GOVERNMENT OF INDIA

MINISTRY OF HOME AFFAIRS

HEADQUARTERS, KENDRIYA POLICE KALYAN BHANDAR
EAST BLOCK-7(LEVEL-II), SECTOR-1, R.K. PURAM, NEW DELHI-66

APPLICATION FORM FOR REGISTRATION WITH KPKB

Name of the Firm/Company :

with PAN & GSTIN
(Attach Copies)

Address :

a) Head Office with Mob. :

No. Fax No. & Email Id

b) Correspondence Address :
with Mob. No. Fax No. &
Email Id

3. Type of Industry with registration No. and Date (attach relevant certificates
supporting document from local authority).
Sl. Type of Documents for Manufacturing Factory License
No. Industries License/Registration Number whichever is
applicable
1 Heavy IEM (Industrial Entrepreneur Memorandum)/ACK-II
(Issued for Ministry of Commerce)
Lic. No._______________ Lic. No._____________
& &
Date_______________ Date_______________
2 Micro/Small Certificate issued by District Industries Center Valid upto___________
/Medium /UdyogAadhaar (MSME)
UID No._______________

Note: Factory and Manufacturing license of applicant only. In case of Sole

Selling Agent / Proprietorship firm FL & ML will be required from OEM
(Original Equipment Manufacturer) only.
 4. Type of Business : Attach relevant documents

Sl. Type of Industries Yes / No Documents Required

No.
1 Sole Proprietorship Single page details about firm certified by C.A.
2 Partnership Partnership Deed (Duly Registered/Notarized)
3 Pvt. Ltd. MOA or AOA
4 Public Ltd. MOA
5 Co-operative/Federation Attach copy of MOA/AOA/MOU whichever is
applicable
6 State/Central Govt. Attach copy of MOA/AOA/MOU whichever is
Undertaking applicable

5. Status of Supplier : Attach relevant documents

Sl. Description Yes / No Documents Required

No.
1 Manufacturer Manufacturing & Factory License
2 Brand Owner Trade Mark
3 All India Sole Selling Agreement / Factory & Manufacturing License of
Agency OEM (Original Equipment Manufacturer) only
4 Importer IEC & Bill of Lading

6. Details of the Firm:

a) Minimum Rs. 5 Cr. Turnover in last three (03) consecutive Financial Years
separately.
Year Turn Over (Rs.)

b) ITR of last 3 years without any Annexure.

c) Has your firm ever been blacklisted by the Central/State Govt. at any time? If so,
please give details.

7. Product Details:
a) Whether the offered products to KPKB are already being sold in the open
market or otherwise.

b) Swadeshi / Imported (Product wise) (Based on criteria of Swadeshi)

c) Government authorized certification for different categories as applicable.

Only standardized certificates from Government approved agencies will be
applicable. Please provide required certificates for each product as applicable.
 Sl. Category of Products Documents Required
No.
1 Food FSSAI License & Lab test product wise
2 Electric/Electronics BIS/BEE & Lab test product wise
3 Cosmetics GMP/Drug/Cosmetics License & Lab test
product wise
4 Utensil BIS & Lab test product wise
5 Footwear FDDI certification product wise
6 Hosiery/ Clothing BIS & Lab test product wise
7 Lifestyle/Daily Uses BIS & Lab test product wise
8 Toiletries Certification as Applicable & Lab test product
wise
Price Sheet, Swadeshi Appendix- ‘B’ ‘C’ & ‘D’
Data, Product wise
manufacturing data

8. Product Promotion:
A digital catalogue depicting multi-dimensional photograph of each
product clearly showing ingredients of the product. (Photographs from the
catalogue may be used on KPKB website at any time without consent of the
firm to show KPKB Inventory only).

9. Bank Guarantee:

As per policy of KPKB. However, firm has to give acceptance to this

clause.

10. Details of your executives/employees (Permanent employees only) with your

firm who are authorized to represent your firm with KPKB.

11. Please confirm your acceptance against each:

a) In case of any default, the CEO-CUM-GM will be the sole authority to
impose any penalty as per established rules/Procedure of KPKB.
(Accepted / Not Accepted)
b) Prior permission will be mandatory for changes in size/pack/packaging.

(Accepted / Not Accepted)

c) You are required to execute all our orders at the existing rates
mentioned in the negotiated sheet till such time price increase is approved
by the Competent Authority.

(Accepted / Not Accepted)

d) You will extend all consumer promotion schemes launched by you in the
civil market, directly or through your stockiest/dealers etc, simultaneously
to KPKB as well. Intimation about such schemes will be given by you well
in advance (at least one month in advance, if not more) to General
Manager by registered post/e-mail. In case of any default, KPKB will be
at liberty to recover the value of the gift offer as liquidity damages plus
penalty thereon as per the prevailing policy of the KPKB form the
outstanding payments. In case the outstanding payments fall short of
recoverable amount, the balance amount would be recovered from your
payments against future supplies and/or from the Bank Guarantee, if any,
held by the KPKB.
(Accepted / Not Accepted)

e) You will neither seek/apply for price increase nor will be granted by the
KPKB for at least six months issuance of the acceptance letter. However,
In case of AFD items frequent price revision may be granted based on
market dynamics and as per decision of Competent Authority.
(Accepted / Not Accepted)

f) After one year of introduction, if your product(s) do not pick up

adequate demand amongst our clientele, those will be deleted. Back
loading of unsold/expired stocks will be done as per KPKB policy time
to time.
(Accepted / Not Accepted)

g) Penalty shall be imposed on late receipt of consignments against

delivery schedule as per KPKB Policy.
(Accepted / Not Accepted)

h) Arrangements for ‘After Sales Service’ of consumer durable products

must exist at All India level and the items under complaint will be
replaced with fresh one at your cost in case your after sales Service
Center is unable to repair the same within 30 days.

(Accepted / Not Accepted)

Signature of the person

Name
Designation
Name of the firm_
 Appendix-‘A’

UNDERTAKING FROM SUPPLIERS TO

HEADQUARTERS, KENDRIYA POLICE KALYAN BHANDAR
MINISTRY OF HOME AFFAIRS, GOVERNMENT OF INDIA

(To be executed on Rs 100/- non-judicial stamp paper duly notarized)

1. We, M/S with Head Office located at

Solemnly affirm the following:-
That the following products have been offered by us to KENDRIYA POLICE
KALYAN BHANDAR for introduction:

i)

ii)

iii)

iv)

v)

2. We are the manufactures of the products stated at para-1above.

OR
We are the brand owners of the products stated at para-1 above and are being
manufactured by M/s. having address
____________________on our behalf our brand stands registered by (state
relevant registration authority) vide theirletter_ dated.

OR

Product at para-1 above are being manufactured by M/s. __ (Name and

address of the firm) and the firm has appointed us their sole selling agent at All India
level including open market for these products. A copy of the agreement between us
and the manufacturer is attached.
OR

We are the principal importers for M/S having address_

3. We will nominate our full time executives/employees for dealing with the KPKB and
undertake NOT to use the services of any liaison agent for the same.

4. All decisions taken by our nominated full time executives/employees will be honored
by the firm.

5. We shall adhere to the delivery schedule stated in the orders placed on us. Unless
amended by the KPKB, penalty imposed by the KPKB for late delivery will be
accepted by us.

6. We also undertake not to make supplies of any our products, listed with KPKB,
directly to any of Shops/Canteens running in the name Para-Military Forces / Police
/ Central Armed Police Forces.

7. We undertake to provide Bank Guarantee valid for one year from schedule ‘A’
Bank for the value specified by the KPKB (As per policy of KPKB).

PACKING

8. Supplies will continue to be made in the existing approved size/pack/packing

material.

9. That in case our packing get damaged in transit/stocking, we will supply packing
material at our cost.

PRICE

10. For any change in the Price or terms, we will apply to the KPKB in the specified
format at least three months in advance through registered post/e-mail and will
continue to make supplies at the existing rates and terms till the approval is
accorded.
11. Price parity established and agreed to from time to time will be maintained.

QUALITY

12. We undertake to ensure the quality of the products being supplied by us as per
specification. In case the quality is found to be lacking, the KPKB is at liberty to make
recovery as per the prevailing policy of the KPKB, impose penalty, and/or delete our
product from the KPKB inventory range.
13. If any of our consignments found to be damaged, unfit for KPKB vending, unfit for
human consumption or of inferior quality or having any deviation from the appropriate
standards, we undertake the responsibility to take back the entire stock at our risk
and cost from the Bhandars and the KPKB can recover the entire cost of the stock
held of affected batch/mfg date plus penalty thereon (as per policy of KPKB) and any
other cost from any of our pending bills and also suspend the ordering and sale of
that particular item/batch. We also accept any punitive action that may be taken by
the KPKB by way of imposing liquidity damages in case, in the departmental
investigation, if it is established/revealed that inferior quality/seconds have been
supplied to the KPKB. Furthermore, we will take back any unsold stock under our
own arrangement.

14. In case our products are found to be not conforming to the prescribed specifications,
recovery may be made and penalty be imposed on us as per the prevailing policy of
the KPKB and on merit of each case. Persistent quality deviations may lead to
deletion of our product without any prior notice. The cost of samples and testing
charges will be debited to us.
DELIVERY

15. We undertake to supply the goods within the prescribed delivery schedule and in
case of delay, the KPKB may recover penalty, as per the prevailing policy of the
KBKB.

16. We also confirm that we have noted the condition that in case of persistent non-
supply on more than three consecutive occasions, our item in question is liable to be
deleted from KPKB inventory range.

For and on behalf of

M/S
Signature
Name & Designation
Date
Witness
(Signature)
(Any permanent company officer)

Name, Designation and Address:

Date :
Important Instructions: -

1. This form shall not be valid for product(s) which are covered under
moratorium at the time of filling this application form.

2. Complete and definite answers to the questions must be given, along

with relevant connecting documents.

3. Application form complete in all respect with the authenticated

supporting documents must be submitted either in person or by post so
as to reach the office of CEO-cum-GM Central Office. Incomplete forms
will not be accepted and returned to prospective supplier intimating
discrepancies for re- submission/acceptance.

4. This form can be deposited after filling up of all relevant columns along
with required documents and payment of Rs. 5000/- only be
(Demand/Bank Draft) in favor of CEO-cum-G.M. Kendriya Police Kalayn
Bhandar payable at SBI Bhikaji Cama Place, New Delhi, Code-07755
payable at any scheduled bank in Delhi for enterprises owned (sole
ownership or majority shareholding confirmed through an affidavit with
the name of each shareholder age, relationship and percentage
shareholding). The fee is neither refundable on any account nor this form
is transferable. Payment of fee and the issue of the application form do
not in any way convey the approval of the product for supplies to KPKB,
this is subject to fulfillment of conditions and requirements of KPKB. This
form may be rejected without assigning any reason and no
representation will be entertained in this connection.
 Appendix-‘B’

PERFORMA : PRICE SHEET OF OFFERED PRODUCTS

S/No Nomenclature Unit New Wholesale HSN New rate % discount GST %
Per MRP rate Code offered to offered to KPKB
case inclusive of KPKB on MRP on MRP
GST inclusive of inclusive of GST
GST
1 2 3 4 5 6 7 8 9
 Appendix-‘C’

Details of Swadeshi as per proforma given below in Excel Format only :-

(In case of New Introduction/One to one replacement)

S/ Product Whether the products, offered to KPKB, Whether the company/ Whether the manufacturing company/firm
No Name are being manufactured by a firm is incorporated in is using domestic inputs in manufacturing
company/firm incorporated in India or India with Indian the products which are listed with KPKB or
otherwise. If so, details thereof. capital or otherwise. otherwise.
(Percentage of Domestic Input)
1 2 3 4 5
Percentage of Domestic Inputs will be taken into account on the basis of an order issued by Department of Promotion of
Industries and Internal Trade, Ministry of Commerce and Industries, Government of India, dated 16.09.2020 about requirements
of “Minimum local Content” to categorize a supplier as “Class-I local supplier, which is minimum 50%”. On the same line, a
product may be categorized as “Swadeshi”.
 Appendix-‘D’

DETAILS OF PRODUCT WISE MANUFACTURING UNIT

Sl.No. Product Name Manufacturing Unit / Vendor Name

1
2

Note: Third Party Agreement is required, if firm has outsourced its manufacturing.