EOI No. BESCOM/BC-47/GM (CR)/2727/2014-15 Expression of Interest for Empanelment of NGO/Non-Profit Organizations for creating awareness among the public on Electrical Safety and Energy Savings in BESCOM Area May 2015 BANGALORE ELECTRICITY SUPPLY COMPANY LIMITED (Wholly owned by Government of Karnataka Undertaking) Empanelment of NGO/Non-Profit Organizations for creating awareness among the public on Electrical Safety and Energy Savings in BESCOM area Notice inviting EoI BESCOM – Bangalore Electricity Supply Company Limited is responsible for power distribution in Eight districts of Karnataka. BESCOM covers an area of 41,092 Sq. Kms. with a population of over 207 lakhs. BESCOM has been in the forefront in providing consumer services by deploying various technologies to meet the growing customer expectations and aims at providing its customers with enhanced services through its various initiatives like Helpline, Online application and payment options, PGRS, etc. In order to create safe working environment for the public and to create awareness among the public on Electrical Safety to avoid electrical accidents and thereby saving lives and property and Energy Saving, BESCOM intends to empanel technically qualified and professionally managed NGOs/ Non-Profit Organizations. Relevant documents along with the quotation document are required to be submitted to the General Manager(CR), BESCOM Corporate office, K R Circle, Bangalore – 560 001 on or before 01.06.2015 by 16:00 Hrs. BESCOM reserves the right to reject any or all offers without assigning any reasons thereof. GM (CR) BESCOM Corporate Office Page 1 of 24 Empanelment of NGO/Non-Profit Organizations for creating awareness among the public on Electrical Safety and Energy Savings in BESCOM area Table of Contents 1 2 3 4 Instructions to Respondents ....................................................................................................... 4 1.1 Introduction ....................................................................................................................... 4 1.2 Purpose of the EoI ............................................................................................................ 4 1.3 Communication regarding this EOI ................................................................................... 5 1.4 Submission of Proposals .................................................................................................. 5 1.5 Schedule ........................................................................................................................... 6 1.6 Confidentiality ................................................................................................................... 6 1.7 One Proposal per Respondent ......................................................................................... 6 1.8 Cost of the Proposal ......................................................................................................... 6 1.9 Clarifications and Additional Information .......................................................................... 6 1.10 Documents comprising the bid ......................................................................................... 7 1.11 EMD .................................................................................................................................. 7 1.12 EMD so deposited will be liable for forfeiture ................................................................... 7 1.13 FORMAT OF BID .............................................................................................................. 7 1.14 DEADLINE FOR SUBMISSION OF BIDS ........................................................................ 7 1.15 MODIFICATION AND WITHDRAWAL OF BIDS .............................................................. 8 1.16 Language of the Proposal ................................................................................................. 8 1.17 Amendment to Bids........................................................................................................... 8 1.18 Preliminary Examination ................................................................................................... 8 1.19 NO COMMITMENT TO ACCEPT ANY EoI ...................................................................... 9 1.20 NOTIFICATION OF EMPANELMENT .............................................................................. 9 1.21 EFFECT AND JURISDICTION OR CONTRACT ............................................................. 9 Technical Proposal and Qualification Requirements .................................................................. 9 2.1 Qualification Requirements ............................................................................................... 9 2.2 Right to accept/ reject any Application ........................................................................... 10 2.3 Technical Evaluation ....................................................................................................... 11 Scope of Work .......................................................................................................................... 12 3.1 Awareness Generation and Change Management Activities ......................................... 12 3.2 Objectives ....................................................................................................................... 12 3.3 Major Activities………………………………………………………………………………………………………….13 3.4 3.5 3.6 3.7 Project duration…………………………………………………………………………………………………………13 Resource Person………………………………………………………………………………………………………..13 Deliverables of Workshop………………………………………………………………………………………….13 Provide progress reporting of all Respondent activities ................................................. 14 Terms and Condition ................................................................................................................. 14 Page 2 of 24 Empanelment of NGO/Non-Profit Organizations for creating awareness among the public on Electrical Safety and Energy Savings in BESCOM area 5 4.1 All deliverables / creative(s) to be the property of the BESCOM .................................... 14 4.2 Intellectual Property and Right to Use ............................................................................ 14 4.3 Dispute Resolution .......................................................................................................... 15 4.4 Governing Language ...................................................................................................... 15 Technical Proposal Template ................................................................................................... 16 5.1 6 Technical Pre-Qualification ............................................................................................. 16 Mandatory Enclosure ................................................................................................................ 20 Declaration of Acceptance of Terms and Conditions in EOI ........................................................ 20 Undertaking on Being Not Black-Listed ........................................................................................ 21 Undertaking on litigation(s) (in letter head) .................................................................................. 22 Page 3 of 24 Empanelment of NGO/Non-Profit Organizations for creating awareness among the public on Electrical Safety and Energy Savings in BESCOM area 1 Instructions to Respondents 1.1 Introduction The Statistics of Electrical accidents in BESCOM presents a very grim picture showing no signs of reduction, and on the other hand there has been a steady rise in number of accidents for the last few years. Analysis of the statistics of accidents clearly indicates that the majority of accidents are due to non-adherence of safety procedures. This is a cause of great concern to the organization. Following are the statistics of Electrical Accidents in last four years: Particulars FY-11 FY-12 FY-13 FY-14 Departmental 11 7 11 7 Non-Departmental 93 103 116 107 Departmental 53 38 38 53 Non-Departmental 27 24 51 52 Animals 62 44 35 47 Total 246 216 251 266 Fatal Non-Fatal In order to create safe working environment for the public and to create awareness among the public on electrical safety to avoid electrical accidents and thereby saving lives and property BESCOM intends to empanel technically qualified and professionally managed NGOs/Non-Profit Organizations. 1.2 Purpose of the EoI This EOI is an invitation to empanel technically qualified and professionally managed NGOs/ Non-Profit Organizations to put forward their Proposal for creating awareness in BESCOM area on Electrical Safety to avoid electrical accidents and thereby saving lives and property and on Energy Savings. This EoI stipulates the scope of work and terms and conditions of the proposed project. The aim is to select a capable and competitive organization that has the ability to collaborate with the BESCOM in delivering/ implementation awareness campaign in BESCOM area which ultimately contributes towards reduction in electrical accidents and thereby saving lives and property and also on Energy Savings. I. BESCOM intends to empanel organization on the basis of merit at its discretion. Page 4 of 24 Empanelment of NGO/Non-Profit Organizations for creating awareness among the public on Electrical Safety and Energy Savings in BESCOM area II. BESCOM however reserves the right to decide the number of Organizations to interview/Presentation based on merit depending on the number of Applications received who fulfill the Eligibility Criteria. III. The Organization would be engaged by the General Manager, Customer Relations for an initial period of One year (which may be extendable for another one year based on the performance of the agency). IV. The consultancy period may be extended further for a certain period on the same terms and conditions at the discretion of the Authority. However, if during the validity of consultancy services for a period of one year from the date of notification, the breach of any terms and conditions of, then the consultancy services of such an applicant shall be withdrawn forthwith. 1.3 Communication regarding this EOI The respondents can download the EOI documents from BESCOM website www.bescom.org. Respondents can get clarifications regarding the scope of work and technical features of the project from the office of the GM(CR) during office hours. Ph No.: 080-22251927 or through email: gmcr@bescom.co.in All communications regarding this EOI should be directed to the following address: General Manager (CR) Corporate Office, BESCOM, K.R Circle Bangalore – 560 001 Ph: 080-22251927 E-mail: gmcr@bescom.co.in Respondent shall not initiate any other form of contact in respect of any matter relating to this EOI with any other employee of the BESCOM. 1.4 Submission of Proposals All the required documents shall be submitted to the Office of the General Manager (CR), BESCOM Corporate Office, K R Circle, Bengaluru - 560001 on or before 01.06.2015, 16:00 Hrs. After evaluation of technical bids, the successful consultant will be intimated. Page 5 of 24 Empanelment of NGO/Non-Profit Organizations for creating awareness among the public on Electrical Safety and Energy Savings in BESCOM area 1.5 Schedule S. No. Event Date 1. Release of EOI 23.05.2015 2. Due date for Submission 01.06.2015 1.6 Confidentiality The information and data in this EOI are provided for the sole purpose of allowing eligible Respondents to submit suitable Proposals. The information and data herein may not be used in any other context nor revealed to any other party who is not directly involved in the preparation of the Respondent’s Proposal. 1.7 One Proposal per Respondent Each Respondent shall submit only one Proposal. The Respondent which submits or participates in more than one Proposal will be disqualified. 1.8 Cost of the Proposal The BESCOM or its employees shall not be liable for any costs incurred by the Respondents in preparing their Proposals in response to this EOI or other work and costs resulting therefrom. The respondent shall bear all costs and expenses associated with preparation and submission of bid including post-bid discussions, technical and other presentations etc., and BESCOM will be in no case is responsible or liable for those costs, regardless of the conduct or outcome of the bidding process. 1.9 Clarifications and Additional Information In case, Respondents requests additional information and clarifications from BESCOM before submitting their Proposal, BESCOM will only respond to enquiries that are received within the due date. BESCOM may issue any clarification or additional information to all participants as an addendum to this EOI. Such an addendum will become part of the EOI Documents. During the evaluation process, BESCOM may request from a Respondent, a clarification concerning elements of their Proposal, or require additional technical and commercial information. Respondent’s response on this will be considered as part of their Proposal within the cost stated in the financial Proposal unless specified otherwise. Page 6 of 24 Empanelment of NGO/Non-Profit Organizations for creating awareness among the public on Electrical Safety and Energy Savings in BESCOM area 1.10 Documents The respondent shall furnish all the Technical Data Required and to indicate the services rendered. The respondents shall furnish the documentary evidence to establish that the respondent meets the Qualification Requirements as detailed above and accompanying Special Conditions of Contract if any. 1.11 EMD The respondents shall pay EMD of Rs.5000/- (Rupees Five thousand Only) through Cash. Earnest money deposited by unsuccessful Tenderers will be returned as soon as possible once the tender is finalized. EMD of successful respondent will be refunded after fulfilment of Security Deposit/Performance Guarantee. The deposit towards EMD as above shall not carry any interest. Permanent EMD will not be considered. 1.12 EMD so deposited will be liable for forfeiture EMD deposited will be liable for forfeiture, if the respondent withdraws/modifies his bid during the period of bid validity specified by the respondent on the bid form. 1.13 Format of Bid a. The bids shall be submitted to the office of the General Manager (CR), BESCOM Corporate Office, K R Circle, Bengaluru - 560001 on or before the last date and time for submission of the bid. b. The bid shall contain no interlineations, erasures or overwriting except as necessary to correct errors made by the respondent, in which case such corrections shall be initialled by the person or persons signing the bid. c. All the documents in support of qualifying requirements shall be submitted. Failure to furnish the documentary evidences would result in outright rejection of their offers. 1.14 Deadline for Submission of Bids I. II. Bids must be submitted to the office of the General Manager (CR), BESCOM Corporate Office, K R Circle, Bengaluru - 560001 on or before 01.06.2015 at 16:00 Hours. BESCOM may, at its discretion, extend this deadline for the submission of bids by amending the Bidding Document, in which case all rights and obligations of BESCOM and respondents previously subject to the deadline will thereafter be subject to the deadline as extended. Page 7 of 24 Empanelment of NGO/Non-Profit Organizations for creating awareness among the public on Electrical Safety and Energy Savings in BESCOM area 1.15 Modification and Withdrawal of Bids I. II. The Respondents may modify or withdraw its bid prior to the deadline prescribed for submission of bids. No bid may be modified subsequent to the deadline for submission of bids. 1.16 Language of the Proposal The Proposal, and all correspondence and documents related to the Proposal exchanged by Respondent and the BESCOM shall be written in English language. Supporting documents and printed literature furnished by the participating company may be in either English or Kannada. Any supporting document in other language must be accompanied by the true and correct English and Arabic translation of the same. 1.17 Amendment to Bids I. At any time prior to the deadline for submission of bids, BESCOM may, for any reason, whether at its own initiative or in response to a clarification requested by a prospective respondent, modify the Bidding Document by amendment(s). II. The amendment will be notified in the website. BESCOM will bear no responsibility or liability arising out of non-acknowledgment of the same by all the prospective respondents before submitting the Bid. III. In order to afford prospective respondents reasonable time in which to take the amendment into account in preparing their bids, BESCOM may, at its discretion, extend the deadline for the submission of bids as deemed fit. IV. Such amendments, clarifications, etc, shall be binding on the respondents and will be given due consideration by the respondents while they submit their bids and invariably enclose such documents as a part of the bid. [[ [ 1.18 Preliminary Examination a. BESCOM will examine the bids to determine whether they are complete, whether any computational errors have been made, whether the documents are generally in order. b. BESCOM may waive any minor informality or non-conformity or irregularity in a bid which does not constitute a material deviation, provided such waiver does not prejudice or affect the relative ranking of any respondents. Page 8 of 24 Empanelment of NGO/Non-Profit Organizations for creating awareness among the public on Electrical Safety and Energy Savings in BESCOM area 1.19 No Commitment to Accept Any EOI BESCOM shall be under no obligation to accept any other offer received in response to this EoI notice and shall be entitled to reject any or all offers including those received late or incomplete offers without assigning any reason whatsoever. BESCOM will not be obliged to meet and have discussions with any bids or to listen to any representations. 1.20 Notification of Empanelment BESCOM will notify the successful respondents in writing by letter or by email regarding empanelment. 1.21 Effect and Jurisdiction or Contract The laws applicable to the contract shall be the law in force in India. The Court of Bangalore in Karnataka State shall have exclusive jurisdiction in all matters arising under the contract. 2 Technical Proposal and Qualification Requirements 2.1 Qualification Requirements S. no. Criteria Evidence Required The bidder should be NGOs, Trusts, Social Non-Profit organizations and non-profit company under Companies Act, Minimum requirement is three years of registration as on due date of submission of application for empanelment. Submit as applicable II. The bidder should have an registered office with minimum 10 employees working Undertaking from the Authorized Signatory (Format ) and relevant address proof III. The Bidder should not be involved in any major litigation that may have an impact of affecting or compromising the delivery of services as required under this RFP. Undertaking from the the Authorized Signatory as per (Format). IV. The Bidder should not be blacklisted by the Government of Karnataka or Government of India or any of its agencies for any reasons whatsoever and the bidder should not be blacklisted by Central / any other State/UT Undertaking from the Authorized Signatory as per (Format) specified in Annexure I. Page 9 of 24 Certificate of Registration. Society Registration Certificate and MOA/AofA or Trust Deed along with the latest filed return. Empanelment of NGO/Non-Profit Organizations for creating awareness among the public on Electrical Safety and Energy Savings in BESCOM area Government or its agencies for indulging in corrupt or fraudulent practices or for indulging in unfair trade practices or any legal case regarding blacklisting in last five years V. The bidder should have an average annual turnover of at least Rs. 30.00 Lakhs related services in the last three years (i.e. 2011-12, 2012-13 & 2013-14) as revealed by audited accounts. A certificate from Chartered Accountant shall be provided as evidence VI. Power of Attorney for the Authorized Signatory Copy of Power of Attorney The bidder should have handled at least two State/ Central Government awareness generation projects per year in last two years Copy of the Work Award V. 2.2 Right to accept/ reject any Application (i) Notwithstanding anything contained in this document, Company reserves the right to accept or reject any Application and to annul the consultancy process and reject all Applications, at any time, without any liability or obligation for such acceptance, rejection or annulment, and without assigning any reason for such action. In the event that all Applications are rejected, company may, at its discretion, invite all eligible Applicants to submit fresh Applications. (ii) The company reserves the right to reject any Application if a. At any time a material misrepresentation is made or uncovered, or; b. The Applicant does not submit the supplementary information required by Authority within the time specified. (iii) The company reserves the right to verify all statements, information and documents submitted by the Applicant in response to this document. Any such verification or lack of such verification by it shall not relieve the Applicant of its obligations or liabilities hereunder nor will it affect any rights of the company. Page 10 of 24 Empanelment of NGO/Non-Profit Organizations for creating awareness among the public on Electrical Safety and Energy Savings in BESCOM area 2.3 Technical Evaluation The selection of NGOs, Trusts, Social Non-Profit organizations and Non-Profit Making companies under Company Act etc would be based on the following marking. The bidder needs to score at least 65 marks for qualifying: S.No 1 Maximum Marks (60) Criteria Past Experience of the NGO/ Social Organization Number of years of experience 15 Past Experience in awareness generation projects in either rural or urban areas 25 20 Past Experience in the field of Implementation of Other development sector projects Strength and Experience of technical Personal for implementing projects 2 3 4 Criteria Fixed for Evaluation Between 5- 7 years 5 yrs to 10 yrs Above 10 years Weights 7 10 15 Projects between 1 and 3 10 Projects between 4-6 15 Projects between 7-10 25 No work carried out Three numbers projects carried out Above three no: projects carried out 0 15 No technical personnel 1-10 technical personnel 0 20 (15) break-up below No of Key Technical Personnel Annual Turnover of the NGO/Social Organisation 15 10 Presence of the NGO/Social Organisation 15 Page 11 of 24 More than 10 technical personnel Between 30 -50 Lac Between 50 Lac-1 crore Above 1 crore Less than five states/UTs Between 5-15 states/UTs More than fifteen states/UTs 6 15 5 7 10 3 9 15 Empanelment of NGO/Non-Profit Organizations for creating awareness among the public on Electrical Safety and Energy Savings in BESCOM area 3 Scope of Work The main objective for empanelment of NGOs/Non-Profit organizations is to create awareness among the public on Energy Savings and Electrical Safety to avoid electrical accidents and thereby saving lives and property. The objectives of this task is to develop a communication strategy and action plan to support BESCOM in reducing number of electrical incidents. An experienced and capable NGO (Nongovernment organization) with diverse experience and local presence will be recruited to formulate and implement a targeted community awareness, and behavior change related strategies and activities and to ensure that the project is successfully implemented and delivers sustainable and satisfactory result. 3.1 Awareness Generation and Change Management Activities The NGO will be responsible for i) creating awareness on electrical incidents, preparedness of community/citizen/local agencies with regards to electrical incident, ii) developing a robust community awareness program and behavior change communications strategy and iii) Spreading awareness, organizing conference, seminar, workshop for experience. Preparation of Annual Action plan on Awareness and change management. All activities will require the proactive participation of various stakeholders. The NGO will therefore seek the support of the following civil society representatives: (i) community influencers and other civil society representatives; (ii) community-based organizations (CBOs) in villages/Taluks and women’s groups at Taluk level (iii) vendor associations and labor union federations; (iv) ward councilors, ward members and citizen forums; and (v) the public at large. Assist BESCOM in preparation of concept notes/PPT while representing before various Government/ Regulatory bodies on perceived issues related to electrical incident. Organizing workshops/meetings to gather feedback of relevant stakeholders including the Government agencies, Local SHG, Communities and various Bi-lateral and Multi-lateral institutions as directed by GM, CR from time to time 3.2 Objectives Make consumers to know about the need for safety while using electric gadgets. Inform consumers about their rights and responsibilities as users of electricity Convey the consumers about the initiatives taken by BESCOM to improve quality of supply of power and consumer grievance redressal machinery and other projects Spreading the awareness amongst the consumers about the evils of malpractice/ theft of electricity and motivate to take legal connections. To encourage consumers about installation of meters, payment of bills in time. Page 12 of 24 Empanelment of NGO/Non-Profit Organizations for creating awareness among the public on Electrical Safety and Energy Savings in BESCOM area Educate and promote consumers to save energy by the use of energy saving devices/ renewable energy resources etc., To establish cordial relationship between the cutting edge employees of BESCOM and the consumers. 3.3 Major Activities Project launch meeting and trainers meeting at Bangalore Developing a training manual in English and Kannada Production of newsletter (bilingual) Conduction of workshops These workshops should be for consumers belonging to domestic, industrial and commercial categories. Each of the workshops should have 100 to 120 participants, thereby this project shall reach around 1000-1200 BESCOM consumers. Media shall be involved in all these workshops also the top officials of BESCOM will be present. 3.4 Project Duration The duration of this project shall be of One year from the date of Work Award. 3.5 Resource Persons The best available resource persons shall be hired to make presentations and to answer the queries of the consumers. The names of the resource persons shall be intimated and get approval from this office before engagement. Sufficient information and education materials (in Kannada and English) shall be distributed to the participants. 3.6 Deliverables of workshop The project shall result in the following deliverables: a. Reports of the workshop b. Training Manual / Tool kit c. News letters d. Photos and Video clippings of training program. e. Consumer feedback Page 13 of 24 Empanelment of NGO/Non-Profit Organizations for creating awareness among the public on Electrical Safety and Energy Savings in BESCOM area 3.7 Provide progress reporting of all Respondent activities The NGO will be responsible for progress reporting and recommending course corrections as and when required to BESCOM management and will deliver weekly progress reports monthly and quarterly status reports. 4 Terms and Condition 4.1 All deliverables / creative(s) to be the property of the BESCOM All deliverables and working documents including but not limited to plans, drawings, specifications and other documents prepared by the Respondent in the execution of the contract shall become and remain the property of the BESCOM, and before termination or expiration of this contract, the Respondent shall deliver all such documents to the BESCOM under the contract along with the detailed inventory thereof. 4.2 Intellectual Property and Right to Use 1. All reports, studies and documents prepared by the Respondent in connection with the services for the project, shall be the exclusive property of the BESCOM and may not be shown, given, related or in any manner whatsoever disclosed to any third party without the prior written consent of the BESCOM. 2. The copyright, patent rights and all other intellectual property rights in all work prepared and / or carried out as part of the services shall vest absolutely with the BESCOM. Additional copies of any reports, research studies, documents or any other related material prepared in connection with the services may not be made or reproduced by the Respondent without prior written approval of the BESCOM. 3. The Respondent shall provide the BESCOM with a complete list of all the methodologies and tools used for provisioning the services mentioned herein. The BESCOM will be free to use such methodologies and tools except the products proprietary to the third parties. 4. The Respondent shall fully indemnify the BESCOM against all claims, and proceedings for the infringement of and on account of infringement of any letters, patent, registered design, copyright, trademark or trade name or industrial property right in internationally, or in India, or elsewhere arising out of the use of the creative material / documents prepared or supplied by the Respondent. Page 14 of 24 Empanelment of NGO/Non-Profit Organizations for creating awareness among the public on Electrical Safety and Energy Savings in BESCOM area 4.3 Dispute Resolution 1. All disputes and differences which may arise between the BESCOM and the Respondent(s) relating to the provisions of this EOI, or any part thereof, or the operation thereof, or the rights or liabilities of the parties hereunder shall be amicably settled through negotiations between the BESCOM and the Respondent(s). The party intending to resolve such dispute through negotiation shall give written notice to the other party of its intention. 2. If the dispute cannot be resolved as provided for in the clause above herein within thirty (30) days from the date of the notice given under clause above herein, upon the decision of the BESCOM it shall be submitted to the competent court in the Bangalore. 3. Any decision made by the court shall be final and binding on the parties and the persons claiming under them respectively and shall not be the subject of any objection or appeal by either party. 4.4 Governing Language The contract shall be written in English. All correspondence and other documents pertaining to the contract which are exchanged by the parties shall be written English. Page 15 of 24 Empanelment of NGO/Non-Profit Organizations for creating awareness among the public on Electrical Safety and Energy Savings in BESCOM area 5 Technical Proposal Template 5.1 Technical Pre-Qualification The Technical Proposal should consist of the following information in the given format in subsequent pages: All conditions and supporting documents for pre-qualification criteria 1. Name of the organization as appearing in the certificate of registration/certificate of incorporation/ trust deed. 2. Complete Postal Address with pin code, telephone numbers and e-mail id. 3. Particulars of the Head of the Organization/ Contact Person for the project Name Address Gender Age Experience in Years Contact Number email 4. Legal Status of the Organization a. Registration as non-profit body i. Date of registration : ii. Registration Number: b. Exemptions under Income Tax Act i. 12A : Yes/No ii. 80G: Yes/No iii. Date of the last submission of IT returns: c. Any other relevant information Please attached relevant documentary Proof i.e 12A/80G certificate, Certificate of Registration, Society Registration Certificate and MOA/AofA or Trust Deed along with the latest filed return. Annual report & Annual Audit Report of the organization for the last three years. FCRA Registration Certificate if any Page 16 of 24 Empanelment of NGO/Non-Profit Organizations for creating awareness among the public on Electrical Safety and Energy Savings in BESCOM area 5. Bank Information and other financial information (along with documentary Proof) a. Name of the account: b. Bank Name: c. Branch and address: d. Type of account: Savings Bank account/Current Account e. Valid Sales tax registration no. f. Valid Service tax registration no. g. Permanent Account Number (PAN) 6. Programmes Undertaken by the Organisation (in the last five years give in chronological order starting with the existing ones) a. List of Project Undertaken by the Organisation Sl. No. 1 Name of the Project Duration Budget Department Current Status 2 3 4 5 6 Details regarding each project to be provided as following format Assignment Name: Cost of the Project: Country: Duration of assignment (months): Location within country: Page 17 of 24 Empanelment of NGO/Non-Profit Organizations for creating awareness among the public on Electrical Safety and Energy Savings in BESCOM area Name of Client: Start date (month/year): Completion date (month/year): Address: Breadth of campaign, target segment, budgets etc. Name of senior professional staff of your firm involved and functions performed (indicate most significant profiles such as Project Director/Coordinator, Team Leader): Narrative description of Project: Description of actual services provided by your staff within the project: Note: Please attach Work orders and/or Completion Certificates for each project 7. Financial information (CA Certificate) a. Receipts and Payments for the last three years Sl. No. 1 2 3 Year Receipts (in Rupees) 2011-12 2012-13 2013-14 Page 18 of 24 Payments (in Rupees) Empanelment of NGO/Non-Profit Organizations for creating awareness among the public on Electrical Safety and Energy Savings in BESCOM area 8. Information on Staff Sl. No. 12. Name Gender Age Education Duration of Service with the Organization Status (Fulltime/Parttime/Voluntary) Certification: I, the undersigned, certify that the information provided are to the best of my knowledge. I understand that any wilful misstatement described herein may lead to my disqualification or dismissal, if engaged. Date: __________ [Signature of staff member or authorized representative of the staff] Page 19 of 24 Day/Month/Year Empanelment of NGO/Non-Profit Organizations for creating awareness among the public on Electrical Safety and Energy Savings in BESCOM area 6 Mandatory Enclosure Declaration of Acceptance of Terms and Conditions in EOI (in letter head) To GM (CR) BESCOM Ref: EOI no. ___________ Dear Sir, Undertaking of compliance This is to Certify that, I/we _ have carefully examined the EOI and undertakes to perform the activities mentioned in the scope of work as mentioned in the EOI. I hereby declare that all the information and statements made in this EOI Proposal are true and accept that any misinterpretation contained in it may lead to our disqualification. Yours faithfully Signature Name: Date Location: Page 20 of 24 Empanelment of NGO/Non-Profit Organizations for creating awareness among the public on Electrical Safety and Energy Savings in BESCOM area Undertaking on Being Not Black-Listed (in letter Head) This is to certify that << COMPANY NAME >> is not blacklisted by the Government of Karnataka or Government of India or any of its agencies for any reasons whatsoever and the bidder should not be blacklisted by Central / any other State/UT Government or its agencies for indulging in corrupt or fraudulent practices or for indulging in unfair trade practices or any legal case regarding blacklisting in last five years Authorized Signatory Name of Signatory: Bidder Name: Date Place Page 21 of 24 Empanelment of NGO/Non-Profit Organizations for creating awareness among the public on Electrical Safety and Energy Savings in BESCOM area Undertaking on litigation(s) (in letter head) This is to certify that << NAME >> is not involved in any major litigation that may have an impact of affecting or compromising the delivery of services as required under this RFP. Authorized Signatory Name of Signatory: Bidder Name: Date: Place: Page 22 of 24 Empanelment of NGO/Non-Profit Organizations for creating awareness among the public on Electrical Safety and Energy Savings in BESCOM area Undertaking on Office Premises (in letter head) This is to certify that << NAME >> has an office in the Karnataka. Relevant address proof is enclosed. Authorized Signatory Name of Signatory: Bidder Name: Date Place Page 23 of 24