Instructions to the Applicant The Application to be submitted in the manner prescribed below All information as detailed below is to be submitted in two hard copies in separately sealed envelopes and one soft copy. 1. 2. 3. 4. 5. 6. 7. Application letter as per Format -1 Organizational contact details as per Format-2 Experience of the organization as per Format-3 Expert details for content development as per Format 4 Financial strength of the organization as per Format - 5 Additional information as per Format – 6 Declaration as per Format – 7 Last date of submission - Within 15 days from the date of publication of the advertisement. FORMAT - 1 To, The Executive Director National Instructional Media Institute P.B.No. 3142, CTI Campus Guindy, Chennai – 600 032 Sub – Submission of Application for Empanelment of Content Developers Ref: Dear In response to the Advertisement published on for the above purpose, we would like to express interest to carry out the above mentioned task. As instructed, we attach 2 sets of the following documents in separately sealed envelopes and one soft copy. 1. 2. 3. 4. 5. 6. Organization details (Format 2) Experience in related field (Format -3) List of Experts with their bio data (Format -4) Financial strength of the organization (Format -5) Additional information (Format -6) Declaration (Format -7) Sincerely Your’s, Signature of the applicant (Full name of the applicant) Stamp Date Encl : As above Note: This is to be furnished in the letter head of the organization. FORMAT - 2 Organizational Details 1. Name of Organization 2. Main area of business 3. Type of organization Firm/Company/partnership Register under Indian Companies Act 1956/ the partnership Act. 1932. 4. Whether the firm has been blacklisted by any Central Govt./State Govt./PSU/Govt. Bodies/ Autonomous ?. If yes detail there of 5. Address of registered office with telephone & Fax 6. Address of office with telephone & Fax in Chennai (if any) 7. Contact Person with telephone no. & e-mail ID Attach 1. Copy of Certificate of Incorporation 2. Copy of Certification in respect of 4 above. Signature of the applicant (Full name of the applicant) Stamp Date FORMAT – 3 Overview of the past experience of the Organization in related field Sl no Item 1 Experience of Assignments of similar nature 1.1 Experience in carrying out in similar assignments in Government 1.2 Experience in carrying out in similar assignments in public sector 1.3 Experience in carrying out in similar assignments in private sector Number of Assignments Order value in Lakhs of Rs. Implementation Project value in Crores of Rs. Decision of Evaluating committee in ascertaining “similar nature” and “similar assignment” will be final. Signature of the applicant (Full name of the applicant) Stamp Date FORMAT –4 Details of Experts to be involved for content Development Sl no Name Qualification Experience (in years) Institute Course/ Sector From Training Institute/ Industry Industry 1 2 3 4 5 6 Note - Please Attach Bio Data of the experts Signature of the applicant (Full name of the applicant) Stamp Date FORMAT – 5 Financial Strength of the Organization Note – Please Attach auditor’s Certificate in support of your claim Sl no Years 1 2010-11 2 2011-12 3 2012-13 Net Profit in crores of Rs. Turnover in crores of Rs. Turnover from Consultancy services registered in India (excluding Turnover from supply and/or implementation of hardware, software & networking equipments etc.) Crores of Rs. Signature of the applicant (Full name of the applicant) Stamp Date FORMAT – 6 Additional Information 1. List of attachments related to the previous sections Sl no Description No of pages 2. Additional information to support the eligibility. (Not more than 2 pages) Signature of the applicant (Full name of the applicant) Stamp Date FORMAT – 7 Declaration We hereby confirm that we are interested to become empanelled content developers for National Instructional Media Institute (NIMI) and all information provided herewith is genuine and accurate. Authorized Person’s Signature : Name and Designation : Date of Signature : Note: This declaration is to be furnished in the letter head of the organization.