Enlistment = Application Form

INDIAN RAILWAYS

OFFICE OF THE CONTROLLER OF STORES

CHITTARANJAN LOCOMOTIVE WORKS

4, CHITTARANJAN=20 AVENUE

KOLKATA =96 700 072

Addressed to M/s. = =85=85=85=85=85=85=85=85=85=85=85=85=85=85=85=85 &n= bsp; &nb= sp; =20 Date :

FORM OF APPLICATION = FOR USE OF=20 FIRMS IN INDIA FOR

ENLISTMENT AS APPROVED = CONTRACTORS=20 TO RAILWAYS

Name of Firm/Company (Whether=20 Private/Public/Government

(i)

Telegraphic Address

(ii)

Address of Head Office

(iii)

Telephone No.

(iv)

Address of Branches

1(a)(i)

Proprietor(s) Name and Address

(ii)

Full details of other undertaking = owned/Controlled by=20 the proprietor(s)

1(b)(i)

Partner(s) Name, Address and percentage of = shares=20 hold.

(ii)

Connection = between the=20 undertaking and other(s) if any i.e. Partners are common or have = shares=20 (percentage) in any other undertaking(s) Firm(s) / Factory(s) with = name(s), Address(ess) & their = registration=20 No.(s) with the concerned Railways for the various group of = stores.

1(c)(i)

Managing Director/Wholetime=20 Director/Manager (Name and Address)

(ii)

Board of Directors (Name and Address)

(iii)

It is a subsidiary of Indian Company / = Foreign Company=20 with particulars of parent holding company.

Page 2 of 7

1(c)

(iv)

Other Companies, if any in Indian which are=20 subsidiaries of the parent company (Name and full particulars)

(v)

In which other companies the Directors have = financial=20 interest or are representated on the = Board(s) of=20 these other companies/Firms / Factories with Name(s) Address(ess) and full particulars about their = registration=20 Nos. with the concerned Railways for the various group of = stores

(vi)

Stores Manufacturers/Handled with details of=20 specification to which these are manufactured/stocked by you as = well as by=20 your subsidiaries mentioned above.

Item of item of stores giving reference to = the sanction=20 and serial No. of the attached list for which enlistment is = desired.

3.(a)

Is your firm incorporated under the Companies = Law or=20 any other Law of India ? if not, who are the partner / proprietors. = (Please give=20 their names and address(ess)

(b)

Is your firm registered under the Indian = Partnership=20 Act.1982

(c)

Is your Factory registered under the Indian = Factories=20 Act, 1948

Does your firm name under the scope of the = Industries=20 (Development & Regulations Act, 1951 = ? If so,=20 the No. and date of Registration or License held under the = Act.

4.(a)

If the firm is registered under the Indian = Companies=20 Act, 1913 or Companies Act 1 of 1956 state.

Page 3 of 7

4.(b)

The name in which item registered

(c)

The Registrar with whom it is registered and = his=20 place.

(d)

The date of registration and the number of = registration=20 certificate.

(e)

Subscribed Capital.

If the firm is registered under the Indian = Partnership=20 Act, 1932 or any other act the = registration of=20 firm / Partnership.

(a)

The name and / or style in which it is = registered.

(b)

The place of registrar or firm with whom registered.

(c)

The date of such registration and the number = and date=20 of registration certificate.

(d)

The Names and addresses of all the partners = and the=20 extent of their shares.

(e)

Whether under the partnership deed any one = partner has=20 been authorized to sign and bind the firm in all contractual = obligations=20 including power of Attorney exists in favour of a particular = partner to=20 perform such functions. In the Later case a copy duly attested by = a Notary=20 Public should be submitted.

Page 4 of 7

In any other cases, the name(s) and = address(es) of the proprietor and for all the = partners and the=20 nature and extent of their interest in the Joint Business (in the = case of=20 Joint Hindu Family) firm give this information regarding all = persons who=20 have any interest in the Business.

(a)

The Income Tax Circle/Ward District in which = the=20 concern and each of its proprietor and each of its proprietors = partner(s)=20 is/are assessed Income Tax and C.I. No. of each.

If you are a manufacturer location of = manufacturing=20 Works/Factory / Factories owned by you. (documentary evidence of ownership must be = produced.

(a)

Brief description of the factory (i.e. are a = covered=20 accommodation, departments into which it is divided, Laboratory = etc).

(b)

Whether the firm comes under the scope of = Industries=20 Development Reputations Act, 1951 and if so, the No./Date of registration of license hold under = the=20 Act.

(c)

Details of Plant & Machinery erected and=20 functioning in each department (Monographs and descriptive = pamphlets=20 should be supplied, if available).

(d)

Whether the process of manufacturer in the = Factory is=20 carried out with the aid of power or without it.

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7.(e)

Details of stores or class of stores which = the factory,=20 as

Is capable of production (specifying each = item=20 separately)

Details of arrangements for quality control = of products=20 such as laboratory etc.

(a)

Whether stores were tested to any standard=20 specification if so, copies of original test certificates should = be=20 submitted in triplicates.

(b)

In case you do not own the factory but = utilize the=20 factory of some other firm for manufacturer, Fabrication of the = stores for=20 which you apply for registration, on lease or other basis you = should=20 furnish a valid legal agreement that the factory of Here indicate = the name=20 of the firm whose factory is being utilized.

If you are accredited agents of any = manufacturers, give=20 =96

(a)

Name and address of manufacturers

(b)

Articles for which you gave agencies

(c)

Stock carried by you

10.

If you are stockiest

(a)

Items stocked

(b)

Approximate value of annual sales

(c)

Address & Stock of your shop/shops

(d)

Address of your Godown where=20 your stores can be inspected

11.

Clauses of articles imported by the firm.

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12.

Classess of = imported articles=20 normally stocker by the firm.

13.

State particulars with value (approx.) and = date of any=20 contract of considerable magnitude) executed in the past 12 months = by your=20 firm for the Industries & supplies Department/

Railway or local body.

14.

Recognized cottage Industries and small scale = Industries N.S.I.C. Units should submit a=20 certificates from the regional Director of the Unit in = support of=20 their statement.

15.

Are you on the approved list of Director = General of=20 Supplies & Disposals and if so, give details of items for = which=20 enlisted and registration No. & date.

16.

If you were on the approved list of Director = General of=20 Supplies & Disposals and if so, give details of items for = which registered.

17.

Who are your Bankers = ? Give=20 complete address (Mailing).

18.

Further remains, if any.

19.

Do you pay Income Tax = ? if so, Income Tax clearance certificate as = per form=20 enclosed be furnished.

Please state whether you have any interest in = any other=20 Firm/Firms as a Proprietor/Partner/Director, if so, the name and = address=20 of the Firm/Firms, the names and address of Partner(s)/Director(s) = of the=20 said Firm should be clearly indicated. This declaration should be = got=20 signed. By each and every Partner/Director.

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=20 I/We _________________________________________________________ do = hereby=20 declare that all entries made in this application form are true to the = best of=20 my/our knowledge and also that I/We shall to found by the acts of my/our = duly=20 constituted Attorney. Mr._______________

_________________________________=20 who has signed this application and of any other person who in future = may be=20 appointed by me/us so, in his stated to carry on the business of the = concern=20 whether an intimation of such change is given to the Railway or not.

=20 I/We do hereby confirm that I/We have read the conditions govern = in=20 Railway contracts as amended from time to time and should abide by those = conditions in all respects.

Signature of = Partner(s)/Proprietor(s)

Manager(s)/Director(s)

=20 All subsequent changes in the constitution or working or a firm = effecting=20 the accuracy of the now given should be promptly communicated to this=20 Railway.

Signature(s)

Name=20 :_________________________________

Place = ___________________ &n= bsp; &nb= sp; =20 Designation :=20 ____________________________

&n= bsp; &nb= sp; &nbs= p; = ; = &= nbsp; &n= bsp; =20 of person signing this application = form

Date=20 ___________________ &n= bsp; &nb= sp; &nbs= p; =20 (Proprietor/Partner/Manager/Director).