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Page 3: uiic.co.in Date 3/8/2013 12:37:43 PM

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(-

grr$as gfetr F-e'Etrq *'. fu .TINITED INDIA INSI]RANCE COMPANY LIMITED

PROFORMA FOR TECHNICAL BID

I.DETAILS OF OWNER

.Notna:

rAddressr

.PhoneNo':(with.STDCoda)....:'......,.,,'i-..'..,'

.iilafketability of Title Deed:S ell Owner/HUF/Lecs edlP A Holder / 6ovt. Prop erty etc.(Pleose t i ck),.....,....

rContact Parson's nome & phone no.:(If other thon owner)

z.DETAILS OF LOCALIW

lAddress/ Locotion of the building/ pramises/ floor: .,..,.,.,...(Attsch sketch Plan)

rfs it low lying oreo, affected by flood during /rionsoon:

.Is there ony odverse feature such os fndustry:Which moy creote noise, smoke, ond dust in the vicinity.

I.DETAILS OF PREMI5E5I FLOOR

rNo. of toilets in each floor: .....,......

e Area of e.ach floor/ Prehises in sg. ft, (nttoch f loor wlsa details if it more than one f loor)(o)Superr built Anea: sff (including common orm)(b)Built up Area; . sft (including woll,

bathroom, toilet etc.)(c)Corpat Areo:

' 6Ref"r "rsr code No. s-3861- rgrS') corpet Areo excluding tha following:(i)Both room and lovatory(ii)Varondohs(iii )dorridors ond possages(iv)Entronce hall ond porchas

Page 4: uiic.co.in Date 3/8/2013 12:37:43 PM

T- C>l

, (v)Stoircose and mumties /(Enclo{Archifect's reporf showing the measurements ol Carpe{frrea)

.Boundqry of Premises / tloorNorth: ,..,,,.,.,......, South:

Eost: ...,........ West:UPPar:......."

Lower:.......,......'..............

rAt which floor the premises is located'.-.. ."..,..,.,..,......,...'.',':,',,".,

l.PLEAsE FURNISH DETAILS OF THE OFFERED PREMISE5/ FLOOR,

.6eneral state of building ond pramises: .......'......'...... ...--.......-.'.'.'-.

.Whefher ccrrying out of cornmerciol octivity in fhe.....,..... ,.. Yesl No

premises is permissible under the locol Byelows

.Whath er cny i mmed ia t e r epair s ar e needed: ."....-...-.......'.'."

.Whether completion certificate obtoined: ",........-'...:,,.....

rReserved Porking space/ Provided exclusivaly f or 4 wheelers &2 Whulers,4Wheelers TWheeler

(o)No. of Covered

(b)No, of Opened

z.TERMS OF LEASE OFFERED

.fnitial period of lease (3 yeors or 5 yeors)

-*----yeorstTncrease/ Escalotion of rent ofter 3 yeors @

.Tncrease/ Escqlotion in rent affer 5 yeors @

.Totol Leas e period:(9/LO/n/$ years)

(Totol leose pariod occeptable is elther 9 yeors. Agreel Not Agree

Initial.3 years plus 2 extensions of 3 years eoch)

OR

10 yeors, initiol 5 years plus one extension of 5 yeors Agree/ Noi Agree

rStahP Duty ond Registrotion charges

(a) Is owner ogreeto beor 100% stcmp dufy/ registrstion charges: yES/NO

(b) Is or/uner qgr€e to baar 50:50 stomp duty/registrotion chorges: yES/NO

I.OTHER FACILITIES AVAILABLE

Page 5: uiic.co.in Date 3/8/2013 12:37:43 PM

T- ( 3,)

.Water ovoilobility (Municipol wate.r/ pore well waler/..........,.............,......Through overhead tank/ sump), (Ppase tick)

rPower phase, clso indiccte sanctioned lood for ; ..,...,...............

Light & power seporately

.Lift fqcilities: ..,,.,..,.,............,1..,..,..,...... ,...,,(Available/ Not Avoiloble)

.6enerator/ fnvertar; ...,,. (Avoiloble/ Not Avoilcble)

.Fire Fighting orrongemenfs: .,,.....,.... ......(Arronge d/ not Arronged)

rAny othar ralavant informatign like security (common/ axclusive for the premises)(Attach separate sheet if necessory): ....,,,,.,..........

,Areyouproviding cabins to Executives and record r0om.......,..,...........................YE5/NO

.Are you providing AC/Lighl filling/ Fons €,tc.: ...,.,,yE5/NO

T/ we confirm thot ollthe above stotements are'frue. We also confirm that we hold clear fifle to theproperty offered and oll construction carried out qs per local rules ond regulations.

PLACEI

DATEI SIGNATURE OF OWNER/Aulhorized Representat ive

The Technical Bid is to be put up in a seperote envelope duly sealed ond superscribed os "Technicsl

Bid' mentioning your ncme, address and lelephone nos, thareon oddressed to Regional Monager,

Estates deportment, United fndia Insuronce Co. Lfd., Regionol office

/ SPECIIAEN /ANNEXURE C

d

Page 6: uiic.co.in Date 3/8/2013 12:37:43 PM

I {'g-{rg?:s Ffs+r Fg*r;lr dr, fu .

LNITED INDIA INSURANCE COMPANY LIMiTED

PROFORMA FOR FINANCIAL BID

(A) Telephone/cell No/Fox Numberr (with STD Code)............,.

(B) Porticulars of the property offered;

2, (A) Type of Premises:Independent/Multi Storied Complex/Apcrtments/ others (Pleose

(B) No, of floors alfered (Menfion the exact floor); .,,.,.....,.

3. DETAIL5 OF RENTOFFERED Amount Rote psft

(o) Rent of esch floor wise(Including oll toxes)

R3.-- e

(b) Mointensnce chorges of the flots/ Rs._ @._Premises (if ony)

(c)othercharges,like5ewicetoxatc',ifonyo'.'@.-

(d)Totolrentincludingollthecharges&faxes:[email protected]

(d) Security Deposit; (3/6 months I others) Rs

T/We confirm thot oll the sbove stotements arelrue.T/wealso confirn that T/we hold clear titleto fhe property, ond construction of the premises is corried out as per locol rules and regulotions.

Pioce:

Dofer SI'NATURE oF OWNER

Auihorized Representotive

(This Finonciol offer isio be put up in the separote envelope duly sealed ond super scribed as "FinancialBid" mentioning your nome, address ond telephone nuhbar therean Region*l Manoger, Estotesdeportment, United