PMC Application for appointment / registration of

PMC
Application for appointment / registration of PROJECT MANAGEMENT CONSULTANT
firms for cross verification of architect works such as site conditions, approvals, planning,
design of structure, estimates, tender documents and drawings supervision & execution of
work etc.
1
Name of Project Management Consultant i.e. :
proprietor of firm
2
Name of the Company
:
3
Type of firm
: i) Proprietor firm
ii) Partnership firm
iii) Pvt. Ltd.
iv) Public Ltd.
4
Company Registration no. & date
:
5
Permanent Account Number (PAN) of Company & :
Proprietor
6
Name of Partners / Directors
:
7
Office Details
:
i) Address
ii) Type of office (Rent / Own)
iii) Carpet area of office
8
Contact No. & e-mail
:
9
Qualification of Project Management Consultant :
i.e. proprietor of firm
10
PMC Registration No. if any
11
Experience
in
years
:
to
handle
project :
independently i.e. after establishment of office
12
Submission of information about turnover of :
company
Sr.
No.
1
Year
2010 – 11
Rs.
2
2011 – 12
Rs.
3
2012 – 13
Rs.
F:/Vaishnavi/Data/Khot Sir/Annexure H
Turnover of Company
Remark
Page 1
13
List of completed work in three financial year 2011-12 to 2013-14
Sr.
No.
Particulars
Name of
Client
1
2
3
1
Buildings upto 4 storeys
2
Buildings upto 7 storeys
3
Buildings upto 15 storeys
4
Buildings upto & more
Location &
Cost of
Project
4
Year of
Completion
of Project
5
than 25 storeys
5
Mass housing / township
projects
14
List of ongoing work as a PMC in three financial year 2011-12 to 2013-14
Sr.
No.
1
Name of Project / Work
2
1
Buildings upto 4 storeys
2
Buildings upto 7 storeys
3
Buildings upto 15 storeys
4
Buildings upto & more
Cost of
Project
3
PMC fee paid
4
Admissible
Architect fee
5
than 25 storeys
5
Mass housing / township
projects
F:/Vaishnavi/Data/Khot Sir/Annexure H
Page 2
15
Name of engineers if in-house facilities available with PMC firm.
Sr.
No.
Particulars
1
1
2
Structural
Design
Engineer
Water Supply
& Drainage
Design
Engineer
Electrical
Design
Engineer
Landscape
Design
Engineer
2
3
4
16
Name of
Engineer
with age
3
Work
From
To
4
5
Qualification Year of
with name Passing
of Institute
6
7
At present number of Engineers working with firm (Excluding employee working on
contract or temporary or project basis)
Sr.
No.
Particulars
1
1
2
Engineer
working since
more than 10
years
with
firm Engineer
working since
more than 5
and upto 10
years
with
firm Engineer
working since
more than 3
&
upto
5
years
with
firm -
2
3
Name of
Engineers
with age
3
Work
From
To
4
5
Qualification Year of
with name Passing
of Institute
6
7
:
F:/Vaishnavi/Data/Khot Sir/Annexure H
Page 3
17
Attach appointment letter regarding empanelment
with other organization
18
Attach certified copy’s of 3 years income tax :
return and certificate of Chartered Accountant for
turnover of company
19
Attach certificate issued by clients during three :
financial years against successful completion of
works.
20
Software available with the Agency
:
21
Willingness to provide services in following region
: (Please underline & tick the
option below)
i) Mumbai Range
ii) Thane / Nashik / Konkan Range
iii) Kolhapur / Aurangabad / Nanded Range
iv) Nagpur / Amravati / Gadchiroli Range
22
Photographs / PPT Disc. / about projects
executed
23
:
Information about awards if any received to firm /
PMC
:
I / We / the firm do hereby state that the above mentioned contents / information are true
and correct. If any information is found to be false / incorrect / misleading then I / we / the
firm shall be held solely responsible.
Place : _____________
Date : _____________
Signature of Proprietor of
Project Management Consultant firm
Note :- (1) Application shall be submitted on the letter head of the applicant.
(2) Attested copies of the relevant documents shall be submitted.
(3) Joint venture is not permitted.
F:/Vaishnavi/Data/Khot Sir/Annexure H
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F:/Vaishnavi/Data/Khot Sir/Annexure H
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