ࡱ> RTMNOPQf bjbj ׈D____ ]O&^&&&&'''\\\\\\\$^`a:\,'',,\&&\E5E5E5,&&\E5,\E5E5_Xx[&v_2YR\\0 ])Za4:aH[[JaG\D',(E5)R*'''\\ 5:''' ],,,,a''''''''' : 9 EMBED MSDraw \* MERGEFORMAT GOA SHIPYARD LTD  COMMERCIAL DEPARTMENT FORMS & FORMATS 7.4.1 VENDOR REGISTER QUESTIONNAIRE Doc. No. : 06/QSF/13P Section : 19 Sheet No. : 1 of 5 Issue 01 Rev. No. 00 Effective Date 10/05/2003  GOA SHIPYARD LIMITED VASCO-DA-GAMA (GOA ) INDIA VENDOR REGISTRATION QUESTIONNAIRE 1. Name of the Firm/Company: 2. Nature of Business whether Manufacturer/ Service Sub-Contractor/Authorized Agent/Trader : 3. Items of Manufacture/Agency/Service for which registration sought : 4. (a) Factory Postal Address/Phone No./Telex No : (b) Registered Office Postal Address/Phone No. Telex No. /Fax No.: (c) Sales Office Address/Phone No./Telex/Fax No.: (d) Correspondence address/Phone No. for this registration : 5. Whether Public Limited/Private Limited/ Partnership/or Proprietary concern: 6. Name of Directors/Partners/Proprietor: 7. Name and Postal address and Telephone No. of firms in which any of your Proprietor/Partner/ Directors are associated : 8. Whether your firm is Registered under (a) Small Scale Industries/NSIC/DGTD, Give details such as Regn. No., Date etc with Photostat copy : (b) Partnership, state whether Regd. under Indian Partnership act 1932 (with Photostat copy) : (c) Indian Factories Act, Please give details : (d) With any Govt. Undertaking/dept. If so attach Photostat copy of registration : 9. (a) Factory License No./Shop Establishment Act Certificate/Registrar of firms certificate/Register of Company Incorporation Certificate (with Photostat copy) : (b) Registration Certificate from Labour Commissioner (in case of Labour jobs) : (c) For Drug. Mfgrs. only Drug Mfg. License with Photostat copy. Please state if you are a loan license : 10.(a) GST Regn. No. with Photostat copy :  Prepared by NR/ SH  Reviewed by MR  Approved by HOD (C) Date of issue 10/05/2003  .2/- -2- EMBED MSDraw \* MERGEFORMAT GOA SHIPYARD LTD  COMMERCIAL DEPARTMENT FORMS & FORMATS 7.4.1 VENDOR REGISTER QUESTIONNAIRE Doc. No. : 06/QSF/13P Section : 19 Sheet No. : 2 of 5 Issue 01 Rev. No. 00 Effective Date 10/05/2003  11. Attach Memorandum/Articles of Assn./ Partnership deed (Photostat copy)/Documentary evidence of Proprietorship: 12. (a) Attach last 3 years Annual Report : (b) Balance Sheet with P/L statement for last 3 years (Photostat copy) : 13. (a) Income Tax clearance Certificate or PAN Card No.: (a) Name of Bankers/Postal Address and Telephone No.: (b) Give details of Banks Credit facilities, solvency available to you. (Attach letter from Bankers) : (c) Give details of Bank Guarantee available to you : 14. Paid Up/Invested Capital : 15. Approx. Annual Turnover in last three years (each year to be shown separately) : 16. Names and Address of associated sister Mfg/ Sub-contracting/trading concern : 17. Name and Address of your Authorized Distributors/dealers and their Phone Nos.: 18. (a) If an authorized Dealers/Stockiest/Sole Selling Agent/Item under authorized agency (Attach Photostat copy of Authorized Agency/Agreement: (b) Address and Telephone No. of Godown: 19. Date of commencement of Business: 20. (a) Major orders executed for Govt./Semi. Govt. Dept. Public Sector undertaking Attach details of Order No., Date, Value etc. attached Xerox copies of five recent major orders): (b) Attach performance report from at least three of your major customers : Number of employees in your firm Qualified Skilled Semi Unskilled Engineers Skilled Total (a) Permanent (b) Temporary _____________________________________________________________ TOTAL: - - - - _____________________________________________________________ (c) Attach category wise list of Skilled/Semi skilled labour : (d) Whether your employees are covered under ESI, If so attach last years ESI contribution clearance certificate :  Prepared by NR/ SH  Reviewed by MR  Approved by HOD (C) Date of issue 10/05/2003  3/- -3- EMBED MSDraw \* MERGEFORMAT GOA SHIPYARD LTD  COMMERCIAL DEPARTMENT FORMS & FORMATS 7.4.1 VENDOR REGISTER QUESTIONNAIRE Doc. No. : 06/QSF/13P Section : 19 Sheet No. : 3 of 5 Issue 01 Rev. No. 00 Effective Date 10/05/2003  (e) Whether your employees are covered under PF Act. If so, give the PF Code No./Attach latest PF Contribution : (f) Weekly off:- Factory ________________________ Office _______________ 22. (a) Plant area of your firm Covered-Uncovered-TOTAL (b) Attach list of machinery & equipment installed (area in sq. mtrs.) giving size & type of M/C.S manufactured & year of manufacture : (c) i) Attach list of equipments owned by you giving capacity make & year of manufacture : ii) Address & Telephone No. of Repairs & Maint. Workshop & list of machinery/equipment/tools (in case of hiring jobs) : (d) Attach list of Quality Control & Inspection eqpt. & other standard measuring instruments : (e) Indicate quality assurance/quality control system presently adopted by your organization for guarantee quality product : 23.(a) Do you have a Laboratory for Metallurgical/Physical/ Chemicals Testing? : (b) Do you avail yourself of testing facilities outside your organization ? If so, please indicate the Name & address of Testing Agency: 24.(a) Do you as a regular practice subject your raw material to Chemical/Metallurgical & other tests before issuing them for production ? : OR Do you depend wholly on suppliers certificate/ guarantee? : 25. Do you employ statistical method for Quality Control?: 26. Do you conduct 100% inspection of all products prior to despatch ? : OR Do you conduct only percentage/random inspection 27. Give a brief write-up of the Inspection and Quality Control Procedures followed by you : 28. Give a brief write-up of the Inspection and Quality Control procedures followed by you : 29. No. of shifts working per day:  Prepared by NR/ SH  Reviewed by MR  Approved by HOD (C) Date of issue 10/05/2003  4/- -4- EMBED MSDraw \* MERGEFORMAT GOA SHIPYARD LTDCOMMERCIAL DEPARTMENT FORMS & FORMATS 7.4.1 VENDOR REGISTER QUESTIONNAIREDoc. No. : 06/QSF/13P Section : 19 Sheet No. : 4 of 5 Issue 01 Rev. No. 00 Effective Date 10/05/2003  30. Name & designation of officials who will directly negotiate or transact business with us: 31. Does your firm have any expansion programme? If any please give details: 32. Attach details of product/services (Technical Leaflets/Literature/Price list) : 33. Transport facility for delivery & collection of goods to and from our yard : 34. (a) Name & Postal Address/Telex No. of the foreign collaborators, if any: (b) Attach copy of foreign collaboration agreement: (c) Name & Postal address of foreign principals for Agency, if any: 35. If importers of Raw materials/product, give details of Import license, name of supplier : 36. If stockiest, minimum stock held for each item [in Qty. & Value] : 37. Whether your products are on rate contract with DGSD, if so please furnish copy of the contract: 38. Whether your products confirm to BS/DIN : 39. Are you in a position to supply items duly approved and Lloyds/ABS/IRS/DNV/MMD/EIL etc : 40. Any other details which you, wish to mention for judging your firms standing in the market : DECLARATION BY THE APPLICANT FIRM I/we hereby declare that the information furnished above is correct and true to the best of my/our knowledge and belief. I/We confirm that our Proprietor/Partner/directors are not associated with any firm with which the business has been banned by the Central/State Govt. Dept/Public Sector Undertaking (Central State Govt.) Signature : NAME (in Block Letter) Designation Seal of CompanyPrepared by NR/ SH Reviewed by MR Approved by HOD (C) Date of issue 10/05/2003  .5/- -5- EMBED MSDraw \* MERGEFORMAT 00000 GOA SHIPYARD LTD  COMMERCIAL DEPARTMENT FORMS & FORMATS 7.4.1 VENDOR REGISTER QUESTIONNAIRE Doc. No. : 06/QSF/13P Section : 19 Sheet No. : 5 of 5 Issue 01 Rev. No. 00 Effective Date 10/05/2003  Place : Date : NOTES: (a) Complete & definite answers must be given in the space provided. In case if it not sufficient, extra sheet may be attached as enclosure. (b) The registration questionnaire duly filled complete in all respects (in a file) should be addressed to for evaluation and consideration. (c) A/c Payee DD/Pay order for Rs. 1000/- +18% GST (Non-refundable) in favour of Goa Shipyard Ltd., Goa as processing fee should accompany along with the Registration Form (in case if not paid already) (d) Kindly contact Commercial Dept. for clarification of any queries/doubts. _____________________________________________________________________________ ( FOR OFFICE USE) Ref. No. : 06/ /V. R./Assessment Date Revised: NIL Revision No. Date of Issue : AUTHORISED SIGNATORY  Prepared by NR/ SH  Reviewed by MR  Approved by HOD (C) Date of issue 10/05/2003  6/- -6- ANNEXUREA DOCUMENTS TO BE ATTACHED WITH VENDOR REGISTRATION QUESTIONNAIRE (Each and every document shall be self attested) 1. a) Details of Products/Service/technical Leaflet/Catalogue (2 copies). Please indicate the category of equipment/items.(Company Profile) b) Please Tick the items for which you want to be registered in the category of equipment/items. However, please note that you have to provide technical catalogues/Purchase orders with Proof of execution for all the items ticked by you. 2. Photo copy of ISO Certification/Zero Effect Zero Defect (ZED) Certification (if applicable). 3. Registration certificate under NSIC/UAM. (To register under UAM, visit www.udyogaadhar.gov.in). 4. Copy of registrar of companys certificate/Factory License/ Municipal Shops/ Establishment Certificate. 5. Registration certificate with govt. undertaking/PSU/DGQA/DPSU/Central Govt/ Any major Industries. 6. GST Registration Details 7. Copy of PAN card and copies of I.T. return paid for last 3 years. 8. Annual report for last 3 year with dully audited Balance sheet together with profit & loss account. (Auditors stamp should be there on the documents) 9. Original Bank Solvency Certificate. 10. a) Copies of Major orders executed for govt./PSU/ defense PSU/ other private organization along with proof of execution. At least one PO and DC for each item / equipment for which registration is being sought. b) Submit a copy of the third party inspection certificate (IRS/ABS/LRS/BV/DNV/DQAN or any other Inspection Agency) for the items to be registered by you. 11. Evidence of QM System/QC Practice/QA System in vogue (Including typical QAP of the firm) and QA/QC/NDE facilities. 12. Evidence of manufacturing methodology used for your products / Infrastructure and standards & modalities used for environmentally suitable packing. 13. Photo copies of products Test and Inspection certificates for last executed order. 14. Import license (if importer)/ Import Export Certificate. 15. Evidence of stock maintained for your products in Qty. and Value. 16. Evidence of your products confirm to BS/DIN/ASTM/ISS Standards. 17. ISI license (if ISI marking). 18. Evidence of your products approved by Lloyds/ABS/IRS/DNV/MMD/EIL etc. 19. Lead time (delivery) for manufacturing and supply of typical product (Inclusive of drawing support, initial Correspondence etc.) and the time required to depute your Service Engineer (no. of days) 20. Authorization Certificate/ Dealership Certificate from OEM (if applicable). 21. A/c Payee DD/Pay order for Rs. 1000/- (Non-refundable) + 18% GST in favour of Goa Shipyard Ltd., Goa as processing fee should accompany along with the Registration Form. 22. Documentary evidence for MSE owned by Women entrepreneur. 23. In case of SC/ST vendor, Caste Certificate issued by Competent Authority. 24. In case of Start-Ups, Intellectual Property Rights for Product / Process & registration certificate issued by DIPP. NOTE: i. Please tick the documents enclosed and if not enclosed, give reason. ii. Please submit documents that have current validity. Documents without validity will not be accepted. iii. Please submit the VR Form with all the documents in a file with proper tags having above sr. nos. for proper handling:i.e. the document submitted against sr.no.1 should be tagged as 1 and document submitted against sr.no.2 as 2 and so on for all the other documents. iv. The list of items/equipment for which your firm wants to be registered with required details in the following format to be submitted. Refer the following two examples in our format Sr. No.DescriptionCategory in our vendor list (refer the list attached with the vendor form)Copy of Purchase order (a)Delivery challan of the corresponding order duly signed by customer for receipt/ Proof of execution of order (b)Third Party Inspection Certificate (c)1Air Compressor* E-4PO. no. 12345 dtd. 17/02/12 O93 dt. 25/06/12IRS certificate no. KDHJI dt.01/02/13 2Mattresses* C-65PO. no. 97786 dtd. 09/09/13 262 dt. 17/10/13No Inspection  *Note: The letter E & C in the third column stand for Engineering & Capital Sections respectively. In E-4, the no. 4 represents the sr. no. of Air Compressor in Engineering Section In C-65, the no. 65 represents the sr. no. of Mattresses in Capital Section Similarly fill up the above columns with the items/eqpt your firm wants to be registered and forward documentary proof against (a), (b) & (c) in above table. Please note that for each and every item you want to register in GSL, you have to forward the Purchase Order copies alongwith the proof of execution and the corresponding Third Party Inspection Certificates against each Order. Make a note of the same and also forward a soft copy of the above duly filled format  Request forward documents having validity. BANK SOLVENY CERTIFICATE BANK. HO. BRANCH. Date:. The General Manager (Commercial) Goa Shipyard Ltd, Vasco-Da-Gama GOA Sub.: Capability Solvency Certificate in respect of M/s... This is to certify that in our opinion and to the best of our knowledge and information available on the records of Bank as on M/s a firm / Private Ltd. Co. carrying on business at .................................................. with Shri......as a proprietor / Partners / Directors is capable of undertaking business/ contract works to the extent of Rs. (Rupees only) This certificate is issued without any guarantee of responsibility or commitment on the part of the bank or any of its Officers / employees. For ..Branch. MANAGER / SENIOR MANAGER FINANCIAL INFORMATION FOR THE PREVIOUS FOUR YEARS Sl. No.ParticularsYear 1Year 2Year 3Year 4Years in ascending order, Money Value in Million / Lakhs1NET WORTH (Share Capital +Reserves) 2Growth over previous year (%) 3Current assets (a) Current investments (b) Inventories (c) Trade receivables (d) Cash and cash equivalents (e) Short-term loans and advances (f) Other current assets 4Current liabilities (a) Short-term borrowings (b) Trade payables (c) Other current liabilities (d) Short-term provisions 5Net Working Capital (3-4)6Sales Revenue from operations7Net Profit (Profit After Tax)8Profitability Ratio (Net Profit/Net Worth) NOTE: 1. Copies of Annual reports/ annual accounts (Audited Balance Sheet and Statement of Profit and Loss Accounts) for the last three years (or from date of incorporation whichever is less) along with audit report are to be submitted. 2. The above details shall be highlighted in the Balance Sheet and Statement of Profit and Loss A/c. Place: Date: SUPPLIERS AUTHORISED SIGNATORY LIST OF CATEGORIES OF EQUIPMENTS / ITEMS Tick the items for which registration is sought HULL SECTIONSr. No.Item Description1A bracket/ P bracket2AC ventilation and Refrigeration system3Adhesive Material Adhesive for MFMB/MFRB4Air Whistle5Aluminium Brow6Aluminium plates, perforated sheets, chequered plates, rods, sections, profiles7Anchor chains and accessories8Anchor Windlass9Anchor and Forging A) Cast anchors B) forged anchors C) General forging10Anodes: Sacrificial Inc/Aluminium anodes11B0, B15 and B-30 class panels12BI Metallic strip13Boats A) Life Boat, Rescue Boat, Survey Motor Boat, Work Boat & RIB B) Inflatable Gemini14Bollards15Breathing Apparatus16Bunks (M.S. & Aluminium)17Bunks(Wooden)18C.P.Towel Rail19Canvas FR Naval Pattern20Canvas PVC21Capstan22Carpet & Curtain Material23Cast Iron Blocks24Castings:Cast/Iron/Cast Steel/SS/Special Steel25Cement26Chains27Clocks28Coir Foot Mat29Compartment Furnishing & Fitting Items A)Coat Hooks,Cromium Plated /Brass/Brass Cromium Plated B)Kitchen Items And Utensils C)Sanitary Fittings D)FRP Shower Tray '(Sanitary Fittings) 30Cranes: a)Deck crane & other special purpose crane for ships B) Pollution control31Curtains - Fire Retardant Type32Damage Control Items & Safety Equipment33Davits : All Types Of Boat Davit ,A) Ammunition davits, torpedo recovery davits B)Radial davits34Deck Covering Material Syncolite Terracrate & Resin Matrix35Diving Equipment36Doors a) Fire class B)Water tight & weather tight/ steel & aluminium C)Hydraulic sliding doors D)Wooden doors37Drain Plugs38Fairleads(Cast Steel)39Fin Stabliliser Eqpt. & Component40Food Lift System41Fueling/Replenishment At Sea(Items)42Furniture a)M.S. furniture B) Aluminum furniture C)Medical furnitures/ equipment43Hardwares & MISC.FTGS.Mild Steel'& Stainless Steel & Brass44Hatches45Heli hanger door46Heli Landing Grid47Heli Lashing Gear48Helicopter hanger hoist49Insulation material A) Glass wool/Mineral wool/rock wool B) Fibreglass tape & cloth50Interior decorators51Jack staff and engine staff52Kit Lockers53Ladders A) Accomdation B) Fabricated/ordinary -sloping/vertical/gangway ladder C)Pilot/jumping/ embarkation D)Stables and painter stage54Laminated Sheets Decorative(M.P.L)55Life Rafts56Life Saving Appliances-Lifebouys,Life Jackets,Line Throwing Appliances57Linolium Rolls58Manholes 59Marine Clock60Mast & Boom61Mattresses a)Fire retardant B)Non fire retardant type62A)Name Plate B) Name Board63National Emblem64Navigational AIDS65Outboard Motors66Particle Board67Pipes A)Seamless(M.S.,CAST STEEL) ETC / ASTM A106 (B)/ASTM A53,A68 B)ERW C)Stainless Steel & Other Special Alloy Steel68Plywood A)Ordinary And Marine Type B)plywood fire retardant C)teak/venear faced plywood ' (one side or both sides) 69Reels For Wirerope (Nylon/Polypropyllene Rope Geared) 70A)Rigging & Towing Ftgs 71Rivets A)S.S Pop B)AL AND M.S Rivets72Ropes A)Nylon And Polypropelene B)Wire Rope C)Sisal Rope/Manila Rope D)PVC Coated73Rubber Fenders A)Solid Rubber Fender B) Pneumatic Type C)Rubber Mats/Non Skid D)Neoprene Rubber Sheets & Packing74Rudder & Rudder Stock75Scrim Cloth76Scuttle77Ship's Bell & Duty Bell78Ship's Model79Stanchions Guard Rail & Awnings80Steel-A)PLATES B) S.S Plates & Sheets And Special Alloys Steel C) MS Angles,Channels And Bars, Bars(Rounds) Tor Bars 'T' Bars,Square Bars D)Angles,Bars(Rounds) Profiles, B.P/H.P ETC.Lrs Grade,'A'/'B'(Imported) ABS GRADE'A'/'B' ETC E)M.S Slotted Angles And Panels81Talley Plates82Tanks(Loose)83Tiles A) Ceramic B) Marblex/PVC84Towing Hooks85B) Tent86Ventilation Sytem Motors And Other Equpt87Vinyl Flooring88Weighing Machine89Winches-Hydrographic, Oceanographic/Specialpurpose Winches--Oceanographic/ Portable, Oceanographic/Special,Winches''-Hydrograpihic90Windows A)AO & A60 Class Window B)Steel & Aluminium91Wood A)Fire Retardant B)Non Fire Retardant Teak,Pine, SAL,FUR,MATTI,JUNGLE WOOD92Wooden Boxes (Battery Box & Box For OBS Etc)93Wooden Furnitures94Russian Supplied Defence Eqpt Spares & Material95Rigid Expandable PVC Slabs96Sunlite Polycarbonate Sheets97Air Conditioning And Refrigeration Plants For Tugs98Material Handling & lifting Equipment(Hoists, Lifting clamps, D Shackle, Chain Pulley Blocks, etc.99CRCA Sheets, TMT Bars100Nickel Alloys in forms of pipes, plates, bars & fittings101Authorised Service Provider102AC Ventilation Grill103A) Bullet Proof Jacket104Toughened Safety Glass/Laminated Safety Glass/Bullet Proof Glass105Gratings106surfing equipment, boards, rigs etc.107Stainless Steel/ Carbon Steel Seamless/ Welded Pipes,Tubes & U-Tubes , heat exchanger pipes & tubes108Modular Accomodation & Installation109Inflatable Survival Tents ENGG SECTIONSr. No.Item Description1Acrylic sheets2Adhesive material3Ador Oerlikon on make filler rod4Air compressor5Air receiver6Air whistle7Anti vibration mounts8AVCAT filter water absorber9AVCAT filter water separator10Bilge eductors11Bulkhead and deck pieces12Chockfast material13Composite/GM flanges14Compound/vaccum/pressure gauge/ measuring equipment15Copper seamless pipes16Cu-NI 90/100 and 70/30 seamless copper pipes & fittings17DG sets( main and emergency & harbour)18Diving H.P air compressor19Duplex filter20Engine marine21Ermeto fitting22Expansion bellows23Fabricated MS & HS hot dip galvanized fitting24Fi-Fi appliances25Flow meter26FO & LO transfer pump & centrifugal pump27Forging and casting28Fresh water generator/RO plant( imported)29Fresh water generator/RO plant( indigenous)30Gear box ( indigenous)31Harware items and fastners32HMT lathe machine, chucks, spares33Hydraulic equipments( jacks, hoses, seals etc)34Industrial heavy duty hoses35Internal fire fighting CO2 system36Marine incinerator37Marine toilet system38Mechanical sales & industrial heavy duty hoses39Neoprene/CAF rubber gaskets & gland packings40Non-ferrous rounds, bars, sheets etc41Oils and lubricants of various grades42Oily bilge water separator43Pipes and pipe fitting44Port submersible pump45Purifiers LO & FO46Remote control system47Sanitary fitting48Screw pumps/AVCAt pumps49Seamless/ERW steel pipes & fitting50Sewage treatment51Ship schandles52SR hand pumps53Stainless steel pipes & pipe fitting54Stearing gear55Stern gear system56Talley plates57Tank content gauges58Taks-loose & hydrophore59Thordon/rubber/copper/ GM bearing60Vaccum toilet system( marine)61Valves( butterfly and vent valves)62Valves( shipside & system)63Wire hose reels for AVCAT64Workshop equipment/ inventory65Fuel/ Air/Hydraulic Filters66Level Guages67Sight flow indicator / sight glasses68Plastic end caps for pipes 69Heat exchangers70Coolers71Authorised service provider72Stainless Steel/ Carbon Steel Seamless/ Welded Pipes,Tubes & U-Tubes , heat exchanger pipes & tubes73Stainless Steel Valves74Couplings75Water lubricated Bearings ELECTRICAL SECTIONSr. No.Item Description1Alarm panel, Refrigerator chamber, poratable tank2Anemometer3Auto Telephone exchange and Telephone4Auto transformer Starter5Automatic direction finder6Batteries( Lead Acid)7Battery Charger8Bell buzzer & hooter9Cabin fan/ Wall mounting fan10Cable lugs, terminals, ferrules11Cable trays, hangers & glands, flat bar & earthing strips12Ceremonial light fitting13Change over switch14Commercial switch, sockets etc15Domestic switch, socket etc16Data communication set17Distribution Board18Dish Antenna19Electrical calorifier and galley eqpt20Electrical motors21Electrical cables( Marine quality)22Electrical clinical equipment23Electrical tools& inventories ( traders)24EPIRB & SART25External communication equipment(HF/MF)26Fire and smoke detection system27Filter & suppressor box/capacitors28Float cum battery charger29Float switches30Food waste disposal unit31Frequency converter32Gyro stabilized horizontal roll bar system33HF SSB transreceiver34Ice cream machine35Impressed current cathodic protector36Inclinometer( navigational AIDS)37Intercom system, MB & SRE eqpt38Interlocked switch socket, plug & sockets39Junction box40Laundry eqpt41Level switch42Life boat radio set43Light fitting & accessories44Magnetic compass45Main switch board46MCP/bridge control console/ control panel47Mechanical engine order telegraph48Mixing and mincing machine49Motor control centres50Navigational lights51Navigational aids52Navigational light panel53Navigational radar54Operation theatre light55Passive night vision binoculars56Pedestal fans57Portable vibration analyzer58Potato peeling machine59Projection eqpt60PVC sleeves, cable ties etc61Rig typeA62Rotating light63RPB eqpt64Rubber mats, anti skid65Shaft RPM indicators66Shock & vibration mountings67Shore connection box68Signaling lantern69Signaling projector10/570Solar battery charger71Spares for A/C units72Star delta starters & DOL starter73Start/Stop push button unit74Talley plates75Test equipment( electronic)76Transformer Rectifier unit & battery charger77Transformer78T.V, V.C.P/V.C.R & music system79V/UHF set80Vertical/horizontal singler pulley81Walkie talkie set82Water cooler/refrigerator/ bottle cooler/deep freezer83Window wiper84CCTV accessories85Service for navigation & communication set86Emergency Switch Board87Optical transmission & Networking Products for Ship Sata Network88Authorised Service Provider IMP/AMC/ARC SECTIONSr. No.Item DescriptionVIRepairs and Annual Maintenance Contract Section IMPORTS1Consolidation Agents for Imported goods2Custom Clearing Agents, Goa3Custom clearing Agents, MumbaiANNUAL MAINTAINANCE CONTRACT1AMC for A/Cs2AMC for canon Xerox machine3AMC for dumb waiters, freight elevator4AMC for micro deil VAX-3400 & VAX-4300 system5AMC for modi Xerox machine6AMC for network microtronic typewriter7AMC for PCs printers8AMC for scribers 9Ammonia printing machine10EOT Cranes11AMC for typewriters12AMC for weighing machineREPAIRS1ARC for telephone2Calibration of electronic eqpt3Repair of digital temp censor4Repair of probe micro processor5Repair of water cooler6Repair of wolf, ralli, bosch grinder drilling machine7Repair/rewinding of motor8Repair of ACs GOA SHIPYARD LIMITED (OUTSOURCING CELL) SERVICE PROVIDER REGISTRATION FORMAT (To be submitted by Service Provider) (THIS INFORMATION WILL BE TREATED AS CONFIDENTIAL) PART -I GENERAL INFORMATION 1.NAME OF THE SERVICE PROVIDER 2.ADDRESSES WITH PIN CODE NO, PHONE NO. RESIDENCE PHONE NO, FAX NO. AND MOBILE NOS. E-MAIL, ETC. (a) REGISTERED OFFICE / HEAD OFFICE (b) ADDRESS OF THE FACTORY: (c) ADDRESS OF THE LOCAL BRANCH, IF ANY.3.DATE OF INCORPORATION: (Certificates from Registrar / Labor Commissioner etc to be enclosed).4.NATURE OF COMPANY: PROPRIETARY PRIVATE LIMITED P.S.U. PUBLIC LIMITED OR EX-SERVICEMAN UNIT. PARTNERSHIP. NOTE: (i) Attach memorandum / Articles of Association / partnership deed /Documentary evidence of proprietary ship and their registration. (ii) Give name , residential address with telephone of proprietor for (a) (iii) Give name designation, residential address of chief executive or Managing Director and directors for (b), (c) (iv) Addresses, name, telephone no with partnership deeds (if partnership firm) of partners in extra sheets as Annexure. 5.HAVE YOU GOT ISO 9000 CERTIFICATE (If yes, please give details, standard no. and the agency which has certified of company). 6.WHETHER REGISTERED WITH ANY GOVT. UNDERTAKINGS / PSU / DEPATMENTS AS A VENDOR. (If yes give details ) 7.IS THE ABOVE SAID FACTORY: SELF OWNED. PARTNERSHIP. RENTAL. NOTE: Attach proof of ownership and details site plan of layout of Premises clearly depicting various areas e.g. production area, Stores, bond rooms, inspection area etc. In case factory premises are rented / leased attach lease deed and recent rent receipt ( within 3 months ) and old one (one year or more ) and give details of the owner (name , address , telephone / telex / Fax No. )8.IS YOUR COMPANY / FIRM REGISTERED UNDER INDIAN PARTNERSHIP ACT 1932. UNDER INDIAN COMPANIES ACT 1956. WITH SSI / NSIC / DEPT OF INDUSTRIES (ST GOVT.). GIVE DETAILS WITH DOCUMENTARY EVIDENCE. 9.ARE YOU AUTHORISED TO QUOTE ON BEHALF OF OTHER FIRM OR COMPANY TO GOVT. INSTITUTIONS / DEPT. / PSUs, ETC.? IF SO, GIVE DETAILS 10.INDICATE CATEGORY FOR WHICH ENLISTMENT IS SOUGHT FOR :  Sl No. Jobs to be outsourced by GSL YES/NO MAX. AVG. MONTHLY CAPACITY(*) a) Hull blocks (steel) fabrication, assembly & erection b) Aluminum fabrication , assembly & erection c) Miscellaneous outfit jobs like fitment andwelding of water tight, weather tight doors etc. d) Rigging work for various systems(Awning arrangement, Towing and Mooring arrangement etc.) e) Insulation of compartments(MFMB,MFRB & A60) f) Paneling & furnishing of compartments, interior decoration. g) Installation & trials of ships main/ auxiliary machinery. h) Installation of shafts, propellers and stern gear, steering gear etc. i) Power cabling, installation of cable glands, tubes, cable trays ,hangers conduits with accessories and related hot work ,installation, termination and trials of Electrical equipment j) Signal cabling, installation of cable glands, tubes, cable trays, hangers, conduits with accessories and related hotwork, Installation, termination and trials of Electronic equipment k) Fabrication, installation, pressure testing and trials of ship- installed piping systems.(ferrous and non-ferrous) l) Machinery painting & compartment painting for ship m) Stitching of canvas awning, equipment covers, upholstery & curtains n) Hiring of crane services o) Supply of fresh water through water barge p) Supply of manpower, (like structural fabricators, welders, painters, cutters, helpers, material handlers, grinders, electricians and supervisor) q) Noise measurement and Vibration measurement & analysis of compartments r) Machining work (gear box, rudder plate) s) Providing certified manning services during sea trials t) Load testing of various deck fittings (Towing and mooring fittings, Mooring capstan etc.) u) Dielectric shielding of ICCP anodes and reference electrodes v) Painting of helo shutter door and ship funnel with Ship emblem and stickers for Boats  (*) TO BE INDICATED IN TERMS OF TONNES / SQ MTRS / MTRS ETC PER MONTH AS THE CASE MAY BE. PART II TECHNICAL INFORMATION 1.DURATION FOR WHICH YOUR FIRM / COMPANY IS IN OPERATION / PRODUCTION.2.NO. OF PERSONS EMPLOYED :HUMAN RESOURCETEMPORARY PERMENANTTOTALUNSKILLED WORKERSFITTER (STRUCTURAL)FITTER (MACHINERY)FITTER (ELECTRICAL)FITTER(PIPING)WELDERS(PL. INDICATE NO OF CLASS APPROVED WELDERS) PAINTERS OTHERS (SPECIFY)SUPERVISORS ENGINEERS3.a) WHETHER YOUR EMPLOYEES ARE COVERED UNDER ESI ACT OR ANY OTHER MEDICAL SCHEME? IF SO, ATTACH XEROX COPY OF ESI REGISTRATION / LATEST PAYMENT CLEARANCE CERTIFICATE. b) WHETHER YOUR EMPLOYEES ARE COVERED UNDER EPF ACT 1952. IF SO, ATTACH XEROX COPY OF P.F. REGISTRATION NO. ALLOTED TO YOUR FIRM / COMPANY AND LATEST P.F. CONTRIBUTION STATEMENT. 4.BUILT UP AREA: SQ. MTRS.UNCOVERED AREA SQ-MTRS.TOTAL AREA SQ-MTRS.OFFICE / SHOPFACTORYR & D LABS / TESTING AREA WAREHOUSETOTAL5.a) ATTACH LIST OF MACHINERIES INSTALLED (IMMOVABLE) GIVING YEAR OF MFG. / SIZE / CAPACITY / HP / KW ETC. b) ATTACH LIST OF MOVABLE / PORTABLE MACHINERIES OWNED c) ATTACH LIST OF QUALITY CONTROL / INSPECTION EQUIPMENT OTHER THAN STANDERED MEASURING INSTRUMENTS (GIVE COMPLETE DETAILS). 6.GIVE A BRIEF WRITE UP ON INSPECTION / QUALITY CONTROL PROCEDURES ADOPTED. 7.GIVE NAME / DESIGNATION OF OFFICIALS WHO WILL DEAL / INTERACT WITH GSL OFFICIALS FOR EXECUTION OF JOB. 8.ARE YOU IN POSITION TO PROVIDE SERVICES WITH APPROVAL OF WOT / LLOYDS / IRS / ABS / DNV / MMD / EIL OR ANY THIRD OARTY INSPECTION AGENCY NOMINATED? 9.DO YOU PROVIDE AFTER SALES SERVICES? IF SO, GIVE DETAILS. 10.ELECTRIC POWER . SANCTIONED. INSTALLED. STANDBY (if any) 11.PL GIVE DETAILS OF IMPORTANT FACILITIES & INFRASTRUCTURE AS PER FOLLOWING FORMAT FOR : (a) PRODUCTION : (Including Heat Treatment Dies, Jigs & Fixtures etcand also details on licensed capacity, installed capacity & licensed no and date ) (b)UNCONVENTIONAL, SPECIAL M/C (Like NC, EDM), CAD/CAM, ROBO ETC. (a) SL NO: (b) DESCRIPTION OF M/C & SPECN: (c) MAKE & QTY MODEL: (d) DATE OF PURCHASE: (e) APPROX COST: (f) PERCENTAGE DEPRICIATION PER YEAR: 12.a) DO YOU HAVE R & D FACILITY / TESTING LAB FOR METALLUGICAL / PHISICAL / CHEMICAL TESTING OF RAW MATERIALS? b) IF NO, GIVE ADDRESS / DETAILS OF OUTSIDE TESTING AGENCY WHERE RAW MATERIAL ARE TESTED. c) DO YOU HAVE LABORATORY AND DRAWING OFFICE FACILITY . PART III COMMERCIAL INFORMATION 1.a) NAME AND ADDERESS OF YOUR BANKERS b) GIVE DETAILS OF CREDIT / OVERDRAFT FACILITIES EXTENDED BY BANKERS. c) PROVIDE BANK SOLVANCY CERTIFICATE, SPECIFIYINFG THE LIMIT AND ADDRESSED TO GSL.2.PAID UP / INVESTED CAPITAL OF YOUR FIRM / COMPANY.3.GIVE DETAILS OF FIXED ASSESTS / CURRENT ASSESTS / LIABILITIES AS ON DATE / 31ST MARCH OF RELEVANT FINANCIAL YEAR.4.GIVE PRECEEDINGS THREE CONSECUTIVE YEARS ANNUAL REPORT / AUDITED & CERTIFIED BALANCE SHEET WITH LATEST AUDITED PROFIT & LOSS A/C.5.TURNOVER DURING PRECEDING THREE CONSECUTIVE ACCOUNTING YEARS.6.GIVE DETAILS OF: STATE SALES TAX REGISTRATION NO. CENTRAL SALES TAX CLEARENCE. EXCISE REISTRATION / SERVICE TAX NO. GSTIN NO.7.GIVE PRECEEDINGS THREE YEARS AUDITED DETAILS OF STATE SALES TAX CLEARENCE. CENTRAL SALES TAX CLEARENCE. EXISE DUTY CLEAARENCE.8.GIVE DETAILS OF PERMENENT INCOME TAX ACCOUNT NO. / CORPORATE TAX NO. ALLOTED TO YOU / YOUR FIRM.9.GIVE DETAILS OF LATEST INCOME TAX / CORPORATE TAX RETURNS FILED BY YOU AND CLEARENCE CERTIFICATE FOR LAST THREE YEARS.10.THE VALUE OF THE JOBS DONE IN THE LAST TWO YEARS / JOBS IN HAND TO BE FURNISHED IN THE FOLLOWING FORMAT SR NO. NAME OF JOB DATE OF COMMENCEMENT DATE OF COMPLETION CLIENT VALUE OF JOB 11.(a) PRESENT NET WORTH OF THE COMPANY. (b) FACILITY FOR WATER, FIRE FIGHTING, SECURITY AND MEDICAL. FACILITIES DECLARATION BY THE APPLICANT FIRM / COMPANY 1. I / WE hereby declare that the GENERAL / TECHNICAL / COMMERCIAL INFORMATIONS pertaining to my / our firm / Company is correct and true to the best of my / our knowledge and belief as on date. 2. I /WE further confirm that proprietor / partners / directors are not associated with any firm / company with which the dealings having been banned by the state / central Govt. Departments / public sectors undertakings (central / state). 3. I / WE understand that poor performance and non adherence to procedures / schedules will lead to cancellation / blacklisting of my / our firm / establishment from the approved list. 4. I / WE shall abstain from forming cartels. I / WE assure that I / WE will not abandon work. 5. I / WE will adhere to the safety regulations and Terms & Conditions of Goa Shipyard and directions of officer in charge for each and every work carried out by me / us for GSL. 6. I / WE understand that the contract value will be finalized based on tender enquiries / guidance rates wherever applicable. 7. I / WE agree for renewal of the enlistment period under the aforesaid conditions, if desired by the company. 8. I / WE confirm that I / WE have never been blacklisted by any firm / organization, including GSL. 9. I / WE also confirm that all documents furnished are valid as of date. Authorized Signatory: _______________________ Name (in capital letters) _____________________ Designation _______________________________ SEAL OF THE COMPANY PLACE: DATE : NOTES: (1) These reports shall be written in legible handwriting (without any overwriting) or neatly typed. Complete / definite answers are required to be furnished. If the space provided is not sufficient, additional sheets may be attached as enclosure. Service Provider Assessment Forms dully filled in and completed in all respect shall be put in a file along with a covering letter addressed to AGM (Outsourcing), Goa Shipyard Ltd, Vaddem, Vasco-da-Gama, Goa. Registration shall be at the discretion of Goa Shipyard Ltd. Incomplete forms are liable to be rejected. These forms are NOT TRANSFERABLE. In the event it transpired later that false declaration / invalid documents were furnished at the time of applying for registration, the registration of the firm is liable for cancellation without notice to the firm. 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