Description As per document Pre-Qualification: pls visit unionbankofindia.com/tenderinfo.aspx REGIONAL OFFICE , B-100 , UNIVERSITY MARG, BAPU NAGAR , JAIPUR –302015 Bio data of security agencies for empanelment 1. Name of the Agency: 2. Office address with phone/mobile no./EMAIL: 1) Head office: 2) Local office: 3. Year of establishment: 4. Status of firm: (Whether Pvt. Ltd. company/ Public ltd. company/ Partnership firm) 5. Name of Directors/ Partners: i) ii) iii) 6. Detail of Infrastructure & network: 7. Whether an assessee of Income tax. If so, mention permanent Account Number. Furnish copies of Income tax Clearance / Return certificate: 8. Detail of supervisory Infrastructure & network: 9. Whether registered with the registrar of companies / registrar of firms. If so mention number and date: 10. Furnish copies of audited balance sheet and profit and loss accounts for past 3 years: 11. Name of the Bankers with address and telephone numbers 12. Enclose solvency certificate (addressed to Union Bank of India and not older than 6 months of the advertisement): 13. Registration with Govt. / Public Sector / Banks (certificates of Registration to be enclosed as Annexure-V. Name of the Organization Year since empanelled 14. Give details if at present involved in litigation in similar type of contracts: Sr. No. Name of Project Name of Employer Nature of work Work order dated Date of completion of work Value Rs. 15. Name & relation, if any, with the staff member of Union Bank of India : 16. Details of work executed during the last 3 years: Type of work Work executed for (name of the Institution / Body) Nature of work (in brief) Location Value Rs. Duration of work with date of Commence and completion If work left incomplete or terminated (give reasons) Note: Copies of work orders along with xerox copies of relevant TDS certificate, satisfactory completion certificate obtained from the client shall be enclosed as Annexure VI. Please note without the copies of certificates, your application is liable to be rejected. 17. Details of work on hand (photo copies of performance certificate, work orders issued by valued clients, preferably Banks, Govt., Semi-Govt. Bodies should be enclosed as Annexure VII). Type of work Work executed for (name of the Institution / Body) Nature of work (in brief) Location Value Rs. Duration of work, stipulated time Present stage of work 18.Should have registration under Shop and Establishment Act (Attach copy) 19. Should have certificate from ESI Corporation (attach copy): 20. Should have certificate under EPF and Miscellaneous Provisions Act 1952: 21. Documents supporting compliance with Minimum Wages Act 1948 & other labour laws and rules: 22. Should be registered with appropriate Authority for service tax purpose. Also furnish copies of Proof of the same: 23. Should have license to engage in business of Private Security agency under Rajasthan Private Security Agency (regulation) rules, 2006 24. Mention the District wise area where you would like to provide services Note: Where copies are required to be furnished these are to be certified preferably by the concerned agencies or a government officer: D E C L A R A T I O N ----------------------------------------------------------- 1. I / We have read the instructions appended to the proforma and I / We understand that if any false information is detected at a later date, any future contract made between ourselves and Union Bank of India, on the basis of the information given by me / us can be treated as invalid by the Bank and I / We will be solely responsible for the consequences. 2. I / We agree that the decision of Union Bank of India in selection of security agencies will be final and binding to me / us. 3. All the information furnished by me hereunder is correct to the best of my knowledge and belief. 4. I / We agree that I / we have no objection if enquiries are made about the work listed by me / us in the accompanying sheets. 5. I / We agree that I / We have not applied in the name of sister concern for the subject empanelment process. Signature: Date: Place: Designation, (Affix company seal) Sector : Banking, Finance & Insurance State : Maharashtra For further Information Contact: Name : Union Bank E-Mail : romharshrazdan@unionbankofindia.com Phone Office : 022-25710446 Fax : 022-25704295 | 
