medical department - mumbai port trust · tender documents may be viewed or downloaded by...

1

MUMBAI PORT TRUST

MEDICAL DEPARTMENT

Tender Ref.No.CMO-18/2017 Date:28/11/2017

TENDER DOCUMENT

(NOT TRANSFERABLE)

Invites

ONLINE TENDER FOR EMPANELMENT OF PRIVATE HOSPITALS, EXCLUSIVE EYE HOSPITALS/CENTRES, EXCLUSIVE DENTAL CLINICS, CANCER HOSPITALS/UNITS, DIAGNOSTIC CENTRES AND EXCLUSIVE DIALYSIS HOSPITALS/CENTER FOR AVAILING CREDIT FACILITIES TO PROVIDE TREATMENT TO MUMBAI PORT TRUST PATIENTS AT THE RATE PRESCRIBED BY CGHS FOR A PERIOD OF TWO YEARS.

CHIEF MEDICAL OFFICER

MUMBAI PORT TRUST HOSPITAL Website: www.mumbaiport.gov.in

For any further clarifications / queries on e-Tendering, Chief Medical Officer, Mumbai

Port Trust can be contacted at: Mobile No. 9820328839, Phone No. 022-24145573;e-

mail:[email protected]

http://www.mumbaiport.gov.in/


2

NOTICE INVITING TENDERS (NIT)

Tender Ref.No. CMO-18/2017 Date:28/11/2017

Chief Medical Officer, Mumbai Port Trust, Nadkarni Park, Wadala (East), Mumbai –

400 037 Invites Online Tender from eligible and qualified tenderers for empanelment of private hospitals, exclusive eye hospitals/centers, exclusive dental clinics, cancer hospitals/units, diagnostic centers and Exclusive Dialysis hospitals/Centers for availing

credit facilities to provide treatment to Mumbai Port Trust patients at the rate prescribed by CGHS for a period of two years.

The Schedule of e-Tendering Activities are as under:

Sr. No. Activity Date and Time

1 Period of sale of Bidding Document 29/11/2017 at 17.00 hours onwards

2 Tender cost Rs.1000/- plus 5%GST (Total Rs.1050/-)

3 EMD Rs.50,000/-

4 Security Deposit As mentioned in tender document

5 Pre- Bid date at the Chamber of Chief Medical Officer, Mumbai Port Trust Hospital, Wadala East, Mumbai – 37.

07/12/2017 at 11.00 hours

6 Queries / Pre- Bid points should be sent 09/12/2017 at 17.00 hours

7 End of purchase of bid document 21/12/2017 up to 11.00hours

8 End of Bid Submission 21/12/2017 up to 14.00hours

9 Opening of Bid (online only) 21/12/2017 up to 15.00hours

1. Tender documents may be viewed or downloaded by interested and eligible Tenderers from the Central Public Procurement Portal (CPPP) of Government of India, website : www.eprocure.gov.in and https://etender.procuretiger.com on the above mentioned dates after payment of Tender fee of Rs.1000/- plus 5% GST (Total Rs.1050/-). Tender document may also be viewed from the website www.mumbaiport.gov.in

2. The Prospective Tenderers are advised to register themselves on the

e-procurement portal https://etender.procuretiger.com and obtain valid Class III Digital Signature Certificate (DSC) as per Information Technology (IT) Act, 2000.The said website can be accessed for additional information about registration and use of Portal.

3. The Tenderers can submit its tender online at

https://etender.procuretiger.com on or before the key dates given above.

4. All further notifications/amendments, if any shall only be posted on websites mentioned above.

Chief Medical Officer, Mumbai Port Trust Hospital,

Wadala(East), Mumbai – 400 037.

http://www.eprocure.gov.in/


https://etender.procuretiger.com/








3

MUMBAI PORT TRUST

Medical Department

CONTENTS

SL.

NO.

DESCRIPTION

1 LAST DATE FOR RECEIPT OF TENDERS

2 GENERAL CONDITIONS

3 PART- I -EMPANELMENT OF PRIVATE HOSPITALS, EXCLUSIVE EYE HOSPITALS/CENTRES,

EXCLUSIVE DENTAL CLINICS, CANCER HOSPITALS/UNITS

4 PART- II - EMPANELMENT OF DIAGNOSTIC LABORATORIES & IMAGING CENTRES

5 APPLICATION FORM

6 DEPOSITION OF FEE FOR TENDER DOCUMENT AND EMD

7 EARNEST MONEY DEPOSIT REFUND

8 PRELIMINARY EXAMINATION OF APPLICATIONS

9 ACCEPTANCE OF RATES

10 OFFER OF EMPANELMENT AND SIGNING OF MEMORANDUM OF AGREEMENT

11 VALIDITY OF CGHS RATES & CONDITIONS RELATED TO PACKAGES AND RATES

12 EMR / HER

13 EMPANELMENT WITH AUTONOMOUS BODIES-

14 PERFORMANCE BANK GUARANTEE (PBG)

15 BILLING TO BE IN ELECTRONIC FORMAT

16 FEE FOR PROCESSING OF BILLS/CLAIMS

17 PAYMENT OF CLAIMS WITHIN AN ASSURED PERIOD

18 CORRUPT AND FRAUDULENT PRACTICES

19 INTERPRETATION OF THE CLAUSES IN THE TENDER DOCUMENT

20 RIGHT TO ACCEPT ANY APPLICATION AND TO REJECT ANY OR ALLAPPLICATIONS

21 MONITORING AND MEDICAL AUDIT

22 EXIT FROM THE PANEL

23 NODAL OFFICERS

24 APPROVED CGHS RATES AND TERMS AND CONDITIONS

25 PRE CONTRACT INTEGRITY PACT (PCI): (In Rs.100/- Stamp paper)

26 TERMINATION OF CONTRACT:

27 PRE TENDER MEETING

ANNEXURES - I TO XII

28 FORM OF TENDER – ANNEXURE – I

29

APPLICATION DOCUMENT FOR EMPANELMENT OF HOSPITALS, CANCER HOSPITALS /

UNITS IN MUMBAI PORT TRUST – ANNEXURE -IIA

4

30 APPLICATION DOCUMENT FOR EMPANELMENT OF EXCLUSIVE EYE HOSPITALS/CENTRES

IN MUMBAI PORT TRUST– ANNEXURE -IIB

31 APPLICATION DOCUMENT FOR EMPANELMENT OF EXCLUSIVE DENTAL CLINICS IN

MUMBAI PORT TRUST– ANNEXURE -IIC

32 APPLICATION DOCUMENT FOR EMPANELMENT OF DIAGNOSTIC LABORATORIES/

IMAGING CENTRES– ANNEXURE -IID

33 CERTIFICATE OF UNDERTAKING– ANNEXURE – III

34 ACCEPTANCE LETTER– ANNEXURE – IV

35 DRAFT MOA– ANNEXURE – V

36 PERFORMANCE BANK GUARANTEE– ANNEXURE – VI

37 DECLARATION (100 RS STAMP PAPER) – ANNEXURE – VIII

38 MANDATE FORM – ANNEXURE – IX

39 PATIENT / ATTENDANT SATISFACTION CERTIFICATE – ANNEXURE – X

40 ANNUAL FINANCIAL TURNOVER STATEMENT – ANNEXURE –VII

41 PRE CONTRACT INTEGRITY PACT (100 RS STAMP PAPER) – ANNEXURE –XI

42 ANY OTHER DOCUMENTS

43 CHECK LIST– ANNEXURE – XII

Chief Medical Officer

Mumbai Port Trust

5

ONLINE TENDER FOR EMPANELMENT OF PRIVATE HOSPITALS,

EXCLUSIVE EYE HOSPITALS/CENTRES, EXCLUSIVE DENTAL

CLINICS, CANCER HOSPITALS/UNITS, DIAGNOSTIC CENTRES AND

EXCLUSIVE DIALYSIS HOSPITALS/CENTER FOR AVAILING CREDIT

FACILITIES TO PROVIDE TREATMENT TO MUMBAI PORT TRUST

PATIENTS AT THE RATE PRESCRIBED BY CGHS FOR A PERIOD OF

TWO YEARS.

Chief Medical Officer, Mumbai Port Trust Hospital, Nadkarni Park, Wadala

(East), Mumbai – 400 037 (hereinafter referred as Tender Inviting Authority

and also called the Tender Acceptance Authority unless the context

otherwise requires) invites Online Tender from eligible and qualified tenderers

for empanelment of private hospitals, exclusive eye hospitals/centers, exclusive

dental clinics, cancer hospitals/units, diagnostic centers and Exclusive

Dialysis hospitals/Centers for availing credit facilities to provide treatment to

Mumbai Port Trust patients at the rate prescribed by CGHS for a period of two

years.

Such hospitals would be inspected for verification of infrastructure, facilities and

staff and if found to be complying with the prescribed norms/requirements

would be empaneled.

LAST DATE FOR ONLINE RECEIPT OF TENDERS.

(a) The last date for online receipt of tenders shall be as per “Schedule of

e Tendering Activities” given above.

(b) The bid will be valid for a period of 180 days from the date of opening of

Technical Bid and prior to the expiration of the bid validity the Tender Inviting

Authority may request the Tenderers to extend the bid validity for a further

period as deemed fit.

GENERAL TERMS & CONDITIONS FOR EMPANELMENT :

Tender documents can be downloaded from https://etender.procuretiger.com The

downloading charges shall be Rs. 1000/- plus 5% GST (Total Rs.1050/-). which

should be deposited in MUMBAI PORT TRUST account as mentioned below through

RTGS or NEFT, receipt copy of the same should be uploaded online. No exemption

from payment of downloading charges is permitted. Also, details of the downloading

charges have to be mentioned online and a scanned copy of RTGS / NEFT slip is to

be uploaded online during e- tendering process at https://etender.procuretiger.com

The downloading charges in the form of demand draft/Cheque / Cash / Postal order

will not be accepted.

Mumbai Port Trust Current Ac/No.- 10996685430

Bank Name - STATE BANK OF INDIA

IFSC CODE - SBIN0000300

BRANCH Address - Mumbai main branch, Horniman

Circle, Marg, Mumbai – 400001.

http://www.mpeproc.gov.in/



6

Alternatively, the tender document can also be downloaded from the website

http://www.mumbaiport.gov.in and www.eprocure.gov.in for purpose of viewing

only and it shall not be entertained as VALID download of tender document. To

participate in tender Tenderer should complete stages of PURCHASE; DOWNLOAD

AND FINAL BID SUBMISSION through https://etender.procuretiger.com Bid

submitted only on-line will be accepted. Tender documents may be downloaded only

from https://etender.procuretiger.com on mentioned dates as in the KEY

SCHEDULE given above. Tender inviting Authority will not be responsible in any

way for any delay.

(i) Scan copy of the downloading charges should be uploaded online. Tenderers

are requested to complete the process of downloading / submission a day

prior to closing in order to safeguard their participation.

(ii) Tenders will be opened online in the presence of Tenderers / authorized

representatives who choose to attend on the specified date and time at Office

of the Chief Medical Officer, Mumbai Port Trust Hospital, Wadala (East),

Mumbai – 400 037. (a) At any time prior to the date of submission of Tender,

Tender Inviting Authority may, for any reason, whether on his own initiative

or in response to a clarification requested by a prospective Tenderer, modify

the condition in Tender documents by an amendment. All the prospective

Tenderers who have received the tender document will be notified of the

amendment only through website, i.e. https://etender.procuretiger.com and

that will be binding on them. In order to provide reasonable time to take the

amendment into account in preparing their bid, Tender Inviting Authority

may at his discretion, extend the date and time for submission of tenders.

(iii) Any person who has downloaded the tender document should watch for

amendment, if any, on the website of Mumbai Port Trust

https://etender.procuretiger.com and Tender Inviting Authority will not issue

separate communication to them.

(iv) Interested eligible Tenderers may obtain further information in this regard

from the office of the Tender Inviting Authority or in person on the day of pre

bid meeting.

(v) Mandate Form (Annexure - IX)

(vi) A self-attested affidavit stating that “the company has not been de-empaneled

/ blacklisted /debarred by any State Government or Central Government

Organization or by Mumbai Port Trust and are eligible to participate in the

present tender.” (Self-attested Affidavit per Annexure - VIII).

(vii) An undertaking to the effect that they will not refuse Mumbai Port Trust

patients sent for management at any time designated for that empaneled

hospital














7

(viii) Hospital /Diagnostic Centers latest rate list inclusive of various package rates

/ Procedures rates along with available discounts / concessions etc.

(ix) Agreement in stamp paper cost value of Rs.100/- of the PRE CONTRACT

INTEGRITY PACT that is available in the Tender Document as

Annexure - XI

(x) All documents enclosed with the bid document should also be signed by the

Tenderer. For online bidding scan copy of documents in proper resolution

should be uploaded online. Tenderers are required to sign their bids online

using Class III -Digital Certificates only, Tenderers are advised to obtain the

same at the earliest. For any further clarifications / queries on e-Tendering,

Chief Medical Officer, Mumbai Port Trust can be contacted at: Mobile No.

9820328839, Phone No. 022-24145573; e-mail: [email protected]

SPECIAL TERMS & CONDITIONS FOR EMPANELMENT: PART-I - EMPANELMENT OF PRIVATE HOSPITALS, EXCLUSIVE EYE

HOSPITALS/CENTRES, EXCLUSIVE DENTAL CLINICS, CANCER HOSPITALS/UNITS, EXCLUSIVE DIALYSIS HOSPITAL/CENTERS.

PART-II - EMPANELMENT OF DIAGNOSTIC LABORATORIES & IMAGING

CENTRES.

PART I

(For Empanelment of Hospitals, exclusive Eye hospitals / centers, exclusive Dental clinics, Cancer Hospitals/units, exclusive Dialysis hospitals/centers in Mumbai Port Trust, Mumbai). PRE QUALIFICATION CRETERIA (PQC): A. Health care organizations located at Mumbai, Navi Mumbai, Mumbai

Metropolitan Region, Thane, Kalyan & Pune cities.

B. Health Care Organizations already empaneled with CGHS (or) Consent to accept the charges fixed by CGHS for availing credit facilities to provide treatment to Mumbai Port Trust patients at the rate prescribed by CGHS are eligible to apply for empanelment in Mumbai Port Trust. The following categories of health care

Organizations are eligible for empanelment:

I. General Purpose & Specialty Hospitals II. Cancer Hospitals/Units

III. Exclusive Eye Hospitals/ Centers IV. Exclusive Dental Clinics V. Diagnostic Laboratories / Imaging Centers

VI. Exclusive Dialysis Hospitals/Centers

C. MINIMUM NUMBER OF BEDS REQUIRED: 50 Beds (Not for exclusive Eye hospitals/centers & Exclusive Dental clinics, Exclusive Dialysis Hospitals/Centers) NB: The number of beds as certified in the Registration

8

Certificate of State Government / Local Bodies/ NABH/ Fire Authorities shall be taken as the valid bed strength of the hospital.

D. SATISFACTORY INSPECTION CERTIFICATE from the team of officers of

inspection Committee of Mumbai Port Trust after physical inspection of private

hospitals, exclusive eye hospitals/centers, exclusive dental clinics, cancer

hospitals/units and diagnostic centers submitted along with Technical Bid. The

Tenderer’s Hospitals / Diagnostic Centre will not be considered empanelment if

the Inspection Committee not satisfied about the documents and infrastructure

facilities of Hospitals / Diagnostic Centre submitted along with Technical Bid.

I. GENERAL PURPOSE & SPECIALITY HOSPITALS

These hospitals may provide following services as per the requirement viz. General Medicine, General Paediatrics, General Surgery, Obstetrics & Gynecology, Orthopaedics, Emergency Medicine, Critical Care Medicine (e.g. HDU, ICU), ENT, Ophthalmology, Dermatology, Community Health, Palliative Medicine, Geriatric Care, Family Medicine, Dentistry including sub specialties, Blood Storage Centre/Blood Bank etc.

The scope of services that may be provided at a hospital practicing Allopathy – Modern system of Medicine may include patient-care services in at least any minimum 60% in each of the following Clinical services and support services:

1. Clinical Services:

1.1. General Medicine

1.2. General Surgery

1.3. Obstetrics and Gynaecology

1.4. Paediatrics including new born care

1.5. Orthopaedics

1.6. Anaesthesiology

1.7. Emergency Medicine & Trauma

1.8. Critical Care Medicine (e.g. HDU, ICU)

1.9. ENT

1.10. Ophthalmology

1.11. Psychiatry

1.12. Dermatology

1.13. Community Health

1.14. Palliative Medicine

1.15. Geriatric Care

1.16. Family Medicine

1.17. Dentistry including sub specialities

1.18. Physical Medicine & Rehabilitation

1.19. Transfusion Medicine/Blood Storage Centre/Blood Bank

1.20. Other emerging sub-specialities in any of the above fields.

9

2. Support services:

2.1. Registration / help desk and billing

2.2. Diagnostic Services:

a. Laboratory

b. Imaging Services

c. Non-imaging services 2.3. Pharmacy and Stores

2.4. CSSD / Sterilization Area

2.5. Linen management

2.6. Kitchen & Dietary Services

2.7. Waste Management Services (General and Biomedical)

2.8. Medical Gas Supply, Storage & Distribution

(a) NABH Accredited Hospitals-

The hospitals applying under this category must be accredited by

National Accreditation Board for Hospitals and Health Care providers

(NABH) or its equivalent such as Joint Commission International (JCI),

ACHS (Australia) or by any other accreditation body approved by

International Society for Quality in Health Care (ISQ).

The hospital shall be empaneled for all the facilities available in the

hospital.

(b) NON NABH Accredited Hospitals-

Non NABH accredited hospitals may be empaneled on the basis of

fulfilling the criteria and submission of performance bank guarantee and

submission of an affidavit that the information provided has been correct.

The hospital shall be empaneled for all the facilities available in the

hospital.

II. CANCER HOSPITALS/UNITS

(a) NABH Accredited Cancer Hospitals/ Units

NABH accredited cancer hospitals/units having all treatment

facilities for cancer - surgery, Chemotherapy and radio-therapy (approved

by BARC / AERB).

(b) Non-NABH Accredited Cancer Hospitals/ Units

Non NABH accredited Cancer hospitals/units having all treatment

facilities for cancer - surgery, Chemotherapy and radio-therapy (approved

by BARC / AERB) may be empaneled on the basis of fulfilling the criteria

and submission of performance bank guarantee and submission of an

affidavit that the information provided has been correct.

10

III.EXCLUSIVE EYE HOSPITALS/ CENTERS:

No minimum bed strength is prescribed for empanelment of exclusive Eye

hospitals/centers

(a) NABH Accredited- Exclusive Eye Hospitals/Centers

(b) Non-NABH Accredited Exclusive Eye Hospitals/ Centers

The exclusive Eye hospital/center may be empaneled on the basis of



IV.EXCLUSIVE DENTAL CLINICS

No minimum bed strength is prescribed for empanelment of exclusive

Dental Clinics However there shall be a minimum of ‘2’ Dental chairs for

all Dental clinics applying for empanelment under Mumbai Port Trust.

(a) NABH accredited - Exclusive Dental Clinics

(b) Non- NABH accredited - Exclusive Dental Clinics

The Dental clinic may be empaneled on the basis of fulfilling the criteria

and submission of performance bank guarantee and submission of an

affidavit that the information provided has been correct.

V. EXCLUSIVE DIALYSIS HOSPITALS/CENTERS

No minimum bed strength is prescribed for empanelment of exclusive Eye

hospitals/centers

(a) NABH Accredited- Exclusive Dialysis Hospitals/Centers

(b) Non-NABH Accredited Exclusive Dialysis Hospitals/ Centers

The exclusive Dialysis hospital/center may be empaneled on the basis of



DOCUMENTS TO BE UPLOADED IN SUPPORT OF ELIGIBILITY CRITERIA FOR

HOSPITALS/ CANCER HOSPITALS/ EXCLUSIVE EYE CENTRES/ EXCLUSIVE

DENTAL CLINICS/ EXCLUSIVE DIALYSIS HOSPITALS/CENTERS:

The health care Organizations must fulfill the requirements as detailed above

depending on the category under which the applicant hospital / exclusive eye

hospital / center, exclusive dental clinic, and cancer hospital/unit, exclusive

Dialysis Hospitals/Centers is seeking empanelment and must attach the copies of

the required documents.

11

1. Scanned copy of receipt of cost of Tender Document submitted online by

NEFT/RTGS.

2. Scanned copy of receipt of EMD submitted online by NEFT/RTGS.

3. Tender Form as per ANNEXURE – I

4. Application document for empanelment of Hospitals, Cancer Hospitals /

units in Mumbai Port Trust – ANNEXURE -IIA

5. Application document for empanelment of exclusive Eye

Hospitals/Centers in Mumbai Port Trust– ANNEXURE -IIB

6. Application document for empanelment of exclusive Dental clinics in

Mumbai Port Trust– ANNEXURE -IIC

7. Application document for empanelment of Diagnostic Laboratories/

Imaging Centers– ANNEXURE -IID

8. Application document for empanelment of exclusive Eye

Hospitals/Centers in Mumbai Port Trust– ANNEXURE -IIE

9. Copy of supporting documents of Registration with GST.

10. Copy of PAN card issued by the Income Tax Department.

11. Power of attorney (in Firms Letterhead) authorizing the signatories of the

bid to participate in the bid.

12. Copy of Documentary evidence for the constitution of the company /Firm

such as Memorandum and Articles of Association, Partnership deed etc. with

details of the Name, Address, Telephone Number, Fax Number, e-mail

address of the firm and of the Managing Director / Partners / Proprietor.

The list of present Directors in the board of the Company duly self-certified.

13. Copy of Certificate of Incorporation / Registration of firm.

14. Certificate of Undertaking – Annexure – III

15. Declaration in Rs.100/ Stamp paper as per Annexure- VIII.

16. Mandate Form as per Annexure - IX.

17. Pre Contract Integrity Pact (PCI) in Rs.100/ Stamp paper as per Annexure-

XI.

12

18. Copy of Documentary proof of Health care organizations located at

Mumbai, Navi Mumbai, Mumbai Metropolitan Region, Thane, Kalyan &

Pune cities a permanent place of business and the complete Postal

Address, telephone / Mobile / Fax / E-mail address, etc.

19. Copy of Tender document with corrigendum with signature of the Bidder

in each and every pages of the tender documents and corrigendum as an

evidence of acceptance of the tender terms and conditions.

20. Copy of Documentary proof of having 50 Beds (Not for exclusive Eye hospitals/centers, Exclusive Dental clinics & Exclusive Dialysis Centre) NB: The number of beds as certified in the Registration Certificate of State Government / Local Bodies/ NABH/ Fire Authorities shall be taken as the valid bed strength of the hospital.

21. Letter of Consent (in firm’s letterhead) to accept the charges fixed by CGHS

for availing credit facilities to provide treatment to Mumbai Port Trust

patients at the rate prescribed by CGHS

22. Copy of Documentary proof of patient-care services in at least any minimum 60% in

each of the following Clinical services and support services

23. Copy of Documentary proof of empanelment with CGHS must be uploaded

in the BID if applicable.

24. Copy of the rates for all treatment procedures / investigations/ facilities

available with Health Care Organization and as charged by Health Care

Organization.

25. Copy of certificate of Registration for Organ Transplant facilities, wherever

applicable.

26. Copy of AERB approval for imaging facilities/ Radiotherapy, wherever

applicable

27. Copy of Registration under PNDT Act, if Ultrasonography facility is

available

28. Copy of Fire Clearance certificate and details of Fire safety mechanism as

in place in the health care Organization. Exclusive Eye centers, exclusive

dental Clinics have to enclose a certificate regarding fire safety of their

premises

29. Copy of compliance with statutory requirements including that of Waste

Management.

30. Copy of State registration certificate / Registration with Local bodies,

wherever applicable.

13

31. Affidavit that the information provided has been correct in case of Non-

NABH/non NABL accredited health care Organizations.

32. Copy of NABH Accreditation in case of NABH Accredited health care

Organizations

33. Copy of list of treatment procedures /investigations/ facilities available in

the applicant healthcare Organization

34. Copy of the documents full filling necessary statutory requirements.

35. Copy of the license for running Blood Bank if applicable

36. Any other supportive documents as required for this tender.

37. Check list as per ANNEXURE – XI

PART II

(Diagnostic Laboratories, Imaging Centers & Cardiac diagnostic centers for Empanelment in Mumbai Port Trust, Mumbai)

PRE QUALIFICATION CRETERIA (PQC):

A. Health care organizations located at Mumbai, Navi Mumbai, Mumbai

Metropolitan Region, Thane, Kalyan & Pune cities.

B. Diagnostic laboratories and Imaging centers already empaneled with CGHS

(OR)

Consent to accept the charges fixed by CGHS for availing credit facilities to provide Diagnostic services to Mumbai Port Trust patients at the rate prescribed by CGHS are eligible to apply for empanelment in Mumbai Port Trust.

C. SATISFACTORY INSPECTION CERTIFICATE from the team of officers of

inspection Committee of Mumbai Port Trust after physical inspection of

Diagnostic centers submitted along with Technical Bid. The Tenderer’s

Diagnostic Centre will not be considered for empanelment if the Inspection

Committee not satisfied about the documents and infrastructure facilities of

Diagnostic Centre submitted along with Technical Bid.

D. CATEGORIES OF DIAGNOSTIC LABORATORIES / IMAGING CENTRES /

CARDIAC DIAGNOSTIC CENTERS

Mumbai Port Trust would consider the following categories of diagnostic

laboratories, imaging centers and Cardiac Diagnostic Centers already have

empaneled with CGHS (OR) Consent to accept the charges fixed by CGHS for

availing credit facilities to provide Diagnostic services to Mumbai Port Trust

patients at the rate prescribed by CGHS are eligible to apply for empanelment in

Mumbai Port Trust:

14

a. NABL / NABH accredited Diagnostic Laboratories/ Imaging Centers

/Cardiac Diagnostic centers.

b. Non- NABL / Non- NABH accredited Diagnostic Laboratories/ Imaging

Centers/Cardiac Diagnostic centers.

The Non-NABL/ Non-NABH diagnostic laboratories/Imaging Centers/Cardiac

Diagnostic centers may be empaneled on the basis of fulfilling the criteria and

submission of performance bank guarantee and submission of an affidavit that

the information provided has been correct

DOCUMENTS TO BE SUBMITTED IN SUPPORT OF ELIGIBILITY CRITERIA FOR

DIAGNOSTIC LABORATORIES/ IMAGING CENTRES:

The Diagnostic Laboratory/Imaging Centers must fulfill the Criteria as specified

above and must attach the copies of the required documents.

1. Tender Form as per ANNEXURE – I

2. Application document for empanelment of Diagnostic Laboratories/ Imaging

Centers– ANNEXURE -IID

3. Copy of supporting documents of Registration with GST.

4. Copy of PAN card issued by the Income Tax Department.

5. Power of attorney (in Firms Letterhead) authorizing the signatories of the

bid to participate in the bid.

6. Copy of Documentary evidence for the constitution of the company /Firm

such as Memorandum and Articles of Association, Partnership deed etc. with

details of the Name, Address, Telephone Number, Fax Number, e-mail

address of the firm and of the Managing Director / Partners / Proprietor.

The list of present Directors in the board of the Company duly self-certified.

7. Copy of Certificate of Incorporation / Registration of firm.

8. Certificate of Undertaking – Annexure – III

9. Declaration in Rs.100/ Stamp paper as per Annexure- VIII.

10. Mandate Form as per Annexure - IX.

11. Pre Contract Integrity Pact (PCI) in Rs.100/ Stamp paper as per Annexure-

XI.

15

12. Copy of Documentary proof of Health care organizations located at

Mumbai, Navi Mumbai, Mumbai Metropolitan Region, Thane, Kalyan &

Pune cities a permanent place of business and the complete Postal

Address, telephone / Mobile / Fax / E-mail address, etc.

13. Copy of Tender document with corrigendum with signature of the Bidder

in each and every pages of the tender documents and corrigendum as an

evidence of acceptance of the tender terms and conditions.

14. Letter of Consent (in firms letterhead) to accept the charges fixed by CGHS

for availing credit facilities to provide treatment to Mumbai Port Trust

patients at the rate prescribed by CGHS

15. Copy of Documentary proof of empanelment with CGHS must be uploaded

in the BID if applicable.

16. Copy of the rates for all treatment procedures / investigations/ facilities

available with Health Care Organization and as charged by Health Care

Organization.

17. Copy of AERB approval for imaging facilities/ Radiotherapy, wherever

applicable

18. Copy of Registration under PNDT Act, if Ultrasonography facility is

available

19. Copy of Fire Clearance certificate and details of Fire safety mechanism as

in place in the health care Organization. Exclusive Eye centers, exclusive

dental Clinics have to enclose a certificate regarding fire safety of their

premises

20. Copy of State registration certificate / Registration with Local bodies,

wherever applicable.

21. Affidavit that the information provided has been correct in case of Non-

NABH/non NABL accredited health care Organizations.

22. Copy of NABH Accreditation in case of NABH Accredited health care

Organizations

23. Copy of list of treatment procedures /investigations/ facilities available in

the applicant healthcare Organization

24. Copy of the documents full filling necessary statutory requirements.

25. Any other supportive documents as required for this tender.

16

26. Check list as per ANNEXURE – XI

27. Scanned copy of receipt of cost of Tender Document submitted online by

NEFT/RTGS.

28 Diagnostic lab / Imaging Center /Cardiac Diagnostic centers must submit

the rates for all investigations services available with it and as charged

by it from other patients.

29. Diagnostic lab / Imaging Center/Cardiac Diagnostic centers must give an

undertaking accepting the terms and conditions spelt out in the

Memorandum of Agreement (Draft at Annexure VI) which should be read

as part of this application document.

30. Diagnostic lab / Imaging Center /Cardiac Diagnostic centers must certify

that they shall charge Mumbai Port Trust beneficiaries as per CGHS rates

and that the rates charged by them are not higher than the rates being

charged from their patients who are not Mumbai Port Trust beneficiaries.

31. Diagnostic lab / Imaging Center/Cardiac Diagnostic centers must certify

that they are fulfilling all special conditions that have been imposed by

any authority in lieu of special concessions such as but not limited to

concessional allotment of land or customs duty exemption.

32. The Diagnostic lab / Imaging center/Cardiac Diagnostic centers must fulfill

the above criteria, wherever applicable and annex copies of relevant

documents.

33. In addition the imaging centers shall meet the following criteria for the

equipment’s available with imaging centers:

i. MRI Centre

Must have MRI machine with magnet strength of 1.0 Tesla or more.

ii. CT Scan Centre

Whole Body CT Scanner with scan cycle of less than one second

(sub-second) must have been approved by AERB

iii. X-ray Centre /Dental X-ray/OPG center

X- Ray machine must have a minimum current rating of 500 MA

with image intensifier TV system Portable X-ray machine must have

a minimum current rating of 60 MA Dental X-ray machine must

have a minimum current rating of 6 MA OPG X-ray machine must

have a current rating of 4.5 -10 MA, must have been approved by

AERB

17

iv. Mammography Centre

Standard quality mammography machine with low radiations and

biopsy attachment.

v. USG / Colour Doppler Centre

It should be of high-resolution Ultrasound standard and of

equipment having convex, sector, linear probes of frequency ranging

from 3.5 to 10 MHz should have minimum three probes. And

provision/facilities of Trans Vaginal/ Trans Rectal Probes. Must

have been registered under PNDT Act

vi. Bone Densitometry Centre

Must be capable of scanning whole body

vii. Nuclear Medicine Centre

Must have been approved by AERB / BARC

TERMS & CONDITIONS:

1. Bidders should upload the Tender Form comprises of EMD and Annexure I to XII

Annexure – II is the application format to be filled up and submitted by the

Hospital General Purpose Hospitals/Cancer Hospitals....shall fill up Annexure-II

A-Hospitals

Eye Care Centres Shall fill up Annexure-II B-Eye

Dental Clinics shall fill up Annexure-II C –Dental

Diagnostic laboratories & Imaging Centers/Cardiac Diagnostic centers shall fill

up Annexure-II D –Diagnostic

Dialysis Hospital/Center Shall fill up Annexure-II E-Dialysis Center

Copies of Documents are to be annexed wherever specified.

2. DEPOSITION OF FEE FOR TENDER DOCUMENT AND EMD:

Tender documents can be downloaded from

https://etender.procuretiger.comThe downloading charges shall be Rs. 1000/-

plus 5% GST (Total Rs.1050/-). which should be deposited in Mumbai Port Trust

account as mentioned below through RTGS or NEFT, receipt copy of the same

should be uploaded online. No exemption from payment of downloading charges

is permitted. Also, details of the downloading charges have to be mentioned

online and a scanned copy of RTGS / NEFT slip is to be uploaded online during

e- tendering process at https://etender.procuretiger.com. The downloading





18

charges in the form of demand draft/ Cheque / Cash / Postal order will not be

accepted.

Earnest Money Deposit shall be Rs.50,000/- which should be deposited in

Mumbai Port Trust account as mentioned below through RTGS or NEFT, receipt

copy of the same should be uploaded online. No exemption from payment of EMD

is permitted. Also, details of the EMD have to be mentioned online and a

scanned copy of RTGS / NEFT slip is to be uploaded online during e-

tendering process at https://etender.procuretiger.com. Earnest money deposit

in the form of demand draft/Cheque / Cash / Postal order will not be accepted.

Purchaser will not pay any interest against the EMD deposited.

3. EARNEST MONEY DEPOSIT REFUND

3.1. In case the Application is rejected on technical grounds Earnest Money would

be refunded in full.

3.2. In case, the Application is rejected after inspection of documents on the

grounds of submitting incorrect information than 50% of the Earnest Money

would be forfeited and the balance amount would be refunded in due course.

4. PRELIMINARY EXAMINATION OF APPLICATIONS

4.1. Mumbai Port Trust will examine the applications to determine whether

they are complete, whether Earnest Money Deposit has been furnished,

and whether the applications are generally in order.

4.2. Mumbai Port Trust may waive any minor formality or non- Applications

without full technical details and/or EMD, and/or incomplete Annexures

will be rejected.

5. LETTER OF CONSENT TO ACCEPTANCE OF CGHS RATES

All the eligible Hospitals, exclusive eye hospitals / centers, exclusive dental

clinics, cancer hospitals/units and diagnostic centers should upload a letter of

consent to accept the charges fixed by CGHS for availing credit facilities to

provide Diagnostic services to Mumbai Port Trust patients at the rate prescribed

by CGHS are eligible to apply for empanelment in Mumbai Port Trust. If the letter

of consent for acceptance of CGHS Rate is not uploaded in the tender, the names

of such health Care Organization would be excluded from the list of health Care

Organizations under consideration for empanelment.

6. OFFER OF EMPANELMENT & SIGNING OF MEMORANDUM OF AGREEMENT

i. All eligible health Care Organizations have to submit the letter of

acceptance of Empanelment to Mumbai Port Trust.



19

ii. All eligible NABH / NABL accredited & Non -NABH / Non- NABL health

Care Organizations shall be asked to sign a Memorandum of Agreement

with Chief Medical Officer of Mumbai Port Trust and submit Performance

Bank Guarantee (PBG).

iii. The health Care Organizations, which are selected for empanelment, will

have to enter into an agreement with Mumbai Port Trust for providing

services at rates notified by CGHS as per the copy provided at annexure.

This MOA has to be executed on Rs.100/- non-judicial Stamp paper. MOA

should be read as part of Tender document.

7. VALIDITY & CONDITIONS OF CGHS RATES

7.1 The empanelment shall be valid for two years and is extendable by another

year with mutual agreement. The empaneled Organizations shall not charge

more than CGHS rates.

7.2 Mumbai Port Trust applicable CGHS “Package Rate” shall mean all inclusive

- including lump sum cost of inpatient treatment / day care / diagnostic

procedure for which a Mumbai Port Trust beneficiary has been permitted by

the competent authority or for treatment under emergency from the time of

admission to the time of discharge including (but not limited to) - (i)

Registration charges, (ii) Admission charges, (iii) Accommodation charges

including patients diet, (iv) Operation charges, (v)Injection charges, (vi)

Dressing charges, (vii) Doctor / consultant visit charges, (viii) ICU / ICCU

charges, (ix) Monitoring charges, (x) Transfusion charges and Blood

processing charges(xi)Pre Anesthetic checkup and Anesthesia charges,

(xii) Operation theatre charges, (xiii) Procedural charges / surgeon’s fee, (xiv)

Cost of surgical disposables and all sundries used during hospitalization, (xv)

Cost of medicines and consumables (xvi) Related routine and essential

investigations (xvii) Physiotherapy charges etc. (xviii) Nursing care charges

etc.

7.3 Package rates also include two pre-operative consultations and two post-

operative consultations.

7.4 Cost of Implants / stents / grafts are reimbursable in addition to package

rates as per CGHS ceiling rates or as per actual, whichever is lower.

7.5 In case a beneficiary demands a specific Brand of Stent / Implant and give

his consent in writing, the difference in cost over and above the ceiling rate

may be charged from the beneficiary, which is non-reimbursable.

7.6 During In-patient treatment of the Mumbai Port Trust beneficiary, the

hospital will not ask the beneficiary or his / her attendant to purchase

separately the medicines / sundries / equipment or accessories from outside

and will provide the treatment within the package rate, fixed by the CGHS

which includes the cost of all the items. However, the following items are not

admissible for reimbursement:

20

a. Toiletries

b. Sanitary napkins

c. Talcum powder

d. Mouth fresheners

7.7. In cases of conservative treatment / where there is no CGHS package

rate, calculation of admissible amount would be done item wise as per

CGHS rates or as per AIIMS rates, if there is no CGHS rate for a particular

item.

7.8. Package rates envisage up to a maximum duration of indoor treatment as

follows:

i. Upto 12 days - for Specialized (Super Specialties)

treatment

ii. Upto 7 days - for other Major Surgeries

iii. Upto 3 days - for/ Laparoscopic surgeries /elective

Angioplasty / normal deliveries

iv. 1 day - for day care / Minor (OPD)

surgeries.

7.9. However, if the beneficiary has to stay in the hospital for his / her recovery

for a period more than the period covered in package rate, in exceptional

cases, supported by relevant medical records and certified as such by

hospital, the additional reimbursement may be allowed, which shall be

limited to accommodation charges as per entitlement, investigations

charges at approved rates, doctors visit charges (not more than 2

visits per day) and cost of Medicines for additional stay).

7.10 No additional charge on account of extended period of stay shall be allowed

if that extension is due to infection on the consequences of surgical

procedure/ faulty investigation procedure etc.

7.11 The empaneled health Care Organization cannot charge more than CGHS

approved rates when a patient is admitted with valid Mumbai Port Trust

Card with prior permission or under emergency. In case of any instance

of overcharging the overcharged amount over and above CGHS rate (except

inadmissible items and difference paid due to implant/stent of a

specific brand chosen by Mumbai Port Trust beneficiary) shall be paid to

the beneficiary and shall be recovered from the pending bills of the

hospital.

7.12 If any empaneled health care Organization charges from Mumbai

Port Trust beneficiary for any expenses incurred over and above the

package rates vis-à-vis medicine, consumables, sundry equipment

and accessories etc., which are purchased from external sources, based

21

on specific authorization of treating doctor / staff of the concerned

hospital and if they are not falling under the list of non-admissible

items, reimbursement shall be made to the beneficiary and the

amount shall be recovered from the pending bills of hospitals.

8. EMR / EHR

The empaneled health Care Organizations (except eye hospital/center, dental

clinics, Diagnostic Labs/Imaging Centers /Cardiac Diagnostic centers.) shall

have to implement Electronic Medical Records and EHR as per the standards and

guidelines approved by Mumbai Port Trust within one year of its empanelment.

9. EMPANELMENT WITH AUTONOMOUS BODIES-

All empaneled hospitals/ diagnostic centers/ exclusive eye centers/ exclusive

dental clinics /Cardiac Diagnostic centers shall also agree for empanelment with

any autonomous body/ public sector undertaking at CGHS Rates.

10. PERFORMANCE BANK GUARANTEE (PBG)

10.1. Private Hospitals, Exclusive Eye Hospitals / Centres, Exclusive Dental

Clinics, Cancer Hospitals/Units, Diagnostic Laboratories & Imaging Centres

that are recommended for empanelment after the initial assessment shall also

have to furnish a performance Bank Guarantee valid for a period of 30 months

i.e. six months beyond the empanelment period, to ensure efficient services

and to safeguard against any default:

Hospitals/ Cancer hospitals/units Rs. 10.00 lac Eye Hospital/Centre Rs. 2.00 lac Dental Clinics Rs. 2.00 lac Diagnostic Centre Rs. 2.00 lac Dialysis Hospitals/Centers Rs. 2.00 lac

10.2. In case of health care Organizations already empaneled under Mumbai Port

Trust, they shall submit a new Performance Bank Guarantee after the validity

of the existing performance bank guarantee is over.

11. BILLING TO BE IN ELECTRONIC FORMAT

All Billing is to be done in electronic format and medical records need to be

submitted in digital format to the Bill Clearing agency (BCA) for necessary

processing. In addition to this physical submission of hard copies will also

have to be done to the BCA.

22

12. FEE FOR PROCESSING OF BILLS/CLAIMS

Bill clearing Agency (BCA) nominated by Chief Medical Officer of Mumbai Port

Trust will not charge any processing fee.

13. PAYMENT OF CLAIMS WITHIN AN ASSURED PERIOD

Mumbai Port Trust would ensure that subject to fulfillment of prescribed

conditions, payment of hospital claims (admissible amount) would be done

in time bound manner admissible amount after due scrutiny within a

maximum period of 30 days. Recoveries, if any, will be effected from future

bills of health care Organizations.

14. CORRUPT AND FRAUDULENT PRACTICES

14.1. “Corrupt practice” means the offering, giving, receiving or soliciting of

anything of value to influence the action of the public official “fraudulent

practice” means a misrepresentation of facts in order to influence E-Tender

process or an execution of a contract to the detriment of Mumbai Port Trust,

and includes collusive practice among bidding hospitals /authorized

representative/service providers (prior to or after bid submission)

designed to establish bid prices at artificial non-competitive levels and to

deprive CGHS of the benefits of the free and open competition; Mumbai Port

Trust will reject a proposal for award if it is established that the health care

Organization recommended for empanelment has engaged in corrupt or

fraudulent practices

14.2. Mumbai Port Trust will declare a health care Organization ineligible, either

indefinitely or for a stated period of time, to be empanelled if it at any time

determines that the applicant health care Organization has engaged in

corrupt and fraudulent practices in competing for, or in executing contract.

15. INTERPRETATION OF THE CLAUSES IN THE TENDER DOCUMENT

In case of any ambiguity in the interpretation of any of the clauses in

Application Document, interpretation of Chief Medical Officer of Mumbai Port

Trust of the clauses shall be final and binding on all parties.

16. RIGHT TO ACCEPT ANY APPLICATION AND TO REJECT ANY OR ALL

APPLICATIONS

Chief Medical Officer of Mumbai Port Trust reserves the right to accept or

reject any application and to annul the process and to reject all the

applications at any time without thereby incurring any liability to the affected

hospital/ authorized representative/ service provider or any obligation to

inform the affected hospital / authorized representative/ service provider of

the grounds for his action.

23

17. LIST OF DOCUMENTS AT ANNEXURE III

Every Application must be accompanied by documents as listed at Annexure

III.

18. MONITORING AND MEDICAL AUDIT

18.1. Mumbai Port Trust reserves the right to inspect the health care Organization

at any time to ascertain their compliance with the requirements of Mumbai

Port Trust

18.2. Bills of empaneled health care Organizations shall be reviewed

periodically for irregularities including declaration of planned procedures /

admissions as ‘emergencies’, unjustified investigations/treatment,

overcharging and prolonged stay, etc., and if any empaneled health Care

Organization is found involved in any wrong doings, then the concerned

hospitals/other health care Organizations would be suspended/ removed

from Mumbai Port Trust panel and would be black listed for specified period

for future empanelment with Mumbai Port Trust. Bank guarantee shall also

be forfeited.

19. EXIT FROM THE PANEL

The Rates fixed by the Mumbai Port Trust shall continue to hold good unless

revised by CGHS. In case the notified rates are not acceptable to the

empaneled health care Organizations, or for any other reason, the health care

Organization no longer wishes to continue on the list under Mumbai Port

Trust, it can apply for exclusion from the panel by giving one-month notice.

Patients already admitted shall continue to be treated.

20. NODAL OFFICERS

Empaneled health care organizations shall notify two Nodal officers for

Mumbai Port Trust beneficiaries, who can be contacted by Mumbai Port Trust

beneficiary in case of any eventuality.

21. APPROVED CGHS RATES AND TERMS AND CONDITIONS

The approved CGHS rates and terms and conditions can be had from the

Ministry of Health & Family Welfare website – http://www.mohfw.nic.in /

cghs.htm .

http://www.mohfw.nic.in/



24

22. PRE CONTRACT INTEGRITY PACT (PCI): (In Rs.100/- Stamp paper)

All the prospective bidders have to provide Integrity pact to Mumbai Port

Trust (MbPT) as per the format enclosed at Annexure- IX. The integrity pact

(IP) is essentially envisages an agreement between Mumbai Port Trust (MbPT)

and prospective Bidders/sellers committing the persons/officials of both

parties not to exercise any corrupt practices/influence on any aspect of the

contract. The vendors/bidders/sellers, only those who commit themselves to

the IP with Mumbai Port Trust (MbPT) would be considered competent to

participate in the bidding process. In other words, entering into this pact

would be a preliminary qualification (PQ) criterion. IP needs to be signed with

all the bidders who have participated in the tender, if the bids not

accompanied with the signed IP by the bidders along with the Technical bids,

the offers shall be summarily rejected.

23. TERMINATION OF CONTRACT:

Tender Inviting Authority will be at liberty to terminate, without assigning

any reasons thereof, the contract either wholly or in part on 30 days’ notice.

The Tenderer will not be entitled for any compensation whatsoever in respect

of such termination.

24. PRE TENDER MEETING:

24.1. Date of pre-tender meeting is mentioned in Schedule of e-tendering

activities.

24.2. Pre-tender meeting is called by the Tender Inviting Authority to explain

briefly about the requirements as well as the terms and conditions of the

tender document and to get the views of the prospective tenderers, as part

of ensuing transparency in the tender process.

24.3. It is an opportunity for the prospective tenderer to obtain all the details

about the tendered items, conditions governing the tenders and also to get

the explanation of any ambiguous condition that may be present in the

tender document.

24.4. It is also an opportunity for the Tender Inviting Authority to assess the

market and obtain feedback on the technical specifications/features etc

requested by the User Institution/funding agency, so as to make

amendments in the tender document on the basis of expert advice.

24.5. Failure to attend the Pre-tender meeting will not be a disqualification, but

a loss of opportunity for the prospective tenderers to understand about the

ambulance hired and the tender conditions.

24.6. Filled up Tenders will be accepted only after the date of pretender meeting.

25

ANNEXURE – I

FORM OF TENDER

The Chief Medical Officer,

Mumbai Port Trust.

1. I/We ___________________________________________, do hereby offer to execute

the work comprised in the annexed Tender Notice for Online Tender from eligible

and qualified tenderers for empanelment of private hospitals, exclusive eye hospitals/centers, exclusive dental clinics, cancer hospitals/units, diagnostic centers and Exclusive Dialysis hospitals/Centers for availing credit facilities to provide treatment to Mumbai Port Trust patients at the rate prescribed by CGHS for a period of two years. in strict accordance with the Instructions to Tenderers, General and Special Conditions of Contract, etc.

2. I/We certify that I/we have not made any interpolation in the tender documents.

3. In the event of my/our tender being accepted, I/We agree to enter into a contract

agreement in the prescribed form with such alterations or additions thereto which

may be necessary to give effect to the acceptance of this tender. However, until

such agreement is executed, this Tender together with your written acceptance

thereof shall constitute a binding contract between us.

4. I/We have independently considered the amount of liquidated damages stipulated

in “Tender Notice” and agree that they represent a fair estimate of the damages

likely to be suffered by you on the event of the work not being completed by us in

time and if not done in a kind of manner of workmanship.

5. I/We understand that MbPT are not bound to accept the lowest or any tender,

you may receive, and you may accept any tender in part.

6. I/We hereby certify that all my/our registration certificate/ license etc. required

to enter into this contract under the law of land is in force.

7. I/We have inspected the site and I am/we are fully aware of the work to be carried

out while tendering for the contract.

8. I/We enclose herewith a sum of Rs. 50,000/- (Rupees Fifty thousand only) as a

deposit or earnest money as proof of my/our willingness to enter into the contract

if my/our tender is accepted.

9. I/We also agree, if awarded the contract that the earnest money lodged with this

tender will be refunded only after submission of Security Deposit by cheque/

demand draft/ G.P. Notes/ Securities of Public Bodies/by way of a Bank

Guarantee, within fifteen days or such extension of the period permitted by the

Chief Medical Officer, in writing, after receipt of information that my/our tender

has been accepted by the Port Trust.

26

10. The Bank’s Guarantee will be from (Name and Address of our Banker) ___________

___________________________________________________.

11. I/We hereby agree for deduction of GST at source as applicable from the bill(s)

payable to me/ us, mentioned separately mentioned in the bill(s).

12. I/We hereby certify that my/our registration certificate under the GST on the

transfer of property in goods involved in the execution of the Works Contract, in

force on the date on which the sale of goods specified in this bill / cash

memorandum is made by me/us and the tax under the Act will be, if payable, be

paid before furnishing my/our return under the Act. I/We hereby agree for

deduction of GST at source at the prescribed rates

OR

13. I/We hereby certify that I/We am /are not registered under GST Act.

14. Our GST Registration Certificate No. is_______________________________.

15. My/Our Permanent Income Tax Account No. is _______________________.

16. I/We hereby agree to furnish as per the ‘mandate form’ the details of Bank

account(s) in which I/ We desire the e-payments to be made for cutting delays in

making payments. I/We hereby agree that Mumbai Port Trust will not be

responsible for any delayed payment due to non-submission of ‘mandate form’ by

me/ us.

17. *(A) mine in a proprietary firm and I am the sole proprietor of the firm.

18. My firm is/is not registered with Registrar of firms.

Witness’s Tenderer’s Signature:____________________ Signature :_____________________

Name: _________________________ Name: ___________________________

Address: ____________________ Address: _____________________

____________________ _____________________

___________________ _____________________

Tel. No.: ____________________ Tel. No.:_____________________ (Mobile No.): _____________________ (Mobile No.): _____________________ Date: ____________________ Date: _____________________

OR

*(B) Ours is a partnership firm and the names of all major partners are given below. Name Age

1. _________________________________ ______ years 2. _________________________________ ______ years

27

3. _________________________________ ______ years 4. _________________________________ ______ years We understand and confirm that if our offer is accepted, the contract will be entered

into with the above mentioned partners only and the Trustees will not recognize or

deal with any minor partners or their guardians.

Witness’s Tenderer’s Signature:____________________ Signature :_____________________

Name: _________________________ Name: ___________________________

Address: ____________________ Address: _____________________

____________________ _____________________

____________________ _____________________

Tel. No.: ____________________ Tel. No.: _____________________ (Mobile No.): _____________________ Date: ____________________ Date: _____________________

OR

*(C) Ours is a Company with liability and a copy of our Memorandum and Articles

of Association will be sent to perusal upon acceptance of our offer.

Proposed contract is intended to be signed by a duly constituted Attorney and

original power of Attorney in his favour will be submitted for perusal immediately on

acceptance of the tender.

The contract will be completed under the Company's Common Seal.

Dated this _________________________________ day of _________________2014.

(Signature) ____________________________(Name)_________________________________

N.B.: *Strike out whichever is not applicable. *****

28

ANNEXURE-II A

APPLICATION DOCUMENT FOR EMPANELMENT OF HOSPITALS, CANCER

HOSPITALS/UNITS IN MUMBAI PORT TRUST

1. Name of the city where hospital is located.

2. Name of the hospital

3. Address of the hospital

4. Tel / fax/e-mail

Telephone No

Fax

e-mail address

Name and Contact details of Nodal

persons

Whether NABH Accredited

Whether NABH Applied for

Whether QCI recommended/ applied for :

Details of Accreditation and Validity period:

Details of QCI/NABH application :

a. Details of the Tender cost of Rs. 1050/-

Name & Address of the Bank RTGS/NEFT No. Date of Issue

b. Details of the draft of EMD of Rs. 50000/-

29


5. For Empanelment as Hospital for all available facilities

Cancer Hospital/Unit

(Please select the appropriate column)

6. Total Number of beds

7. Categories of beds available with number of total beds in following type of

wards

Casualty/Emergency ward

ICCU /ICU

Private

Semi-Private (2-3 bedded)

General Ward bed (4-10)

Others

8. Total Area of the hospital

Area allotted to OPD

Area allotted to IPD

Area allotted to Wards

9. Furnishing specify as (a), (b), (c), (d) as per index below Index

(a) Bedsides table

b) Wardrobe

(c) Telephone

(d) Any other

30

10. Amenities specify as (a), (b) (c) (d) as per index below Amenities

(a) Air conditioner

(b) T.V.

(c) Room service

(d) Any other

11. Nursing Care

Total No. of Nurses

No. of Para-medical staff

12. Category of bed Bed/Nurse Ratio (acceptable Actual bed/nurse standard) ratio

a) General 6:1

b) Semi-Private 4:1

c) Private 4:1

d) ICU/ICCU 1:1

e) High dependency Unit 1:1

13. Alternate power source Yes

14. Bed occupancy rate

(Norm 85%)

General bed

Semi-Private Bed

Private Bed

Av daily census

Note: Bed occupancy rate = ______________________

Av No. of bed available

(i.e. number of authorized bed)

Total discharge during a year

15. Turnover ratio = --- -----------------------------------

Bed occupancy

No

Bed turnover rate

31

16. Man power:

1. No. of in house Doctors

2. No. of in house Specialists/Consultants

17. Laboratory facilities available –

Pathology

Biochemistry

Microbiology or

any other

18. Imaging facilities available

19. No. of Operation Theaters

20. Whether there is separate OT

for Septic cases

21. Supportive services

Boilers/sterilizers

Ambulance

Laundry

Housekeeping

Canteen

Gas plant

22. Waste disposal system as per statutory requirements

- Dietary

Others (preferably)

- Blood Bank

- Pharmacy

- Physiotherapy

32

23. ESSENTIAL INFORMATION REGARDING ARDIOLOGY & CTVS

Number of coronary angiograms done in last one year

Number of Angioplasty done in last one year

Number of open heart surgery done in last one year

Number of CABG done in last year

24. RENAL TRANSPLANTATION, HAEMODIALYSIS / UROLOGY-UROSURGERY

Number of Renal Transplantations done in one year (2012-

13)

Number of years of duration of facilities

Number of Hemodialysis unit.

Criteria for Dialysis:

The center should have good dialysis unit neat, clean and hygienic like a

minor OT.

Centre should have at least four good Haemodialysis machines with

facility of giving bicarbonate Haemodialysis.

Centre should have water-purifying unit equipped with reverse osmosis.

Unit should be regularly fumigated and they should perform regular

antiseptic precautions.

Centre should have facility for providing dialysis in Sero positive cases.

Centre should have trained dialysis Technician and Sisters and full time

Nephrologist and Resident Doctors available to combat the complications

during the dialysis.

Centre should conduct at least 150 dialyses per month and each session

of hemodialysis should be at least 4 hours.

Facility should be available 24 hours a day.

Whether it has an immunology lab. Yes

If so, does it exist within the city where the hospital is located Yes

Whether it has blood transfusion Service with facilities Yes

for screening HIV markers for Hepatitis (B&C), VDRL

Whether it has a tissue typing unit DBCA/IMSA/DRCG scan

facility and the basic radiology facilities

No

No

No

33

No. of cases treated by lithotripsy in last one year ( 2012-

2013)

Average number of sitting required Per case

Percentage of cases selected for Lithotripsy, which required y

conventional Surgery due to failure of lithotripsy

25. LIVER TRANSPLANTATION- Essential information reg.

Technical expert with experience in liver Transplantation who had

assisted in at least fifty liver transplants. Yes

Name and qualifications)

Month and year since Liver

Transplantation being carried out:

No. of liver transplantation done

during the last one year:

Success rate of Liver Transplant:

Facilities of transplant immunology lab.

Tissue typing facilities Yes

Blood Bank Yes

No

No

No

34

26. ORTHOPAEDIC JOINT REPLACEMENT

a. Whether there is Barrier Nursing for Isolation for patient. Yes

b. Facilities for Arthroscopy Yes

27. NEUROSURGERY.

Whether the hospital has Operation theatre for Neuro Surgery Yes

Whether there is Barrier Nursing for Isolation for patient Yes

Whether, it has required instrumentation for Neuro-surgery Yes

Facility for Gamma Knife Surgery , Yes

Facility for Trans-sphenoidal endoscopic Surgery Yes

Facility for Stereotactic surgery Yes

28. GASTRO-ENTEROLOGY

Whether the hospital has aseptic Operation theatre for Gastro-

Enterology & GI Surgery Yes No

Whether, it has required instrumentation for Gastro-Enterology Yes No

– GI Surgery

Facilities for Endoscopy – specify details Yes

29 E.N.T. – Essential information reg.

Whether the hospital has aseptic Operation theatre for ENT Yes

Whether, it has required instrumentation for E.N.T. Surgery

including diagnostic procedures Yes

Facilities for Endoscopy – Yes

Facilities for reconstruction surgery – Yes

30. Oncology.

I. Whether the hospital has aseptic Operation theatre for Oncology –

Surgery Yes

No

No

No

No

No

No

No

No

No

No

No

No

No

No

35

II. Whether, it has required instrumentation for Oncology Surgery

Yes No

III. Facilities for Chemotherapy Yes No

IV. Facilities for Radio-therapy ( specify ) Yes

V. Radio-therapy facility and Manpower shall be as Per guidelines of

BARC Yes

VII. Details of facilities under Radiotherapy Yes

31. Endoscopic / Laparoscopic Surgery:

Criteria for Laparoscopic/Endoscopic Surgery:

- Center should have facilities for casualty/emergency ward, full-fledged ICU,

proper wards, proper number of nurses and paramedical, qualified and

sufficient number of Resident doctors/specialists.

- The surgeon should be Post Graduate with sufficient experience and

qualification in the specialty concerned.

- He/She should be able to carry out the surgery with its variations and able to

handle its complications.

- The hospital should carry out at least 250 laparoscopic surgeries per year.

- The hospital should have at least one complete set of laparoscopic equipment

and instruments with accessories and should have facilities for open surgery

i.e. after conversion from Laparoscopic Surgery.

Yes

SIGNATURE OF APPLICANT OR AUTHORIZED AGENT

No

No

No

No

36

ANNEXURE-II B(EYE)

APPLICATION DOCUMENT FOR EMPANELMENT OF EXCLUSIVE EYE

HOSPITALS/CENTRES IN MUMBAI PORT TRUST

1. Name of the city where Eye Hospital /Centre is located.

2. Name of the Eye hospital/ centre

3. Address of the Eye hospital / centre

4. Tel / fax/e-mail

Telephone No

Fax

e-mail address


persons






37





8. FOR IOL IMPLANT:

(i) Phacoemulsifier Unit (IIIrd or IVth generation) –

minimum 2 with extra hand pieces

(ii) Flash/rapid sterilizer – one per OT

(iii) YAG laser for capsulotomy

(iv) Digital anterior segment camera

(v) Specular microscope

Whether beds available Yes No

( General, Semi Private, Private or Deluxe Room Yes No

(If yes, specify the number)

G1 Ward

9 ) OCULOPLASTY & ADENEXA:

Specific for Oculoplasty & Adenexa:

Specialized Instruments and kits for:

(i)Dacryocystorhinostomy

(ii) Eye lid Surgery e.g ptosis and Lid reconstruction Surgery

(iii) Orbital surgery

(iv) Socket reconstruction

(v) Enucleation/evisceration

Semi Pvt.

Ward

Pvt. Ward

38

(Vi) Availability of Trained, proficient Oculoplasty surgeon who is trained for

Oculoplasty , Lacrimal and Orbital Surgery

10). A) INVESTIGATIVE FACILITIES:

(i) Syringing, Dacryocystography

(ii) Exophthalmometry

(iii) Ultrasonography – A&B Scan

(iv) Imaging facilities - X-ray, CT Scan & MRI Scan

(v) Ocular pathology, Microbiology services

(vi) & Blood bank services.

(vii) Consultation facilities from related Specialties such as ENT,

Neurosurgery,Hematology, Oncology

(B) OPERATIVE (O.T.) FACILITIES:

Specialized instruments & Kits for the following surgeries should be available.

(i) Dacryo cystorhinostomy

(ii) Lid surgery including eyelid reconstruction & Ptosis correction.

(iii) Orbital surgery

(iv) Socket reconstruction

(v) Enucleation & Evisceration

(vi) Orbital & Adnexal Trauma including Orbital fractures.

(C) PERSONNEL:

i) Resident Doctor Support

ii) Nursing care (24 hours)

iii) Resuscitative facilities

11) STRABISMUS SURGERY:

Functional OT with Instruments needed for strabismus Surgery Yes

Availability of set up for Pediatric Strabismus - Orthoptic room

with distance fixation targets (preferably child friendly) may

No

39

have TV/VCR, Lees/Hess. Chart Yes

12) GLAUCOMA:

1) Specific: Facilities for Glaucoma investigation & management.

a) Applanation tonometery

b) Stereo Fundus photography/OCT/ Nerve fibre Analyser

c) YAG Laser for Iridectomy

d) Automated/Goldmann fields (Perimetry)

e) Electrodiagnostic equipments (VER, ERG, EOG)

f) Colour Vision – Ishiahara Charts

g) Contrast sensitivity – Pelli Robson Charts

h) Pediatric Vision testing – HOTV cards

i) Autorefractometers

j) Synaptophore (basic type with antisuppresion)

k) Prism Bars

l) Stereo test (Randot/TNO)

m) Red – Green Goggles

n) Orthoptic room with distance fixation targets

Preferably child friendly) may have TV/VCR.

o) Lees/Hess chart


No

40

ANNEXURE-II C(DENTAL)

APPLICATION DOCUMENT FOR FOR EMPANELMENT OF EXCLUSIVE

DENTAL CLINICS IN MUMBAI PORT TRUST

1. Name of the city where Exclusive Dental clinic is located.

2. Name of the Exclusive Dental Clinic

3. Address of the Exclusive Dental Clinic

1. Telfax/e-mail

Telephone No

Fax

e-mail address


persons






41





8. Exclusive Dental Clinic : (Infrastructure and technical Specifications)

Number of Dental Chairs:

(A) (i)For General Dental Clinic

(Availability of recovery bed for Dental Clinic)

(if available, specify the number of beds)…………….

(ii)For Specialized Dental Clinic

(Whether beds are available for Specialized Dental Clinic) Yes

If, Yes Number

(B) Whether separate O.T. available for aseptic /septic cases(For specialized

Dental clinics) Yes

(C) Alternative Power supply Give details Yes

(D) (a)Laboratory facilities for routine Clinical Yes

(E) Dental X-ray Machine

IOPA 60-70 Kv, 8 mA, Exposure Yes

(with minimum radiation leakage) time selection 0.01 to 3 seconds

O.P.G. Machine 60-70 Kv, 8 MA Yes

* All Specialists employed on regular and visiting basis must possess Dental

Council of India’s recognized qualifications. A Post Graduate should head each

specialty.


No

No

No

No

Pathology, Bio-chemistry, Microbiology ….

(b) Routine facilities for X-ray OPG Dental X-ray

No

No

42

ANNEXURE-II D(DIAGNOSTIC)

APPLICATION DOCUMENT FOR EMPANELMENT OF DIAGNOSTIC

LABORATORIES/ IMAGING CENTRES

1. Name of the city where DIAGNOSTIC LAB / IMAGING CENTRE is located.

2. Name of the Diagnostic Lab / Imaging Centre

3. Address of the Diagnostic Lab / Imaging Centre

4. Tel/fax/e-mail

Telephone No

Fax

e-mail address


persons

Whether QCI recommended :

Whether NABL/NABH/QCI applied for :

Enclose copy of accreditation certificate (wherever applicable) :

Applied for ----------------------------------- Diagnostic Lab (Facilities to be mentioned)

Applied for ……………………………….Imaging Centre (Facilities to be mentioned)

43

Nuclear Medicines Lab :

X-Ray :

Ultra Sonography :

CT Scan :

MRI :

ECG / EEG/ Nerve Conduction velocity :

Others (for listed procedures) :

Details of application fee of Rs. 1000/-

Name of bank Address of bank DD no. Validity

Details of EMD amount of Rs. 50,000/-

Name of bank Address of bank DD no. Validity

CRITERIA FOR LABORATORY DIAGNOSTIC CENTER: -

Indicate (√ ) for Yes and (x) for No in the Box 1) Laboratories (Clinical Pathology):

- Space: Minimum 10X12 ft

Adequate space for collection of samples and dispatch of reports.

Waiting space - Minimum for 10 patients.

- Equipment:

Microscope

fully automatic hematology cell counter

Incubator

centrifuge machine

fridge (300 liters)

Automated Electrophoresis apparatus

44

Automated Coagulation apparatus

Cytology and histopathology related set up

Needle Destroyer Trolley for waste disposal with Bags.

- Manpower with Qualification:

Technician –

Diploma in MLT and adequate experience of handling pathology

specimens including Cytology and Histopathology.

Facilities for Waste Management: Provision for waste management as

per the Biomedical waste Act., 1998

- Quality Control:

Arrangement for Internal and external quality control.

The set up should be able to handle the workload with adequate staff

and equipments. Reports should be available at the earliest depending

on the test.

- Backup of Generator, UPS, Emergency light

- General requirements for Pathological Diagnostic Centers:

• Minimum workload of 40-50 samples per day (not tests).

• Slides for Histopathology / Cytology should be preserved a reasonable

period.

• Records of patients /investigation should be well maintained and

updated.

• Charges should be displayed on the notice board.

• Fire Fighting system should be in place wherever it is necessary.

(certificate of fire compliance)

2) Laboratory (Biochemistry):-

- Space for working lab minimum 10X12 ft.

Reception and sample collection should have an area for at

least 10 patients to sit.

45

Laboratory (Preferably air-conditioned)

Washing area/waste disposal.

- Equipment:

Refrigerator

Water-bath

Hot-air-oven

Centrifuge machine

Photo-electric calorie meter or

Spectrophotometer or

semi-auto-analyzer/autoanalyzer

Flame Photometer or ISE Analyzer

Micro-pipettes

All related Lab glassware and

reagents needle destroyer

standard balance

- Manpower with qualification:

Technician with DMLT.

Provision for waste management as per the Biomedical waste Act., 1998:

- Quality Control:

Should be Internal as well as External Backup of Generator, UPS, and

Emergency light

- 24 hours supply of water,

provision for toilet.

- Indicate (√ ) for Yes and (x) for No in the Box

Additional requirements for Laboratory for Hospitals/ Nursing Homes:-

46

- In addition to the criteria written above the following

additional equipment will be required Blood Gas analyzer

Elisa Reader

HPLC and

Electrophoresis apparatus

3) Laboratory (Microbiology):

- Minimum Space required is 10X12 ft.

Receiving samples & labeling, sorting, registration minimum

waiting space for 10 patients and dispatch area

Media room (autoclave, hot air oven, pouring hood) Area required

minimum 6X4 ft.

Processing of samples – staining, cultures etc.

- Minimum Space required is 10X12 ft.

- Equipment:

Non-expendable – Autoclave

Hot Air oven

water bath,

Incubator

centrifuge

Microscopes vortex ELISA reader.

Expendable – Chemicals, media, glassware,

stationery etc.

- Manpower with qualification:

Technician – DMLT

- Provision for waste management as per the Biomedical waste Act., 1998.

- Quality control:

Internal

External tie up with higher Organizations.

Backup of Generator, UPS, Emergency light.


42

ANNEXURE-II E (DIALYSIS CENTRE)

APPLICATION DOCUMENT FOR EMPANELMENT OF EXCLUSIVE DIALYSIS

HOSPITALS/ CENTERS IN MUMBAI PORT TRUST

5. Name of the city where hospital/Center is located.

6. Name of the hospital / Centers

7. Address of the hospital /Centers

8. Tel / fax/e-mail

Telephone No

Fax

e-mail address


persons






c. Details of the Tender cost of Rs. 1050/-


48

d. Details of the draft of EMD of Rs. 50000/-


9. For Empanelment as Hospital for all available facilities

Dialysis Hospital/Unit

(Please select the appropriate column)

10. Total Number of beds

11. Categories of beds available with number of total beds in following type of wards

Casualty/Emergency ward

ICCU /ICU

Private

Semi-Private (2-3 bedded)

General Ward bed (4-10)

Others

12. Total Area of the hospital

Area allotted to OPD

Area allotted to IPD

Area allotted to Wards

9. Furnishing specify as (a), (b), (c), (d) as per index below Index

(a) Bedsides table

b) Wardrobe

(c) Telephone

(d) Any other

11. Amenities specify as (a), (b) (c) (d) as per index below Amenities

49

(e) Air conditioner

(f) T.V.

(g) Room service

(h) Any other

11. Nursing Care

Total No. of Nurses

No. of Para-medical staff

12. Category of bed Bed/Nurse Ratio (acceptable Actual bed/nurse standard) ratio

a) General 6:1

f) Semi-Private 4:1

g) Private 4:1

h) ICU/ICCU 1:1

i) High dependency Unit 1:1

15. Alternate power source Yes

16. Bed occupancy rate

(Norm 85%)

General bed

Semi-Private Bed

Private Bed

Av daily census

Note: Bed occupancy rate = ______________________

Av No. of bed available

(i.e. number of authorized bed)

Total discharge during a year

23. Turnover ratio = --- -----------------------------------

Bed occupancy

24. Man power:

No

Bed turnover rate

50

a. No. of in house Doctors

b. No. of in house Specialists/Consultants

25. Laboratory facilities available –

Pathology

Biochemistry

Microbiology or

any other

26. Imaging facilities available

27. No. of Operation Theaters

28. Whether there is separate OT

for Septic cases

21. Supportive services

Boilers/sterilizers

Ambulance

Laundry

Housekeeping

Canteen

Gas plant

22. Waste disposal system as per statutory requirements

- Dietary

Others (preferably)

- Blood Bank

- Pharmacy

- Physiotherapy

24. RENAL TRANSPLANTATION, HAEMODIALYSIS / UROLOGY-UROSURGERY

51

Number of Renal Transplantations done in one year (2016-

17)

Number of years of duration of facilities

Number of Hemodialysis unit.

Criteria for Dialysis:

The center should have good dialysis unit neat, clean and hygienic like a minor

OT.

Centre should have at least four good Haemodialysis machines with facility of

giving bicarbonate Haemodialysis.

Centre should have water-purifying unit equipped with reverse osmosis.

Unit should be regularly fumigated and they should perform regular antiseptic

precautions.

Centre should have facility for providing dialysis in Sero

positive cases.

Centre should have trained dialysis Technician and Sisters and full time

Nephrologist and Resident Doctors available to combat the complications

during the dialysis.

Centre should conduct at least 150 dialyses per month and each session of

hemodialysis should be at least 4 hours.

Facility should be available 24 hours a day.

Whether it has an immunology lab. Yes

If so, does it exist within the city where the hospital is located Yes

Whether it has blood transfusion Service with facilities Yes

for screening HIV markers for Hepatitis (B&C), VDRL

Whether it has a tissue typing unit DBCA/IMSA/DRCG scan

facility and the basic radiology facilities

Yes


No

No

No

52

ANNEXURE-III

CERTIFICATE OF UNDERTAKING

1. It is certified that the particulars given above are correct and eligibility criteria

are satisfied.

2. That Hospital/ eye center/Exclusive Dental Clinic/ Diagnostic laboratory/

Imaging Centre /Cardiac Diagnostic centers shall not charge CGHS

beneficiaries higher than the CGHS notified rates or the rates charged from

other patients who are not CGHS beneficiaries.

3. That the rates have been provided against a facility/procedure/investigation

actually available at the Organization.

4. That if any information is found to be untrue, Hospital/ Eye center/Dental

clinic/ Diagnostic Centre/Cardiac Diagnostic centers would be liable for de-

empanelment by Mumbai Port Trust. The Organization will be liable to pay

compensation for any financial loss caused to Mumbai Port Trust or physical

and or mental injuries caused to its beneficiaries.

5. That the Hospital/ Eye center/Dental clinic/ Diagnostic Centre/Cardiac

Diagnostic centers has the capability to submit bills and medical records in

digital format and that all Billing will be done in electronic format and medical

records will be submitted in digital format.

6. The Hospital/ Eye center/Dental clinic/ Diagnostic Centre /Cardiac

Diagnostic centers will pay damage to the beneficiaries if any injury, loss of

part or death occurs due to gross negligence.

7. That the Hospital/ Eye center/Dental clinic/ Diagnostic Centre/Cardiac

Diagnostic centers has not been derecognized by CGHS or any State

Government or other Organizations.

8. That no investigation by central Government/State Government or any

statuary Investigating agency is pending or contemplated against the

Hospital/ Eye centre/Dental clinic / Diagnostic Centre/Cardiac Diagnostic

centers.

9. Agree for the terms and conditions prescribed in the Tender document.

10. Hospital agrees to implement Electronic Medical Records and EHR as per the

standards approved by Mumbai Port Trust within one year of its

empanelment.


53

ANNEXURE-IV

ACCEPTANCE LETTER

(To be given on Health Care Organizations Letter Head)

Date:

To,

______________________

______________________

Sub: Acceptance of Terms & Conditions of Tender.

Tender Reference No: ________________________

Name of Tender/ Work: -

________________________________________________________________________________

Dear Sir,

1. I/ We have downloaded / obtained the Tender document(s) for the above

mentioned ‘Tender/Work’ from the web site(s) namely:

________________________________________________________________________________

as per your advertisement, given in the above mentioned website(s).

2. I / We hereby certify that I / we have read the entire terms and conditions of the

Tender documents from Page No. _______ to ______ (including all documents like

annexure(s), schedule(s), etc .,), which form part of the contract agreement and I /

we shall accept hereby by the terms / conditions / clauses contained therein.

3. The corrigendum(s) issued from time to time by your department/ organizations

too have also been taken into consideration, while submitting this acceptance letter.

4. I / We hereby unconditionally accept the Tender conditions of above mentioned

Tender document(s) / corrigendum(s) in its totality / entirety.

5. In case any provisions of this tender are found violated, then your

department/organization shall without prejudice to any other right or remedy be at

liberty to reject this Application/application including the forfeiture of the full said

earnest money deposit absolutely.

6. Also I / We have not been suspended / blacklisted by any PSU / Government

Department /Financial Organization / Court.

Yours Faithfully,

(Signature of the Applicant with Official Seal)

54

ANNEXURE- V

DRAFT MOA

MUMBAI PORT TRUST MUMBAI

AGREEMENT BETWEEN BOARD OF TRUSTEES OF PORT OF MUMBAI AND

…………………………………Name of the City

This Agreement is made on the ________ day of _________, 2017 between the BOARD

OF TRUSTEES OF PORT OF MUMBAI through Chief Medical Officer, Mumbai Port

Trust having its office at Port Bhawan, P.D’meilo Road, Shoorji Vallabhdas Marg,

Ballard Estate, Mumbai – 400 001(hereinafter called MbPT, which expression shall,

unless repugnant to the context or meaning thereof, be deemed to mean and include

its successors and assigns) of the First Part

AND

……………………………………….. (Name of the Hospital with Address) of the Second

Part.

WHEREAS, the MUMBAI PORT TRUST is providing comprehensive medical care

facilities to the Mumbai Port Trust Employees / Pensioners / CISF and such other

categories ofbeneficiaries as are decided from time to time.

AND WHEREAS, MUMBAI PORT TRUST proposes to provide treatment facilities and

diagnostic facilities to theBeneficiaries in the Private empanelled Hospitals, exclusive

eye hospitals/centres, exclusive dentalclinics, Diagnostic Laboratories/ Imaging

centres in ------------- (Name of City)

AND WHEREAS, (Name of the Hospitals, Exclusive Eye Hospitals/ Centres, Exclusive

Dental Clinics and Diagnostic Laboratories/ Imaging Centers) has agreed to give the

following treatment /diagnostic facilities to the Mumbai Port Trust Beneficiaries in

the Health Care Organization at the rates offeredby CGHS:

……………………………………………………………………………………………………………

………………………………………………

……………………………………………………………………………………………………………

……………………

NOW, THEREFORE, IT IS HEREBY AGREED between the Parties as follows:

1. DEFINITIONS & INTERPRETATIONS

1.1 The following terms and expressions shall have the following meanings for

purposes ofthis Agreement:

55

1.1.1 “Agreement” shall mean this Agreement and all Schedules,

supplements,appendices, appendages and modifications thereof made in

accordance withthe terms of this Agreement.

1.1.2 “Benefit” shall mean the extent or degree of service the beneficiaries areentitled

to receive as per the rules on the subject.

1.1.3 “Bill Clearing Agency “(BCA) means the agency appointed by Mumbai Port Trust

for processing of Data/ Bills of all Mumbai Port Trust beneficiaries (both

serving and pensioner) attending the empanelled Private Hospitals and for

making payment.

1.1.4 “Card” shall mean the Mumbai Port Trust Card, issued by any competent

authority, of Mumbai Port Trust.

1.1.5 “Card Holder” shall mean a person having a Mumbai Port Trust Card.

1.1.6 “Mumbai Port Trust Beneficiary” shall mean a person who is eligible and hold

a valid Mumbai Port Trust card for the benefit.

1.1.7 “Coverage” shall mean the types of persons to be eligible as the beneficiaries

of the Scheme to health services provided under the Scheme, subject to the

terms, conditions and limitations.

1.1.8 “Diagnostic Center” shall mean the (Name of the Diagnostic Center)

performing tests / investigations

1.1.9 “Imaging Centre” shall mean the (Name of the Imaging Centre) performing X-

ray, CT Scan, MRI, USG, etc.,

1.1.10 “Emergency” shall mean any condition or symptom resulting from any cause,

arising suddenly and if not treated at the early convenience, be detrimental to

the health of the patient or will jeopardize the life of the patient.

1.1.11 “Empanelment” shall mean the hospitals, exclusive eye hospitals/centres,

exclusive dental clinics, Diagnostic Laboratories/ Imaging centres authorized

by the Mumbai Port Trust for treatment/ investigation purposes for a

particular period.

1.1.12 “Hospital” shall mean the (Name of the Hospital) while performing under this

Agreement providing medical investigation, treatment and the healthcare of

human beings.

1.1.13 “De-recognition of Hospital” shall mean debarring the hospital on account of

adopting unethical practices or fraudulent means in providing medical

treatment to or not following the good industry practices of the health care for

the Mumbai Port Trust beneficiaries after following certain procedure of

inquiry

1.1.14 “Party” shall mean either the Mumbai Port Trust or the Hospital and “Parties”

shall mean both the Mumbai Port Trust and the Hospital .

1.1.15 “CGHS “Package Rate” shall mean all inclusive – including lump sum cost of

inpatient treatment / day care / diagnostic procedure for which a Mumbai

Port Trust beneficiary has been permitted by the competent authority or for

treatment under emergency from the time of admission to the time of

discharge including(but not limited to) – (i) Registration charges, (ii) Admission

charges, (iii)Accommodation charges including patients diet, (iv) Operation

charges, (v)Injection charges, (vi) Dressing charges, (vii) Doctor / consultant

56

visit charges,(viii) ICU / ICCU charges, (ix) Monitoring charges, (x) Transfusion

charges and Blood processing charges (xi)Pre Anesthetic checkup and

Anesthesia charges, (xii) Operation theatre charges, (xiii) Procedural charges

/ surgeon’s fee, (xiv) Cost of surgical disposables and all sundries used during

hospitalization, (xv) Cost of medicines and consumables (xvi) Related routine

and essential investigations (xvii) Physiotherapy charges etc. (xviii) Nursing

care charges etc.

Package rates also include two pre-operative consultations and two

postoperative consultations.

Cost of Implants / stents / grafts is reimbursable in addition to package rates

as per CGHS ceiling rates or as per actual, whichever is lower.

In case a beneficiary demands a specific Brand of Stent / Implant and give his

consent in writing, the difference in cost over and above the ceiling rate maybe

charged from the beneficiary, which is non-reimbursable.

During In-patient treatment of the Mumbai Port Trust beneficiary, the

hospital will not ask the beneficiary or his / her attendant to purchase

separately the medicines /sundries / equipment or accessories from outside

and will provide the treatment within the package rate, fixed by the CGHS

which includes the cost of all the items. However, the following items are not

admissible for reimbursement:

Toiletries

Sanitary napkins

Talcum powder

Mouth fresheners

In cases of conservative treatment / where there is no CGHS package rate,

calculation of admissible amount would be done item wise as per CGHS rates

or as per AIIMS rates , if there is no CGHS rate for a particular item.

Package rates envisage up to a maximum duration of indoor treatment as

follows:

Upto 12 days for Specialized (Super Specialties) treatment

Upto 7 days for other Major Surgeries

Upto 3 days for / Laparoscopic surgeries / elective Angioplasty / normal

deliveries and 1 day for day care / Minor (OPD) surgeries.

However, if the beneficiary has to stay in the hospital for his / her recovery for

a period more than the period covered in package rate, in exceptional cases,

supported by relevant medical records and certified as such by hospital, the

additional reimbursement may be allowed, which shall be limited to

accommodation charges as per entitlement , investigations charges at

approved rates, doctors visit charges (not more than 2 visits per day per visit

by specialists / consultants) and cost of medicines for additional stay).

57

No additional charge on account of extended period of stay shall be allowed if

that extension is due to infection on the consequences of surgical

procedure/faulty investigation procedure etc.

The empanelled health Care Organization cannot charge more than CGHS

approved rates when a patient is admitted with valid Mumbai Port Trust Card

with prior permission or under emergency. In case of any instance of

overcharging the over charged amount over and above CGHS rate (except

inadmissible items and difference paid due to implant/stent of a specific

brand chosen by Mumbai Port Trust beneficiary) shall be paid to the

beneficiary and shall be recovered from the pending bills of the hospital.

If any empanelled health care Organization charges from CGHS beneficiary for

any expenses incurred over and above the package rates vis-à-vis medicine,

consumables, sundry equipment and accessories etc., which are purchased

from external sources, based on specific authorization of treating doctor / staff

of the concerned hospital and if they are not falling under the list of non-

admissible items, reimbursement shall be made to the beneficiary and the

amount shall be recovered from the pending bills of hospitals.

1.1.16. “BCA” shall mean a Third Party Administrator authorized by Mumbai Port

Trust to process the medical reimbursement claims or to carry out medical

audit.

Annexures-I shall be deemed to be an integral part of this Agreement.

The terms and conditions stipulated in the Tender document shall be read as part of

this agreement.

2. DURATION OF AGREEMENT

The Agreement shall remain in force for a period of 2 years. The Agreement may be

extended for another year subject to fulfillment of all the terms and conditions of this

Agreement and with mutual consent of both parties.

3. CONDITIONS FOR PROVIDING TREATMENT/SERVICES

A. GENERAL CONDITIONS

The hospitals, Exclusive Eye hospitals/centres, Exclusive Dental Clinics and

Diagnostic centres shall be empanelled for all facilities/services available in the

health care organization as approved by NABH/NABL/QCI and shall not be

empanelled for selected specialties/ facilities.

The Hospitals, Exclusive Eye Hospitals/centres, Exclusive Dental clinics, Diagnostic

Laboratories/ Imaging Centres shall investigate / treat the Mumbai Port Trust

58

beneficiaries only for the condition for which they are referred with due authorization

letter.

In case of unforeseen emergencies of these patients during admission for approved

procedure, ‘provisions of emergency treatment’ shall be applicable.

It is agreed that Mumbai Port Trust beneficiaries shall be attended to on priority.

Mumbai Port Trust has the right to monitor the treatment provided in the Private

Hospitals, exclusive eye hospitals/centres, exclusive dental clinics, Diagnostic

Laboratories/ Imaging centres.

B. AUTHORISATION LETTER FOR TREATMENT

The treatment/procedure shall be performed on the basis of the authorization letter

issued by the Chief Medical Officer of Mumbai Port Trust.

C. INVESTIGATIONS PRIOR TO ADMISSION

All investigations regarding fitness for the surgery will be done prior to the admission

for any elective procedure and are part of package.

D. ADDITIONAL PROCEDURES/INVESTIGATIONS

For any material / additional procedure / investigation other than the condition for

which the patient was initially permitted, would require the permission of the

competent authority except under emergency.

E. PROCEDURE WHERE REFERRED CASE NEEDS TREATMENT IN A

SPECIALITY(s) WHICH ARE NOT AVAILABLE IN THE HOSPITAL

The Hospital, Exclusive Eye centre, Exclusive Dental clinic, Diagnostic Laboratory/

Imaging shall not undertake treatment of referred cases in specialties which are not

available in the hospital. But it will provide necessary treatment to stabilize the

patient and transport the patient safely to nearest recognized hospital under

intimation to Mumbai Port Trust authorities. However in such cases the Hospital will

charge as per the CGHS rates only for the treatment provided.

F. CHANGES IN INFRASTRUCTURE/STAFF TO BE NOTIFIED TOMUMBAI PORT

TRUST


Imaging Centreshallimmediately communicate to Chief Medical Officer of Mumbai

Port Trust about any change in the infrastructure /Shifting of premises. The

empanelment will betemporarily withheld in case of shifting of the facility to any

other location without priorpermission of Mumbai Port Trust. The new establishment

59

of the same Hospital shall attract a freshinspection, at the prescribed fee, for

consideration of continuation of empanelment.

F. ANNUAL REPORT


Imaging will submit an annual report regarding number of referrals received,

admitted Mumbai Port Trust beneficiaries, bills submitted to the Mumbai Port Trust

and payment received, details of monthly report submitted to the Chief Medical

Officer of Mumbai Port Trust. Annual audit report of the hospitals will also be

submitted along with the statement.


Imaging shall submit all the medical records in digital format.

H. EMR / EHR

The empanelled health Care Organizations (except eye hospital/centre, dental

clinics, Diagnostic Labs/Imaging Centres) shall have to implement Electronic

Medical Records and EHR as per the standards and guidelines approved by Mumbai

Port Trust within one year of its empanelment.

I. EMPANELMENT WITH AUTONOMOUS BODIES

All empanelled hospitals/ diagnostic centres/ exclusive eye centres/ exclusive dental

clinics shall also agree for empanelment with any autonomous body/ public sector

undertaking on same terms & conditions as with Mumbai Port Trust

J. MEETINGS

Authorized signatory / representative of the empanelled health care organizations

shall attend the periodic meetings held by Chief Medical Officer of Mumbai Port Trust

required in connection with improvement of working conditions and for redressal of

grievances.

K. INSPECTIONS

During the visit by Chief Medical Officer of Mumbai Port Trust or any other

authorized representative of the Chief Medical Officer of Mumbai Port Trust,

including BCA, the empanelled health care organization’s authorities will cooperate

in carrying out the inspection.

L. AID TO PUBLIC HEALTH AUTHORITIES

In case of any natural disaster / epidemic, the empanelled health care organizations

shall fully cooperate with the Chief Medical Officer of Mumbai Port Trust and will

convey / reveal all the required information, apart from providing treatment.

60

M. NO COMMERCIAL PUBLICITY


Imaging Centre will not make any commercial publicity projecting the name of

Mumbai Port Trust. However, the fact of empanelment under Mumbai Port Trust

shall be displayed at the premises of the empanelled health Care Organization

indicating that the charges will be as per CGHS approved rates.

N. AGREE FOR CONDUCTING ANNUAL HEALTH CHECK-UP FOR GROUP ‘A’

MUMBAI PORT TRUSTOFFICERS AGED ‘40’ AND ABOVE AND FOR OTHER

CATEGORIES OFMUMBAI PORT TRUST BENEFICIARIES AS SPECIFIED BY

MUMBAI PORT TRUST.

The Hospital shall agree for conducting all investigations / diagnostic tests /

consultations etc. of the Mumbai Port Trust Class “I” officers of above 40 years of age

and other categories of Mumbai Port Trust beneficiaries as specified by Mumbai Port

Trust from time to time as per the prescribed protocol, subject to the condition that

the hospital shall not charge more thanRs.2000/- for conducting the prescribed

medical examination of the male officers andRs.2200/- for female officers of Mumbai

Port Trust who come to the hospital/ institution with the requisite permission letter

from Chief Medical Officer of Mumbai Port Trust.

4. TREATMENT IN EMERGENCY

The following ailments may be treated as emergency which is illustrative only and

not exhaustive, depending on the condition of the patient:

Acute Coronary Syndromes (Coronary Artery Bye-Pass Graft / Percutaneous,

Transluminal

Coronary Angioplasty) Including Myocardial Infarction,

Unstable Angina,

Ventricular Arrhythmias,

Paroxysmal Supra Ventricular Tachycardia,

Cardiac Temponade,

Acute Left Ventricular Failure / Severe Congestive Cardiac Failure,

Accelerated Hypertension,

Complete Heart Block And Stoke Adam Attack, Acute Aortic Dissection.

Acute Limb Ischemia,

Rupture Of Aneurysm,

Medical And Surgical Shock And Peripheral Circulatory Failure.

Cerebro-Vascular Attack-Stokes,

Sudden Unconsciousness,

Head Injury,

Respiratory Failure,

61

Decompensated Lung Disease, Cerebro-Meningeal Infections,

Convulsions, Acute Paralysis,

Acute Visual Loss.

Acute Abdomen Pain.

Road Traffic Accidents / With Injuries Including Fall.

Severe Hemorrhage Due To Any Cause.

Acute Poisoning. Acute Renal Failure.

Acute Abdomen Pain In Female Including Acute Obstetrical And Gynecological

Emergencies.

Electric Shock.

Any Other Life Threatening Condition.

In emergency the hospital will not refuse admission or demand an advance payment

from the beneficiary or his family member and will provide credit facilities to the

patient whether the patient is a serving employee or a pensioner availing medical

facilities, on production of a valid Mumbai Port Trust card and the hospital shall

submit the bill for reimbursement to the Chief Medical Officer of Mumbai Port Trust.

The refusal to provide the treatment to bonafide Mumbai Port Trust Beneficiaries in

emergency cases and other eligible categories of beneficiaries on credit basis, without

valid ground, would attract disqualification for continuation of empanelment.

The nature and appropriateness of the emergency is subject to verification, which

may be verified, inspected or medically audited by the nominated authority on

random basis at its own discretion.

The Hospital will intimate all instances of patients admitted as emergencies without

prior permission to the Chief Medical Officer of Mumbai Port Trust within the

prescribed time.

5. ENTITLEMENTS FOR VARIOUS TYPES OF WARDS

Mumbai Port Trust beneficiaries are entitled to facilities of private, semi-private or

general ward depending on latest order in this regards needs to be followed. The

entitlement is as follows:-

S. No. Pay drawn in pay band/Basic

Pension

Entitlement

1 Class IV Employees General Ward

2 Class III Employees Semi-Private Ward

3 Class II & I and above Private Ward

a. Private ward is defined as a hospital room where single patient is accommodated

and which has an attached toilet (lavatory and bath). The room should have

furnishings like wardrobe, dressing table, bed-side table, sofa set, carpet, etc. as

well as a bed for attendant. The room has to be airconditioned.

62

b. Semi Private Ward is defined as a hospital room where two to three patients are

accommodated and which has attached toilet facilities and necessary furnishings.

c. General ward is defined as a hall that accommodates four to ten patients.

Treatment in higher Category of accommodation than the entitled category is not

permissible.

6. APPROVED RATES TO BE CHARGED

The empanelled health care organization shall charge from the Mumbai Port Trust

beneficiary as per the rates for a particular procedure / package deal as prescribed

by the CGHS and attached as Annexure (rate list), which shall be an integral part of

this Agreement. The rates notified by CGHS shall also be available on web site of

Ministry of Health & F.W. athttp://msotransparent.nic.in/cghsnew/index.aspThe

package rate will be calculated as per the duration specified in the Tender document.

No additional charge on account of extended period of stay shall be allowed if, that

extension is due to infection on the consequences of surgical procedure or due to any

improper procedure and is not justified.

The rate being charged will not be more than what is being charged for same

procedure from other (non-Mumbai Port Trust) patients or Organizations. An

authenticated list of rates being charged from other non-Mumbai Port Trust will also

be supplied to Mumbai Port Trust within 30 days of this Agreement.

The procedure and package rates for any diagnostic investigation, surgical procedure

and other medical treatment for Mumbai Port Trust beneficiary under this Agreement

shall not be increased during the validity period of this Agreement.

The empanelled health care organization agrees that during the In-patient treatment

of the Mumbai Port Trust beneficiary, the Hospital will not ask the beneficiary or his

attendant to purchase separately the medicines / sundries / equipment or

accessories from outside and will provide the treatment within the package deal rate,

fixed by the CGHS which includes the cost of all the items. Appropriate action,

including removal from Mumbai Port Trust empanelment and /or termination of this

Agreement, may be initiated on the basis of a complaint, medical auditor inspections

carried out by Mumbai Port Trust teams.

The hospital/ diagnostic centres shall agree to charge CGHS rates to Mumbai Port

Trust Employees / Pensioners on production of valid I-Card / Documentary proof ,

even though treatment is not sought as Mumbai Port Trust beneficiary.

7. MODE OF PAYMENT FOR TREATMENT OF BENEFICIARIES

In respect of the following categories of beneficiaries, treatment /

procedures/services shall be undertaken/provided on credit: No payment shall be

sought from them and the bills should be submitted to the Chief Medical Officer,

Mumbai Port Trust.

http://msotransparent.nic.in/cghsnew/index.asp

http://msotransparent.nic.in/cghsnew/index.asp

63

MbPT Employees and their family members

CISF posted at MbPT and their family members

Pensioners and their spouses,

8. BILL CLEARING AGENCY (BCA)

Bill clearing Agency (BCA) nominated by Chief Medical Officer of Mumbai Port Trust

will not charge any processing fee.

9. NOTIFICATION OF NODAL OFFICERS

Empanelled health care Organizations shall notify two Nodal officers for Mumbai Port

Trust beneficiaries, who can be contacted by Mumbai Port Trust beneficiaries in case

of any eventuality.

10. INFORMATION TO BE PROVIDED TO THE BCA BY HOSPITALS EMERGENCY

ADMISSIONS

The Hospital will intimate to the Chief Medical Officer of Mumbai Port Trust within

two(2) hours of such admission and the Chief Medical Officer of Mumbai Port Trust

will respond with due authorization in four (4) hours. Treatment in no case would be

delayed or denied because authorization by the Chief Medical Officer of Mumbai Port

Trust is only confirmation of theeworkflow in respect of such patient. Post discharge,

the hospital would upload bills and other documents as per requirement of Mumbai

Port Trust within seventy two (72) hours.

REFERRED ADMISSIONS

Where the Mumbai Port Trust beneficiary visits the hospital with a proper referral

and authorization letter, the hospital will verify and submit information of admission

to the Chief Medical Officer of Mumbai Port Trust online. The Chief Medical Officer

of Mumbai Port Trust would respond with an authorization within four (4) hours.

Post discharge, the hospital would upload bills and other documents as per

requirement of Mumbai Port Trust within seventy two(72) hours.

11. SUBMISSION OF BILLS TO BILL CLEARING AGENCY

In case of Mumbai Port Trust beneficiary visits., where credit bills are sent to Chief

Medical Officer of Mumbai Port Trust, the Private Empanelled health care

Organizations shall submit the physical bill as well as electronic bill to the Chief

Medical Officer of Mumbai Port Trust for processing of bills.

The Data and electronic bills in respect of Serving employees shall be utilized for

medical audit and statistical purposes.

64

12. PROCESSING OF CLAIMS/BILLS BY THE BCA

Bill Clearing Agency (BCA) shall make payment of admissible amount after due

scrutiny within a maximum period of 30 days. Recoveries, if any, will be affected

from future bills of hospitals, exclusive Eye hospitals / Centres, exclusive Dental

Clinics, Cancer Hospitals/units and diagnostic centres as the case may be.

The BCA during the course of the auditing will restrict the claims as per CGHS rates.

BCA will also examine in terms of

(a) Appropriateness of treatment including screening of patients records to identify

unnecessary admissions and unwarranted treatments

(b) Whether the planned treatment is shown as emergency treatment

(c) Whether the diagnostic medical or surgical procedures that were not required were

conducted by hospital including unnecessary investigations

(d) Maintaining database of such information of Mumbai Port Trust beneficiaries for

future use.

(e) Whether the treatment procedures have been provided as per the approved rates

and the packages.

(f) Whether procedures performed were only those for which permission has been

granted

The BCA shall record their findings and intimate the same to the Private Hospital

concerned with a copy endorsed to Chief Medical Officer of Mumbai Port Trust. The

payment of the bill/claim to the Private Hospital concerned will be made directly by

the Mumbai Port Trust after receipt of the physical bills in respect of Mumbai Port

Trust beneficiaries.

13. MEDICAL AUDIT OF BILLS

There shall be a continuous Medical Audit of the services provided by the empanelled

Private Hospital.

14. DUTIES AND RESPONSIBILITIES OF EMPANELLED HEALTH

CAREORGANIZATIONS

It shall be the duty and responsibility of the empanelled Hospital, Exclusive Eye

centre, Exclusive Dental clinic, Diagnostic Laboratory/ Imaging Laboratory/ Imaging

Centre at all times, to obtain, maintain and sustain the valid registration, recognition

and high quality and standard of its services and healthcare and to have all statutory

/ mandatory licenses, permits or approvals of the concerned authorities under or as

per the existing laws”.

65

15. NON ASSIGNMENT

The empanelled Hospital, Exclusive Eye centre, Exclusive Dental clinic, Diagnostic

Laboratory/Imaging Centre shall not assign, in whole or in part, its obligations to

perform under the agreement, except with the Mumbai Port Trust’s prior written

consent at its sole discretions and on such terms and conditions as deemed fit by

the Mumbai Port Trust. Any such assignment shall not relieve the Hospital/Eye

centre/Dental clinic/ Diagnostic Centre from any liability or obligation under this

agreement

16. EMPANELLED HEALTH CARE ORGANIZATION’S INTEGRITY AND OBLIGAITONS

DURING AGREEMENT PERIOD


Laboratory/Imaging Centre is responsible for and obliged to conduct all contracted

activities in accordance with the Agreement using state-of-the-art methods and

economic principles and exercising all means available to achieve the performance

specified in the Agreement. The Hospital, Exclusive Eye centre, Exclusive Dental

clinic, Diagnostic Laboratory/ Imaging Centre is obliged to act within its own

authority and application by the directives issued by the Mumbai Port Trust. The

Hospital, Exclusive Eye centre, Exclusive Dental clinic, Diagnostic Laboratory/

Imaging Centre is responsible for managing the activities of its personnel and will

hold itself responsible for their misdemeanors, negligence, misconduct or deficiency

in services, if any.

17. PERFORMANCE BANK GUARANTEE (PBG)

Health Care Organizations that are recommended for empanelment after the initial

assessment shall also have to furnish a performance Bank Guarantee valid for a

period of30 months i.e. six month beyond empanelment period to ensure efficient

service and to safeguard against any default:

Hospitals/Cancer Units Rs.10.00 lac

Eye Centers Rs.2.00 lac

Dental Clinics Rs.2.00 lac

Diagnostic Centers Rs.2.00.lac

Dialysis Hospital/Center Rs.2.00 Lac

In case of health Care Organizations already empanelled under Mumbai Port Trust

they shall submit anew Performance Bank Guarantee after the validity of the existing

performance guarantee is over.

18. FORFEITURE OF PERFORMANCE BANK GUARANTEE AND REMOVAL FROM

LIST OF EMPANELLED ORGANIZATIONS

In case of any violation of the provisions of the MOA by the health care Organizations

empanelled under Mumbai Port Trust such as:

66

1. refusal of service,

2. undertaking unnecessary procedures,

3. prescribing unnecessary drugs/tests

4. over billing,

5. reduction in staff/ infrastructure/ equipment etc. after the hospital/ has been

empanelled.

6. Non submission of the report, habitual late submission or submission incorrect

data in the report

7. refusal of credit to eligible beneficiaries and direct charging from them.

8. if not recommended by NABH/NABL/QCI at any stage

9. Discrimination against Mumbai Port Trust beneficiaries vis-à-vis general patients

The amount of Performance Bank Guarantee will be forfeited and the Mumbai Port

Trust shall have the right to de-recognize the health Care Organization as the case

may be. Such action could be initiated on the basis of a complaint, medical audit or

inspections carried out by Mumbai Port Trust teams at random.

The decision of the Mumbai Port Trust will be final.

19. LIQUIDATED DAMAGES

a. The Hospital, Exclusive Eye centre, Exclusive Dental clinic, Diagnostic

Laboratory/ Imaging Centre shall provide the services as per the requirements

specified by the Mumbai Port Trust in terms of the provisions of this Agreement. In

case of initial violation of the provisions of the Agreement by the Hospital such as

refusal of service or direct charging from the Mumbai Port Trust Beneficiaries or

defective service and negligence, the amount equivalent to15% of the amount of

Performance Bank Guarantee will be charged as agreed Liquidated Damages by the

Mumbai Port Trust, however, the total amount of the Performance Bank Guarantee

will be maintained intact being a revolving Guarantee.

b. In case of repeated defaults by the Hospital, Exclusive Eye centre, Exclusive Dental

clinic, Diagnostic Laboratory/ Imaging Centre, the total amount of Performance

Bank Guarantee will be forfeited and action will be taken for removing the Health

Care Organization from the empanelment of Mumbai Port Trust as well as

termination of this Agreement.

c. For over-billing and unnecessary procedures, the extra amount so charged will be

deducted from the pending / future bills of the Hospital, Exclusive Eye centre,

Exclusive Dental clinic, Diagnostic Laboratory/ Imaging Centre and the Mumbai Port

Trust shall have the right to issue a written warning to the health Care Organization

not to do so in future. The recurrence, if any, will lead to the stoppage of referral to

that particular Health care Organization or De-recognition from Mumbai Port Trust.

67

20. TERMINATION FOR DEFAULT

The Mumbai Port Trust may, without prejudice to any other remedy for breach of

Agreement, by written notice of default sent to the Hospital terminate the

Agreement in whole or part:

If the empanelled Hospital, Exclusive Eye centre, Exclusive Dental clinic, Diagnostic

Laboratory/Imaging Centre fails to provide any or all of the services for which it has

been empanelled within the period(s) specified in the Agreement, or within any

extension thereof if granted by the Mumbai Port Trust pursuant to Condition of

Agreement or If the Health Care Organization fails to perform any other obligation(s)

under the Agreement.

If the Hospital, Exclusive Eye centre, Exclusive Dental clinic, Diagnostic Laboratory/

Imaging Centre in the judgment of the Mumbai Port Trust has engaged in corrupt or

fraudulent practices in competing for or in executing the Agreement.

In case of any wrong doings as specified in Memorandum of Agreement by one

hospital /centre / clinic / lab of a particular group,Mumbai Port Trust reserves the

right to remove all empanelled hospitals / centres/ clinics/labs of that particular

groups from its empanelled list of hospitals.

21. INDEMNITY


Laboratory/Imaging Centre shall at all times, indemnify and keep indemnified

Mumbai Port Trust / the Government against all actions, suits, claims and demands

brought or made against it in respect of anything done or purported to be done by

the Health Care Organization in execution of or in connection with the services under

this Agreement and against any loss or damage to Mumbai Port Trust / the

Government in consequence to any action or suit being brought against the Mumbai

Port Trust / the Government, along with (or otherwise), Health Care Organization as

a Party for anything done or purported to be done in the course of the execution of

this Agreement. The HealthCare Organization will at all times abide by the job safety

measures and other statutory requirements prevalent in India and will keep free and

indemnify the Mumbai Port Trust from all demands or responsibilities arising from

accidents or loss of life, the cause or result of which is the Hospital negligence or

misconduct.

The Health care Organization will pay all indemnities arising from such incidents

without any extra cost to Mumbai Port Trust and will not hold the Mumbai Port Trust

responsible or obligated. Mumbai Port Trust may at its discretion and shall always

be entirely at the cost of the Health Care Organization defend such suit, either jointly

with the Health Care Organization enter or singly in case the latter chooses not to

defend the case

22. ARBITRATION

If any dispute or difference of any kind whatsoever (the decision whereof is not herein

otherwise provided for) shall arise between the Mumbai Port Trust and the Hospital,

68

Exclusive Eye centre, Exclusive Dental clinic, Diagnostic Laboratory/ Imaging Centre

upon or in relation to or in connection with or arising out of the Agreement, shall be

referred to for arbitration by Chairman of Mumbai Port Trust, who will give written

award of his decision to the Parties. The decision of the Chairman will be final and

binding. The provisions of the Arbitration and Conciliation Act, 1996 shall apply to

the arbitration proceedings. The venue of the arbitration proceedings shall be at

Mumbai.

23. MISCELLANEOUS

Nothing under this Agreement shall be construed as establishing or creating

between the Parties any relationship of Master and Servant or Principal and

Agent between the Mumbai Port Trust and the Health Care Organization. The

Health care Organization shall work or perform their duties under this

Agreement or otherwise.

The Health care Organization agrees that any liability arising due to any

default or negligence in not represent or hold itself out as agent of the Mumbai

Port Trust.

The Mumbai Port Trust will not be responsible in any way for any negligence

or misconduct of the Health Care Organization and its employees for any

accident, injury or damage sustained or suffered by any Mumbai Port Trust

beneficiary or any third party resulting from or by any operation conducted by

and on behalf of the Hospital or in the course of doing its performance of the

medical services shall be borne exclusively by the hospital who shall alone be

responsible for the defect and / or deficiencies in rendering such services.

The Hospital/ Exclusive Eye centre/Exclusive Dental clinic/ Diagnostic

Laboratory/ Imaging Centre shall notify the Government of any material

change in their status and their shareholdings or that of any Guarantor of the

in particular where such change would have an impact on the performance of

obligation under this Agreement.

This Agreement can be modified or altered only on written agreement signed

by both the parties.

Should the Hospital/ Exclusive Eye centre/Exclusive Dental clinic/

Diagnostic Laboratory/

Imaging Centre get wound up or partnership is dissolved, the Mumbai Port

Trust shall have the right to terminate the Agreement. The termination of

Agreement shall not relieve the hospital or their heirs and legal representatives

from the liability in respect of the services provided by the Health care

Organization during the period when the Agreement was in force.

69

The Hospital, Exclusive Eye centre, Exclusive Dental clinic, Diagnostic

Laboratory/ Imaging Centre shall bear all expenses incidental to the

preparation and stamping of this agreement.

24. OTHER SERVICES TO BE PROVIDED

The empanelled Private Health Care Organization will, on the request of Mumbai Port

Trust, agree to provide training to Mumbai Port Trust medical, Para-medical and

nursing staff.

25. EXIT FROM THE PANEL

The Rates fixed by the Mumbai Port Trust shall continue to hold good unless revised

by CGHS. In case the notified rates are not acceptable to the empanelled health care

Organizations, or for any other reason, the health care Organization no longer wishes

to continue on the list under Mumbai Port Trust, it can apply for exclusion from the

panel by giving one month notice. Patients already admitted shall continue to be

treated.

26. NOTICES

26.1 Any notice given by one party to the other pursuant to this Agreement shall be

sent to other party in writing by registered post or by facsimile and confirmed by

original copy by post to the other Party’s address as below.

Chief Medical Officer of Mumbai Port Trust Hospital, Wadala (East), Mumbai – 400

037.

Hospital with address:

(………………………………………………………………………)

26.2 A notice shall be effective when served or on the notice’s effective date,

whichever is later. Registered communication shall be deemed to have been served

even if it returned with remarks like refused, left, premises locked, etc.

IN WITNESSES WHEREOF, the parties have caused this Agreement to be signed and

executed on the day, month and the year first above mentioned.

Signed by

Chief Medical Officer of Mumbai Port Trust

For and on behalf of

BOARD OF TRUSTEES OF PORT OF MUMBAI

In the Presence of

(Witnesses)

1.

70

2.

Signed by

For and on behalf of (Hospital )

Duly authorized vide Resolution No. ……… dated …….

of (name of Hospital )

In the presence of

(Witnesses)

1.

2.

71

ANNEXURE -VI

PERFORMANCE BANK GUARANTEE

To:

(Board of Port of Mumbai)

WHEREAS _____________________________________________________(Name of

HealthCare Organization ) has undertaken, Agreement No.

______________________________________ dated, __________________2013 to ________

____________________ _______________________

(Description of Services) hereinafter called "the Agreement".

AND WHEREAS it has been stipulated by you in the said Agreement that the

Hospital, Exclusive Eye hospital/center, Exclusive Dental clinic, Diagnostic

Laboratory/ Imaging Centre, Exclusive Dialysis Hospital/Centre selected for

empanelment shall furnish you with a bank Guarantee by a nationalized bank for

the sum specified therein as security for compliance with the Hospital performance

obligations in accordance with the Agreement.

AND WHEREAS we have agreed to give the Hospital, Exclusive Eye hospital/Centre,

Exclusive Dental clinic, Diagnostic Laboratory/ Imaging Centre a guarantee:

THEREFORE WE hereby affirm that we are Guarantors and responsible to you, on

behalf of Hospital / Diagnostic Centre (herein after referred to “the Second Part,” up

to a total of_________________________________(Amount of the guarantee in Words and

Figures) and whereby irrevocably, unconditionally and absolutely undertake to

immediately pay you, upon your first written demand declaring the Second Part to

be in default under the Agreement and without cavil or argument, any sum or sums

within the limit of ___________________________ as aforesaid, without your needing to

prove or to show this grounds or reasons for your demand or the sum specified

therein. This guarantee is valid until the ___________ day of ______________ 20…

Signature and Seal of Guarantors

_____________________________________

_____________________________________

Date _____________________________________

Address:_____________________________________

72

ANNEXURE - VIII

DECLARATION (100 Rs Stamp Paper)

I/We M/s._____________________ represented by its Proprietor / Managing

Partner / Managing Director having its Registered Office at

________________________________________________ competent to sign this declaration

and execute this tender document and do declare that I/We have carefully read all

the conditions of tender in Ref.No. ________________________, for empanelment of

private hospitals, exclusive eye hospitals/centers, exclusive dental clinics, cancer

hospitals/units, diagnostic centers and Exclusive Dialysis hospitals/Centers for availing

credit facilities to provide treatment to Mumbai Port Trust patients at the rate prescribed

by CGHS for a period of two years. from the date of signing of contract with the selected

Tenderer and accepts all conditions of the Tender including

amendments/corrigendum subsequently issued by the Tender Inviting authority, if

any. Further I/we confirm our eligibility for this tender and all items quoted as per

the tender condition and Governing laws of India, in case of typographical error found

in submitted documents / affidavits / declarations, in this case we accept all the

Terms and conditions of bid documents.

I am/we are aware of the Tender Inviting Authority’s right to forfeit the Earnest

Money Deposit and/or Security Deposit if, any information furnished in the affidavit

by us proved to be false at the time of inspection / verification and if, not complying

the conditions as per Contract Agreement.

I/We ___________________ (name of proprietor) have carefully gone through and

understood the contents of the tender document and I/We undertake to abide

myself/ourselves by all the terms and conditions set forth.

I/We do hereby declare that we have not blacklisted/debarred either by

Tender Inviting Authority or by any State Government or Central Government

Organization.

I/We do hereby declare that we have (except exclusive eye hospitals/centers,

exclusive dental clinics, Exclusive Dialysis Hospital/Centre) must agree for

implementation of EMR/ EHR as per the standards by Mumbai Port Trust within one

year of their empanelment.

I/We do hereby declare that we shall charge as per CGHS rates and that the

rates charged by them are not higher than the rates being charged from their other

patients who are not Mumbai Port Trust beneficiaries.

I/We do hereby declare that we have submitted the rates for all treatment procedures

/

investigations/ facilities available with us and as charged by us are true.

73

I/We do hereby declare that we have the capacity to submit all claims / bills

in electronic format to the Bill Clearing Agency and must also have dedicated

equipment, software and connectivity for such electronic submission.

I/We do hereby declare that we have been in operation for at least one year.

I/We do hereby declare that we have given an undertaking accepting the terms

and conditions spelt out in the Memorandum of Agreement (Draft at Annexure V)

which should be read as part of this application document.

I/We do hereby declare that we are fulfilling all special conditions that have

been imposed by any authority in lieu of special concessions such as but not limited

to concessional allotment of land or customs duty exemption.

The information/ documents furnished along with the tender are true and

authentic to the best of my knowledge and belief. I /we, am / are well aware of the

fact that furnishing of any false information / fabricated document would lead to

rejection of my tender at any stage besides liabilities towards prosecution under

appropriate law.

Date:

Place: Signature of Authorized Person

Full Name:

Company³s Seal:

74

ANNEXURE – IX

MANDATE FORM

01 Name of Private Hospitals, Exclusive Eye

Hospitals/Centers, Exclusive Dental

Clinics, Cancer Hospitals/Units

And Diagnostic Centers Exclusive

Dialysis Hospital/Centre.

02 Postal Address of the Private Hospitals,

Exclusive Eye Hospitals/Centers,

Exclusive Dental Clinics, Cancer

Hospitals/Units And Diagnostic Centers

/ Exclusive Dialysis Hospital/Centre

with

Telephone No.,

Fax No.

Mail I.D.

03 Name of the Managing Director /

Director /

Manager

Mobile No. / Phone No.

E-mail I.D.

04 Name and Designation of the authorized

person of Private Hospitals, Exclusive

Eye Hospitals/Centers, Exclusive

Dental Clinics, Cancer Hospitals/

Units And Diagnostic Centers/

Exclusive Dialysis Hospital/Centre

Official Mobile No.

E-mail ID

Date: Signature

Place: (Name of the person signing and designation)

Company Seal

75

01

Name of the Bank .

Branch Name and address.

Branch Code No.

Branch Manager Mobile No.

Branch Telephone no.

Branch E-mail ID

02 9 digit MICR code number of the bank

and branch appearing on the MICR

cheque issued by the bank.

03 IFSC code of the Branch

04 Type of Account (Current / Savings).

05 Account Number (as appear in cheque

book)

(in lieu of the bank certificate to be obtained, please attach the original cancelled

cheque issued by your bank for verification of the above particulars).

I /We hereby declare that the particulars given above are correct and complete. If

the transaction is delayed or not effected at all for reasons of incomplete or incorrect

information, I would not hold Chief Medical Officer on behalf of Mumbai Port Trust

responsible. I have read the conditions of the tender/agreement entered and agree

to discharge the responsibility expected of me / from the Hospital / Diagnostic Centre

as a Tenderer /successful Tenderer.

Date: Hospital / Diagnostic Centre Seal

Signature

Place: (Name of the person signing and designation)

------------------------------------------------------------------------------------------------------

----------

CERTIFIED THAT THE PARTICULARS FURNISHED ABOVE BY THE COMPANY ARE

CORRECT AS PER OUR RECORDS.

Bank Seal with address. Signature of the authorized

official of the bank.

------------------------------------------------------------------------------------------------------

----------

76

ANNEXURE-X

PATIENT/ATTENDANT SATISFACTION CERTIFICATE

1. I am satisfied/ not satisfied with the treatment given to me/ my patient and

with the behavior of the hospital staff.

2. If not satisfied, the reason(s) thereof.

3. It is stated that no money has been demanded/ charged from me/my relative

during the stay at hospital.

Date &Time:

Sign/Thumb impression of

patient/Attendant

Name of the Patient/attendant

Name of IP

Date of Admission

Date of Discharge

77

ANNEXURE - XI

PRE CONTRACT INTEGRITY PACT (In Rs.100/- Stamp Paper)

MUMBAI PORT TRUST (MbPT) hereinafter referred to as "The Principal"

AND

(Name of The bidders and consortium members) ..............................

................................ hereinafter referred to as "The Bidder/Contractor

Preamble: The Principal intends to award, under laid down organizational procedures,

contract/concession for Tender No.

E........................... The Principal values full compliance with all relevant laws and

regulations, and the principles of economic use of resources, and of fairness and

transparency in its relations with its Bidders. The Central Vigilance Commission

(CVC) has been promoting Integrity, transparency, equity and competitiveness in

Government / PSU transactions and as a part of Vigilance administration and

superintendence, CVC has, recommended adoption of Integrity Pact and provided

basic guidelines for its implementation in respect of major procurements in the

Government Organizations in pursuance of the same, the Principal agrees to appoint

an external independent Monitor who will monitor the execution of the contract for

compliance with the principles mentioned above.

Section 1 - Commitments of the Principal

(1) The Principal commits itself to take all measures necessary to prevent corruption

and to observe the following principles: -

(a) No employee of the Principal, personally or through family members, will in

connection with the execution of a contract, demand, take a promise for or accept, for

him/herself or third person, any material or immaterial benefit which he/she is not

legally entitled to.

(b) The Principal will, during the pre-contract stage, treat all BIDDERs alike, and

will provide to all BIDDERs the same information and will not provide any such

information to any particular BIDDER which could afford an advantage to that

particular BIDDER in comparison to other BIDDERs.

(c) The Principal will exclude from the process all known prejudicial persons.

(2) If the Principal obtains information on the conduct of any of its employees which

is a criminal offence under the relevant Anti-Corruption Laws of India, or if there

be a substantive suspicion in this regard, the Principal will inform its Vigilance Office

and in addition can initiate disciplinary actions. In such a case, while an enquiry

78

is being conducted by the Principal, the proceedings under the contract would not be

stalled.

Section 2 - Commitments of the Bidder / Contractor

(1) The Bidder/Contractor commits themselves to take all measures necessary to

prevent corrupt practices, unfair means and illegal activities, during pre-contract as

well as post- contract stages. He commits himself to observe the following principles

during the contract execution.

a. The Bidder/Contractor will not, directly or through any other person or firm, offer,

promise or give to any of the Principal's employees involved in the execution of the

contract or to any third person any material or immaterial benefit, which he/she is not

legally entitled to, in order to obtain in exchange of advantage of any kind, whatsoever

during the execution of the contract.

b. The Bidder/Contractor w i l l not enter with other Bidders into any undisclosed

agreement or understanding, whether formal or informal. This applies in particular

to prices, specifications, certifications, subsidiary contracts, submission or non-

submission of bids, or any other actions to restrict competitiveness, or to introduce

cartelization in the bidding process.

c. The Bidder/Contractor will not commit any offence, under the relevant

Anticorruption Laws of India; further the Bidder/Contractor will not use improperly,

for purposes of competition, or personal gain, or pass on to others, any information or

document provided by the Principal, as part of the business relationship, regarding

plans, technical proposals and business details, including information contained or

transmitted electronically.

d. The Bidder will not collude with other parties interested in the contract to impair

the transparency, fairness and progress of the bidding process, bid evaluation,

contracting and implementation of the contract.

e. The Bidder/Contractor will, when presenting his bid, disclose any and all

payments he has made, is committed to or intends to make to agents, brokers or any

other intermediaries, in connection with the award of the contract.

f. The Bidder commits to refrain from giving any complaint directly or through any

other manner without supporting it with full and verifiable facts.

g. The Bidder shall not lend to or borrow any money from or enter into any monetary

dealings or transactions, directly or indirectly, with any employee of the Principal.

(2) The Bidder/Contractor will not instigate third persons to commit offences

outlined above or be an accessory to such offences.

79

Section-3 Disqualification from or exclusion from future contracts

If the Bidder, before award of contract, has committed a transgression, through a

violation of Section-2 or in any other form, such as to put his reliability as Bidder, into

question, the principal is entitled to disqualify the Bidder, from the tender process, or

to terminate the contract, if already signed, for such reason.

1. If the Bidder/Contractor has committed a transgression, through a violation of

Section-2, such as to put his reliability, or credibility into question, the Principal is

entitled to disqualify the Bidder/Contractor from the tender process, terminate the

contract if already awarded and also, to exclude the Bidder/Contractor from future

contract award processes. The imposition and duration of the exclusion, will be

determined by the severity of the transgression. The severity will be determined, by

the circumstances of the case, in particular the number of transgressions, the position

of the transgressions, within the company hierarchy of the Bidder and the amount of

the damage. The execution will be imposed for a minimum of 6 months and maximum

of 3 years.

Note: A transgression is considered to have occurred, if in the light of available

evidence, no reasonable doubt is possible.

2. The Bidder accepts and undertakes to respect and uphold, the principal's

Absolute right to resort to and impose such exclusion and further accepts and

undertakes, not to challenge or question such exclusion, on any ground, including the

lack of any hearing before the decision, to resort to such exclusion is taken. This

undertaking is given freely and after obtaining independent legal advice.

3. If the Bidder/Contractor can prove that, he has restored/recouped the Damage

caused by him and has installed a suitable corruption prevention system, the Principal

may revoke the exclusion prematurely.

Section-4 Compensation for damages

1. If the Principal has disqualified the Bidder, from the tender process prior to the

award, according to Section-3, the Principal is entitled to demand and recover the

damages equivalent to Earnest Money Deposit/Bid Security.

2. If the Principal has terminated the contract according to Section-3, or if the

Principal is entitled to terminate the contract according to Section3, the Principal shall

be entitled to demand and recover from the Contractor, liquidated damages equivalent

to 5% of the contract value, or the amount equivalent to Security Deposit/Performance

Bank Guarantee, whichever is higher.

3. The Bidder agrees and undertakes to pay the said amounts, without protest or

demur, subject only to condition that, if the Bidder/Contractor can prove and establish

that the termination of the contract, after the contract award has caused no damage

80

or less damage than the amount of the liquidated damages, the Bidder/Contractor

shall compensate the principal, only to the extent of the damage in the amount proved.

Section-5 Previous transgression

1. The Bidder declares that, no previous transgression has occurred in the last 3

years, with any other company, in any country, or with any other Public Sector

Enterprises in India, that could justify his exclusion from the award of the contract.

2. If the Bidder makes incorrect statement on this subject, it can be declared

disqualified for the purpose of the contract and the same can be terminated for such

reason.

Section-6 Equal treatment of all Bidders/Contractors/ Subcontractors

1. The Bidder/Contractor undertakes to demand from all subcontractors, a

commitment in conformity with this Integrity Pact, and to submit it to the Principal

before contract signing.

2. The Principal will enter into agreements with identical conditions as this one

which all Bidders, Contractors and Subcontractors.

3. The Principal will disqualify from the tender process all Bidders, who do not sign

this part or violates its provisions.

Section-7. Criminal charges against violating Bidders/

Contractors/ Sub-contractors

If the principal obtains knowledge of conduct of a Bidder/Contractor or Subcontractor,

or of an employee, or a representative, or an associate of a Bidder/Contractor, or

Subcontractor, which constitutes corruption, or if the Principal has substantive

suspicion, in this regard, the Principal will inform the Vigilance office.

Section-8. External Independent Monitor

1. Pursuant to the need to implement and operate this Integrity Pact the Principal

has appointed Shri P.K. Gopinath, IPoS (Rtd) independent Monitor, for this Pact. The

task of the Monitor, is to review independently and objectively, whether and to what

extent, the parties comply with the obligations under this agreement.

2. The Monitor is not subject to instructions, by the representative of the parties to

the Chairperson of the Board of the Principal.

3. The Bidder/Contractor accepts that, the monitor has the right to access, without

restriction to all Project documentation of the Principal, including that provided by the

Contractor. The Bidder/Contractor will also grant the Monitor, upon his request and

81

demonstration of a valid interest, unrestricted and unconditional access, to the project

documentation. The same is applicable to Subcontractors. The monitor is under

contractual obligation, to treat the information and documents of the

Bidder/Contractor/Subcontractor with confidentiality.

4. The Principal will provide to the Monitor, sufficient information about all

meetings, among the parties related to the Project, provided such meetings could have

an impact, on the contractual relations between the Principal and the

Bidder/Contractor. The parties offer to the Monitor the option to participate in such

meetings.

5. As soon as the Monitor notices a violation of this agreement, he will so inform the

Management of the Principal and request the management to discontinue, or heal the

violation. Or to take other relevant action. The Monitor can in this regard submit

non- binding recommendations. Beyond this, the Monitor has no right to demand

from the parties, that they act in a specific manner, refrain from action or tolerate

action.

6. The Monitor will submit a written report, to the Chairperson of the Board of the

Principal, within 8 to 10 weeks, from the date of reference of intimation to him by the

'Principal' and, should the occasion arise, submit proposals for correcting problematic

situations.

7. If the Monitor has reported to the Chairperson of the Board, a substantiate

suspension of an offence, under relevant Anti-Corruption Laws of India, and the

Chairperson has not, within reasonable time, taken visible action to proceed against

such offence, or reported it to the Vigilance Office, the Monitor may also transmit this

information directly to the Central Vigilance Commissioner, Government of India.

Section-9 Pact Duration

This Pact begins when both parties have signed it. It expires 12 months after the last

payment under the contract Agreement is made.

If any claim is made/lodged during this time, the same shall be binding and continue

be valid, despite the lapse of this Pact, as specified above, unless it is

discharged/determined Chairperson of the Principal.

The Pact duration in respect of unsuccessful Bidders shall expire after

3 months of the award of the contract.

Section-10: Other Provisions

1. This agreement is subject to Indian Law. Place of performance and jurisdiction is

the Registered Office of the Principal, i.e. Mumbai, Maharashtra.

82

2. Changes and supplements as well as termination notices, need to be made in

writing, before they become effective and binding on the both parties.

3. If the Bidder / Contractor is a partnership or a consortium, this agreement must

be, signed by all partners or consortium members.

4. Should one or several provisions of this agreement, turn out to be invalid, the

remainder of this agreement remains valid. In this case, the parties will strive to come

to an agreement, to their original intensions.

For the Principal For the Bidder

Place: Mumbai

Witness-1 : ..................................... Witness-1 : .....................................

Witness-2 : ..................................... Witness-2 : .....................................

Date : /_ /2017 Date : /_ /2017

83

ANNEXURE - XII

CHECK LIST

(Mandatorily to be attached at the starting of the Technical bid.)

Sr.No. Description Submitted

1 Scanned copy of receipt of cost of Tender Document submitted

online by NEFT/RTGS. Yes/No

2 Scanned copy of receipt of EMD submitted online by

NEFT/RTGS. Yes/No

3 Tender Form as per ANNEXURE – I

4 Application document for empanelment of Hospitals, Cancer

Hospitals / units in Mumbai Port Trust – ANNEXURE -IIA Yes/No

5 Application document for empanelment of exclusive Eye

Hospitals/Centers in Mumbai Port Trust– ANNEXURE -IIB Yes/No

6 Application document for empanelment of exclusive Dental

clinics in Mumbai Port Trust– ANNEXURE -IIC Yes/No

7 Application document for empanelment of Diagnostic

Laboratories/ Imaging Centers– ANNEXURE -IID Yes/No

8 Application document for empanelment of exclusive Dialysis

Hospitals/Centers in Mumbai Port Trust– ANNEXURE -IIE

9 Copy of supporting documents of Registration with GST. Yes/No

10 Copy of PAN card issued by the Income Tax Department. Yes/No

11 Power of attorney (in Firms Letterhead) authorizing the

signatories of the bid to participate in the bid. Yes/No

12

Documentary evidence for the constitution of the company /Firm

such as Memorandum and Articles of Association, Partnership

deed etc. with details of the Name, Address, Telephone Number,

Fax Number, e-mail address of the firm and of the Managing

Director / Partners / Proprietor. The list of present Directors in the

board of the Company duly self-certified.

Yes/No

13 Copy of Certificate of Incorporation / Registration of firm. Yes/No

14 Certificate Of Undertaking – Annexure – III Yes/No

15 Declaration in Rs.100/ Stamp paper as per Annexure- VIII. Yes/No

16 Mandate Form as per Annexure - IX. Yes/No

17 Pre Contract Integrity Pact (PCI) in Rs.100/ Stamp paper as per

Annexure- XI. Yes/No

18

Copy of Documentary proof of Health care organizations located

at Mumbai, Navi Mumbai, Mumbai Metropolitan Region, Thane,

Kalyan & Pune cities a permanent place of business and the

complete Postal Address, telephone / Mobile / Fax / E-mail

address, etc.

Yes/No

19

Copy of Tender document with corrigendum with signature of the

Bidder in each and every pages of the tender documents and

corrigendum as an evidence of acceptance of the tender terms

and conditions.

Yes/No

20 Copy of Documentary proof of having 50 Beds (Not for exclusive Eye hospitals/centres & Exclusive Dental clinics) NB: The number of beds as certified in the Registration Certificate of State

Yes/No

84

Government / Local Bodies/ NABH/ Fire Authorities shall be taken as the valid bed strength of the hospital.

21

Letter of Consent (in firms letterhead) to accept the charges fixed

by CGHS for availing credit facilities to provide treatment to

Mumbai Port Trust patients at the rate prescribed by CGHS

Yes/No

22 Copy of Documentary proof of patient-care services in at least any

minimum 60% in each of the following Clinical services and support services Yes/No

23 Copy of Documentary proof of empanelment with CGHS must be

uploaded in the BID if applicable. Yes/No

24

Copy of the rates for all treatment procedures / investigations/

facilities available with Health Care Organization and as charged

by Health Care Organization.

Yes/No

25 Copy of certificate of Registration for Organ Transplant facilities,

wherever applicable. Yes/No

26 Copy of AERB approval for imaging facilities/ Radiotherapy,

wherever applicable Yes/No

27 Copy of Registration under PNDT Act, if Ultrasonography facility

is available Yes/No

28

Copy of Fire Clearance certificate and details of Fire safety

mechanism as in place in the health care Organization. Exclusive

Eye centres, exclusive dental Clinics have to enclose a certificate

regarding fire safety of their premises

Yes/No

29 Copy of compliance with statutory requirements including that

of Waste Management. Yes/No

30 Copy of State registration certificate / Registration with Local

bodies, wherever applicable. Yes/No

31 Affidavit that the information provided has been correct in case

of Non-NABH accredited health care Organizations. Yes/No

32 Copy of NABH Accreditation in case of NABH Accredited health

care Organizations Yes/No

33 Copy of list of treatment procedures /investigations/ facilities

available in the applicant healthcare Organization Yes/No

34 Copy of the documents full filling necessary statutory

requirements. Yes/No

35 Copy of the license for running Blood Bank if applicable Yes/No

36 Any other supportive documents as required for this tender. Yes/No

37 Check list as per ANNEXURE – XI Yes/No

Note: Tenderer must ensure that all the required documents are signed in all pages and

stamped before scanned and uploaded online by them and submitted in Technical

cover.