Contract Identification: Name of Employer: Address of Employer: Matter in dispute: Party who initiated the dispute: Status of dispute: Litigation History in accordance with Section III, Evaluation and Qualification Criteria No Litigation History in accordance with Section III, Evaluation and Qualification Criteria, Sub-Factor 2.4. Litigation History in accordance with Section III, Evaluation and Qualification Criteria, Sub-Factor 2.4 as indicated below. Year of Outcome as Contract Identification Total Contract award percentage of Net Amount (Rs) Worth Contract Identification: [indicate [insert [insert [insert complete contract name, number, and year] percentage] amount] any other identification] Name of Employer: [insert full name] Address of Employer: [insert street/city/country] Matter in dispute: [indicate main issues in dispute] Party who initiated the dispute: [indicate or “Employer” “Contractor”] Reason(s) for Litigation and award decision [indicate main reason(s)] Appendix to Technical Part Form CON 3: Environmental, Social, Health, and Safety – Performance Declaration [The following table shall be filled in for the Bidder, each member of a Joint Venture and each Specialized Subcontractor] Name: [insert full name] Bidder’s Date: [insert day, month, year] Joint Venture or Specialized Name: [insert full name] Member’s Subcontractor’s RFB No. and title: [insert RFB number and title] Page of pages [insert page number] [insert total number]
Contract Identification: Name of Employer: Address of Employer: Matter in dispute: Party who initiated the dispute: Status of dispute: Litigation History in accordance with Section III, Evaluation and Qualification Criteria No Litigation History in accordance with Section III, Evaluation and Qualification Criteria, Sub-Factor 2.4. Litigation History in accordance with Section III, Evaluation and Qualification Criteria, Sub-Factor 2.4 as indicated below. Year of award Outcome as percentage of Net Worth Contract Identification Total Contract Amount (Rs) [insert year] [insert percentage] Contract Identification: [indicate complete contract name, number, and any other identification] Name of Employer: [insert full name] Address of Employer: [insert street/city/country] Matter in dispute: [indicate main issues in dispute] Party who initiated the dispute: [indicate “Employer” or “Contractor”] Reason(s) for Litigation and award decision [indicate main reason(s)] [insert amount] Appendix to Technical Part Form CON – 3: Environmental, Social, Health, and Safety Performance Declaration [The following table shall be filled in for the Bidder, each member of a Joint Venture and each Specialized Subcontractor] Bidder’s Name: [insert full name] Date: [insert day, month, year] Joint Venture Member’s or Specialized Subcontractor’s Name: [insert full name] RFB No. and title: [insert RFB number and title] Page [insert page number] of [insert total number] pages
W-2%20Medium%20(two%20cover%20e-GP)%20NPF%20ESHS%20Version.docx