STOCK HOLDING CORPORATION OF INDIA LTD. Regd. Office : 301, Centre Point, Dr. Babasaheb Ambedkar Road,

Parel, Mumbai 400 012.

Sr.No. Description

1 Tender no. SHCIL/ADMIN/STATIONERY/06/2017

2 Subject Contract for supply of Pre printed stationery/ envelopes/ DP books at all Stockholding offices located in Mumbai, Thane and Navi Mumbai

3 Last date and time for submission of Tender

16th June,2017, 11.00 a.m.

4 Date and time for opening of Technical bid

16th June,2017, 12.00 p.m.

5 Department Administration

6 Contact Details (022)61779059 / 61779036

7 Tender available on site www.shcil.com

INDEX

SR. NO. CONTENTS

1 Notice Inviting Tender (Annexure- A)

2 Eligibility Criteria (Annexure- B)

3 General Terms and Conditions (Annexure- C)

4 List of locations (Annexure-D)

5 Procedure for submission of Technical bid and Financial bid for

supply of Pre printed stationery/ envelopes/ DP books (Annexure-

E)

6 Application for Technical Bid (Annexure- F)

7 Format of Financial Bid with List / Details of pre-printed

stationery / envelopes / DP books (Annexure-G)

Annexure -A

Notice Inviting Tender

Stock Holding Corporation Of India Ltd.

Regd Office : 301, Centre Point, Dr. B.Ambedkar Road, Parel, Mumbai-400 012

CIN : U67190MH1986GOI040506

TENDER NOTICE Stock Holding Corporation of India Limited invites bids in the prescribed format from reputed

bidders based at Mumbai/Navi Mumbai/Thane for supplying pre printed

stationery/envelopes/DP books, etc. items for a period of two years.

The details of tender can be downloaded from Stock Holding website: www.shcil.com. Last

date for submission of forms is 16thJune’2017 upto 11.00 a.m. Further, any Corrigendum

/ Addendum with regard to this advertisement, if any, shall be uploaded on our website

www.shcil.com“

SHCIL reserves the right to accept or reject any or all other applications without assigning

any reason.

For queries contact : (022)61779059/61779036 between 11.00a.m.to 04.00p.m.

Annexure-B

ELIGIBILITY CRITERIA

1. The bidder should be of repute and an established entity having

minimum turnover of Rs. 3 crores p.a.

2. The bidder should have capacity to supply stationery (as mentioned in

Annexure – G) to all branch offices in & around Mumbai (list of

addressed as mentioned in Annexure -D).

3. The bidder should have at least 3 existing reputed clients preferably

e.g. Govt. entities / Banks.

4. The Bidder should submit documentary evidence in support of fulfilling

eligibility criteria including performance certificate from clients.

5. In case the party signing the tender is not the sole proprietor himself,

the necessary power of attorney authorizing the party to act on behalf

of the organization should be attached along with the tender

documents.

Annexure - C

GENERAL TERMS AND CONDITIONS

1. Validity of Contract - Contract shall remain valid for a period of two

years.

2. Validity of Offer – The offer should be valid for 60 days from the

date of opening of tender.

3. Earnest Money Deposit & Security Deposit - The bidder shall

deposit an amount of Rs. 2,00,000/- by means of a demand draft in

favour of ‘STOCK HOLDING CORPORATION OF INDIA LIMITED”,

payable at Mumbai as Earnest Money Deposit (EMD). Tenders without

the EMD shall not be considered. EMD will be converted into interest

free Security Deposit on award of the contract to the successful bidder

and shall not bear any interest and will be refunded after completion

of the contract subject to deduction of dues, if any. EMD for the

unsuccessful bidders will be refunded only after finalisation of the

tender. Tender not accompanied by EMD will be rejected.

4. Payment terms – The payment will be made only against invoices

and delivery challan duly stamped and signed by the user department

of Stockholding. Invoices shall be raised as per the following details :-

Administration Department at Mahape Office : For the deliveries

made at Mahape Office.

Administration Department at Centre Point Office : For the

deliveries made at Centre Point Office.

Administration Department at Fort Office : For the deliveries made

at branches Offices in and around Mumbai except Mahape & Centre

Point Offices.

5. The bidders have to quote all the items mentioned in the financial bid.

6. The Tender shall be unconditional and any conditional/incomplete

Tender shall not be accepted.

7. The prices quoted in tender should be inclusive of all taxes, Octroi,

packing, delivery charges/courier charges etc. to all locations

(Annexure-D)

8. Successful bidder shall have to prepare its own draft copy before

printing and get it approved by the Corporation. No soft copy of any

printing and stationery items would be provided to any bidder.

9. The comparison of the bids will be done based on the rates quoted

by the bidders for all stationery items. The bidder must fill the rates

per unit and total cost per item correctly. In case of erroneous

calculations, the bid will be rejected.

10. The written offer issued to the successful bidder shall have to be

accepted by the bidder in writing within 3 working days from the

date of issue of the offer. Failure to accept the offer within this period

will result in forfeiture of the EMD and cancellation of the award.

11. No escalation in rates on any account shall be permitted during the

contract period.

12. No advance shall be paid.

13. The Corporation reserves the right to change (increase / decrease)

the quantity of items to be procured or to place the purchase order

for the selected items only i.e. some of the items may be omitted

from procurement in entirety.

14. In case the delivery is not made within the stipulated period and as

per the quality of the items as per prescribed in the financial bid,

Stockholding reserves the right to cancel/reject entire/part

order/delivery. Any defective supplies will be replaced by the bidder

within 7 days from the date of receipt from Stockholding.

15. In case of failure / delays in supply fully or partially, the Corporation

is at liberty to procure the items through other sources at its sole

discretion and the difference in cost, if any, will be recoverable from

the bidder.

16. The Successful bidder shall not be entitled to terminate the contract

during the initial 6 months of the term of the contract. Subject to the

lock-in period as afore said, the contract shall be terminated by 60

days prior notice in writing from either of parties. In case of failure to

provide the services, Stockholding reserves the right to forfeit the

amount deposited as security deposit.

17. In the event of failure on the part of Bidder to supply stationery as

prescribed by Stockholding at any point of time during the period of

contact Stockholding reserves the right to terminate the contract

immediately at its sole discretion.

18. All disputes relating to this delivery / quality / price of the stationery

items supplied there under or otherwise arising there from between

the Bidder and Stockholding shall be resolved through mutual

discussion and subject to the same, the court or competent

jurisdiction situated within the limits of the City of Mumbai shall have

jurisdiction.

19. The successful bidder will have to execute an Integrity pact with the

Corporation. The format of the same is available on the website of

the Corporation.

20. Stockholding interpretation regarding errors in particulars or

typographical or clerical errors shall be final and binding on the

Bidder.

21. Stockholding reserves the right to ask for any further details for

arriving at a decision. Stockholding reserves the right to waive any

minor deviation or omission.

22. Stockholding reserves the right to accept or reject any or all other

applications without assigning any reason.

23. Stockholding also reserves the right to re-issue / recommence the

entire bid process without the bidders having the right to object. Any

decision of Stockholding in this regard shall be final, conclusive and

binding on the bidders.

Annexure –D

List of locations

MUMBAI (Andheri) 022

SHOP No.4 , PARISIAN APARTMENTS, V.P ROAD , NEXT TO ZOROASTRIAN CO-OP BANK, OFF S.V.ROAD, ANDHERI (WEST), MUMBAI - 400 058

26230910 26230912

26230909(Fax)

MUMBAI (Borivali) 022

SHOP NO.10, GROUND FLOOR, MADHUMILAN CHS, MANGAL KUNJ, SV ROAD, BORIVALI (W), MUMBAI - 400 092

28332104 / 28332085 28334067 (Fax)

MUMBAI (Chembur) 022

1ST FLOOR, RAMESH NIWAS, PLOT NO-60/A ROAD NO-20, NEAR SBI, OPP CORAL CLASSIC CHEMBUR EAST, MUMBAI - 400 071

25288358 / 25290439 25290542

MUMBAI (Dadar) 022

GROUND FLOOR, 169/C , NEELKANTH NIWAS, DR. AMBEDKAR ROAD, DADAR TT, NEAR METRO SHOWROOM, MUMBAI 400 014

24151706 24151722

24151707 (Fax)

MUMBAI (Dombivali) 0251

OFFICE NO 6, FIRST FLOOR SHRI SUYASH CHS,NEAR MADHUBAN TALKIES DOMBIVALI EAST, THANE - 421 201

2861195/96/97

MUMBAI (Fort) 022

12/14, UTI BUILDING, BANK STREET, CROSS LANE, NEAR OLD CUSTOM HOUSE, FORT, MUMBAI - 400 023

22622677 22675960 / 61

22622756 (Fax)

MUMBAI (Ghatkopar) 022

VISHWA CHS, GR. FLOOR, JUNCTION OF RB MEHTA ROAD & HINGWALA LANE, GHATKOPAR (EAST), MUMBAI - 400 077

21020790 / 21021795 21021800

21023822 (Telefax)

MUMBAI (Goregaon) 022

G-2, UNIQUE TOWERS, GR. FLOOR, BEHIND PATEL AUTO, SV ROAD, GOREGAON (WEST), MUMBAI - 400 062

28787336 / 41 28787338

MUMBAI (Kalyan) 0251

GALA NO 110, VASANT VIHAR COMPLEX CHANDULAL JOSHI COMPOUND OPP KALYAN STATION, KALYAN WEST, THANE - 421 301

0251 - 2315421/22/24

MUMBAI (Mahalaxmi) 022

REWA APARTMENT, B WING, GR. FLOOR, BEHIND BANK OF INDIA, OPP. CADBURY HOUSE, BHULABHAI DESAI ROAD, MAHALAXMI, MUMBAI - 400 026

23538225 / 23526220, 23538221

MUMBAI (Mahape) 022

SHCIL HOUSE, PLOT NO. P-51, T.T.C. INDUSTRIAL AREA, MIDC, MAHAPE, NAVI MUMBAI- 400 710

61778100 /01/ 02/ 03/ 04/ 05/ 06/ 07/ 08/ 09

MUMBAI (Mulund) 022

SHOP NO.2, KOTESHWAR APTS, RHB ROAD, NEAR ICICI BANK, MULUND WEST, MUMBAI - 400 080

25907618/25907617 25620703/25676339

MUMBAI (Nariman Point) 022

RAHEJA CHAMBERS, OFFICE NUMBER 15, GROUND FLOOR, NARIMAN POINT, MUMBAI - 400 021

22844247/22852977 22818624 (Fax)

MUMBAI (Parel) 022

301, CENTRE POINT, DR. BABASAHEB AMBEDKAR ROAD, PAREL, MUMBAI - 400 012

61779400 /01 / 02/ 03/ 04/05/06/07/08/09

61779058(Fax)

MUMBAI (Parel Branch) 022

SHOP NO 8, BAY SIDE ARCADE, DR. BABASAHEB AMBEDKAR ROAD, OPP BHARATMATA CINEMA, PAREL, MUMBAI - 400 012

24115313 / 24125313/ 24707289

MUMBAI (Thane) 022

SHOP NO.5, LAXMI NIWAS CHS, VISHNU NAGAR OPP. THANE BHARAT SAHAKARI BANK, NAUPADA, THANE WEST – 400 602

25453790 / 91 25453802

MUMBAI (Vashi) 022

BLOCK NO.2, GROUND FLOOR, TYPE C-1, BUILDING NO.12, SECTOR – 2, NEAR ABHYUDAYA BANK, OPP. SHANTI CENTRE, VASHI, NAVI MUMBAI - 400 703

27821105 to 27821108

MUMBAI (Vikhroli) 022

25 HAZARI BAUG, GROUND FLOOR, STATION ROAD, VIKHROLI WEST, MUMBAI - 400 083

25778466 / 25779282

MUMBAI (Vileparle) 022

104, SHYAM KAMAL, A - WING, 1ST FLOOR, OPP. VILE PARLE STATION (EAST), MUMBAI - 400 057

26161101 /26105363 26184143

26161108 (Fax)

Annexure-E

PROCEDURE FOR SUBMISSION BID

1. The application form shall be signed by the person/s having necessary

authority /Power of Attorney to do so. Each page of tender

documents will have to be initialled by the person who has signed the

tender document.

2. The bidder shall enclose the copy of Terms & Conditions (given in

tender document as Annexure-C) duly signed by the authorised

person in acceptance thereof.

3. The bidder shall enclose the stationery samples as stated in point no.

11 of Application Form for technical bid.

4. In case, the party signing the tender is not the sole proprietor

himself, the necessary power of attorney authorizing the party to act

on behalf of the organization should be attached along with the

tender documents.

5. The bidder is advised to visit office at Centre Point and thoroughly

understand the nature and scope of work and be familiar with the

supply of stationery before quoting. The samples will be displayed for

the bidders at the Corporation’s head office at Centre Point from 7th

June,2017 to 12th June,2017 (excluding Saturday & Sunday)

between 02.00 p.m. to 05.00 p.m.

6. Last date for submission of sealed quotations is on or before 16th

June’2017 by 11.00 a.m.

7. Tender received after the prescribed time and date will not be

considered and be rejected forthwith.

8. The bidder shall strictly conform the terms & conditions of the

tender.

9. The bidder shall abide by all the guidelines issued by Stockholding

from time to time.

10. Duly filled in Technical bid with samples and Financial bid shall be

sealed in separate covers super-scribing “Technical Bid & Samples for

supply of pre printed stationery/envelopes/DP books” and “Financial

Bid for supply of pre printed stationery/envelopes/DP books”. The

two covers put together in a single envelope should be sealed and

super-scribed as “Tender for supply of pre printed

stationery/envelopes/DP books”, and be dropped in tender box

placed at Stock Holding Corporation of India Ltd, 301, Centre Point,

Dr. B.Ambedkar Road, Parel, Mumbai-400012.

OPENING OF BIDS:

The technical bids shall be opened in the presence of the bidders, in the first

place and the same shall be evaluated by the Corporation, internally. Upon

such evaluation, the Financial Bids of the bidders, whose Technical bids have

been accepted as qualified, shall be opened. The date for the same shall be

intimated to those qualified bidders.

Annexure - F

APPLCIATION FORM FOR PREQUALIFICATION

1. Name & address of the Proprietary

concern / Company / Partnership

Firm :_________________________________________

2. Correspondence Address : _________________________________________

3. Registered Address : _________________________________________

4. Contact Person Name : _________________________________________

Phone No: :__________________________________________

E-mail :__________________________________________

5. Experience in Services (in years) :_______________________________

6. Annual Turnover Financial Year : 2014-15 (Rs.)______________________

: 2015-16 (Rs.)______________________

: 2016-17 (Rs.)______________________

7. Self Attested copies of following Statutory Registrations viz. :

a. VAT Act

b. Service Tax, if applicable

c. Copies of the registration certificate

d. Signed copy of PAN card

e. Any other regulatory requirement or Certification

f. Certificate from CA for turnover of last 3 years

g. Letter from Manufactures appointing the bidder as the authorised distributor.

8. Important Customers:

Name of the Client Contact Person Phone No.

9. I /We hereby declare that I / We have neither been debarred nor put in the negative list by

any client in the last 3 Financial Years for breach of applicable laws or violation of

regulatory prescriptions or breach of agreement.

10. Any other relevant information.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

11. The samples for stationery items are enclosed as mentioned below.

Sr.No. of Financial

bid

Samples to be provided Description for Printing

1 A4, 2 colour 80 gsm Name, address & logo

2 letterhead copy-‘100 gsm – executive bond – two colour Name, address & logo

4 Certificate of Holding - '2colour 120gsm Name address and logo (full page printing)

6 fine dhoti Cloth Cover -'16x12 -90gsm- one colour - name and address , logo

8 Brown Cover (Window Cover)-'10x12 -80 gsm - one colour Name, address & logo

10 Window envelope of 2 colour printing 9.5inchesX4 inches; 70 gsm white; paper thickness 0.15mm and maximum 5mm; Glassine paper of 35 gsm/cellophane paper of 40gms/PVC or BOPP of 15 microne thickness used for window material (as instructed Indian Postal Dept.

As per sample

14 Lamination kit cover (10X7 - 10 % x 13 %- two colour) Name, address & logo

15 P/P Letter Head Two Colour Printing (Data Centre)'10 x 12 x1 - 70 gsm

Name, address & logo

18 Pledge / Hypothecation form'1 book - size 13X19cm(LXB) '10x2 - 70gsm,58gsm sheshesai colour paper for copy. First4 colours & last page plain and inner pages 1 colour Annexure-W

Printing will be as per sample

20 Combined dis book (form no. 36) 5X2 Printing will be as per sample

35 Morocco folders A/4 (two colour printing-) Name and logo

36 Spring file (one colour printing ) Name and logo

48 Visiting cards size 9.2X5.4cm (front & back 2 colours) As per sample

12. Declaration.

I / We agree to abide by the terms and conditions of the tender document along with any

guidelines as may be issued by the Corporation from time to time. Further, I/We hereby

declare that the information furnished above is true and correct. I/We am/are aware that

incorrectness of the aforesaid information shall result in immediate termination of the

contract and Stockholding shall be entitled to recover the necessary costs and damages. I/We

confirm that we comply with the pre-qualification eligibility criteria.

Signature

With Seal and stamp

Annexure – G

FINANCIAL BID

Sr.No

Name of the Items Unit Estimated

quantity p.a. (A)

Unit Rate

(Rs.) (B)

Total Rs. (AXB)

Papers

1 A4, 2 colour 80 gsm Per 1000

2500

2 SHCIL letterhead copy-‘100 gsm – executive bond – two colour

per rim of 500 pages

150

3 Continuation sheet –‘100 gsm – executive bond – two colour

per rim of 500 pages

75

4 Certificate of Holding - '2colour 120gsm per book

24000

5 A4 Size Plain Paper – 75 gsm per pkt 4800

Envelopes

6 Shcil fine dhoti Cloth Cover -'16x12 -90gsm- one colour - name and address , logo

per envelop

e

7600

7 Shcil Plain Envelope-'11x5 - 70gsm - three colour - name and address

per envelop

e

31500

8 Brown Cover (Window Cover)-'10x12 -80 gsm - one colour - name and address, logo

per envelop

e

30000

9 Shcil fine dhoti Cloth Cover -'10x12-90gsm - one colour - name, logo and address

per envelop

e

12700

10 Window envelope of 2 colour printing 9.5inchesX4.25 inches, 70 gsm white, paper thickness 0.15mm and maximum 5mmGlassine apper of 35 gsm/cellophane paper of 40gms/PVC or BOPP of 15 microne thickness used for window material

per envelop

e

12 lakhs

11 Shcil fine dhoti Cloth Cover -'18x14 -90gsm - one colour - name and address , logo

per envelop

e

2600

12 Shcil Window Envelope-'11x5-70gsm - two colour - name and address

per envelop

e

25000

13 Brown Cover Plain )-'10x12 -80 gsm - one colour - name and address, logo

per envelop

e

4200

14 Lamination kit cover (10X7 - 10 % x 13 %- two colour)

per no. 80000

Computer Stationery

15 P/P Letter Head Two Colour Printing (Data Centre)'10 x 12 x1 - 70 gsm (Name, address, and SHCIL Logo )

Per 1000

50

16 P/P Letter Head Two Colour Printing (Data Centre)'15 x 12 x1 - 70 gsm (Name, address, and SHCIL Logo )

Per 1000

30

17 P/P Letter Head Three Colour Printing (Mumbai Branches) '10x12x1-70gsm .(Name address and SHCIL logo) front & Back

Per 1000

18

DP Books

18 Pledge / Hypothecation form'1 book - size 13X19cm(LXB) '10x2 - 70gsm,58gsm sheshesai colour paper for copy. First4 colours & last page plain and inner pages 1 colour Annexure-W

per book

5600

19 CDSL DIS form 6.2a, Delivery instruction by clientForm 12 as per sample, sheshesai colour paper for copy, first 4 colours and last page 3 colours and inner pages 1 colour . (cover & last page glossy paper 220 gsm)

per book

5100

20 combined dis book (form no. 36) 5X2 per book

2000

21 combined dis book (form no. 36) 10X2 per book

30000

22 combined dis book (form no. 36) 20X2 per book

30000

23 Delivery instruction by client - size13X19cm(LXB)excluding space for margin. '20x2 - 70gsm, 58gsm sheshesai colour paper for copy. First (front&back) & last page (front&back) 4 colours and inner pages 1 colour, plus requisition slip (front&back) with differant colour Annexure-L (cover & last page glossy paper 220 gsm)

per book

5000

24 Dematerialization request form'1 book - size 28X21cm(LXB) contains 10X3 pages -70gsm, 58gsm sheshesai 2 different colours papers for2 copies. Covering page will be one colour printing Annexure-D - (cover & last page glossy paper 220 gsm)

per book

6500

25 Inter depository instruction slip'1 book size 13X19cm (LXB) excluding space for margin. '20x2 - 70gsm, 58gsm sheshesai colour paper for copy. First (front&back)& last (front&back) page 4 colours and inner pages 1 colour plus requisition slip with differant colour

Annexure-N Form no.15 (cover & last page glossy paper 220 gsm)

per book

300

26 Delivery out instruction by clearing member for pay-out -'1 book contains size13X19cm(LXB)excluding space for margin. '50x2 - 70gsm, 58gsm sheshesai colour paper for copy. First 4 colour & last page plain and inner pages 1 colour (as per sample) Annexure-T (cover & last page glossy paper 220 gsm)

per book

2000

27 Delivery out instruction by clearing member for pay-out -'1 book contains size13X19cm(LXB)excluding space for margin. '20x2 - 70gsm, 58gsm sheshesai colour paper for copy. First 4 colour & last page plain and inner pages 1 colour Annexure-T (cover & last page glossy paper 220 gsm)

per book

500

28 Delivery out instruction by clearing member for pay-in -'1 book contains size13X19cm(LXB)excluding space for margin. '50x2 - 70gsm, 58gsm sheshesai colour paper for copy. First -4 colour & last page plain and inner pages 1 colour (as per sample) Annexure-S (cover & last page glossy paper 220 gsm)

per book

200

29 Delivery out instruction by clearing member for pay-in -'1 book contains size13X19cm(LXB)excluding space for margin. '20x2 - 70gsm, 58gsm sheshesai colour paper for copy. First -4 colour & last page plain and inner pages 1 colour (as per sample) Annexure-S (cover & last page glossy paper 220 gsm)

per book

500

30 Receipt Instruction ' 1 book containssize13X19cm(LXB)excluding space for margin. '10x2 - 70gsm, 58gsm sheshesai colour paper for copy. First (front&Back)& last page (front&Back) 4 colours and inner pages 1 colour (as per sample) Annexure-M (cover & last page glossy paper 220 gsm)

per book

200

31 Inter Settlement Instruction '1 book contains size13X19cm(LXB)excluding space for margin. '50x2 - 70gsm, 58gsm sheshesai colour paper for copy. First page 4 colours & last page plain and inner pages 1 colour (as per sample) Annexure-SS (cover & last page glossy paper 220 gsm)

per book

100

32 Inter Settlement Instruction '1 book contains size13X19cm(LXB)excluding space for margin. '20x2 - 70gsm, 58gsm sheshesai colour paper for copy. First page 4 colours & last page plain and inner pages 1 colour (as per sample) Annexure-SS (cover & last page glossy paper 220 gsm)

per book

200

33 CM Pool to pool delivery instruction by clearing member'1 book contains size13X19cm(LXB)excluding space for margin. '20x2 - 70gsm, 58gsm sheshesai colour paper for copy. First page (front 4 colour& back 1 colour) & last page plain and inner pages 1 colour Annexure-ST (cover & last page glossy paper 220 gsm)

per book

200

34 CDSL Plege/unpledged/invocation request form'1 book contains size 21X28cm(LXB) '10x2 - 70gsm, 58gsm sheshesai colour paper for copy. First page 4 colour & last page plain and inner pages 1 colour

per book

200

Other stationery items

35 Morocco folders A/4 (one colour printing-)

per folder

2100

36 Spring file (one colour printing ) per folder

1000

37 Writing Pad1/4 per unit 40

38 SHCIL Logo Pad (Waterlogo on each page)15 pages

per unit 350

39 Conference Pad per unit 50

40 Corugated Printing Box with printing size 18"X12 1/2X11"address and logo

per box 200

41 Payment Voucher (100 pages) per unit 14

42 HRD Application Form per unit 500

43 Security Attendance Book per unit 40

44 Employee Entry Book per unit 40

45 SHCIL Gate Pass Book per unit 10

46 Motor Log Book – 300 pages per unit 10

47 Visitor Pass Book per unit 40

48 Visiting cards size 9.2X5.4cm (front & back 3 colours)

per pkt of 100

700

Total(Rs.)

Total (Rupees in words)-----------------------------------------------------

--------------------------------------------------------------------------------

-----

Signature

Name of the Authorised Person :

Designation:

Company Seal :

Date :