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1 1 No : DGMM/STSR-BG/EST-20/2007-10/73 Dtd at BG. The 24.06 ...

1 1 No : DGMM/STSR-BG/EST-20/2007-10/73 Dtd at BG. The 24.06 ...

1 1 No : DGMM/STSR-BG/EST-20/2007-10/73 Dtd at BG. The 24.06 ...

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6. Name(s) of the sole Proprietor/Partners/Directors :<br />

7. Name of person authorized to enter into and execute<br />

contract agreement(authoriz<strong>at</strong>ion to be enclosed) :<br />

8. Permanent Account Number.(PAN) :<br />

9. Details of other Branches of the Firm/Contractor<br />

with Address, if any :<br />

<strong>10</strong>. Number of labourers employed in the firm :<br />

11. Details of License from labour Commissioner for<br />

engaging labourers :<br />

12. Specimen Sign<strong>at</strong>ure of the Contractor :<br />

1.<br />

2 .<br />

30<br />

13. Experience details, if any (To be <strong>at</strong>tached separ<strong>at</strong>ely):<br />

I,ÖÖÖÖÖÖÖÖÖÖÖÖÖÖÖÖÖÖÖÖÖÖÖÖ.declare th<strong>at</strong> all the inform<strong>at</strong>ion given above are true and<br />

correct to the best of my knowledge.<br />

RECEIPT<br />

30<br />

Sign<strong>at</strong>ure of the tenderer:<br />

Name (in block letters):<br />

Address of the Tenderer with Seal<br />

Received Rupees /-(Rupees only) from Accounts Officer Cash<br />

O/o <strong>DGMM</strong> <strong>STSR</strong>, Bangalore towards refund of EMD for the Tender <strong>No</strong> : TENDER /DE<br />

TM/HSN/w-4 (6)/<strong>20</strong>09-<strong>10</strong>/26 dtd <strong>at</strong> HSN <strong>24.06</strong>.09.<br />

vide Cheque no.---------------<br />

dt.-------------

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