HINDUSTAN ORGANIC CHEMICALS LIMITED
(A GOVERNMENT OF INDIA ENTERPRISE)
P.O. RASAYANI. DIST: RAIGAD, MAHARASHTRA.
PIN-410207, TEL: (02192) 258501/502, FAX: (02192) 250648
APPLICATION FOR REGISTRATION OF INFORMATION TECHNOLOGY SUPPLIERS AND SERVICES PROVIDER
1. Name of the supplier:
2. Address, Telephone No. Fax No. and e-mail Address:
Office:–
3. Registration No.:
4. Category of the Company: Public / Private / Partnership / Proprietors.
(Enclose copy of article & memorandum of association)
5. Name and Designation of head of the company:
6. Name and Designation of the dealing officer:
7. Are you Manufacturer (OEM) / Supplier/Distributor / Authorized Dealer/ Service Provider?
8. Whether Small Scale Industry (SSI Unit) Yes / No SSI No. :
If yes submit copy of certificate
9. a) Do you have a Rate contract with DGS&D
If yes, i) Furnish a copy of R/C (Rate Contract)
Yes / No.
ii) Attach list of items covered under R/C
b) Are you TDC approved?
If yes, please furnish a copy of certificate.
10. Category of items for which registration is sought (Please tick whichever is applicable)
Add as per annexure I
Part A:
To be filled in by manufacturers (OEM):
i. List of products presently manufactured/Supplied by you:
Name of Items: (Please attach separate List)
i) ISI Registration No. if any, for products stated above.
HINDUSTAN ORGANIC CHEMICALS LIMITED
(A GOVERNMENT OF INDIA ENTERPRISE)
P.O. RASAYANI. DIST: RAIGAD, MAHARASHTRA.
PIN-410207, TEL: (02192) 258501/502, FAX: (02192) 250648
ii) Manufacturing Facility Type of equipment: Make / Specifications.
v) Details of foreign collaboration (if any)
(Please give details of agreement)
Part B: To be filled in by other than manufacturer:
11. List of items/services dealt by you with its trade Name and Name of Principals.
Enclose copies of certificate for these items showing appointment of your company as Authorized
distributor / Partner/Service Partner etc.
12. Name and addresses of parties to who above items are supplied / services are provided regularly
by you.
(Please indicate Govt. and Public Undertakings) and enclosed the list of your present clients.
13. Are you registered with any other company as approved supplier/service provider? If so, give
details.
14. a) ECC No (Excise Registration Code No.):
b) Range :15. Sales Tax Registration No. and date MST/VAT No.
TIN No.
VAT No.
CST N0.
16. Total turnover of last 3 financial years:
17. Do you agree to the payment terms of HOC which are:
Full payment generally within 30 days of receipt of material in acceptable condition along with
pre-receipted bills in triplicate supported by S.T. Exemption certificate and copy of receipted delivery
challan.
OR
Full payment generally after every quarter during which services are provided as and when valid bill
submitted along with documents as per work order.
18. Income Tax details, proofs of all taxes paid to the Government till date.
19. Capital Outlay. (Specify clearly if any foreign investment is involved)
HINDUSTAN ORGANIC CHEMICALS LIMITED
(A GOVERNMENT OF INDIA ENTERPRISE)
P.O. RASAYANI. DIST: RAIGAD, MAHARASHTRA.
PIN-410207, TEL: (02192) 258501/502, FAX: (02192) 250648
a. Give details of loans obtained from various bodies if any
b. Bank Solvency Certificate (Value to be mentioned)
20. Profit / Loss statement for the previous 3 years (please enclose copies of Balance Sheets duly
certified by your auditors for the above period)
21. Name and address of your bankers.
22. Are you prepared to give security deposit against single purchase exceeding Rs.5,00,000.00
23. Are you supplying to HOC any of the items in which registration is sought, if so,
Please give details of your sales turnover for the past three years in each category.
24. Please give your Client list for the past 3 years.
Attach satisfactory performance certificates from reputed customers or repeated purchase order from
reputed customers.
25. Have you ever been discharged / black listed / prosecuted by any of Govt. Public or Private
undertaking, if yes, give full details.
26. Specify minimum and maximum value of order you have executed in the last 3 years. (Copy of
largest order executed by you to be attached)
27. Please attach a Demand Draft of Rs. 1000/-(Rs. One Thousand Only) in favour of HINDUSTAN
ORGANIC CHEMICALS LTD., payable at State Bank of India Rasayani Branch.
28. Registration form & one copy of other documents mentioned at the end of the form are to be put in
file cover before sending to us.
RULES & REGULATIONS
1. Duration: Initially the registration shall be for a period of three years and thereafter subject to
renewal.
2. Limitation: Registered suppliers are not guaranteed for any business however enquiries shall be
sent to every registered supplier at the discretion of H.O.C.
3 Cancellation: (a) In the event of continuous regret letter to our enquiries will lead to Cancellation of
registration.
HINDUSTAN ORGANIC CHEMICALS LIMITED
(A GOVERNMENT OF INDIA ENTERPRISE)
P.O. RASAYANI. DIST: RAIGAD, MAHARASHTRA.
PIN-410207, TEL: (02192) 258501/502, FAX: (02192) 250648
(b) Non execution of order on any account (Not approved by us.) will lead to cancellation of
registration.
DECLARATION
I / We hereby agree that I / We have read the rules & regulations for registration as approved supplier
with HOC & shall abide all these &such rules as may be framed by company from time to time for the
said purpose.
I / We further declare that the above stated information is true to the best of my / our knowledge and
further understand that in the event of any breach of rules or false information, my / our registration is
liable to be cancelled with any notice and financial repercussions.
Place:
Date:
Authorized Signatory
List of documents to be submitted along with suppliers registration form, duly filed in.
1. Copy of Excise registration No. and Date.
2. Copy of Maharashtra Sales Tax / VAT and Central Sales Tax registration Certificate
3. Copy of Income Tax clearance certificate of Last Financial Year.
4. Bank Solvency Certificate.
5. Balance sheet of three years (Profit and Loss A/c)
6. Reputed Client list.
7. Product catalogue for each item you want to supply to HOC.
8. Satisfactory performance certificates from reputed customers.
9. Copies of value of largest purchase order executed by you.
10. Please specify minimum and maximum value of order you have executed in the last 3 years.
11. Demand Draft of Rs.1000/- (One Thousand only) in favour of Hindustan Organic Chemicals Limited
in payable at State Bank of India, Branch Rasayani.
Please fill-up the enclosed format and send it with above documents in a file cover to HOC. Please note
that only documents along with application form submitted in file is acceptable to us.
Annexure - I
A) Supply
(Please mention the brand / Make against each item to be registered for supply)
i. Personal Computers :___________________________________________
ii. Laptop :____________________________________________
iii. Printers Dot Matrix :_____________________________________________
iv. Printers Line Matrix :____________________________________________
v. Printers Ink Jet / Laser Jet / Multifunction :______________________________________
vi. Scanners :______________________________________________________________
vii. Servers (Entry Level / Mid-Range / High end) :____________________________
viii. Thin Clients: :______________________________________________________________
ix. Network Active components
a. Switches : _____________________________________________________
b. Firewall : ______________________________________________________
c. Routers : ______________________________________________________
x. Network Passive Components
a. Fibre cable
________________________________________________
b. Data cable (UTP)
c. Rack
_____________________________________________
______________________________________________________
xi. Supply of Consumables
a. Printer ribbon Cartridge for Dot Matrix (EPSON) / Line Matrix (LIPI): (Yes/No)_____
b. Toner for laser Jet printers
(yes/No) _____
c. Gear assembly for DMP
(yes/No) _____
d. Printer Head for DMP
(yes/No) _____
e. CD/DVD
(yes/No) _____
xii. Software Licenses and License Renewal
a. Microsoft (Operating System / Office / Any Other)
(Yes / No)
b. Symantec
(Yes / No)
c. Norton
(Yes / No)
d. Oracle
(Yes / No)
e. Tally
(Yes / No)
f. Any other
(The necessary documents showing that the vendor is an authorized sales / service partner
/ provider of above OEMs must be submitted along with Vendor Registration Form to
corroborate their credibility in carrying out corresponding jobs.)
xiii. CCTV Setup
a. DVR (Hikvision / Sony / Samsung / Hitachi / Panasonic / Bosch / Toshiba / Any Other)
(Yes / No) _____
b. Camera (Analog / Digital / IP Based) (Sony / Samsung / Hitachi / Philips / Any Other)
(Yes / No) _____
c. Any other affiliated accessories like Balun Transceiver, Power Supply, Coaxial Cables, etc.
(Yes / No) _____
B) Services
i) Data Centre Infrastructure Maintenance Service comprises of
a. Precision Air Conditioner (Make - Uniflair) (Yes / No) _____________
b. Fire Detection Systems ( Make – Morley IAS) (yes/ No) _______________
c. Fire Prevention System (Make - Kidde ) (Yes /No) ________________
d. Rodent Repellent (Make -Maser): (Yes / No) ________________
e. UPS ( Make - APC) 7 KVA / 8 KVA / 15 KVA : (Yes / No) _________________
f. Electrical Equipments (General )________________________________
ii. Maintenance of Personal Computers, Printers, Network Components and Allied Devices
(Yes / No): __________
iii. CCTV Setup & Implementation (Yes / No): _______
iv. Facility Management (Yes / No): _______
v. Cloud Computing (Yes/No): _______
i) Software as a Service (SaaS) (Yes/No): _______
ii) Infrastructure as a Service (IaaS) (Yes/No): _______
vi. Design, Development and Implementation of Customized Website based application/
Software. (Yes / No): ______
Please mention the development tools and platform and database
vii. Web hosting services: (Yes /No): _______
(Please mention the hosting infrastructure details such as server farm location (must be in
India only), Hosting Platform, Database etc
viii. Refilling of
a. Printer Ribbon Cartridge : Epson / LIP Line Matrix (Yes /No)
b. Laser Printer Toner : HP Laser printers / Canon Laser Printers (Yes /No)
c. Xerox Machine Toner : (Yes / No) ______________________________
ix. System integrator for LAN (Fibre, UTP, Wireless) / WAN etc. (Yes / No) _____________
x. Data centre hosting services: (Yes / No) __________________________________
xi. Data Centre Co-location Services: (Yes / No) __________________________________
Location of data centre in India (Full address): _______________________
Full infrastructure details such as capacity of data centre, Power supply sources, Cooling
arrangement, technical manpower deployed, services covered under data centre hosting
facility. (Furnish latest set of your pamphlets, catalogues, price list, etc.)
Authorized Signatory with Seal