Common use of AFFIDAVIT Clause in Contracts

AFFIDAVIT. To, ▇▇▇▇, ▇▇▇▇ GS Medical College & KEM Hospital and Managing Trustee, Seth GS Medical College & KEM Hospital Diamond Jubilee Society Trust (DJST), Parel, Mumbai 400 012. Sir, “I/We (full name in capital letters, starting with surname),the Proprietor/Managing Partner/ Managing Director/Holder of the Business/Manufacturer/Authorized Dealer, for the establishment/ firm/registered company, named herein below, do hereby state and declare that I/We, whose names are given herein below in details with the addresses, have not filled in this quotation under any other name or under the name of any other establishment /firm or otherwise, nor are we in any way related or concerned with any establishment/ firm or any other person, who have filled in the tender/quotation for aforesaid supply/work. "I/We (full name in capital letters, starting with surname),the Proprietor/ Managing Partner/ Managing Director/ Holder of the Business/Manufacturer/Authorized Dealer, for the establishment /firm/registered company, named herein below, do hereby undertake that we have offered the best prices for the subject supply/work as per the present market rates and that we have not offered less prices for the subject supply/work to any other outside agencies including Govt./Semi Govt. agencies and within the Seth GS Medical College (GSMC& KEMH-Department of Clinical Pharmacology) and DJST also. Further, we have filled in the accompanying quotations with full knowledge of the above liabilities and therefore we will not raise any objection or dispute in any manner relating to any action for giving any information which is found to be incorrect and against the instruction and direction given in this behalf in this tender and failure to execute. I/We further agree and undertake that in the event, if it is revealed subsequently after the allotment of work/ contract to me/us that any information given by me/us in this tender is false or incorrect, I/We shall compensate the GSMC& KEMH-Department of Clinical Pharmacology and DJST for any such losses or inconveniences caused to the GSMC& KEMH-Department of Clinical Pharmacology and DJST, in any manner and will not resist any claim for such compensation on any grounds what so ever .I/We agree and undertake that I/We shall not claim in such case any amount, by way of damages or compensation for cancellation of the contract given to me/us or any work assigned to me/us or is withdrawn by the GSMC& KEMH-Department of Clinical Pharmacology and DJST. I/We hereby request you not to enter into a contract with any other person/persons for the supply/work underlying this contract for which the present tender is submitted until notice of non-acceptance of this tender has been first communicated to me/us and in consideration of your agreeing to refrain from so doing I/We agree not to withdraw the offer constituted by this tender before the date of communication to me/us or such notice of non-acceptance, which date shall be not later than fifteen days from the date of the decision of the ▇▇▇▇ (G&K),GSMC& KEMH-Department of Clinical Pharmacology and DJST, not to accept this tender. I / We have quoted for all Items and Quantities as per your specifications, which include all Taxes and Duties payable & born by us and have carefully noted the conditions of the Contract and the Specifications with all the stipulations which I /We agree to comply. I / We undertake to complete the delivery within the period stipulated after receiving an order. However, in case of price difference, if it is a result of differential tax structures, different Dollar value of Rupee, differential logistic of transport etc. considering this aspect, before invoking the action, I/we will be given a reasonable opportunity of being heard by representing our case as to why such price variation/differential has been arisen. In case, if the explanation submitted by me/us is unsatisfactory then action may be taken against me/us. I/ we undertake that I/we have thoroughly read and understood the terms and conditions as indicated in this tender document and accept all the terms and conditions. I/ we also undertake that I /we have also appraised myself /ourselves with ▇▇▇▇ ▇▇ Medical College, Department of Clinical Pharmacology (GSMC& KEMH-DCP) and DJST, actual nature of supply/work and other prevalent conditions. I/we hereby confirm that I/we will be able to carry out the supply/ work offered by me/us as per specifications indicated in the tender, after compliance of all the required formalities within the specified time at the quoted rates, if accepted by GSMC& KEMH-Department of Clinical Pharmacology and DJST. I/We confirm that I / We shall not sublet the work or supply to any other agency without the prior approval of the ▇▇▇▇ (G&K) and Managing trustee, DJST. I/We agree to abide the regulations of the GSMC& KEMH-Department of Clinical Pharmacology) and DJST premises now in force or which may come into force, during the currency of the contract. I/ We also undertake to carry out the supply/work without any interference, what-so-ever to the supply/work. I/We agree for reserving the right to stop any supervising staff/lab or employed by me/us from entering in the GSMC & KEMH-Department of Clinical Pharmacology and DJST premises/area, if GSMC& KEMH- Department of Clinical Pharmacology and DJST feels that the said person is an undesirable element or is likely to create mischief. ▇▇▇▇ (G&K) and Managing trustee, DJST will not be required to assign any reason while exercising this right and I/We shall abide by such decision of the ▇▇▇▇(G&K) and Managing trustee, DJST as final and binding on me/us. I/ We agree to execute an agreement in the Proforma given and shall bear necessary cost of stamp duty as per Government directives in this regard. I/We also agree,to undertake to carry out all types of supply /work covered under Items of this tender as ordered from time to time by the Officer in Charge or by his authorized representatives. I/whereby declare that the information furnished in the tender is correct and true to the best of my /our knowledge and belief. l/we also know and accept that if at any stage the information is found to be not correct, my/our quotations shall not be considered by GSMC& KEMH-Department of Clinical Pharmacology and DJST and I /we will be liable for action as per terms and condition. The acceptance of this tender by GSMC& KEMH- Department of Clinical Pharmacology and DJST,shall constitute abinding contract between me/us and GSMC& KEMH- Department of Clinical Pharmacology and DJST.I/we solemnly confirm the compliance of all the requirements/Conditions of the tender documents. I/wehere by certify that I/we was/ were never blacklisted by any of central Govt./state Govt./Public sector undertaking/any other Local body. Solemnly affirmed on this the day of 2021. (Note:This affidavit should be given by the prospective bidders on Rs.200/-stamp paper duly notarized by Notary with red seal and registration Number.) To, ▇▇▇▇, ▇▇▇▇ GS Medical College & KEM Hospital and Managing Trustee, Seth GS Medical College & KEM Hospital Diamond Jubilee Society Trust (DJST), Parel, Mumbai 400 012. DearSir, We, who are an established and reputed manufacturer of (name & description of the goods offered in the enquiry ) having factories at , hereby certify that M/s.(name &address of the distributor/dealer/ agent)is our authorized distributor/dealer/agent &authorize them to submit quotation, process the same further and enter into a contract with you against your requirement as contained in the above referred enquiry for the above goods manufactured by us. This authorization is valid till Yours faithfully, Note: 1) This letter of authorization should be on the letter head of the manufacturing firm and should be signed by a person competent and having the power of attorney to legally bind the manufacturer. Proforma for Triparty Agreement between GSMC& KEMH- Department of Clinical Pharmacology, Manufacturer and Bidder

AFFIDAVIT. To, ▇▇▇▇, ▇▇▇▇ GS Medical College & KEM Hospital ‘Notarized on Rs. 100/- Non Judicial stamp paper’ 1. That our firm / company / corporation and Managing Trustee, Seth GS Medical College & KEM Hospital Diamond Jubilee Society Trust (DJST), Parel, Mumbai 400 012. Sir, “Iany of its Directors / Proprietor / Partner / authorized signatories has not been convicted / or a CBI/We (full name vigilance/criminal case filed against us or pending in capital letters, starting with surname),the Proprietor/Managing Partner/ Managing Director/Holder any court of India by any department of the Business/Manufacturer/Authorized Dealer, government under Prevention of Corruption Act or for cheating / defrauding government / embezzlement of government fund or for any criminal conspiracy in the establishment/ said matters. 2. That our firm/registered company, named herein below, do hereby state and declare that I/We, whose names are given herein below in details with the addresses, have corporation is not filled in this quotation currently under conviction for manufacturing/supplying sub-standard products or on any other name or under the name of any other establishment /firm or otherwise, nor are we in any way related or concerned with any establishment/ firm or any other person, who grounds under. 3. That I have filled in the tender/quotation for aforesaid supply/work. "I/We (full name in capital letters, starting with surname),the Proprietor/ Managing Partner/ Managing Director/ Holder of the Business/Manufacturer/Authorized Dealer, for the establishment /firm/registered company, named herein below, do hereby undertake that we have offered the best prices for the subject supply/work as per the present market rates and that we have not offered less prices for the subject supply/work to any other outside agencies including Govt./Semi Govt. agencies and within the Seth GS Medical College (GSMC& KEMH-Department of Clinical Pharmacology) and DJST also. Further, we have filled in the accompanying quotations with full knowledge of the above liabilities and therefore we will not raise any objection or dispute in any manner relating to any action for giving any information which is found to be incorrect and against the instruction and direction given in this behalf in this tender and failure to execute. I/We further agree and undertake that in the event, if it is revealed subsequently after the allotment of work/ contract to me/us that any information given by me/us in this tender is false or incorrect, I/We shall compensate the GSMC& KEMH-Department of Clinical Pharmacology and DJST for any such losses or inconveniences caused to the GSMC& KEMH-Department of Clinical Pharmacology and DJST, in any manner and will not resist any claim for such compensation on any grounds what so ever .I/We agree and undertake that I/We shall not claim in such case any amount, by way of damages or compensation for cancellation of the contract given to me/us or any work assigned to me/us or is withdrawn by the GSMC& KEMH-Department of Clinical Pharmacology and DJST. I/We hereby request you not to enter into a contract with any other person/persons for the supply/work underlying this contract for which the present tender is submitted until notice of non-acceptance of this tender has been first communicated to me/us and in consideration of your agreeing to refrain from so doing I/We agree not to withdraw the offer constituted by this tender before the date of communication to me/us or such notice of non-acceptance, which date shall be not later than fifteen days from the date of the decision of the ▇▇▇▇ (G&K),GSMC& KEMH-Department of Clinical Pharmacology and DJST, not to accept this tender. I / We have quoted for all Items and Quantities as per your specifications, which include all Taxes and Duties payable & born by us and have carefully noted the conditions of the Contract and the Specifications with all the stipulations which I /We agree to comply. I / We undertake to complete the delivery within the period stipulated after receiving an order. However, in case of price difference, if it is a result of differential tax structures, different Dollar value of Rupee, differential logistic of transport etc. considering this aspect, before invoking the action, I/we will be given a reasonable opportunity of being heard by representing our case as to why such price variation/differential has been arisen. In case, if the explanation submitted by me/us is unsatisfactory then action may be taken against me/us. I/ we undertake that I/we have thoroughly read and understood the terms and conditions as indicated in this tender document and accept all the terms and conditions. I/ we also undertake that I /we have also appraised myself /ourselves with ▇▇▇▇ ▇▇ Medical College, Department of Clinical Pharmacology (GSMC& KEMH-DCP) and DJST, actual nature of supply/work and other prevalent conditions. I/we hereby confirm that I/we will be able to carry out the supply/ work offered by me/us as per specifications indicated in the tender, after compliance of all the required formalities within the specified time at the quoted rates, if accepted by GSMC& KEMH-Department of Clinical Pharmacology and DJST. I/We confirm that I / We shall not sublet the work or supply to any other agency without the prior approval of the ▇▇▇▇ (G&K) tender and Managing trustee, DJST. I/We I agree to abide the regulations by these terms and conditions and other guidelines issued in this regard. 4. That I declare I am aware of the GSMC& KEMH-Department of Clinical Pharmacology) and DJST premises now in force or which may come into force, during the currency of the contract. I/ We also undertake to carry out the supply/work without any interference, what-so-ever to the supply/work. I/We agree for reserving the Tender Inviting Authority’s right to stop any supervising staff/lab or employed by me/us from entering in the GSMC & KEMH-Department of Clinical Pharmacology and DJST premises/area, if GSMC& KEMH- Department of Clinical Pharmacology and DJST feels that the said person is an undesirable element or is likely to create mischief. ▇▇▇▇ (G&K) and Managing trustee, DJST will not be required to assign any reason while exercising this right and I/We shall abide by such decision of forfeit the ▇▇▇▇(G&K) ▇▇▇ Money Deposit and/or Security Deposit and Managing trusteeblacklist my company, DJST as final if any information furnished by us proved to be false at the time of inspection and binding not complying the tender/contract conditions. 5. In case of exemption of my/our Proprietary Concern/ Firm / Company Ltd from payment of ▇▇▇▇▇▇▇ Money Deposit by a govt. order, I undertake to pay the said sum without any demur on me/usreceipt of demand issued by the tender inviting authority. 6. I/ We agree That the information given by me in this tender form is true and correct to execute an agreement the best of my knowledge and belief and the rates quoted are not higher than the rates quoted to other Govt. / Semi Govt. / Autonomous / Public Sector Hospitals / Institutions / Organizations situated in India in the Proforma given and shall bear necessary cost of stamp duty as per Government directives same financial year. 7. That our firm has not been deregistered or black listed by any govt. /autonomous institution, hospital or body in India for any item which is being quoted here by me in this regardtender or for participating in bid altogether. 8. I/We also agree,That I shall inform the Directorate immediately, if there is any conviction from any authority which adversely affects my eligibility to undertake to carry out all types of supply /work covered under Items of bid in this tender as ordered from time to time by the Officer in Charge for one or by his authorized representativesmore items,. I/whereby declare Our firm / company / corporation details are: Photo 1. 8. Date: Nature of firm (Public Ltd, Pvt. Ltd, Proprietary, Partnership etc): Authority with which it is registered : Contact Person Registered Address: Address of correspondence: Phone: Landline: Mobile Fax: email *: Office seal Name Designation Signature Verification I pledge and solemnly affirm that the information furnished in the tender submitted above is correct and true to the best of my /our knowledge and belief. l/we also know Place …………………….. Date * All correspondence shall go to the email given here, and accept that if at any stage the information is found to preferably be not correct, my/our quotations shall not be considered by GSMC& KEMH-Department of Clinical Pharmacology and DJST and I /we will be liable for action as per terms and condition. The acceptance of this tender by GSMC& KEMH- Department of Clinical Pharmacology and DJST,shall constitute abinding contract between me/us and GSMC& KEMH- Department of Clinical Pharmacology and DJST.I/we solemnly confirm the compliance of all the requirements/Conditions with @domain name of the tender documents. I/wehere by certify that I/we was/ were never blacklisted by any of central Govt./state Govt./Public sector undertaking/any other Local body. Solemnly affirmed on this the day of 2021. (Note:This affidavit should be given by the prospective bidders on Rs.200/-stamp paper duly notarized by Notary with red seal and registration Number.) To, ▇▇▇▇, ▇▇▇▇ GS Medical College & KEM Hospital and Managing Trustee, Seth GS Medical College & KEM Hospital Diamond Jubilee Society Trust (DJST), Parel, Mumbai 400 012. DearSir, We, who are an established and reputed manufacturer of (name & description of the goods offered in the enquiry ) having factories at , hereby certify that M/s.(name &address of the distributor/dealer/ agent)is our authorized distributor/dealer/agent &authorize them to submit quotation, process the same further and enter into a contract with you against your requirement as contained in the above referred enquiry for the above goods manufactured by us. This authorization is valid till Yours faithfully, Note: 1) This letter of authorization should be on the letter head of the manufacturing firm and should be signed by a person competent and having the power of attorney to legally bind the manufacturer. Proforma for Triparty Agreement between GSMC& KEMH- Department of Clinical Pharmacology, Manufacturer and Bidderfirm

AFFIDAVIT. To, ▇▇▇▇, ▇▇▇▇ GS Medical College & KEM Hospital and Managing Trustee, Seth GS Medical College & KEM Hospital Diamond Jubilee Society Trust (DJST), Parel, Mumbai 400 012. Sir, “I/We (full name in capital letters, starting with surname),the Proprietor/Managing Partner/ Managing Director/Holder of the Business/Manufacturer/Authorized Dealer, for the establishment/ firm/registered company, named herein below, do hereby state and declare that I/We, whose names are given herein below in details with the addresses, have not filled in this quotation under any other name or under the name of any other establishment /firm or otherwise, nor are we in any way related or concerned with any establishment/ firm or any other person, who have filled in the tender/quotation for aforesaid supply/work. "I/We (full name in capital letters, starting with surname),the Proprietor/ Managing Partner/ Managing Director/ Holder of the Business/Manufacturer/Authorized Dealer, for the establishment /firm/registered company, named herein below, do hereby undertake that we have offered the best prices for the subject supply/work as per the present market rates and that we have not offered less prices for the subject supply/work to any other outside agencies including Govt./Semi Govt. agencies and within the Seth GS Medical College (GSMC& KEMH-Department of Clinical Pharmacology) and DJST also. Further, we have filled in the accompanying quotations with full knowledge of the above liabilities and therefore we will not raise any objection or dispute in any manner relating to any action for giving any information which is found to be incorrect and against the instruction and direction given in this behalf in this tender and failure to execute. I/We further agree and undertake that in the event, if it is revealed subsequently after the allotment of work/ contract to me/us that any information given by me/us in this tender is false or incorrect, I/We shall compensate the GSMC& KEMH-Department of Clinical Pharmacology and DJST for any such losses or inconveniences caused to the GSMC& KEMH-Department of Clinical Pharmacology and DJST, in any manner and will not resist any claim for such compensation on any grounds what so ever .I/We agree and undertake that I/We shall not claim in such case any amount, by way of damages or compensation for cancellation of the contract given to me/us or any work assigned to me/us or is withdrawn by the GSMC& KEMH-Department of Clinical Pharmacology and DJST. I/We hereby request you not to enter into a contract with any other person/persons for the supply/work underlying this contract for which the present tender is submitted until notice of non-acceptance of this tender has been first communicated to me/us and in consideration of your agreeing to refrain from so doing I/We agree not to withdraw the offer constituted by this tender before the date of communication to me/us or such notice of non-acceptance, which date shall be not later than fifteen days from the date of the decision of the ▇▇▇▇ (G&K),GSMC& KEMH-Department of Clinical Pharmacology and DJST, not to accept this tender. I / We have quoted for all Items and Quantities as per your specifications, which include all Taxes and Duties payable & born by us and have carefully noted the conditions of the Contract and the Specifications with all the stipulations which I /We agree to comply. I / We undertake to complete the delivery within the period stipulated after receiving an order. However, in case of price difference, if it is a result of differential tax structures, different Dollar value of Rupee, differential logistic of transport etc. considering this aspect, before invoking the action, I/we will be given a reasonable opportunity of being heard by representing our case as to why such price variation/differential has been arisen. In case, if the explanation submitted by me/us is unsatisfactory then action may be taken against me/us. I/ we undertake that I/we have thoroughly read and understood the terms and conditions as indicated in this tender document and accept all the terms and conditions. I/ we also undertake that I /we have also appraised myself /ourselves with ▇▇▇▇ ▇▇ Medical College, Department of Clinical Pharmacology (GSMC& KEMH-DCP) and DJST, actual nature of supply/work and other prevalent conditions. I/we hereby confirm that I/we will be able to carry out the supply/ work offered by me/us as per specifications indicated in the tender, after compliance of all the required formalities within the specified time at the quoted rates, if accepted by GSMC& KEMH-Department of Clinical Pharmacology and DJST. I/We confirm that I / We shall not sublet the work or supply to any other agency without the prior approval of the ▇▇▇▇ (G&K) and Managing trustee, DJST. I/We agree to abide the regulations of the GSMC& KEMH-Department of Clinical Pharmacology) and DJST premises now in force or which may come into force, during the currency of the contract. I/ We also undertake to carry out the supply/work without any interference, what-so-ever to the supply/work. I/We agree for reserving the right to stop any supervising staff/lab or employed by me/us from entering in the GSMC & KEMH-Department of Clinical Pharmacology and DJST premises/area, if GSMC& KEMH- Department of Clinical Pharmacology and DJST feels that the said person is an undesirable element or is likely to create mischief. ▇▇▇▇ (G&K) and Managing trustee, DJST will not be required to assign any reason while exercising this right and I/We shall abide by such decision of the ▇▇▇▇(G&K) and Managing trustee, DJST as final and binding on me/us. I/ We agree to execute an agreement in the Proforma given and shall bear necessary cost of stamp duty as per Government directives in this regard. I/We also agree,to undertake to carry out all types of supply /work covered under Items of this tender as ordered from time to time by the Officer in Charge or by his authorized representatives. I/whereby declare that the information furnished in the tender is correct and true to the best of my /our knowledge and belief. l/we also know and accept that if at any stage the information is found to be not correct, my/our quotations shall not be considered by GSMC& KEMH-Department of Clinical Pharmacology and DJST and I /we will be liable for action as per terms and condition. The acceptance of this tender by GSMC& KEMH- Department of Clinical Pharmacology and DJST,shall constitute abinding abiding contract between me/us and GSMC& KEMH- Department of Clinical Pharmacology and DJST.I/we solemnly confirm the compliance of all the requirements/Conditions of the tender documents. I/wehere by certify that I/we was/ were never blacklisted by any of central Govt./state Govt./Public sector undertaking/any other Local body. Solemnly affirmed on this the day of 2021. (Note:This affidavit should be given by the prospective bidders on Rs.200/-stamp paper duly notarized by Notary with red seal and registration Number.) To, ▇▇▇▇, ▇▇▇▇ GS Medical College & KEM Hospital and Managing Trustee, Seth GS Medical College & KEM Hospital Diamond Jubilee Society Trust (DJST), Parel, Mumbai 400 012. DearSir, We, who are an established and reputed manufacturer of (name & description of the goods offered in the enquiry ) having factories at , hereby certify that M/s.(name &address of the distributor/dealer/ agent)is our authorized distributor/dealer/agent &authorize them to submit quotation, process the same further and enter into a contract with you against your requirement as contained in the above referred enquiry for the above goods manufactured by us. This authorization is valid till Yours faithfully, Note: 1) This letter of authorization should be on the letter head of the manufacturing firm and should be signed by a person competent and having the power of attorney to legally bind the manufacturer. Proforma for Triparty Agreement between GSMC& KEMH- Department of Clinical Pharmacology, Manufacturer and Bidder

AFFIDAVIT. To, ▇▇▇▇, ▇▇▇▇ GS Medical College & KEM Hospital and Managing Trustee, Seth GS Medical College & KEM Hospital Diamond Jubilee Society Trust (DJST), Parel, Mumbai 400 012. Sir, “I/We (full name in capital letters, starting with surname),the Proprietor/Managing Partner/ Managing Director/Holder of the Business/Manufacturer/Authorized Dealer, for the establishment/ firm/registered company, named herein below, do hereby state and declare that I/We, whose names are given herein below in details with the addresses, have not filled in this quotation under any other name or under the name of any other establishment /firm or otherwise, nor are we in any way related or concerned with any establishment/ firm or any other person, who have filled in the tender/quotation for aforesaid supply/work. "I/We (full name in capital letters, starting with surname),the Proprietor/ Managing Partner/ Managing Director/ Holder of the Business/Manufacturer/Authorized Dealer, for the establishment /firm/registered company, named herein below, do hereby undertake that we have offered the best prices for the subject supply/work as per the present market rates and that we have not offered less prices for the subject supply/work to any other outside agencies including Govt./Semi Govt. agencies and within the Seth GS Medical College (GSMC& KEMH-Department of Clinical Pharmacology) and DJST also. Further, we have filled in the accompanying quotations with full knowledge of the above liabilities and therefore we will not raise any objection or dispute in any manner relating to any action for giving any information which is found to be incorrect and against the instruction and direction given in this behalf in this tender and failure to execute. I/We further agree and undertake that in the event, if it is revealed subsequently after the allotment of work/ contract to me/us that any information given by me/us in this tender is false or incorrect, I/We shall compensate the GSMC& KEMH-Department of Clinical Pharmacology and DJST for any such losses or inconveniences caused to the GSMC& KEMH-Department of Clinical Pharmacology and DJST, in any manner and will not resist any claim for such compensation on any grounds what so ever .I/We agree and undertake that I/We shall not claim in such case any amount, by way of damages or compensation for cancellation of the contract given to me/us or any work assigned to me/us or is withdrawn by the GSMC& KEMH-Department of Clinical Pharmacology and DJST. I/We hereby request you not to enter into a contract with any other person/persons for the supply/work underlying this contract for which the present tender is submitted until notice of non-acceptance of this tender has been first communicated to me/us and in consideration of your agreeing to refrain from so doing I/We agree not to withdraw the offer constituted by this tender before the date of communication to me/us or such notice of non-acceptance, which date shall be not later than fifteen days from the date of the decision of the ▇▇▇▇ (G&K),GSMC& KEMH-Department of Clinical Pharmacology and DJST, not to accept this tender. I / We have quoted for all Items and Quantities as per your specifications, which include all Taxes and Duties payable & born by us and have carefully noted the conditions of the Contract and the Specifications with all the stipulations which I /We agree to comply. I / We undertake to complete the delivery within the period stipulated after receiving an order. However, in case of price difference, if it is a result of differential tax structures, different Dollar value of Rupee, differential logistic of transport etc. considering this aspect, before invoking the action, I/we will be given a reasonable opportunity of being heard by representing our case as to why such price variation/differential has been arisen. In case, if the explanation submitted by me/us is unsatisfactory then action may be taken against me/us. I/ we undertake that I/we have thoroughly read and understood the terms and conditions as indicated in this tender document and accept all the terms and conditions. I/ we also undertake that I /we have also appraised myself /ourselves with ▇▇▇▇ ▇▇ Medical College, Department of Clinical Pharmacology (GSMC& KEMH-DCP) and DJST, actual nature of supply/work and other prevalent conditions. I/we hereby confirm that I/we will be able to carry out the supply/ work offered by me/us as per specifications indicated in the tender, after compliance of all the required formalities within the specified time at the quoted rates, if accepted by GSMC& KEMH-Department of Clinical Pharmacology and DJST. I/We confirm that I / We shall not sublet the work or supply to any other agency without the prior approval of the ▇▇▇▇ (G&K) and Managing trustee, DJST. I/We agree to abide the regulations of the GSMC& KEMH-Department of Clinical Pharmacology) and DJST premises now in force or which may come into force, during the currency of the contract. I/ We also undertake to carry out the supply/work without any interference, what-so-ever to the supply/work. I/We agree for reserving the right to stop any supervising staff/lab or employed by me/us from entering in the GSMC & KEMH-Department of Clinical Pharmacology and DJST premises/area, if GSMC& KEMH- Department of Clinical Pharmacology and DJST feels that the said person is an undesirable element or is likely to create mischief. ▇▇▇▇ (G&K) and Managing trustee, DJST will not be required to assign any reason while exercising this right and I/We shall abide by such decision of the ▇▇▇▇(G&K) and Managing trustee, DJST as final and binding on me/us. I/ We agree to execute an agreement in the Proforma given and shall bear necessary cost of stamp duty as per Government directives in this regard. I/We also agree,to undertake to carry out all types of supply /work covered under Items of this tender as ordered from time to time by the Officer in Charge or by his authorized representatives. I/whereby declare that the information furnished in the tender is correct and true to the best of my /our knowledge and belief. l/we also know and accept that if at any stage the information is found to be not correct, my/our quotations shall not be considered by GSMC& KEMH-Department of Clinical Pharmacology and DJST and I /we will be liable for action as per terms and condition. The acceptance of this tender by GSMC& KEMH- Department of Clinical Pharmacology and DJST,shall constitute abinding contract between me/us and GSMC& KEMH- Department of Clinical Pharmacology and DJST.I/we solemnly confirm the compliance of all the requirements/Conditions of the tender documents. I/wehere by certify that I/we was/ were never blacklisted by any of central Govt./state Govt./Public sector undertaking/any other Local body. Solemnly affirmed on this the day of 2021. (Note:This affidavit should be given by the prospective bidders on Rs.200/-stamp paper duly notarized by Notary with red seal and registration Number.) Proforma for Manufacturer’s Authorization Letter ( To be submitted in Folder ‘A’) To, ▇▇▇▇, ▇▇▇▇ GS Medical College & KEM Hospital and Managing Trustee, Seth GS Medical College & KEM Hospital Diamond Jubilee Society Trust (DJST), Parel, Mumbai 400 012. DearSir, We, who are an established and reputed manufacturer of (name & description of the goods offered in the enquiry ) having factories at , hereby certify that M/s.(name &address of the distributor/dealer/ agent)is our authorized distributor/dealer/agent &authorize them to submit quotation, process the same further and enter into a contract with you against your requirement as contained in the above referred enquiry for the above goods manufactured by us. This authorization is valid till Yours faithfully, Note: 1) This letter of authorization should be on the letter head of the manufacturing firm and should be signed by a person competent and having the power of attorney to legally bind the manufacturer. Proforma for Triparty Agreement between GSMC& KEMH- Department of Clinical Pharmacology, Manufacturer and Bidder

AFFIDAVIT. To, ▇▇▇▇, ▇▇▇▇ GS Medical College & KEM Hospital and Managing Trustee, Seth GS Medical College & KEM Hospital Diamond Jubilee Society Trust (DJSTTo be furnished in a Twenty Rupees Non - Judicial stamp paper duly certified by Notary Public), Parel, Mumbai 400 012 1. Sir, “I/We (full name in capital letters, starting with surname),the Proprietor/Managing Partner/ Managing Director/Holder of I /We the Business/Manufacturer/Authorized Dealer, for the establishment/ firm/registered company, named herein below, do hereby state and undersigned solemnly declare that I/We, whose names are given herein below in details with all the addresses, have not filled in this quotation under any other name or under the name of any other establishment /firm or otherwise, nor are we in any way related or concerned with any establishment/ firm or any other person, who have filled statements made in the tender/quotation for aforesaid supply/work. "I/We (full name in capital lettersdocuments, starting records etc., attached with surname),the Proprietor/ Managing Partner/ Managing Director/ Holder of the Business/Manufacturer/Authorized Dealer, for the establishment /firm/registered company, named herein below, do hereby undertake that we have offered the best prices for the subject supply/work as per the present market rates this application are true and that we have not offered less prices for the subject supply/work to any other outside agencies including Govt./Semi Govt. agencies and within the Seth GS Medical College (GSMC& KEMH-Department of Clinical Pharmacology) and DJST also. Further, we have filled in the accompanying quotations with full knowledge of the above liabilities and therefore we will not raise any objection or dispute in any manner relating to any action for giving any information which is found to be incorrect and against the instruction and direction given in this behalf in this tender and failure to execute. I/We further agree and undertake that in the event, if it is revealed subsequently after the allotment of work/ contract to me/us that any information given by me/us in this tender is false or incorrect, I/We shall compensate the GSMC& KEMH-Department of Clinical Pharmacology and DJST for any such losses or inconveniences caused to the GSMC& KEMH-Department of Clinical Pharmacology and DJST, in any manner and will not resist any claim for such compensation on any grounds what so ever .I/We agree and undertake that I/We shall not claim in such case any amount, by way of damages or compensation for cancellation of the contract given to me/us or any work assigned to me/us or is withdrawn by the GSMC& KEMH-Department of Clinical Pharmacology and DJST. I/We hereby request you not to enter into a contract with any other person/persons for the supply/work underlying this contract for which the present tender is submitted until notice of non-acceptance of this tender has been first communicated to me/us and in consideration of your agreeing to refrain from so doing I/We agree not to withdraw the offer constituted by this tender before the date of communication to me/us or such notice of non-acceptance, which date shall be not later than fifteen days from the date of the decision of the ▇▇▇▇ (G&K),GSMC& KEMH-Department of Clinical Pharmacology and DJST, not to accept this tender. I / We have quoted for all Items and Quantities as per your specifications, which include all Taxes and Duties payable & born by us and have carefully noted the conditions of the Contract and the Specifications with all the stipulations which I /We agree to comply. I / We undertake to complete the delivery within the period stipulated after receiving an order. However, in case of price difference, if it is a result of differential tax structures, different Dollar value of Rupee, differential logistic of transport etc. considering this aspect, before invoking the action, I/we will be given a reasonable opportunity of being heard by representing our case as to why such price variation/differential has been arisen. In case, if the explanation submitted by me/us is unsatisfactory then action may be taken against me/us. I/ we undertake that I/we have thoroughly read and understood the terms and conditions as indicated in this tender document and accept all the terms and conditions. I/ we also undertake that I /we have also appraised myself /ourselves with ▇▇▇▇ ▇▇ Medical College, Department of Clinical Pharmacology (GSMC& KEMH-DCP) and DJST, actual nature of supply/work and other prevalent conditions. I/we hereby confirm that I/we will be able to carry out the supply/ work offered by me/us as per specifications indicated in the tender, after compliance of all the required formalities within the specified time at the quoted rates, if accepted by GSMC& KEMH-Department of Clinical Pharmacology and DJST. I/We confirm that I / We shall not sublet the work or supply to any other agency without the prior approval of the ▇▇▇▇ (G&K) and Managing trustee, DJST. I/We agree to abide the regulations of the GSMC& KEMH-Department of Clinical Pharmacology) and DJST premises now in force or which may come into force, during the currency of the contract. I/ We also undertake to carry out the supply/work without any interference, what-so-ever to the supply/work. I/We agree for reserving the right to stop any supervising staff/lab or employed by me/us from entering in the GSMC & KEMH-Department of Clinical Pharmacology and DJST premises/area, if GSMC& KEMH- Department of Clinical Pharmacology and DJST feels that the said person is an undesirable element or is likely to create mischief. ▇▇▇▇ (G&K) and Managing trustee, DJST will not be required to assign any reason while exercising this right and I/We shall abide by such decision of the ▇▇▇▇(G&K) and Managing trustee, DJST as final and binding on me/us. I/ We agree to execute an agreement in the Proforma given and shall bear necessary cost of stamp duty as per Government directives in this regard. I/We also agree,to undertake to carry out all types of supply /work covered under Items of this tender as ordered from time to time by the Officer in Charge or by his authorized representatives. I/whereby declare that the information furnished in the tender is correct and true to the best of my /our knowledge and beliefknowledge. 2. l/we also know and accept I /We the undersigned do hereby certify that if at any stage the information is found to be not correct, neither my/our quotations shall not be considered by GSMC& KEMH-Department firm/company nor any of Clinical Pharmacology it’s constituent partners have abandoned any work/works of similar nature and DJST and magnitude in India, during the Last “Five” years. 3. I /we will be liable for action as per terms and condition. The acceptance /We the undersigned do hereby certify that any of this tender by GSMC& KEMH- Department of Clinical Pharmacology and DJST,shall constitute abinding the contract between awarded to me/us has not been terminated rescinded, due to breach of contract on my/our part, during the last “Five” years. 4. I / we the undersigned authorize (s) and GSMC& KEMH- Department request (s) any bank/person/firm / corporation / Government Departments to furnish pertinent information deemed necessary and requested by the Executive Engineer, TNSAMB, Chennai - 32 to verify the statement made by me/ us or to assess my/ our competence and general reputation. 5. I / we the undersigned, understand(s) that further qualifying information / clarifications on the statement made by me/us may be requested by the Executive Engineer, Tamil Nadu Agricultural Marketing Board, Guindy, Chennai-32 and agree(s) to furnish such information/ clarification within “SEVEN” Days from the date of Clinical Pharmacology and DJST.I/we solemnly confirm receipt of such request from the compliance of all the requirements/Conditions Executive Engineer, Tamil Nadu Agricultural Marketing Board, Guindy, Chennai-32. Signature of the tender documentsApplicant with date & seal. I/wehere To be signed by certify that I/we was/ were never blacklisted the officer authorized by any the Firm / company to sign on behalf of central Govt./state Govt./Public sector undertaking/any other Local body. Solemnly affirmed on this the day Firm/ company with company’s seal) Note:- In case of 2021. (Note:This sole proprietary concern, affidavit should be given signed only by the prospective bidders sole proprietor. (Title of the Officer) (Title of the firm/company) (Date) declared and affirmed by the deponent in my presence at and signed before me on Rs.200/-stamp this day of…………………………… (Seal) (Signature of the Notary Public) Under taking should be furnished in a Twenty Rupees Non-Judicial stamp paper duly notarized with the Qualification Application and certified by the Notary public. I / We the applicant do hereby undertake that I/ we will abide by the terms and conditions if any modified by the Government in the contract conditions subsequent to submission of Qualification Tender / Price tender or subsequent to execution of the agreement. Place: Date: Signature of the Applicant with red seal date & seal. The above named deponent has understood the contents well and registration Number.) To, ▇▇▇▇, ▇▇▇▇ GS Medical College & KEM Hospital and Managing Trustee, Seth GS Medical College & KEM Hospital Diamond Jubilee Society Trust (DJST), Parel, Mumbai 400 012. DearSir, We, who are an established ▇▇▇▇▇▇▇▇▇ declared and reputed manufacturer affirmed by the deponent in my presence at….......................................................and signed before me…........................ ….................................on this day of (name & description …......................................... Place: Date: Signature of the goods offered Notary Public with Seal. To Sir, The Executive Engineer, Tamil Nadu State Agricultural Marketing Board, CIPET Road, Thiru.Vi.Ka. Industrial Estate, Guindy Chennai -32 Sub: Selection of operating agency to operate, maintain and manage the Machineries of Baby care oil, Cosmetic grade oil and Dietary supplemental capsule production unit from the fresh mature coconut in the enquiry Pattukottai Coconut Market complex in Thanjavur District . Ref: Tender Reference No- T.28/▇▇.▇▇/▇.▇▇▇▇/▇▇▇▇/▇▇▇▇▇.▇▇.▇▇.▇▇▇▇ I/we inspected and examine the infra structure facilities defined in the Scope of Work (3.0) having factories at mentioned in the pre COVERdocument and ascertained ourselves the project site conditions, hereby certify that Mtraffic, location, surroundings, climate, availability of power, water & other operational utilities, access to site, Business forward and backward linkages, handling and storage of agricultural produce, weather data, applicable laws and regulations, and any other matter considered relevant to the agricultural produce business. I/s.(name &address we deemed to have full knowledge of the distributorinfra structure going to be handed over to me/dealer/ agent)is our authorized distributor/dealer/agent &authorize them to submit quotation, process the same further and enter into a contract with you against your requirement us as contained mentioned in the above referred enquiry for the above goods manufactured by ustender document. This authorization is valid till Yours faithfully, Note: 1) This letter of authorization should be on the letter head I/we aware of the manufacturing firm and should be signed by a person competent and having bidders scope of work. Signature of the power of attorney to legally bind the manufacturer. Proforma for Triparty Agreement between GSMC& KEMH- Department of Clinical Pharmacology, Manufacturer and Bidderbidder with seal

AFFIDAVIT. To, ▇▇▇▇, ▇▇▇▇ GS Medical College & KEM Hospital and Managing Trustee, Seth GS Medical College & KEM Hospital Diamond Jubilee Society Trust (DJST), Parel, Mumbai 400 012‘Notarized on Rs. Sir, “I100/- Non Judicial stamp paper’ I ……………………………… S/We (full name in capital letters, starting with surname),the Proprietor/Managing Partner/ Managing o resident of ……………………………… …………………........................................do solemnly affirm:- That I am the Director/Holder proprietor / partner/authorized signatory (tick the appropriate one) of M/s. ………………………………………………situated at ………………………. That my/our firm/company/corporation has participated in tender no. of Director General Medical & Health, UP, Lucknow and I am executing this Undertaking for myself and on behalf of my/our firm/company/corporation. 1. That our firm / company / corporation and any of its Directors / Proprietor / Partner / authorized signatories has not been convicted / or a CBI/vigilance/criminal case filed against us or pending in any court of India by any department of the Business/Manufacturer/Authorized Dealer, government under Prevention of Corruption Act or for cheating / defrauding government / embezzlement of government fund or for any criminal conspiracy in the establishment/ said matters. 2. That our firm/registered company, named herein below, do hereby state and declare that I/We, whose names are given herein below in details with the addresses, have corporation is not filled in this quotation currently under conviction for manufacturing/supplying sub-standard products or on any other name or under the name of any other establishment /firm or otherwise, nor are we in any way related or concerned with any establishment/ firm or any other person, who grounds under. 3. That I have filled in the tender/quotation for aforesaid supply/work. "I/We (full name in capital letters, starting with surname),the Proprietor/ Managing Partner/ Managing Director/ Holder of the Business/Manufacturer/Authorized Dealer, for the establishment /firm/registered company, named herein below, do hereby undertake that we have offered the best prices for the subject supply/work as per the present market rates and that we have not offered less prices for the subject supply/work to any other outside agencies including Govt./Semi Govt. agencies and within the Seth GS Medical College (GSMC& KEMH-Department of Clinical Pharmacology) and DJST also. Further, we have filled in the accompanying quotations with full knowledge of the above liabilities and therefore we will not raise any objection or dispute in any manner relating to any action for giving any information which is found to be incorrect and against the instruction and direction given in this behalf in this tender and failure to execute. I/We further agree and undertake that in the event, if it is revealed subsequently after the allotment of work/ contract to me/us that any information given by me/us in this tender is false or incorrect, I/We shall compensate the GSMC& KEMH-Department of Clinical Pharmacology and DJST for any such losses or inconveniences caused to the GSMC& KEMH-Department of Clinical Pharmacology and DJST, in any manner and will not resist any claim for such compensation on any grounds what so ever .I/We agree and undertake that I/We shall not claim in such case any amount, by way of damages or compensation for cancellation of the contract given to me/us or any work assigned to me/us or is withdrawn by the GSMC& KEMH-Department of Clinical Pharmacology and DJST. I/We hereby request you not to enter into a contract with any other person/persons for the supply/work underlying this contract for which the present tender is submitted until notice of non-acceptance of this tender has been first communicated to me/us and in consideration of your agreeing to refrain from so doing I/We agree not to withdraw the offer constituted by this tender before the date of communication to me/us or such notice of non-acceptance, which date shall be not later than fifteen days from the date of the decision of the ▇▇▇▇ (G&K),GSMC& KEMH-Department of Clinical Pharmacology and DJST, not to accept this tender. I / We have quoted for all Items and Quantities as per your specifications, which include all Taxes and Duties payable & born by us and have carefully noted the conditions of the Contract and the Specifications with all the stipulations which I /We agree to comply. I / We undertake to complete the delivery within the period stipulated after receiving an order. However, in case of price difference, if it is a result of differential tax structures, different Dollar value of Rupee, differential logistic of transport etc. considering this aspect, before invoking the action, I/we will be given a reasonable opportunity of being heard by representing our case as to why such price variation/differential has been arisen. In case, if the explanation submitted by me/us is unsatisfactory then action may be taken against me/us. I/ we undertake that I/we have thoroughly read and understood the terms and conditions as indicated in this tender document and accept all the terms and conditions. I/ we also undertake that I /we have also appraised myself /ourselves with ▇▇▇▇ ▇▇ Medical College, Department of Clinical Pharmacology (GSMC& KEMH-DCP) and DJST, actual nature of supply/work and other prevalent conditions. I/we hereby confirm that I/we will be able to carry out the supply/ work offered by me/us as per specifications indicated in the tender, after compliance of all the required formalities within the specified time at the quoted rates, if accepted by GSMC& KEMH-Department of Clinical Pharmacology and DJST. I/We confirm that I / We shall not sublet the work or supply to any other agency without the prior approval of the ▇▇▇▇ (G&K) tender and Managing trustee, DJST. I/We I agree to abide the regulations by these terms and conditions and other guidelines issued in this regard. 4. That I declare I am aware of the GSMC& KEMH-Department of Clinical Pharmacology) and DJST premises now in force or which may come into force, during the currency of the contract. I/ We also undertake to carry out the supply/work without any interference, what-so-ever to the supply/work. I/We agree for reserving the Tender Inviting Authority’s right to stop any supervising staff/lab or employed by me/us from entering in the GSMC & KEMH-Department of Clinical Pharmacology and DJST premises/area, if GSMC& KEMH- Department of Clinical Pharmacology and DJST feels that the said person is an undesirable element or is likely to create mischief. ▇▇▇▇ (G&K) and Managing trustee, DJST will not be required to assign any reason while exercising this right and I/We shall abide by such decision of forfeit the ▇▇▇▇(G&K) ▇▇▇ Money Deposit and/or Security Deposit and Managing trusteeblacklist my company, DJST as final if any information furnished by us proved to be false at the time of inspection and binding not complying the tender/contract conditions. 5. In case of exemption of my/our Proprietary Concern/ Firm / Company Ltd from payment of ▇▇▇▇▇▇▇ Money Deposit by a govt. order, I undertake to pay the said sum without any demur on me/usreceipt of demand issued by the tender inviting authority. 6. I/ We agree That the information given by me in this tender form is true and correct to execute an agreement the best of my knowledge and belief and the rates quoted are not higher than the rates quoted to other Govt. / Semi Govt. / Autonomous / Public Sector Hospitals / Institutions / Organizations situated in India in the Proforma given and shall bear necessary cost of stamp duty as per Government directives same financial year. 7. That our firm has not been deregistered or black listed by any govt. /autonomous institution, hospital or body in India for any item which is being quoted here by me in this regardtender or for participating in bid altogether. 8. I/We also agree,That I shall inform the Directorate immediately, if there is any conviction from any authority which adversely affects my eligibility to undertake to carry out all types of supply /work covered under Items of bid in this tender as ordered from time to time by the Officer in Charge for one or by his authorized representativesmore items,. IOur firm / company / corporation details are: Photo 1. 8. Date: Nature of firm (Public Ltd, Pvt. Ltd, Proprietary, Partnership etc): Authority with which it is registered : Contact Person Registered Address: Address of correspondence: Phone: Landline: Mobile Fax: email *: Office seal Name Designation Verification Signature Name of Proprietor / Partner/whereby declare Authorized Signatory of bidder With firm’s rubber stamp I pledge and solemnly affirm that the information furnished in the tender submitted above is correct and true to the best of my /our knowledge and belief. l/we also know Place …………………….. Date * All correspondence shall go to the email given here, and accept that if at any stage the information is found to preferably be not correct, my/our quotations shall not be considered by GSMC& KEMH-Department of Clinical Pharmacology and DJST and I /we will be liable for action as per terms and condition. The acceptance of this tender by GSMC& KEMH- Department of Clinical Pharmacology and DJST,shall constitute abinding contract between me/us and GSMC& KEMH- Department of Clinical Pharmacology and DJST.I/we solemnly confirm the compliance of all the requirements/Conditions with @domain name of the tender documents. I/wehere by certify that I/we was/ were never blacklisted by any of central Govt./state Govt./Public sector undertaking/any other Local body. Solemnly affirmed on this the day of 2021. (Note:This affidavit should be given by the prospective bidders on Rs.200/-stamp paper duly notarized by Notary with red seal and registration Number.) To, ▇▇▇▇, ▇▇▇▇ GS Medical College & KEM Hospital and Managing Trustee, Seth GS Medical College & KEM Hospital Diamond Jubilee Society Trust (DJST), Parel, Mumbai 400 012. DearSir, We, who are an established and reputed manufacturer of (name & description of the goods offered in the enquiry ) having factories at , hereby certify that M/s.(name &address of the distributor/dealer/ agent)is our authorized distributor/dealer/agent &authorize them to submit quotation, process the same further and enter into a contract with you against your requirement as contained in the above referred enquiry for the above goods manufactured by us. This authorization is valid till Yours faithfully, Note: 1) This letter of authorization should be on the letter head of the manufacturing firm and should be signed by a person competent and having the power of attorney to legally bind the manufacturer. Proforma for Triparty Agreement between GSMC& KEMH- Department of Clinical Pharmacology, Manufacturer and Bidderfirm

AFFIDAVIT. To, ▇▇▇▇, ▇▇▇▇ GS Medical College & KEM Hospital and Managing Trustee, Seth GS Medical College & KEM Hospital Diamond Jubilee Society Trust (DJSTTo be furnished in a Twenty Rupees Non - Judicial stamp paper duly certified by Notary Public), Parel, Mumbai 400 012 1. Sir, “I/We (full name in capital letters, starting with surname),the Proprietor/Managing Partner/ Managing Director/Holder of I /We the Business/Manufacturer/Authorized Dealer, for the establishment/ firm/registered company, named herein below, do hereby state and undersigned solemnly declare that I/We, whose names are given herein below in details with all the addresses, have not filled in this quotation under any other name or under the name of any other establishment /firm or otherwise, nor are we in any way related or concerned with any establishment/ firm or any other person, who have filled statements made in the tender/quotation for aforesaid supply/work. "I/We (full name in capital lettersdocuments, starting records etc., attached with surname),the Proprietor/ Managing Partner/ Managing Director/ Holder of the Business/Manufacturer/Authorized Dealer, for the establishment /firm/registered company, named herein below, do hereby undertake that we have offered the best prices for the subject supply/work as per the present market rates this application are true and that we have not offered less prices for the subject supply/work to any other outside agencies including Govt./Semi Govt. agencies and within the Seth GS Medical College (GSMC& KEMH-Department of Clinical Pharmacology) and DJST also. Further, we have filled in the accompanying quotations with full knowledge of the above liabilities and therefore we will not raise any objection or dispute in any manner relating to any action for giving any information which is found to be incorrect and against the instruction and direction given in this behalf in this tender and failure to execute. I/We further agree and undertake that in the event, if it is revealed subsequently after the allotment of work/ contract to me/us that any information given by me/us in this tender is false or incorrect, I/We shall compensate the GSMC& KEMH-Department of Clinical Pharmacology and DJST for any such losses or inconveniences caused to the GSMC& KEMH-Department of Clinical Pharmacology and DJST, in any manner and will not resist any claim for such compensation on any grounds what so ever .I/We agree and undertake that I/We shall not claim in such case any amount, by way of damages or compensation for cancellation of the contract given to me/us or any work assigned to me/us or is withdrawn by the GSMC& KEMH-Department of Clinical Pharmacology and DJST. I/We hereby request you not to enter into a contract with any other person/persons for the supply/work underlying this contract for which the present tender is submitted until notice of non-acceptance of this tender has been first communicated to me/us and in consideration of your agreeing to refrain from so doing I/We agree not to withdraw the offer constituted by this tender before the date of communication to me/us or such notice of non-acceptance, which date shall be not later than fifteen days from the date of the decision of the ▇▇▇▇ (G&K),GSMC& KEMH-Department of Clinical Pharmacology and DJST, not to accept this tender. I / We have quoted for all Items and Quantities as per your specifications, which include all Taxes and Duties payable & born by us and have carefully noted the conditions of the Contract and the Specifications with all the stipulations which I /We agree to comply. I / We undertake to complete the delivery within the period stipulated after receiving an order. However, in case of price difference, if it is a result of differential tax structures, different Dollar value of Rupee, differential logistic of transport etc. considering this aspect, before invoking the action, I/we will be given a reasonable opportunity of being heard by representing our case as to why such price variation/differential has been arisen. In case, if the explanation submitted by me/us is unsatisfactory then action may be taken against me/us. I/ we undertake that I/we have thoroughly read and understood the terms and conditions as indicated in this tender document and accept all the terms and conditions. I/ we also undertake that I /we have also appraised myself /ourselves with ▇▇▇▇ ▇▇ Medical College, Department of Clinical Pharmacology (GSMC& KEMH-DCP) and DJST, actual nature of supply/work and other prevalent conditions. I/we hereby confirm that I/we will be able to carry out the supply/ work offered by me/us as per specifications indicated in the tender, after compliance of all the required formalities within the specified time at the quoted rates, if accepted by GSMC& KEMH-Department of Clinical Pharmacology and DJST. I/We confirm that I / We shall not sublet the work or supply to any other agency without the prior approval of the ▇▇▇▇ (G&K) and Managing trustee, DJST. I/We agree to abide the regulations of the GSMC& KEMH-Department of Clinical Pharmacology) and DJST premises now in force or which may come into force, during the currency of the contract. I/ We also undertake to carry out the supply/work without any interference, what-so-ever to the supply/work. I/We agree for reserving the right to stop any supervising staff/lab or employed by me/us from entering in the GSMC & KEMH-Department of Clinical Pharmacology and DJST premises/area, if GSMC& KEMH- Department of Clinical Pharmacology and DJST feels that the said person is an undesirable element or is likely to create mischief. ▇▇▇▇ (G&K) and Managing trustee, DJST will not be required to assign any reason while exercising this right and I/We shall abide by such decision of the ▇▇▇▇(G&K) and Managing trustee, DJST as final and binding on me/us. I/ We agree to execute an agreement in the Proforma given and shall bear necessary cost of stamp duty as per Government directives in this regard. I/We also agree,to undertake to carry out all types of supply /work covered under Items of this tender as ordered from time to time by the Officer in Charge or by his authorized representatives. I/whereby declare that the information furnished in the tender is correct and true to the best of my /our knowledge and beliefknowledge. 2. l/we also know and accept I /We the undersigned do hereby certify that if at any stage the information is found to be not correct, neither my/our quotations shall not be considered by GSMC& KEMH-Department firm/company nor any of Clinical Pharmacology it’s constituent partners have abandoned any work/works of similar nature and DJST and magnitude in India, during the Last “Five” years. 3. I /we will be liable for action as per terms and condition. The acceptance /We the undersigned do hereby certify that any of this tender by GSMC& KEMH- Department of Clinical Pharmacology and DJST,shall constitute abinding the contract between awarded to me/us has not been terminated rescinded, due to breach of contract on my/our part, during the last “Five” years. 4. I / we the undersigned authorize (s) and GSMC& KEMH- Department request (s) any bank/person/firm / corporation / Government Departments to furnish pertinent information deemed necessary and requested by the Executive Engineer, TNSAMB, Chennai - 32 to verify the statement made by me/ us or to assess my/ our competence and general reputation. 5. I / we the undersigned, understand(s) that further qualifying information / clarifications on the statement made by me/us may be requested by the Executive Engineer, Tamil Nadu Agricultural Marketing Board, Guindy, Chennai-32 and agree(s) to furnish such information/ clarification within “SEVEN” Days from the date of Clinical Pharmacology and DJST.I/we solemnly confirm receipt of such request from the compliance of all the requirements/Conditions Executive Engineer, Tamil Nadu Agricultural Marketing Board, Guindy, Chennai- 32. Signature of the tender documentsApplicant with date & seal. I/wehere To be signed by certify that I/we was/ were never blacklisted the officer authorized by any the Firm / company to sign on behalf of central Govt./state Govt./Public sector undertaking/any other Local body. Solemnly affirmed on this the day Firm/ company with company’s seal) Note:- In case of 2021. (Note:This sole proprietary concern, affidavit should be given signed only by the prospective bidders sole proprietor. (Title of the Officer) (Title of the firm/company) (Date) The above named deponent has understood the contents well and solemnly and sincerely declared and affirmed by the deponent in my presence at……………………………………..and signed before me on Rs.200/-stamp this day of…………………………… (Seal) (Signature of the Notary Public) Under taking should be furnished in a Twenty Rupees Non-Judicial stamp paper duly notarized with the Qualification Application and certified by the Notary public. I / We the applicant do hereby undertake that I/ we will abide by the terms and conditions if any modified by the Government in the contract conditions subsequent to submission of Qualification Tender / Price tender or subsequent to execution of the agreement. Place: Date: Signature of the Applicant with red seal date & seal. The above named deponent has understood the contents well and registration Number.) To, ▇▇▇▇, ▇▇▇▇ GS Medical College & KEM Hospital and Managing Trustee, Seth GS Medical College & KEM Hospital Diamond Jubilee Society Trust (DJST), Parel, Mumbai 400 012. DearSir, We, who are an established ▇▇▇▇▇▇▇▇▇ declared and reputed manufacturer affirmed by the deponent in my presence at….......................................................and signed before me…........................ ….................................on this day of (name & description …......................................... Place: Date: Signature of the goods offered Notary Public with Seal. To Sir, The Executive Engineer, Tamil Nadu State Agricultural Marketing Board, CIPET Road, Thiru.Vi.Ka. Industrial Estate, Guindy Chennai -32 Sub: Selection of operating agency to operate, maintain and manage the following Machineries in the enquiry Coconut Value Addition Center at Shenbagaramanpudur in Kanyakumari District Ref: Tender Reference No- T.26/▇▇.▇▇/▇.▇▇▇▇/▇▇▇▇/▇▇▇▇▇.▇▇.▇▇.▇▇▇▇ I/we inspected and examine the infra structure facilities defined in the Scope of Work (3.0) having factories at mentioned in the pre bid document and ascertained ourselves the project site conditions, hereby certify that Mtraffic, location, surroundings, climate, availability of power, water & other operational utilities, access to site, Business forward and backward linkages, handling and storage of agricultural produce, weather data, applicable laws and regulations, and any other matter considered relevant to the agricultural produce business. I/s.(name &address we deemed to have full knowledge of the distributorinfra structure going to be handed over to me/dealer/ agent)is our authorized distributor/dealer/agent &authorize them to submit quotation, process the same further and enter into a contract with you against your requirement us as contained mentioned in the above referred enquiry for the above goods manufactured by ustender document. This authorization is valid till Yours faithfully, Note: 1) This letter of authorization should be on the letter head I/we aware of the manufacturing firm and should be signed by a person competent and having bidders scope of work. Signature of the power of attorney to legally bind the manufacturer. Proforma for Triparty Agreement between GSMC& KEMH- Department of Clinical Pharmacology, Manufacturer and Bidderbidder with seal

AFFIDAVIT. To, ▇▇▇▇, ▇▇▇▇ GS Medical College & KEM Hospital and Managing Trustee, Seth GS Medical College & KEM Hospital Diamond Jubilee Society Trust (DJST), Parel, Mumbai 400 012. Sir, “I/We (full name in capital letters, starting with surname),the Proprietor/Managing Partner/ Managing Director/Holder of the Business/Manufacturer/Authorized Dealer, for the establishment/ firm/registered company, named herein below, do hereby state and declare that I/We, whose names are given herein below in details with the addresses, have not filled in this quotation under any other name or under the name of any other establishment /firm or otherwise, nor are we in any way related or concerned with any establishment/ firm or any other person, who have filled in the tender/quotation for aforesaid supply/work. "I/We (full name in capital letters, starting with surname),the Proprietor/ Managing Partner/ Managing Director/ Holder of the Business/Manufacturer/Authorized Dealer, for the establishment /firm/registered company, named herein below, do hereby undertake that we have offered the best prices for the subject supply/work as per the present market rates and that we have not offered less prices for the subject supply/work to any other outside agencies including Govt./Semi Govt. agencies and within the Seth GS Medical College (GSMC& KEMH-Department of Clinical PharmacologyUrology) and DJST also. Further, we have filled in the accompanying quotations with full knowledge of the above liabilities and therefore we will not raise any objection or dispute in any manner relating to any action for giving any information which is found to be incorrect and against the instruction and direction given in this behalf in this tender and failure to execute. I/We further agree and undertake that in the event, if it is revealed subsequently after the allotment of work/ contract to me/us that any information given by me/us in this tender is false or incorrect, I/We shall compensate the GSMC& KEMH-Department of Clinical Pharmacology Urology and DJST for any such losses or inconveniences caused to the GSMC& KEMH-Department of Clinical Pharmacology Urology and DJST, in any manner and will not resist any claim for such compensation on any grounds what so ever .I/We agree and undertake that I/We shall not claim in such case any amount, by way of damages or compensation for cancellation of the contract given to me/us or any work assigned to me/us or is withdrawn by the GSMC& KEMH-Department of Clinical Pharmacology Urology and DJST. I/We hereby request you not to enter into a contract with any other person/persons for the supply/work underlying this contract for which the present tender is submitted until notice of non-acceptance of this tender has been first communicated to me/us and in consideration of your agreeing to refrain from so doing I/We agree not to withdraw the offer constituted by this tender before the date of communication to me/us or such notice of non-acceptance, which date shall be not later than fifteen days from the date of the decision of the ▇▇▇▇ (G&K),GSMC& KEMH-Department of Clinical Pharmacology Urology and DJST, not to accept this tender. I / We have quoted for all Items and Quantities as per your specifications, which include all Taxes and Duties payable & born by us and have carefully noted the conditions of the Contract and the Specifications with all the stipulations which I /We agree to comply. I / We undertake to complete the delivery within the period stipulated after receiving an order. However, in case of price difference, if it is a result of differential tax structures, different Dollar value of Rupee, differential logistic of transport etc. considering this aspect, before invoking the action, I/we will be given a reasonable opportunity of being heard by representing our case as to why such price variation/differential has been arisen. In case, if the explanation submitted by me/us is unsatisfactory then action may be taken against me/us. I/ we undertake that I/we have thoroughly read and understood the terms and conditions as indicated in this tender document and accept all the terms and conditions. I/ we also undertake that I /we have also appraised myself /ourselves with ▇▇▇▇ ▇▇ Medical College, Department of Clinical Pharmacology (GSMC& KEMH-DCP) and DJST, actual nature of supply/work and other prevalent conditions. I/we hereby confirm that I/we will be able to carry out the supply/ work offered by me/us as per specifications indicated in the tender, after compliance of all the required formalities within the specified time at the quoted rates, if accepted by GSMC& KEMH-Department of Clinical Pharmacology and DJST. I/We confirm that I / We shall not sublet the work or supply to any other agency without the prior approval of the ▇▇▇▇ (G&K) and Managing trustee, DJST. I/We agree to abide the regulations of the GSMC& KEMH-Department of Clinical Pharmacology) and DJST premises now in force or which may come into force, during the currency of the contract. I/ We also undertake to carry out the supply/work without any interference, what-so-ever to the supply/work. I/We agree for reserving the right to stop any supervising staff/lab or employed by me/us from entering in the GSMC & KEMH-Department of Clinical Pharmacology and DJST premises/area, if GSMC& KEMH- Department of Clinical Pharmacology and DJST feels that the said person is an undesirable element or is likely to create mischief. ▇▇▇▇ (G&K) and Managing trustee, DJST will not be required to assign any reason while exercising this right and I/We shall abide by such decision of the ▇▇▇▇(G&K) and Managing trustee, DJST as final and binding on me/us. I/ We agree to execute an agreement in the Proforma given and shall bear necessary cost of stamp duty as per Government directives in this regard. I/We also agree,to undertake to carry out all types of supply /work covered under Items of this tender as ordered from time to time by the Officer in Charge or by his authorized representatives. I/whereby declare that the information furnished in the tender is correct and true to the best of my /our knowledge and belief. l/we also know and accept that if at any stage the information is found to be not correct, my/our quotations shall not be considered by GSMC& KEMH-Department of Clinical Pharmacology and DJST and I /we will be liable for action as per terms and condition. The acceptance of this tender by GSMC& KEMH- Department of Clinical Pharmacology and DJST,shall constitute abinding contract between me/us and GSMC& KEMH- Department of Clinical Pharmacology and DJST.I/we solemnly confirm the compliance of all the requirements/Conditions of the tender documents. I/wehere by certify that I/we was/ were never blacklisted by any of central Govt./state Govt./Public sector undertaking/any other Local body. Solemnly affirmed on this the day of 2021. (Note:This affidavit should be given by the prospective bidders on Rs.200/-stamp paper duly notarized by Notary with red seal and registration Number.) To, ▇▇▇▇, ▇▇▇▇ GS Medical College & KEM Hospital and Managing Trustee, Seth GS Medical College & KEM Hospital Diamond Jubilee Society Trust (DJST), Parel, Mumbai 400 012. DearSir, We, who are an established and reputed manufacturer of (name & description of the goods offered in the enquiry ) having factories at , hereby certify that M/s.(name &address of the distributor/dealer/ agent)is our authorized distributor/dealer/agent &authorize them to submit quotation, process the same further and enter into a contract with you against your requirement as contained in the above referred enquiry for the above goods manufactured by us. This authorization is valid till Yours faithfully, Note: 1) This letter of authorization should be on the letter head of the manufacturing firm and should be signed by a person competent and having the power of attorney to legally bind the manufacturer. Proforma for Triparty Agreement between GSMC& KEMH- Department of Clinical Pharmacology, Manufacturer and Bidder