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STATEMENT NO.

III
DETAILS OF WORKS OF SIMILAR TYPE AND MAGNITUDE CARRIED OUT BY THE CONTRACTOR IN LAST THREE YEAR i.e. 2008-2009,2009-2010,2010-2011

NAME OF TENDER: Name and address of the Place and Agreement organization for whom the country No & Date work was done 3 4 5 Remarks Total Cost Tender Date of (Principle of work Cost completion features in done brief) 7 8 9 10

Sr No

Name of work

Date of Commenecent 6

STATEMENT NO. IV
STATEMENT SHOWING TECHNICAL PERSONNEL AVAILABLE WITH CONTRACTOR WHICH CAN BE SPRED EXCLUSIVELY FOR THIS WORK NAME OF TENDER: Whether working in field or in office Period for which Experience of the person is execution of Remarks working with the similar works tender 4 5 6

Sr No. 1

Name of person 2

Qualification 3

Note:This is only a standard form.Details are to be furnished in this format in the form of typeritten statement which shall be enclosed in envelop-I. duly signed

STATEMENT V

STATEMENT SHOWING WORK DONE IN ALL CLASSES OF CIVIL ENGINEERING CONSTRUCTION WORKS DURING LAST THREE YE i.e.2008-2009,2009-2010,2010-2011

Name of Contractor: Amount put to tender/ tendererd cost 3 Amount of work done during each of last three year 2008-09 6 2009-10 7 2010-11 8

Sr No.

Name of work

Agreement no 4

Date of commencement 5

Total am work still r to be exe next 18 9

Grand total

Outward No.and date of certficate issuing authority.

Executive Engineer

Remarks

10

STATEMENT NO. 1
Statement of List of Works in Hand and works Tendered for as on last date of submissionof this tender Name of Contractor: _______________________________________________________________

(A) Works in Hand


Sr No. Name of Agreeme Tendered Date of Stipulate Value of Value of Probable Remarks work nt No. Amount Commenc d date of work balance date of ement Completi already work to Completi on done executed on in next 12 months 2 3 4 5 6 7 8 9 10

(B) Works Tendered for


Sr No. Name of work Name Tendered and Amount address of Client Time Limit Probable other rele date vant when details if decision any is expected 6 7

STATEMENT NO. ll

Details of tools and plants and owned machinery immediately available with the tendere for this work. Name of Contractor: _______________________________________________________________ Sr No. Name of work 2 No. of Units 3 Kind and Capacity Age and Present Mark Condition Location 4 5 6 7 Remarks

10

STATEMENT NO. VI
STATEMENT SHOWING QUANTITIES OF WORKEXECUTED IN any one year DURING LAST THREE YEARS Name of Contractor: _______________________________________________________________

Sr No.

Name of work

Year

Agreement No. Exacavation (Cum)

1 1 2 3

3 2008-09 2009-10 2010-11

Quality of work performed BUSG BM Hot Mix Hot Laid Works like BM, OGC 6 7 8

Remarks indicate contract No. and name of work 10

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