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Annexure-A BIDDER’S PROFILE a) Name of the Vendor: b) Incorporated as _______________ in year ____________________ at ____________ (State Sole Proprietor, Partnership, Private Limited or Limited Firm) c) Whether any Legal/Arbitration proceedings have been instituted against the Vendor or the Vendor has lodged any claim in connection with works carried out by them. If yes, please give details. d) Vendor profile i) ii) iii) iv) v) Full Address : Year when set up : Name of the top executive with designation : Telephone Number(s) : Email address : Mobile : vi) Service Tax No : vii) Sales Tax/VAT No : viii) CST No : ix) PAN No : x) Turnover from sale of computer system Financial Year Turnover from sale of computer system (in Rs.) 2009-10 2010-11 2011-12 e) EMD details Particulars Tender fee EMD f) Draft No. Amount (Rs.) Date Bank Branch 500 Rs. 1,00,000 for each category of Annexure-1 Service centers: The following information for service centers at least major cities, operational for more than 3 years, as per eligibility clause 4.3 may be given. For authorized distributor / OEM centers the vendor shall produce a copy of the valid agreement/undertaking from authorized distributor/OEM. NICSI would verify the information furnished here and if found incorrect the bid is liable to be rejected. S. No. Location Name of Center Full Postal Address with Telephone Nos. Page 25 of 53 Year of Setup Own centre Or Franchisee Whether spares are stocked