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ISI / W-2(I)/2 / Patrolling of OFC Route / 2011-2012 Dated ... - wtr - Bsnl

ISI / W-2(I)/2 / Patrolling of OFC Route / 2011-2012 Dated ... - wtr - Bsnl

ISI / W-2(I)/2 / Patrolling of OFC Route / 2011-2012 Dated ... - wtr - Bsnl

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SCHEDULE --I<br />

(ANNEXURE -B)<br />

QUESTIONNAIRE FORMING PART OF TO BE FILLED IN BY THE TENDERER.<br />

*****************************************************************************<br />

1. Full Name <strong>of</strong> the firm :<br />

(In capital)<br />

2. Firms address :<br />

3. Telephone (Nos.) Office / Res. :<br />

4. Is the firm proprietary or partnership. :<br />

5. Name (s) <strong>of</strong> proprietor <strong>of</strong> partner :<br />

6. Detail description <strong>of</strong> similar work carried<br />

out in BSNL nature & value <strong>of</strong> work done<br />

for each. :<br />

7. Has the firm been black listed by an<br />

organization if so, attach the details<br />

<strong>of</strong> the same . :<br />

8. Income tax A/C No / PAN No. Service :<br />

Tax No (Attach Copy)<br />

9. Details <strong>of</strong> past work experience <strong>of</strong><br />

similar nature and year. :<br />

Work done for :<br />

Name <strong>of</strong> the organization :<br />

Value <strong>of</strong> the work :<br />

Passport<br />

Size<br />

photograph<br />

<strong>of</strong><br />

proprietor<br />

Certification from past employers should be enclosed with support <strong>of</strong> above.<br />

I hereby certify that the above particulars are verified and correct.<br />

Passport<br />

Size<br />

photograph<br />

<strong>of</strong> Partner<br />

<strong>Patrolling</strong> <strong>of</strong> <strong>OFC</strong> <strong>Route</strong> Signature <strong>of</strong> the Bidder<br />

Seal <strong>of</strong> the Firm<br />

7

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