FORM NO:-PROC/VEN/04.

00

Page 1 of 9 of Vendor Registration Form EFFECTIVE DATE:05.11.2005

JAMSHEDPUR UTILITIES & SERVICES COMPANY LIMITED PROCUREMENT DEPARTMENT

DETAILS FOR VENDOR REGISTRATION SL. NO. 1 2 FIELD DESCRIPTION Name of Vendor Registered Office Address DETAILS

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Country PIN / ZIP code Contact Persons 1. 2.

Telephone Numbers 1. 2. Mobile No. Fax Number E-Mail ID Internet Site Local Sales Tax Regn. No. Central Sales Tax Regn. No. VAT Regn. No. PIN / TIN No. Excise Regn. No.

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JUSCO

Page 2 of 9 of Vendor Registration Form

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Excise Range No. Excise Division Excise Collectorate Excise Control Code No. Service Tax Regn. No. Service Tax Code No. IEC No. Provident Fund Regn. No. ESI Code No. PAN / GIR No. Constitution of Organization: Proprietary, Partnership, Private Ltd., Public Ltd., PSU, Govt., JV, Foreign Co., Subsidiary, Tata Group of Companies Regn. No. under Shops & Establishments Act SSI Regn. No. & Validity Factory License No. & Validity Labour License No., Nature of work, No. of employees covered & Validity Electrical Contract License No. & Validity Workmen Compensation Policy No. Quality Management System Compliance to Factories Act & rules Compliance to Social Accountability Norms

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JUSCO

Page 3 of 9 of Vendor Registration Form

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IT Systems employed Banks Name Address of the Bank Account No. MICR / Bank Branch Code Bankers Solvency Certificate No. / Date Financial Data: Turnover / Net Profit of Last Three Financial Years:

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Names of the Proprietor / All Partners / Directors / Chief Executives with contact details:

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Names of Key Customers for reference with contact details:

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Do you or any of your partners have any connection with any firm having business dealings with JUSCO? If yes, give details. Do you have any close relations working in Tata Steel / JUSCO? If yes, give details. Signature & Date Name of the Authorized Signatory Seal of the Vendor : : :

JUSCO

Page 4 of 9 of Vendor Registration Form

DETAILS FOR VENDOR CATEGORIZATION & ASSESMENT

(To be filled at the time of verification of documents at Procurement Department)

Please tick the boxes appropriately describing your area (restricted to only two categories). Copies of orders awarded on you are to be attached. A. SERVICE PROVIDER / CONTRACTOR GROUP Earthwork Concrete Reinforcement Formwork Masonry Woodwork Roadwork Plumbing & Drainage Interior & Exterior Decoration Sports Facility Development Job Specialized Civil Job Others Equipment Erection Piping Structural Fabrication Automobile Maintenance HVAC System Machine Maintenance & Repairing Safety & Fire Others Power Distribution Equipment Maintenance & Repairing Instrumentation Telecommunication Others Conservancy & Sanitation Fumigation & Pest Control Immunization Others Gardening Landscaping & Irrigation Inland Transportation Overseas Freight Forwarding Clearing & Handling

CATEGORY CIVIL

MECHANICAL

ELECTRICAL

PUBLIC HEALTH

HORTICULTURAL SERVICES LOGISTICS

JUSCO

Page 5 of 9 of Vendor Registration Form

MISCELLANEOUS

Hospitality Education IT services Courier Services Advertising & Event Management Security Survey, Consultancy & Recruitment Medical Services Travel & Ticketing Administration & Liaison

B.

MATERIAL SUPPLIER GROUP Cement Steel Bricks & Aggregates Tiles & Stones Wooden Items Bitumen Pipes & Fittings Paints Decorative Items Fabricated Items HDPE & Plastic Items Explosives Hardware Pumps & Motors Valves Instruments & Meters Machinery & Tools HVAC System Spares Automotive Items Fuel, Oil & Lubricants Consumables Cables Lamps, Posts & Fittings Panels & Boards Electrical Equipment Instrumentation Items Telecommunication Items Consumables

CATEGORY CIVIL

MECHANICAL

ELECTRICAL

JUSCO

Page 6 of 9 of Vendor Registration Form

CHEMICALS

MISCELLANEOUS

Water Purifying Chemicals Pesticides Admixtures Food & Beverages Horticulture Items Safety Items Books, Stationery, Gift, Exhibition Items IT Related Items Medical Items Consumables

SELF ASSESMENT BY VENDOR We request you to register us provisionally as: Class A Vendor (capable of executing orders valued more than 20 Lakhs) Class B Vendor (capable of executing orders valued 5 to 20 Lakhs) Class C Vendor (capable of executing orders valued less than 5 Lakhs) We also understand that the same are subject to periodic review by JUSCO.

Signature & Date Name of the Authorized Signatory Seal of the Vendor Address

: : : :

JUSCO

Page 7 of 9 of Vendor Registration Form

Acceptance of guidelines of Code of Conduct by Vendor

I / We have read and understood the contents of Tata Code of Conduct and agree to uphold its values during our association with JUSCO. I / We shall not take recourse to any unethical behaviour (implicit or explicit) with any employee of JUSCO / Tata Steel for the purpose of obtaining an order from JUSCO or any information that may have a favourable financial impact for us. I / We fully understand that in the event we are suspended / blacklisted by Tata Steel for violation of Code of Conduct, JUSCO shall be at full liberty to suspend / blacklist us in its sole discretion. I / We shall not indulge in any activity to obtain undue monetary / material advantage during execution of orders of JUSCO. I / We shall forthwith report any unethical activity or discrimination if practiced by any JUSCO employee. I / We shall no take any advantage of any family / social / political connections in obtaining favour with regard to any order from JUSCO. Merit shall be the sole attribute for association with JUSCO. I / We shall desist from all unfair trade practices with our competitors who are also associated with JUSCO. I / We shall ensure compliance to all governmental norms on Statutory Compliances such as, Environment Protection, Minimum Wages, Child Labour, Health & Safety etc. I / We hereby confirm our acceptance to abide by the above principles and values and understand that any violation of the same may be dealt with firmly by JUSCO.

Signature & Date Name of the Authorized Signatory Seal of the Vendor Address

: : : :

JUSCO

Page 8 of 9 of Vendor Registration Form

Declaration by Vendor
I / We hereby declare that all the above information and statements furnished are true and in case of any false / incomplete statement or misrepresentation on our behalf, our registration is liable to be withdrawn / cancelled by Jamshedpur Utilities and Services Company Limited (JUSCO). In case of any change in the details of information provided by me / us in the form, the same shall be intimated in writing to JUSCO forthwith. I /We shall inform about any alteration in the status / constitution of our firm / company to JUSCO well in advance and fully understand that JUSCO in such case shall at its discretion be fully entitled to cancel any / all ongoing orders. I / We also declare that we do not / shall not make any unauthorized use of any property of Tata Steel / JUSCO for any purpose whatsoever. I / We fully understand that in the event we are suspended / blacklisted by any Tata Group Company for any reason, JUSCO shall be at full liberty to suspend / blacklist us in its sole discretion. I / We also accept that the registration is not a promise, in any form, by JUSCO for award of any order. I / We also understand that the orders shall be generally governed by the relevant clauses of The Indian Contract Act, 1872, Payment of Wages Act, 1936, The Workmen Compensation Act, 1923, The Minimum wages act, 1984, The Contract Labour (Regulations & Abolition) Act, 1970, Employees Provident Funds & Miscellaneous Provision Act, 1952, The ESI Act, 1948, The Payment of Gratuity Act, 1972, The Bonus Act, 1965, The Companies Act, 1956, Sick Industrial Companies (Special Provisions) Act, 1985, Central Excise Act, 1944, CST Act, 1956, State Sales Tax Acts & Rules, Adopted Bihar Finance Act, 1981, Adopted Bihar Mine & Mineral Concession Rules, 1972, Adopted Bihar Shops & Establishment Act, 1953, Service Tax Act, 1994, IT Act, 2000 and all other laws of the land as applicable to us. I / We hereby confirm our acceptance to fully abide by the above terms and conditions of this undertaking and hereby indemnify and

JUSCO

Page 9 of 9 of Vendor Registration Form

keep JUSCO indemnified in case of any breach / violation of the same. We agree that in such event, JUSCO shall be free to initiate any punitive action against us as deemed fit including withholding of our bills against any order and suspension / cancellation of our registration and we shall not be entitled to raise any objection / claim for any compensation for the same.

Signature & Date Name of the Authorized Signatory Seal of the Vendor Address

: : : :

Check-list of enclosures 1. Application on Vendors letterhead 2. All 9 pages duly filled-up 3. Copies of Registration Certificates and Licenses duly attested (As applicable; For Suppliers, Sales Tax is mandatory; For Contractors Sales Tax, PAN, PF & ESI are mandatory.) 4. Registered Partnership Deed (for Partnership Firms) / Memorandum and Articles of Association and Certificate of Incorporation (for Companies) 5. Power of Attorney of the Authorized Signatory 6. Certificate from the Bank confirming account number and solvency 7. Copies of previous orders 8. Clearance from Land, Market & Estate Department of Tata Steel

JUSCO