
o. work Agreement No. & Date Amoun Amoun Amount
contractor contract value completion by theMain or out of
Authority t year t year year
or firm item 9
1 2 3 4 5 6 7 8 9 10 11 12 13

NB : Details of works actually completed should only be furnished

 Statement- III
Details of ongoing public works on hand
A) In the Name of the Firm, Rs. In Lakhs.
Designation, Period date Total value of Year wise break up value of work
Total Value of
Name of the address of Agreement of completion work done so executed
Sl.No. contract Balance
work Agreement No. & Date as per far (month) Amoun t Amoun t Amount
value work
Authority Agreement year year year
1 2 3 4 5 6 7 8 9 10 11

B) As Joint Venture with other Registered Co-partner Firm (s) Rs. In Lakhs.
Year wise breakup
Value of work done Value of balance
Total Contract Period & value of work done
Designation, so far (month) work
Agree contract value date of under joint venture.
Sl.N Name of the address of Name of
m ent value of under JV completion With Current
o. work Agreement JV firm By the With the
No. & the main (% of as per By the the JV Amount year
Authority Main Main
Date firm share) Agreement JV Firm firm year upto
firm firm
(month)
1 2 3 4 5 6 7 8 9 10 11 12 13 14

C) As Sub contract (with the Approval of department) Rs. In Lakhs.

Year wise breakup
Total value of work Value of balance value of work
Designation, Firm Period date done so far (month) work executed by firm as
Agreeme Total Name of
Sl.N Name of the address of share as ofcompletion sub contractor
nt No. & contract the Main
o. work Agreement sub as per With With the
Date value contracto Current
Authority contractor Agreement By the By the sub the sub Amoun
r year upto
Main firm contractor Main contracto t year
(month)
firm r
1 2 3 4 5 6 7 8 9 10 11 12 13 14

NB : 1. Details of all the works in progress as on 01.04.2004 should only be included.

2. The value of work done particulars shall be used on certificates issued by the Executive Engineer
 Statement - IV
Details of Prime (Physical) Quantities executed during the last 5 years (i.e.,2011 -12 to 2015-16.)

A) In the name of the Firm

Sl. Name of the Designation & Agreement Financial FINANCIAL YEAR WISE QUANTITIES EXECUTED
work Address of No. & date year Lining
No.
Agreement EWE Forming CCF/ RCC Paver Manual BM DBM MSS Any
Authority Embankme CRS/ other
nt RR items
Sqm/Cu Sqm/Cu
Cum Cum Cum Cum m m Cum Cum Sqm
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

B) As Joint Venture with Other Registered Co-partnerfirms.

Sl. Name of the Designation & Agreeme Name of Firm Financ FINANCIAL YEAR WISE QUANTITIES EXECUTED IN JV SHARE
work Address of nt No. & the JV shares ial Lining
No.
Agreement date firm as JV year EWE Forming CCF/ RCC Paver Manual BM DB MSS Any
Authority Embankme CRS/ M other
nt RR Sqm/Cu items
Sqm/ m Cum Sqm
Cum Cum Cum Cum Cum Cum
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

C) As a Sub contractor (with the Approval ofdepartment)

Sl. Name of the Agreemen Agreeme Name of Firm’s Financi FINANCIAL YEAR WISE QUANTITIES EXECUTED AS SUB CONTRACTOR
work t nt No. & the main shares al year Lining
No.
authority date contractor as sub EWE Forming CCF/ RCC Paver Manu BM DBM MSS Any
contrac Embankme CRS/ al other
tor nt RR items
Sqm/ Sqm/ Cum Cum Sqm
Cum Cum Cum Cum Cum C um
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

N.B. : Details of quantities executed under completed works as well as ongoing works should be furnished duly supported with the certificates
issued by the Executive Engineer concerned.
 Statement – V
Details of works for which tenders are submitted (as on…………) - No -
Designation & Address Present
ECV Put
S.No. Name of the work of the Authority who stage of
to tender
called for tenders the tender
1 2 3 4 5

N.B. : - Details of JV/Sub-contract tenders should also befurnished.

Statement – VI
Details of construction/quality control equipment owned (as on…………) - Nil -
S.No. Details of Equipment (Make model, capacity etc. Number
1 2 3

B. : -The details of equipment owned and in working condition only should be Furnished.

Statement – VII
Details of Technical personnel working in the firm (as on… .......... )
Total years Working with
Educational
S.No. Name Designation of the organisation
Qualification
Experience since
1 2 3 4 5 6

Statement – VIII
Details of manpower available with the firm (as on… .......... )
S.No. Details of Equipment (Make model, capacity etc. Number
1 2 3

Statement – IX
Details of retired State/Central Govt. servants working with firm (as on… .......... )
Working in
Retired as Year of
S.No. Name the firm
(Designation) Retirement
since (Date)
1 2 3 4 5
 Statement – X
Details of near relatives working in the Government of Telangana.
Presen
Relationship
S.No. Name Designation Department t place
with the firm
of
1 2 3 4 5 6

Statement – XI
Details of Training undergone by the firm’s personnel at NAC’ and others.
S.No. Name Designation Details of Training undergone
1 2 3 4

Statement – XII
Outstanding achievements in the Civil Engineering contract field. –No-
Outstanding Achievement(Like
Designation & Address of
S.No. Name of the work early completion, completion @
Agreement Authority
less costs, etc.)
1 2 3 4

Statement – XIII
Details of Penalties imposed/waived/paid (for slow progress, defective work etc.)
Penalty
Details of
Agreement Reasons for paid/reduced)
S.No. Name of the work penalty
Authority the penalty waived etc.
imposed
details
1 2 3 4 5 6

Statement – XIV
Details of all the court cases filed by the firm against Government (Won, Lost, -No-
Withdrawn, Pending).
Subject Respondents
Case No. / Final outcome
S.No. Court where filed matter/Prayer i.e., Name
Year of the case
in the case of CE/SE
1 2 3 4 5 6
 DECLARATION

I/We, (name and

address) hereby solemnly declare that the information furnished by me in this BIO- DATA
and the statements appended to BIO-DATA is correct, and I/we personally take
responsibility for the corrections of the information furnished.

I/We also declare that, I am/we are aware of the fact that, if any of the
information, furnished in this BIO-DATA and statements if found to be incorrect, false
fabricated and suppressed. My Name/our firm/our company is liable for blacklisting.

Place:
Date :

Signature Of Contractor/Managing Partner/ Managing Director

 ANNEXURE – III

(ENCLOSURE TO G.O.MS.NO.94, I&CAD(PW-COD) DEPARTMNET DT. 01-07-

2003) FORM OF SOLVENCY CERTIFICATE BY
SCHEDULEDBANKS

I _____________________ Managing Director / Manager / General Manager /

of _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Bank Ltd., do hereby certify that _ _ _ _ _ _

_ _ _ __ _ (Name and address of the contractor) to be solvent to the extent of

Rs._ _ _ _ _ _ _ _ (Rupees ___ _ _ _ _ ______________________ ) as

disclosed by the information and records which are available with the afore-said Bank.

Date:
Place:

For the Bank

(Designation of the Officer authorized
to sign.)
 ANNEXURE – IV (a)

Declaration on Rs .100 Non Judicial Stamp Paper

(Only for Partnership Firm / Company)

1) We hereby declare that the statements, documents, certificates

produced/submitted by us along with the application for registration of
contractor are genuine. If found false in future we will be held responsible
for the consequences.

2) Further, we hereby declare that, we have not been blacklisted /

debarred/suspended so far in any department of Government of
Telangana and also in any Department in other states of India due to any
reasons.

3) We solemnly
declare that the information furnished by us along with this application is correct
and we personally take responsibility for the correctness of the information
furnished.

4) We also declare that, we are aware of the fact that if any of the information
furnished along with this application is found to be in-correct, false, fabricated and
suppresses Our Firm Name/Our company name is liable for blacklisting.

If found false in future, we will be held responsible for the consequences.

Name of Partner/Director Signature of Partner/Director:

1.

2.

3.

Date :
Place :

Official Seal of Partnership Firm/Company

 ANNEXURE – IV (b)

Declaration on Rs .100 Non Judicial Stamp Paper

(Onlyfor Individual)

1) I hereby declare that the statements, documents, certificates

produced/submitted by me along with the application for registration
of contractor is genuine. If found false in future I will be held responsible
for the consequences.

2) Further, I hereby declare that, I have not been blacklisted /

debarred/suspended so far in any department of Government of
Telangana and also in any Department in other state of India due to
any r e a s o n s .

3) I
solemnly declare that the information furnished by me along with this
application is correct and I personally take responsibility for the correctness
of the information furnished.

4) I also declare that, I am aware of the fact that if any of the information Furnished
along with this application is found to be in-correct, false, fabricated and suppresses
My Name is liable for blacklisting.

If found false in future, I will be held responsible for the consequences.

Date :
Place :

Signature of the Individual

 ANNEXURE – V (a)
Declaration on Rs .100 Non Judicial Stamp Paper

(Only for Partnership Firm / Company )

1) We hereby declare that, we are Partners/Directors of ------------------

------------------ (Firm/ Company Name) and there are no Vigilance cases,
Court Cases, Criminal Cases filed/ pending against us and there are no
Public litigations cases are filed / pending against the works executed by
us for the last Ten (10) Years.

2) We declare that, our application for contract registration in any class and category are
not rejected /returned in any department of Telangana State.

If found false in future, we will be held responsible for the consequences.

Name of Partners/Directors Signature of Partners/Directors:

1.

2.

3.

Date :
Place :

Official Seal of Partnership Firm/Company

 ANNEXURE –V(b)
Declaration on Rs .100 Non Judicial Stamp Paper

(Only for Individual )

1) I ---------------------------- (Name & address) hereby declare that, there

are no Vigilance cases, Court Cases, Criminal Cases filed/ pending against

me and there is no Public litigation cases are filed / pending against the

works executed by me for the last Ten (10) Years.

2) I declare that, my application for contract registration in any class and

category are not rejected /returned in any department of Telangana State

If found false in future, I will be held responsible for the

consequences.

Date :
Place :

Signature of the Individual

 ANNEXURE – VI (a)

(Declaration on Rs .100 Non Judicial Stamp Paper)

(Only for Partnership Firm / Company)

1) We are registered contractor as Special Class / Class-I / Class-II vide

Proceedings No. Dt. issued by
in the category of Civil/Electrical/PHE/F&ESS/Transportation only and
we are not having any other registration other than the mentioned above.

2) “We……………………………………………………………………………………………
(Managing Directors / Directors/ Partners/Managing Partners) of M/s
………………………………………....(Company / firm), solemnly
affirm that, “We do not have any contractor registration either in our
individual names or as a sole proprietor of any firm/Company, [except
the registration mentioned above and furnished along with the
application].

3) We also declare that, We are not a partner / director of any firm /

company which is having contractor registration in any department in
Government of Telangana.

4) We assure that on registration of

(Name of Firm / Company) under Class-I / Class-II in the
category of Electrical / PHE will, we will not take up any work in future on
our individual names.

5) We hereby certify that, We will employ qualified technical personnel with suitable
complimentary staff to meet the requirements of the works as specified in the tender
documents.

6) If the above statement found false at a later date, We will be held responsible
for the consequences”.

Name of Partners/Directors Signature of Partners/Directors:

1.
2.
3.
4.
5.

Date
Place
Official Seal of Partnership Firm/Company
 ANNEXURE – VI(b)

Declaration on Rs .100 Non Judicial Stamp Paper (

Only for Individual )

1) I am registered contractor as Special Class / Class-I / Class-II vide

Proceedings No. Dt. issued by
in the category of Civil/Electrical/PHE/F&ESS/Transportation only
and I am not having any other registration other than the mentioned
above.

2) I solemnly affirm that, I do not have any contractor registration either in my

individual name or as a sole proprietor of any firm, [except the registration
mentioned above and furnished alongwith the application].

3) I also declare that I am not a partner / director of any firm / company which is
having contractor registration in any department under Government of
Telangana.

4) I hereby certify that, I will employ qualified technical personnel with suitable
complimentary staff to meet the requirements of the works as specified in the
tender documents.

5) If the above statement found false at a later date, I will be held responsible for
the consequences”.

Date :
Place :

Signature of the Individual

 Annexure- VII
(applicable incase of change of Contractor Registration from
i. Individual to Proprietor firm/ Partnership Firm/ Company
ii. Proprietor firm to Partnership firm / Company
iii. Partnership Firm to Company )

( Declaration on Rs. 100 Non Judicial Stamp Paper)

1) All the assets and liabilities including obligations and the ongoing works entrusted in the
name of (individual / firm/Company/Proprietor firm) and to receive all the
bills pending from various departments along with the experience gained shall stand
transferred into the name
of (individual / firm/Company/Proprietor firm) from
the date of registration of Special Class/Class I/Class II Contractor under Civil Category
is registered.

2) All the Partners/Directors of (Firm/ Company) shall

be responsible and personally discharge all the liabilities, dues to the department that arise
out of at anytime in future from the works done by
(Individual/ Proprietory firm/Firm/Company)

Name of Partners/Directors Signature of Partners/Directors:

1.
2.
3.

Date
Place
Official Seal of Partnership Firm/Company
 ANNEXURE – VIII

Declaration on Rs .100 Non Judicial Stamp Paper

UNDERTAKING

I/We, Contractor/Firm/Company (Name and

Address) Proprietor/Managing Partner/Director/Managing Director (Name) hereby solemnly
declare that on (Date) the names Viz.,

(Different style Name Contractor/Firm/Company) are one and the same.

If the above statement is found false at a later date, I/We will be held responsible for
the consequences
Signature of the Contractor /Proprietor/
Managing Director/Managing Partner

Date
Place
 ANNEXURE –IX

Declaration on Rs .100 Non Judicial Stamp Paper

(Applicable only in case of a Plumber employed under Contractor / firm/ Company)

Declaration

I .................................................................................................. (name of Plumber) hereby

solemnly declare that, Iam working at/with ……………………………………………………
( Name & address of Contractor / Firm/Company) as Plumber since ............................. I am always Punctual to
my duty and so on date have no remarks on my work and conduct.

(Signature of Plumber)
 ANNEXURE –
X
DECLARATI
ON
(different address on letter head)
(Applicable only in case of a Plumber employed under Contractor / firm/ Company)

TO WHOM SO EVER IT MAY CONCERN

This is to Certify that Sri..................................................................................... is working under
me /our firm / our Company as Plumber since .......................... His working performance and
punctuality is satisfactory.

Signature of Contractor /
Managing Partner / Managing Director
 ANNEXURE –
XI
DECLARATIO
N
(different address on letter head)

I/We, Contractor/Firm/Company
(Name and Address) Proprietor/Managing Partner/Director/Managing Director (Name)
hereby solemnly declare that the addresses mentioned in the Documents submitted are as
follows:

Sl. No. Name of the Documents Addresses Remarks

If the above statement is found false at a later date, I/We will be held
responsible for the consequences

Date
Place
Signature of the Contractor /Proprietor/
Managing Director/Managing Partner