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PROFORMA FOR ASSESSMENT REPORT OF TECHNICAL AND FINANCIAL CAPABILITY AND COMPETENCY OF FIRMS Name of the firm

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1.POSITION OF THE FIRM / FACTORY

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A)

Ownership / Proprietorship of the firm

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B)

Area occupied by the work premises, road, height of the working shed.

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C)

Distance of work premises from main road and its approachability.

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D)

Copy of the registered lease deed/ rent deed registration certificate from competent authority of the Government indicating name(s) and quantities of the item(s) to be produced. Copy of the approved blue print of the plant layout of the factory showing its permanently constructed boundary (distinctly and clearly separating it from others , with reference to its name board, entrance/ exit gate(s), other dimensioned details and important surroundings like other factories with names, buildings, roads, drains etc.

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Certificate of competence showing quantity wise capacity of the factory for manufacturing the item(s) applied for, based on its actual installed capacity/ facilities. E)

Position of power/ water/ telephone connections at the works/ standby power generating source, if any (attach copies).

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F)

Plant and machinery installed.

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G)

Equipment and testing facilities. Calibration certificate about all the meters/ instruments/ equipments from the manufacturers )or its authorized test house) or Govt. testing laboratories recognized for the purpose)attach copies of the test cetificates).

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H)

Standard followed in production of the : items.

I)

Particulars of raw materials/ components used.

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J)

Manpower and human resources; engineers and other technical supervisory staff employed in production; other staff on permanently/ temporary basis.

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K)

Marketing of the product(s), transportation arrangement.

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L)

Telephone & Fax No. alongwith code No. of the company.

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M)

Name and designation of the the contact person.

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N)

Complete address of the work premises

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O)

Any other information

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2.

FINANCIAL STATUS OF THE FIRM

A)

Balance sheet(attach copies).

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B)

Credit limits sanctioned by Banks/ other financial institutions.

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C)

Registration and clearance from the Income Tax and Sales Tax deptts.(attach copies)

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D)

Any other information to authenticate / substantiate financial soundness/ ability of the firm.

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3. LIST OF ENCLOSURES TO BE APPENDED: A) Plant and machinery installed: SL No.

Description of machinery

Make

Sr. No.

1

2

3

4

Year and sources of purchase 5

Capacity 6

B) Testing Facilities and Equipments: S No.

Name of the testing equipments

Type/ make & Sl No. 3

1

2

Year of Measuring purchase capacity , symbols marked on dial etc. 4 5

C) Particulars of Raw materials & components:

Range

6

Grade/ No. & Dt. Accuracy of last class calibration certificate & name of 7 test house. 8

S No. 1

Name of materials/ components 2

Specification to which conforms 3

Name of manufacturer / supplier. 4

D) Manpower & Human Resources : S No.

Name of persons

Designation

Qualification Experience

Nature of work/ duties performed in the past

E) Finance and working capital : S No. 1

Date : Place:

Source of finance (Bank etc.) 2

Finance available 3

Signature with seal of the company / firm