empanelment of drug testing laboratories - Kerala Medical Services ...

DECLARATION FORM
ANNEXURE-VI
Ref. Clause No.5.10.17
I / We ………………………………………………………………… (Name of
the laboratory) having our office at
………………………………………………………………………………………………
……………………………………………………………………………………… Lab at
………………………………………………………………………………………………
…..………………………………….. do declare that I / We have carefully read all the
conditions of EOI document of Kerala Medical Services Corporation Ltd.,
Thiruvananthapuram, for the EOI floated for empanelment of analytical testing
laboratories for the analysis of drugs / surgical / sutures etc., for a period of two years
from the date of acceptance and abide by all conditions set forth therein.
I / We further declare that I / We posses valid License bearing No.
………………………………………………………………………………. valid upto.
………………………………………..
Signature :
Date :
Name of the Lab :
Office Seal :
ATTESTED BY NOTARY PUBLIC
KMSCL: EOI for Empanelment of Drug testing Laboratories Page 44