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Annexure-V Revised Format For Certificate

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ANNEXURE-V

Reference -Para 6.1 of ITT

FORMAT FOR CERTIFICATE TO BE SUBMITTED / UPLOADED BY


TENDERER ALONGWITH THE TENDER DOCUMENTS

I………………………………(Name and designation)**appointed as the


attorney/authorized signatory of the tenderer,

M/s_____________________________ (hereinafter called the tenderer) for the purpose of


the Tender documents for the work of
____________________________________________ as per the tender No.____________
of ________(Railway)**, do hereby solemnly affirm and state on the behalf of the tenderer
including its constituents as under:

1. I/we the tenderer (s) am/are signing this document after carefully reading the
contents.
2. I/We the tenderer(s) also accept all the conditions of the tender and have signed all
the pages in confirmation thereof.
3. I/we hereby declare that I/we have downloaded the tender documents from Indian
Railway website www.ireps.gov.in . I/we have verified the content of the document
from the website and there is no addition, no deletion or no alteration to the content
of the tender document. In case of any discrepancy noticed at any stage i.e.
evaluation of tenders, execution of work or final payment of the contract, the master
copy available with the railway Administration shall be final and binding upon
me/us.

4. I/we declare and certify that I/we have not made any misleading or false
representation in the forms, statements and attachments in proof of the qualification
requirements.

5. I/We also understand that my/our offer will be evaluated based on the
documents/credentials submitted along with the offer and same shall be binding
upon me/us.

6. I/We declare that the information and documents submitted along with the
tender by me/us are correct and I/we are fully responsible for the correctness of
the information and documents, submitted by us.

7. I/we certify that I/we the tenderer(s) is/are not blacklisted or debarred by Railways or
any other Ministry / Department of Govt. of India from participation in tender on the
date of submission of bids, either in individual capacity or as a HUF/ member of the
partnership firm/LLP/JV/Society/Trust.

8. I/we understand that if the contents of the certificate submitted by us are found to be
forged/false or incorrect at any time during process for evaluation of tenders, it shall
lead to forfeiture of the Bid Security besides banning of business for a period of upto
two year. Further, I/we (insert name of the tenderer) **_____________and all
my/our constituents understand that my/our offer shall be summarily rejected.

9. I/we also understand that if the contents of the certificate submitted by us are found to
be false/forged or incorrect at any time after the award of the contract, it will lead to
termination of the contract, along with forfeiture of Bid Security/Security Deposit
and Performance guarantee besides any other action provided in the contract
including banning of business for a period of upto two year.

10. I/We have read the clause regarding restriction on procurement from a bidder of a
country which shares a land border with India and certify that I am/We are not from
such a country or, if from such a country, have been registered with the competent
Authority. I/We hereby certify that I/we fulfil all the requirements in this regard and
am/are eligible to be considered (evidence of valid registration by the competent
authority is enclosed)

SEAL AND SIGNATURE


OF THE TENDERER
Place:
Dated:

**The contents in Italics are only for guidance purpose. Details as appropriate are to be
filled in suitably by tenderer.
E. New Annexure-V(A), Part I of GCC shall be read as under

ANNEXURE-V(A)

Reference -Para 6.1 of ITT

(This certificate is to be given by attorney/authorized signatory/each member of


Partnership firm/Joint Venture (JV) / Hindu Undivided Family (HUF) / Limited Liability
Partnership (LLP) etc.)

I/We………………………(Name), attorney/authorized signatory of the


……………..….. (constituent firm/constituent partner) and member/partner of the
………………………………(tenderering firm) hereby solemnlPy affirm and state as
under:

1. I/we certify that ……………..….. (constituent firm/constituent partner) is/are not


blacklisted or debarred by Railways or any other Ministry / Department of Govt. of
India from participation in tender on the date of submission of bids, either in
individual capacity or as a HUF/ member of the partnership
firm/LLP/JV/Society/Trust.
2. I/We have read the clause regarding restriction on procurement from a bidder of a
country which shares a land border with India and certify that I am/We are not from
such a country or, if from such a country, have been registered with the competent
Authority. I/We hereby certify that I/we fulfil all the requirements in this regard and
am/are eligible to be considered (evidence of valid registration by the competent
authority is enclosed),

SEAL AND SIGNATURE


OF THE CONSTITUENT FIRM/CONSTITUENT PARTNER
Place:
Dated:

*****

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