ITI LIMITED      Phone: 022-2019758  
                   REGIONAL OFFICE    Fax: 022-22019795  
                   1st Floor, National Insurance Building  Email:mumbai_ro@itiltd.co.in
                   A.K.Nayak Marg,Fort Mumbai-400001.      
         
  APPLICATION FOR VENDOR EVALUATION/ REGISTRATION  
   
             
CATEGORY  
(Please slect field for registristation & tick in the corresponding box)  
   
  CONTROL COMMUNICATION EQUIPMENTS ( PRIMARY DROP INSERT      
   MUX AND SDH, STM-I EQUIPMENTS)          
  COMPUTERS AND ACCESSORIES, NETWORKING AND ITES    
  CABLE LAYING TRENCHING ETC..        
  BUILDING WIRING / MINOR INDOOR CABLING ETC.,    
  TELECOM PCB, SMPS REPAIRS   
  ELECTRICAL          
  MECHNICAL          
  ELECTRONIC COMPONENTS AND SPARES      
  ANY OTHER SERVICES          
1 (a) Name of the Company / Applicant :          
  (b)  Registered No :          
  ( Enclose copy of the certificate of registration ) :    
        Phone    
  ( c)  ( I ) Registered Head office Address :   Grams  
      Telex  
      Fax  
      Email  
             
  ( ii )  Local office Address :   Phone  
    Grams  
    Telex  
    Fax  
    Email  
     
             
  ( d )  List of service Centres    
  ( Enclose if more service centres are avilable )        
  ( e ) Name of Executives to be contancted & phone no .      
  ( f ) Local Office in Madhya Pradesh/Chhattisgarh State.      
     
  Nearest place and address and phone no.    
     
     
     
             
2  Year of Establishment          
3 Constitution    
  Individual / Sole Proprietorship Concern /    
  Partnership Firm / Public ltd Company /     
  Private Ltd. Company          
4 If partnership firm, names of partners ;    
   If company name of Directors :    
  If sole trade, name of the Proprietor :    
             
5 Annual turnover for last 3 financial years    
  2006-07    
  2005-06    
  2004-05          
6 PAN No.    
  ( Income tax clearance certificate to be enclosed)     
             
7 Financial status ( Copy of the    
  Latest Balance Sheet / Annual Reports    
  to be enclosed)          
8 Sales Tax Registration   /    
  TIN No.          
     
9 Service tax Registration No.    
     
             
     
10 Previous experience with ITI    
  (Corporate Office, Plants & Ros)     
             
     
11 Acceptance for submitting EMD    
  (If required)    Yes/ No  
             
     
12 Acceptance for submitting PBG    
  (If required)    Yes/ No  
             
     
13 Acceptance for Back to Back payment    
  (for any orders from our customers)     Yes/ No    
     
14 Acceptance for after sales service    
        Yes/ No    
   
15 Any other useful information  
   
   
   
   
   
   
             
             
  DECLARATION  
   
   
I/We hereby declare that all statements made in this application form for enlistment/Registration of 
Vendors are true/complete and correct to the best of my/our knowledge In the event of any information
beeing found false or incorerect,  the enlistment / registration and any purchase order/ work order / Contract   
 placed on our firm may be cancelled  
   
   
   
  Date Singnature
   
   
  Seal of the Company Name and Designation
   
   
             
  Note :  
  1. Filled in applications may be sent through email ID mumbai_ro@itiltd.co.in.   
      Application should be sent to us for enlishment  
   
  2. Terms and conditions of tender will be sent to you / Published in the web site for each enquiry/NIT 
   
   
   
  LIST OF ENCLOSURES   
   
  1. Copy of registration of Unit   
  2. Copy of Income Tax Clearance certificate   
  3. Copy of Sales Tax registration Certificate   
  4. Copy of the latest Balance Sheet/ Annual Report   
  5. Proof of annual turn over / financial capacity   
  5. Proof of annual turn over / financial capacity   
  6. Proof for experience details (Completion Certificate)  
  7. Proof for previous experince with ITI   
  8. Solvency Certificate