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1 | P a g e संदभ सं. /डीपीएसपी-परिसि/ 2202 / कनसलटंस का पैनल /2017-18 28 दसबि 2017 चना NOTICE कनसलटंस का पैनल बनाना Empanelment of Consultants नाबाडभ दो वभ की अवधि के ललए म बई थित अपने िान कााभल के वन औि म बई थित थटाफ़ वाटभसभ म ोजेट काम संबंिी सेवाओं के ललए तठित कनसलटंस का एक पैनल तैाि किना चाहता है. आवेदक काभ की एक ा अधिक ेणि के ललए आवेदन कि सकते ह . ेड मद/काभ-स ची की ेिी के ललए क पा एललके शन फॉमभ देख. पैनल म शालमल होने के लए आवेदक को सी वथत त जानकािी के साि तनिाभरित प म आवेदन थत त किना होगा. आवेदन प www.nabard.org से डाउनलोड ककए जा सकते ह. आवेदन, तनिाभरित प म ववधिवत प से म हिबंद लफ़ाफ़े म म महाबंिक, नाबाडभ , परिसि, िऔि अधिालत ववाग-डीपीएसपी, िान कााभल, तल, बीवंग, लॉट नं. सी-24, जीलॉक, बांा-क लाभ संक , बांा(प वभ), बई 400 051 को थत त ककए जा सकते ह. ललफ़ाफ़ पि “कनसलटंस के एपैनलमट हेत आवेदन” (काभ इंधगत का जाए) थपठट प से ललखा जाए. आवेदन 18 जनवरी 2018 को अपरान 3:00 बजे तक त त ककए जा सकते ह. NABARD intends to prepare a panel of reputed consultants, valid for 2 years, for undertaking project works in its Head Office Building & Staff Quarters at Mumbai. The applicants can apply for one or more categories of work. For category of Trade items/work list please refer to Application form. Applicants for empanelment should apply in the prescribed form, which, alongwith all the other details, can be downloaded from the banks’s Website www.nabard.org. The applications dully filled in the prescribed proforma may be submitted in a sealed cover clearly subscribing it as “Application for Empanelment of Consultants for (Trade to be indicated)” to the Chief General Manager, DPSP, NABARD Head Office, Ground Floor ‘B’ Wing, Plot No. C-24, ‘G’ Block, Bandra Kurla Complex, Bandra (East), Mumbai 400 051. Last Date of submission of application is 18 January 2018 up to 3.00 PM.
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  • 1 | P a g e

    संदर्भ सं. /डीपीएसपी-परिसि/ 2202 / कनसलटंट्स का पैनल /2017-18 28 ददसम्बि 2017

    सूचना NOTICE

    कनसलटंट्स का पनैल बनाना Empanelment of Consultants

    नाबाडभ दो वर्भ की अवधि के ललए म ंबई स्थित अपने प्रिान कार्ाभलर् के र्वन औि म ंबई स्थित थटाफ़ क्वाटभसभ में प्रोजेक्ट काम संबंिी सेवाओं के ललए प्रततस्ठित कनसलटंट्स का एक पैनल तैर्ाि किना चाहता है. आवेदक कार्भ की एक र्ा अधिक शे्रणिर्ों के ललए आवेदन कि सकते हैं. टे्रड मद/कार्भ-सूची की शे्रिी के ललए कृपर्ा एस्ललकेशन फॉमभ देखें. पैनल में शालमल होने के ललए आवेदकों को सर्ी ववथततृ जानकािी के साि तनिाभरित प्रपत्र में आवेदन प्रथत त किना होगा. आवदेन पत्र www.nabard.org स ेडाउनलोड ककए जा सकते हैं. आवेदन, तनिाभरित प्रपत्र में ववधिवत रूप से म हिबंद ललफ़ाफ़े में म ख्र् महाप्रबंिक, नाबाडभ, परिसि, स िक्षा औि अधिप्रास्लत ववर्ाग-डीपीएसपी, प्रिान कार्ाभलर्, र्ू तल, ‘बी’ ववगं, ललॉट नं. सी-24, ‘जी’ ब्लॉक, बांद्रा-क लाभ संक ल, बांद्रा(पूवभ), म ंबई – 400 051 को प्रथत त ककए जा सकते हैं. ललफ़ाफ़ों पि “कनसलटंट्स के एम्पैनलमेंट हेत आवेदन” (कार्भ इंधगत ककर्ा जाए) थपठट रूप से ललखा जाए. आवेदन 18 जनवरी 2018 को अपराह्न 3:00 बजे तक प्रस्तुत ककए जा सकते हैं.

    NABARD intends to prepare a panel of

    reputed consultants, valid for 2 years, for undertaking project works in its Head Office Building & Staff Quarters at Mumbai. The applicants can apply for one or more categories of work. For category of Trade items/work list please

    refer to Application form. Applicants for empanelment should apply in the prescribed form, which, alongwith all the other details, can be downloaded from the banks’s Website www.nabard.org. The applications dully filled in the prescribed proforma may be submitted in a sealed cover clearly subscribing it as “Application for Empanelment of

    Consultants for (Trade to be indicated)” to the Chief General Manager, DPSP, NABARD Head Office, Ground Floor ‘B’ Wing, Plot No. C-24, ‘G’ Block, Bandra Kurla Complex, Bandra (East), Mumbai – 400 051. Last Date of submission of application is 18 January 2018 up to 3.00 PM.

    http://www.nabard.org/http://www.nabard.org/

  • 2 | P a g e

    31 माचच 2018 तक पहले से सूचीबद्ध कनसलटंट्स नए ससरे से अपना आवेदन प्रस्तुत कर सकते हैं. ककसी र्ी आवेदन र्ा सर्ी आवेदनों को बबना कोई कािि बताए अथवीकाि किने का अधिकाि बैंक को होगा.

    Already empaneled consultants whose empanelment is up to 31 March 2018 may submit applications afresh. The Bank reserves the right to reject any or all the applications without assigning any reasons thereof.

    Sd/-

    महाप्रबंधक General Manager नाबार्च, प्रधान कार्ाचलर् मुंबई

    NABARD, Head Office, Mumbai

  • 3 | P a g e

    NATIONAL BANK FOR AGRICULTURE & RURAL DEVELOPMENT (NABARD)

    HEAD OFFICE, DEPARTMENT OF PREMISES, SECURITY AND PROCUREMENT

    (DPSP), MUMBAI

    NOTICE FOR EMPANELMENT OF CONSULTANTS

    STRUCTURAL CONSULTANTS

    INTERIOR DESIGNER / ARCHITECT

    PROJECT MANAGEMENT CONSULTANT FOR SUPERVISION, QUANTITY SURVEY ETC.

    CONSULTANT FOR WATERPROOFING WORKS

    HVAC CONSULTANTS

    MEP(MECHANICAL, ELECTRICAL & PLUMBING) CONSULTANTS

    AT

    NABARD HEAD OFFICE, PLOT NO. C-24, G BLOCK, BANDRA KURLA

    COMPLEX, BANDRA (EAST), MUMBAI

    NAME OF APPLICANT _

    ADDRESS

    _

    _

    _

    LAST DATE OF SUBMISSION : 18 JANUARY 2018 (15:00HRS.)

    THE CHIEF GENERAL MANAGER

    DPSP, NABARD HEAD OFFICE, GROUND FLOOR, ‘A’ WING

    PLOT NO. C-24, G BLOCK, BANDRA KURLA COMPLEX,

    BANDRA (EAST), MUMBAI- 400 051

  • 4 | P a g e

    Proforma of application for empanelment of Consultants

    Issued to

    M/s. _

    Last date for submission : _

    The application form in duplicate duly filled in shall be addressed to :

    Chief General Manager, DPSP, Ground Floor A wing, NABARD, HO

    Plot No. : C-24, 'G' Block

    Bandra Kurla Complex

    Bandra (E), Mumbai 400051

    I/We have read and understood the instructions and the terms and conditions contained in

    the application form. I/We do hereby declare that the information furnished in the

    application and in the supplementary sheets from

    pages _ is correct to the best of my/our knowledge and belief.

    Signature ______________________

    Name _

    Designation

    Address _

    Seal of the Applicant

    Place :

    Date :

  • 5 | P a g e

    National Bank for Agriculture and Rural Development (NABARD), Mumbai

    ENLISTMENT OF CONSULTANTS

    National Bank for Agriculture and Rural Development intends to prepare a panel of

    consultants in the following trades for their projects likely to be taken up in the office

    premises and staff quarters in Mumbai.

    1. Structural Consultants

    2. Interior Designer/ Architect

    3. Project Management Consultant for supervision, quantity survey etc

    4. Consultant for waterproofing works

    5. HVAC Consultants

    6. MEP(Mechanical, Electrical & Plumbing)consultants

    The panel would be prepared under 3 categories i.e. works costing -

    (i) upto Rs 50.00 lakhs (Category-I) (ii) upto Rs.200.00 lakhs (Category-II) (iii) upto Rs.500.00 lakhs (Category-III)

    1) The Consultants / Architects who are registered with the Government/Semi-Government Undertaking/s / Financial Institutions / Autonomous bodies / Reputed

    Corporate Sector institutions in the field of similar works as per the following criteria and

    having service set up at Mumbai/Navi Mumbai/Thane wherefrom required quality after

    sales services can be provided, may apply in the prescribed form for the purpose. The

    Consultants/Architects should meet the following minimum criteria : PRE-QUALIFICATION CRITERIA

    Criteria Category-I (upto

    Rs.50.00 lakh)

    Category-II (upto

    Rs.200.00 lakh)

    Category-III (upto

    Rs.500.00 lakh)

    (1) Minimum years

    of experience in

    works of similar nature

    05 years 05 years 05 years

    (2) EXPERIENCE : Experience of having successfully completed similar works

    during last five years ending 30 November 2017 (i.e. works prior to 30 November

    2012 will not be considered) should be either of the following (Category-wise)

    Note:- Value of work means the actual cost of work and not the Consultant/Architect

    fee.

  • 3 | P a g e

    Three similar

    completed works

    each costing not less

    than Rs.20.00 lakh

    Three similar

    completed works

    each costing not

    less than Rs.80.00 lakh

    Three similar

    completed works

    each costing not less

    than Rs.200.00 lakh

    OR OR OR

    Two similar

    completed works

    each costing not

    less than Rs.25.00

    lakh

    Two similar

    completed works

    each costing not

    less than

    Rs.100.00 lakh

    Two similar

    completed works

    each costing not less

    than Rs.250.00 lakh

    OR OR OR

    One similar

    completed work

    costing not less

    than Rs.40.00 lakh

    One similar

    completed work

    costing not less

    than Rs.160.00 lakh

    One similar

    completed work

    costing not less

    than Rs.400.00 lakh

    (3) Technical

    competence

    The firm should have adequate technically qualified and

    experienced staff in the category for which empanelment has been

    applied for. The Architect/Consultant must have registered as a

    fellow or a member of any of the Institutions like

    Institution of Engineers or Interior Designers, Indian

    Council of Architecture , American Society of Heating and

    Refrigeration Engineering or Indian Society of Heating and

    Refrigeration Engineering or any such professional body related

    to the Consultant's field of working

    (4) SERVICE

    SET-UP

    Having full-fledged service setup at MUMBAI/NAVI

    MUMBAI/THANE and have Registration and valid Licenses for

    related trades and GST Registration etc.

  • 4 | P a g e

    Note: The following documents should invariably be attached

    alongwith application in support of experience, establishment and

    financial capability :

    i) Copies of Work orders, Completion Certificates in support of experience

    ii) Copies of Registration certificate, valid licenses for related trades and GSTIN Registration certificate.

    iii) Copies of Balance Sheet and Profit & Loss statement for the previous three years, duly certified by a practicing Chartered Accountant,

    in support of Average Annual Turnover OR Banker’s Solvency Certificate

    in proof of having adequate financial standing.

    2) The application form duly filled in shall be submitted in a sealed envelope super subscribed as “Empanelment of Consultants” on the cover

    and addressed to Chief General Manager, DPSP, NABARD Head Office,

    Ground floor A-Wing, Plot No. C-24, G Block, Bandra-Kurla Complex,

    Bandra (East), Mumbai – 400 051 on or before 03:00 P.M., 18

    JANUARY 2018. Already enlisted consultants whose enlistment is

    upto the year 2017-18, also need to apply afresh.

    3) NABARD encourages electronic mode of payment to vendors. For this purpose, please furnish the information in Annxure-VII.

    4) The Bank reserves the right to reject any or all the applications without assigning any reason thereof.

    Encl. : Annexure-I (Trade wise list of Consultants for empanelment) Annexure-II (General Instructions to the applicants for Empanelment)

    Annexure-III (Basic Information)

    Statement – I (Technical and administrative staff)

    Statement – II (List of projects executed)

    Statement – III(List of projects in hand)

    Annexure-IV (Details of Bank account of the applicant)

    Annexure-V (Proforma of covering letter to be submitted on applicant’s letter-

    head)

  • 5 | P a g e

    ANNEXURE – I

    Trade wise list for empanelment of Consultants at NABARD Office

    Premises and Staff Quarters in Mumbai

    S

    S

    TRADE/ITEMS FOR

    EMPANELMENT

    CATEGORY- I

    (UPTO RS.50.00

    LAKH)

    CATEGORY-

    II (UPTO

    RS.200.00

    LAKH)

    CATEGORY

    -III (UPTO

    RS.500.00

    LAKH)

    TRADE-CODE

    1 STRUCTURAL CONSULTANT

    1A 1B 1C

    2 INTERIOR DESIGNER /

    ARCHITECT

    2A 2B 2C

    3 PROJECT MANAGEMENT

    CONSULTANT FOR SUPERVISION,

    QUANTITY SURVEY ETC

    3A 3B 3C

    4 CONSULTANT FOR

    WATERPROOFING WORKS

    4A 4B 4C

    5 HVAC CONSULTANTS

    5A 5B 5C

    6 MEP (MECHANICAL, ELECTRICAL

    & PLUMBING CONSULTANTS

    6A 6B 6C

  • 6 | P a g e

    Annexure - II

    General Instruction to the applicants

    1. Intending applicants are required to submit their full bio-data giving

    details about their organisation, experience, technical personnel in their

    organisation, spare capacity, proven competence to handle major works

    etc. in the enclosed proforma.

    2. The C o n s u l t a n t for any particular work (Estimated cost upto Rs. 5.00

    crore) shall be selected from the respective panel of the Bank through

    competitive bidding and such selected consultants are required to execute

    agreements as per Bank’s format, if required.

    3. The fees to be paid will have to be quoted by the Consultant as

    and when work arises and as per the scope of work

    4. Applicants are required to indicate on the top of the envelope the trade-code and

    category in which they desire empanelment as per list enclosed (Annexure – I).

    The applicants can apply for one or more trades/categories of empanelment,

    which may be clearly mentioned in Annexure – V of the application document.

    5. In deciding upon the selection of a Consultant, great emphasis will be given on

    the ability and competence of applicants to render required services within

    specified time frame.

    6. The application shall be signed by the person/s on behalf of the organisation

    having necessary Authorisation / Power of Attorney to do so. Each

    page of the application shall be signed (copy of Power of Attorney for

    signing the empanelment form shall be furnished along with the

    application).

    7. If the space in the proforma is insufficient for furnishing full

    details, such information may be supplemented on separate sheet stating

    therein the part of the proforma and serial number. Separate sheets shall

  • 7 | P a g e

    be used for each part of the application.

    8. Applications containing false and/or incomplete information are liable for rejection.

    9. While filing up the application with regard to the list of important projects

    completed or on-hand, applicants shall only include those completed

    works which individually cost more than the minimum value of work

    specified for the category to which the applications are submitted.

    10. The applicant should have at least one qualified Interior Designers/Post

    Graduate Engineers (having about 5 years of experience in their respective

    discipline) in their employment besides other staff.

    11. The applicant shall have registered office of reasonable size with

    necessary equipment and supporting staff at senior and middle level.

    12.A ) Services to be rendered by the I n t e r i o r D e s i g n e r/Architect

    (a) to take instructions from the Bank and prepare alternative

    preliminary designs drawings and rough estimate of cost. These

    designs and drawings shall be modified as required till the same

    are approved by the Bank.

    (b) to design and prepare detailed working drawings, drawing up of

    tender documents including specifications, Schedule of Quantities

    and detailed cost estimate.

    (c) To scrutinise the tenders received from different parties on

    the basis of the specifications and submit Assessment

    reports together with recommendations.

    (d) to prepare contract documents, get them executed and prepare certified

    copies for the use of various offices including all drawings.

    (e) to supervise the work at site through duly qualified and

    responsible representatives of the firm till commissioning of the

    system/area.

    (f) to check the Contractor's bills including final bill and certify for

    the payment.

  • 8 | P a g e

    (g) to supply six sets of 'As-built drawings'.

    (h) to attend to all other services connected with the work normally

    rendered by the Consultant Designer.

    12(B) Services to be rendered by the Structural Consultant

    (a) to prepare all the structural design calculations and assume full

    responsibility for the structural stability required for the project. The

    soil investigation reports shall be made available by the Bank.

    (b) To work in co-ordination with the Bank's Architect.

    (c) To prepare all the structural drawings including revised drawings as

    required by the Bank and supply 6 sets of all structural drawings

    issued for the construction purpose.

    (d) To visit site when the foundation work is in progress and advise

    Bank's Engineer in respect of sufficiency of foundation strata.

    (e) To visit site when the work is in progress if required by the Bank.

    (f) To submit 2 sets of 'As-built drawings' after completion of work.

    (g) To carry out the structural audit testing of the building

    (h) To give structural fitness certificate as per local authorities format

    13. Decision of the Bank in regard to selection of the Consultants shall be

    final. The Bank is not bound to assign any reasons therefor.

    14. The Panel of respective Consultants once prepared shall be valid for

    period of 2 years ie 01 April 2018 to 31 March 2020 subject to annual review

    every year. If the performance and dealings of the Consultant/Architect is found

    to be unsatisfactory, Bank reserves the right to delete their name from the

    empaneled list.

    I/We have read the various items and conditions and the same are

    acceptable to me/us.

    Date : Signature of the applicant with full address

    Place :

    Office Seal

  • 9 | P a g e

    Annexure - III

    Information To Be Furnished By The Applicant

    1

    Name and registered office

    address

    2 Organisational set up of the

    firm including names,

    qualifications and experience

    of partners/associates and

    staff

    Details to be furnished in the prescribed proforma

    (Statement I)

    3 Whether registered as a

    fellow or a m ember of

    any of the Institutions

    like Institution of

    Engineers or Interior

    Designer s, Indian

    Cou ncil o f A r c h i t ec t u r e ,

    America n Society of

    Heating a n d Ref riger ation

    Engineering o r Indian

    Society of Heating and

    Refrigeration Engineering

    o r any such professional

    body r e l a t e d t o t h e

    Consultant's field of

    workin g

    4 Experience as practising

    Consultant/ Designer in

    number of years.

    Enclose copies of relevant

    supporting documents.

    5 Important large projects Details to be furnished in the prescribed proforma

    executed during last 5 (Statement II)

    years by the firm together

    with approximate cost of

    individual project. The full

    address of the clients for

    whom the works have been

    executed with telephone

    Nos.

  • 10 | P a g e

    6 Important large projects on

    which the firm is engaged at

    present and their estimated

    cost (stages of work viz.

    Planning and Construction).

    The full address of the

    clients shall be indicated

    against each project.

    Details to be furnished in the prescribed proforma

    (Statement III)

    7 Important large projects, if

    any, completed by the

    partners prior to joining the

    firm (these projects not to be

    included under 5 and 6 above,

    but shall be shown separately)

    Attach a separate sheet

    8 Name and address of the

    banker/s of the firm

    9 Turnover of the firm during

    last 3 years (year wise)

    2014-15 Rs.

    2015-16 Rs.

    2016-17 Rs.

    10 Permanent Account

    Number(PAN) of the

    consultant/firm

    11 Details of Registrations

    (i) GST

    (ii) ESIC

    (iii) EPFO

    Enclose copies of relevant

    documents

    12 Whether the fees as decided

    by the bank, in case of L-1

    agency will be acceptable or

    not?

    13 List of meritorious awards, if

    any

    Note : The jobs undertaken by the firm will be inspected and clients will be

    approached by the bank for their report and this will be taken into

    consideration while selecting the panel.

    Signature of the Applicant

    Full address & office seal

  • 11 | P a g e

    STATEMENT – I

    List of Technical Personnel, giving their Technical Qualifications, Experience,

    including that in the present Organisation.

    The statement should also show the

    Administrative

    Organisation.

    Staff available in the

    Sr. No .

    Name Age Qualificati on

    Consultancy experience

    Nature of works

    handle d

    Name of the project s handl ed

    Date from which employed in the present organisation.

    Indicate special experience , if any.

    1 2 3 4 5 6 7 8 9

    Signature of the Applicant

    Mention other points, if any, to show technical and managerial

    competency to indicate any important point in your favour.

  • 12 | P a g e

    STATEMENT- II

    List of Important Projects Executed by the Organisation

    during last Five years.

    Note : Separate sheet to be furnished for different projects viz. (a) office buildings (b)

    residential buildings and (c) commercial buildings like hospital, factory, cinema etc.

    Sr. No.

    Name of the project

    and location

    Nature of work

    involved in the contract

    (e.g. residential, offices etc.)

    Name of the owner. Also indicate

    whether

    Government/ Semi

    Government/

    Government of

    India Undertaking or Private Body

    with full address

    Project cost in

    lakhs of Rs.

    Completion period Any other relevant

    information

    Stipulated Actual

    1 2 3 4 5 6 7 8

    Signature of the Applicant

  • 13 | P a g e

    STATEMENT-III

    List of Important Projects ON HAND being executed by the Organisation

    Note : Separate sheet to be furnished for different projects viz. (a) office buildings

    (b) residential buildings and (c) commercial buildings like hospital, factory, cinema,

    theatre etc Sr. Name of Nature of Name of the Project Completion period Present Any other

    No. the project the work owner. Also cost in stage of relevant and involved in indicate lakhs work with information location the whether of Rs. reasons if

    contract Government/ the work

    (e.g. Semi is getting

    residential, Government/ delayed.

    offices Government

    etc.) of India

    Undertaking

    or Private

    Body with full

    address

    Stipulated Expected

    1 2 3 4 5 6 7 8 9

    Signature of the Applicant

  • 14 | P a g e

    ANNEXURE-IV

    Details of Bank Account

    Name of Firm

    Name of Account Holder

    Address of firm

    Name of Bank Branch and

    Address

    Bank Code & Branch

    Code

    IFSC Code of Bank

    Branch

    Type of Account (Saving /

    Current / Cash Credit)

    Account Number

    PAN of firm

    GSTIN of the firm

    (A COPY OF CANCELLED CHEQUE UNDER WHICH ACCOUNT OF THE VENDOR IS

    OPERATED MUST BE ENCLOSED)

  • 15 | P a g e

    ANNEXURE-V

    To be submitted on Consultants own Letter head

    No. ……………..

    Date : ……………..

    Chief General Manager

    NABARD Head Office,

    DPSP, Ground Floor A-wing,

    Plot No. C-24, G-block, BKC,

    Bandra(East), Mumbai – 400 051

    Dear Sir,

    Empanelment of Consultants/Architects for various projects likely to be taken up in NABARD

    office premises and staff quarters in Mumbai – “ ”(write

    name of the trades & code number under which the applicant wants to be empaneled)

    1. With reference to your advertisement in the Newspaper on 201__ for the

    Empanelment of Consultants, I am / We are pleased to offer myself / ourselves to

    be empaneled under “ ” (write name of

    the trade(s) under which the applicant wants to be empaneled) trade, Category , in

    your organization.

    2. I am / We are already registered with “ .....................................................” (write

    the name of Govt./ Semi Govt./ Govt. Undertakings/Autonomous

    bodies/Reputed corporate sector Institutions with which the Applicant is

    registered) under class/category .............and the maximum financial limit

    under the said class/category is Rs. ……................ . I am / We are enclosing a

    copy of the certificate to this effect issued by them. All the other desired

    information, documents and certificates as required by you, are enclosed

    herewith in the prescribed proforma for your perusal.

    3. 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 NABARD, Head Office, Mumbai on the basis of the

    information given by me/us will be treated as invalid.

    4. I/We agree that the decision of NABARD, Head Office, Mumbai in selection of the Consultants will be final and binding on me/us.

    5. All the information furnished under Statements I, II & III is correct to the best of my/our knowledge.

    6. I/We also agree that I/We have no objection if enquiries are made about the works listed by me/us in the accompanying sheets or any other inquiry on the

    information furnished herewith in the accompanying sheets.

    7. I / We, therefore, request you to kindly do the needful to empanel me / us under “ ” (write name of the trade/s under which the applicant

    wants to be empaneled) trade/s / category .

    Yours faithfully

    (Signature of Authorized person on behalf

    of the Firm / Agency / Contractor)


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