Tender Forms 2013-14 Hospital Side - SN Medical College, Agra

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Every offer of the tenderer should be accompanied with the following 'FORMALITIES" sheet in duplicateName and Address of the Tenderers :Along with the Phone number, Fax number, if any.FORMALITIES SHEET..............................................................................................................................................................................................................................................................................................................Tenderers,Please complete the following information and attach the supporting documents. The tender withoutsupporting documents or with false information will be rejected without notice.1. Forwarding letter of the tenderer on the prescribe proforma annexed.2. Name and Address of the person responsible for the conduct of business.3. Rate Offered asA. ManufacturerB. Registered Depot (Only in case of firm whose manufacturing units are located outsideIndia)4. Registered for claim Date of grant of approval Date of ValidityDGQA approval ....................................... .......................................orWHOGMP certification ....................................... .......................................orGMP as per revised schedule Mof drug and cosmetic rules....................................... .......................................5. Firm should file CA certificate of total turnover of last three years, having not less than 10 crores perannum.6. The quoted rates are supply to Central Medicine Store, S.N. Medical College Hospital, Agra.7. Rates are not more than approved rates by National Pharmaceutical Pricing Authority under DPCO.8. You should quote rate for only those items, for which you have enclosed three years, production/salecertificate, verified by C.A. and certified by State Drug Controller.9. Have you attached the following documents duly attested by Gazetted Officer.A. Attested copy of valid Drug Manufacturing License and Narcotics License from thecompetent authority.B. Attested copy of valid Drug Item List with highlighted "quoted" items.C. Certificate of Sole manufacturer of product from drug controller if applicable.D. Non Conviction Certificate not more than six months old.E. Original and Duplicate copies of tender form.F. Attested copy of valid Trade Tax Registration Certificate.G. Attested copy of Trade Tax Clearance Certificate.H. Have you submitted duly filled statement on prescribed proformas annexed.I. Attested copies of certificates of DGQA/WHOGMP/GMP as per revised schedule Mof drugs and cosmetics rules.J. One copy of price list on prescribed under Drugs (Prices) control order.
K. Affidavit regarding lowest supply, company rates on prescribed proforma.L. Your consent regarding half percent rebate if payment is made within 15 days fromactual date of receipt of supply.M. Are you ready to emboss "UPG supply not for sale" on the supply.10. Please ensure that all documents/papers of the tender are numbered serially and signed by theauthorised signatory.11. Please ensure that all the copies of the documents submitted by you are dully attested by a GazettedOfficer.12. Your consent that incase your product sample is declared not of standard quality, you will take backthe goods from point of storage at your cost.13. You have quoted your prices on the basis of pack sizes demanded as per tender in accordance withschedule P-1 of the Drug Rules.14. Please enclose copy of your certificate.A. Large Scale Unit.orB. Medium Scale UnitorC. Small Scale Unit.15. Affidavit that your firm has not been barred/blacklisted/prosecuted by any State/Central Governmentagency for any breach of lower contract.DECLARATIONI do hereby solemnly affirm that all the above information furnished are true and nothing material isconcealed.Date :Signature of the tendererName in Capital LetterOffice Seal
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Page 46 and 47: 523 Tab. Hydroxurea 500 Mg.524 Tab.
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Tender Forms 2013-14 Hospital Side - SN Medical College, Agra

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