T E N D E R F O R M * * * 1. Name in Block letters : 2. Father's Name : 3. Present Address : 4. Permanent Address : 5. Occupation : 6. Details of Reach/Mandal as per Notification : 7. Offered amount : (a) in figures : (b) in words : I hereby declare that I am aware of the particulars furnished in regard to the Reach/Mandal in the Notification in response to which I am submitting the tender. I further, declare that I am also fully aware of all the rules in regard to grant of quarry leascs for Sand. I hereby undertake to abide by the provisions of A.P. Panchayat Raj Rules. Signature (Name in Block letters) NOTE : 1. This tender is to be submitted in a sealedcover in person of by Regd. Post Ack due or through his Power of Attomey holder and acknowledgement contained. 2. Application with the enclosure as required under conditions (2) under annexure to From-A should accompany the Seald Cover. 3. The Mandal Revenue Officer shall not be resposible for the loss in the Post transit or the delay in receipt of the Sealed Cover. ANNEXURE - I APPLICATION FOR ISSUE OF HAIL TICKET (See rule I (i)) 1. Name and present address of the applicant : (In block letters) 2. Name and Present Address of the applicant : (in Block letters) Note: In case of partnership firm the Partnership deed in case of privatelimited company The Articles of Association and in case Registered Labour Contract Co-Ioerative Society a Certrificate from the Divisional Co-operative Officer concerned should be produced for Participating in the auction. 3. Date of birth and age of the applicant : (Person of 18 years below not eligible) 4. Area for which he intends to participates in the : auction for submission of Scaled Tender. 5. Affidivit in the prescribed Form on a Nonmedical stamped paper worth of Rs.25/enclosed or not. : 6. No and Date of Bank Draft/Bankers cheque obtained from any scheduled Bank for an amount equivatent to 25% of the minimum bid. : 7. Particulars of leases if any under different Mineral concessions. : 8. Mineral Revenue dues clearance certificte in form H/Affidivit enclosed or not. : 9. (a) Has he been convicted for any penal offence or any offence under M & M (R&D) Act,1957 : (b) Has he been debarred earlier in participating : auctions or to obtain leases under different Mineral concessions. 10. Whether agreed to pay a sum equivalent to 25% of the knocked down amount on the immediate next working day and the remaining 75% of the amount within the prescribed time in the confirmation order. : 11. Sealed tender or not : I declare that the particulars furnished above are true to the best of my knowledge, I hereby undertake that the deposit made by me may be forfeited to the Government if the information furnished above is proved to be incorrect. SIGNATURE OF THE APPLICANT. Place : Date : A F F I D A V I T I.......................................................S/o.......................................................................................... R/o................................................................................................ aged about.......................................... years do hereby solemnly affirm and State as follows:- That I have gone through the auction notice issued by the concerned M.R.O. and conditions laid down therein. I intend to obtain quarry lease through Sealed Tendeer / auction for the ....................... .................... Mandal / Reach as per the Notification No. .................. dated .................... If I am the highest tenderer/bidder and if it is knocked down in my favour, I declare and agree to abide: 1. To pay the sum equivalent to 25% of knocked down amount in the form of demand draft obtained from any scheduled bank on the day of auction or on the immediate next working ady and to tender the same before the auctioning authority. 2. To pay balance 75% of the knocked down amount and Security deposit of 2% of the knocked down amount and subject to the minimum amount of Rs.1,000/- on before the date mentioned in confirma tion orders and to execute the lease deed with the M.R.O./R.D.O. concerned in Form 'G' within a week from such payment. 3. In case of default in payment of 25% of the knocked down amount within immediate next working day or the remaining 75% of the knocked down amount within the time specified in the confirmation orders and to execute the lease deed within a week from such payment to abide with the condition that the result monetary loss to Governemtn due to such default shall be born by me. 4. To abide by the condition that I shallpay tghe knocked down amount alongwith 10% enhancement towards the second year lease amount in the Government Treasury and submit the challans to the concerned M.R.O. on or before forty fove days of the expiry of the Ist year lease period. If no such payment is received by the M.R.O. concerned, the Joint Collector shall make necesary arrangements for leasing out the quarry and forefeit the Security paid by the original lessee. 5. In case of negligence on my part to pay the balance amount and to execute the leasedeed in respect, I accept for any action taken by concerned authority to cancel the auction or terminate thje lease as the case may be. 6. To abide by the additional conditions if any imposed by the authority component to do so and 7. To abide by the decision of the Government of Andhra Pradesh in case of any doubt as to the appli cation or interpretation of the versions of any of the conditions or provisions of Panchayat Act and the Rules made there under. 8. I declare that I hold/ do not hold anylicence or lease under any of the Minveral Concession Rules and not in debt to the Department of Mines & Geology. Sworn and signed before Me on day of DEPONENT. Notary Attested A N N E X U R E - II (See rule 15) Sl.No. Name and Date of 25% of the Name and Name of Other Remarks address of receipt of Minimum Date of the Bank docu the applicant the applicant bid amount D.O. ments. deposited. 1. 2. 3. 4. 5. 6. 7. 8. A N N E X U R E -III (See Rule 16) SEPARATE KNOCK DOWN AMOUNT REGISTER: The knockdown amount should be entered in the register separately for each Reach/Mandal. The following shall be recorded and the same shall be signed by the highest bidder/Tender. The following shall be recorded and the same shall be signed by the highest bidder/Tender. The auction is knocked down infavour of M/s Sri........................................ for Rs.................. being the highest bidder / Tender, subject to the condition that he should pay 25% of the knocked down amount within immediate next working day by way of Demand Draft from any Schedule bank in Andhra Pradesh and the remaining 75% knocked down amount within the time mentioned in the confirmation order, and execute lease deed in Form-G within 7 (seven) days from the date of such remittence. Signature of the highest, SIGNATURE OF THE DISTRICT PANCHAYAT OFFICER. Bidder / Tender.,
