APPLICATION /QUESTIONNAIRE TO BE FILLED IN BY THE PRIVATE INVESTOR 1. NAME AND COMMUNICATION DETAILS 1.1 Full legal name/structure of applicant : 1.2 Registered Office Address : 1.3 (i) Telephone (ii) Telex (iii) Fax : : : 1.4 Telegraphic address : 1.5 Name and address of contact person : 1.6 Branch Office Address : 2. NATURE/STATUS OF APPLICANT (Whether sole proprietary/Partnership/Private Ltd./ Public Limited/Public Sector/Society/Co-operative Society) (i) Copy of Registration Certificate (ii) Memorandum of articles of Association (iii) Partnership deed, in case of firm (iv) Brief history of operation since inception: : : : 3. NAME OF YOUR SUBSIDIARIES/ ASSOCIATE AND PARENT COMPANIES (Providing in brief their nature of activities capital layout and balance sheet for the last three years) : 4. WHAT BEST DESCRIBES YOUR VENTURE, GIVE PRESENT ACTIVITIES BUSINESS : 5. Detail of the project site i) Project Name ii) Capacity iii) Code iv) Location v) Elevations a) Power House b) Weir Site vi) Stream vii) Basin viii) District 5.1 Has the site of the project applied for been visited by the engineers of your venture : : : : : : : : : : 5.2 What is the estimated capacity of the project as per your preliminary technical evaluation. Give details of measurements conducted, if any 6. DETAILS OF ORGANISATIONAL SET UP OF APPLICANT (give category wise breakup of employees particularly technical experts who have to handle this project) : 7. ARE YOU PRE-QUALIFIED/ENLISTED WITH ANY GOVERNMENT DEPARTMENT/PSU INVOLVED IN HYDRO-ELECTRIC PROJECTS? IF SO GIVE DETAILS: 8. Have you/subsidiary/associate company applied earlier to HIMURJA for allotment of projects? if yes (i) (ii) (iii) (iv) * Have you been allotted projectsHIMURJA: If yes, please specify the sites Indicate the date of signing of MOUs Indicate the present status Please See note below:- by : : : 9. EXPERIENCE DETAILS OF APPLICANT 9.1 Have you worked in hydro electric projects (i) As a Joint Venture (ii) As a Prime Contractor (iii) As a Sub-Contractor : : : : 9.2 Do you have any experience of execution of Hydro Electric Projects in Himalayan region. If yes give details: 9.3 What is the maximum capacity of Hydro Electric Projects you have handled so far : 9.4 Technical Collaboration, if any : 10. 9.5 Details of technology used FINANCIAL DETAILS OF APPLICANT 10.1 Investment of IPP in other ventures: : 10.2 Share capital at the time of formation of company (i) Authorized (ii) Paid up : : 10.3 Present Share Capital (i) Authorized (ii) Paid up : : 10.4 Turnover during last three years: 10.5 Net profit/loss during last three years: 10.6 Full name and address of all your Bankers: 10.7 Audited Annual Balance Sheets and profit and loss account for last three financial years: 10.8 Foreign investment years: in the last three 10.9 Financial assistance secured from any financial institution: 10.10 Likely annual turnover and profitability for the current year and projections for next two years: 10.11 Details of proposal to finance the project (i) Resource mobilization : (ii) Pattern of financing : (iii) Details of foreign investment proposed: 11. LIST OF INDUSTRIES IN HIMACHAL PRADESH (either owned by the IPP or a third party, where the IPP may like to use the power generated from the project): 11.1 If yes, energy requirements : 12. DETAILS OF FIELD ORGANIZATION/ EQUIPMENT AND OTHER INFRASTRUCTURE AVAILABLE WITH THE APPLICANT FOR EXECUTION OF THE PROJECT : 13. COMPONENT WISE DETAILS OF THE PROJECTS ALREADY EXECUTED : 14. ANY OTHER INFORMATION : I/We, hereby, certify that the information furnished by me/us is a true statement of facts. Date : (Name, Designation/Title of Place: Person Signing) With Seal List of enclosures enclosed :- NOTES : 1. If a Private Investor is interested to apply for more than one project, application accompanied with a draft of Rs. 5000/- only per project should be submitted separately. 2. Where the space provided above is not sufficient, extra sheet may be used. 3. The Private Investor shall submit all the pages duly signed and stamped by the authorized person. CHECK LIST OF DOCUMENTS TO BE ENCLOSED 1. Application fee of Rs. 5000/- submitted vide DD No.________ issued by _______Bank. 2. A certified copy of partnership deed. 3.. A certified copy of Registration, if the partnership registered. 4.. A certified copy of Memorandum and Articles of Association of the Public/Private Limited Company and copy of Registration Certificate. 5. A certified copy of registration certificate in case of Society/Co-operative Society. 6. The resolution of Board of Directors on stamp paper of worth Rs. 5/- duly attested by the public notary or oath commissioner to the person(s) who is/are competent to sign the application, MOU, Implementation Agreement and for all the correspondences which will be made with Himurja, Himachal Pradesh Government, HPSEB and other Government Departments related to the Project applied for. The authority should be in the name of one of the Director of the applicant. 7. Original published audited balance sheet and profit & loss account for the last three years of the applicant . 8. Original published audited balance sheet and profit & loss account for the last three years of parent/ subsidiary/associate companies. 9. Details of field organization/equipment and other infrastructure available with the applicant . 10 Every paper of the application should be paged and signed/ self attested by the authorized person(s) with seal full name and designation. 11. Any other relevant document asked for in the application, brochure etc. Note:i) Whether the applied project is proposed to be developed in cascade as per brochure guidelines? If yes, give complete details of already allotted/ applied projects in respect of Applicant .
