NATIONAL INSTITUTE OF TECHNOLOGY, WARANGAL - 506004

TELENGANA (INDIA)

Tender No. NITW/CS-28/LabFurniture/2021-22/ Date: 25-10-2021

INVITATION FOR SUPPLY OF LABORATORY FURNITURE ITEMS

Established vendors with proven track record and experience in the supply of concerned items are

invited to submit their most competitive bids on or before 17-11-2021 at 11.00 AM.

Important Dates:

1 Pre-Bid meeting

09th November 2021 @ 11.00 AM Venue: Central Stores Meeting Hall

2 Last Date for Submission of Tenders 17th November 2021 up to 11:00 AM

3 Date of Opening of Technical Bids 17th November 2021 at 11:30 AM

* Any queries should be addressed to dr_ps@nitw.ac.in on or before 08th November, 2021, so that the same can be clarified in pre-bid meeting.

Prospective bidders may download the Tender document from

https://eprocure.gov.in/eprocure/app - Tenders by Organisation – National Project

Implementation Unit - World Bank Tenders – NATIONAL INSTITUTE OF TECHNOLOGY

WARANGAL and https://nitw.ac.in/main/update/Jobs/Tenders/ submit the ebids on-line as

per the Tender Document.

The bidders should remit a non-refundable tender fee of Rs. 1,180/- (Rs.1000 + GST @ 18% =

Rs.1180/-) (Rupees one thousand one hundred Eighty only) and EMD by NEFT Beneficiary name:

DIRECTOR NITW, Account No. 52109375198, IFSC Code: SBIN0020149, Bank Name: State Bank of

India, Branch address: NIT COMPLEX, HNK-KAZIPET MAIN ROAD, WARANGAL - 506004. The

proof of NEFT details alongwith a forwarding letter are required to be submitted with Technical Bid. The

technical bids of those who have not submitted the tender fee will be rejected as technically disqualified. No

exemption is applicable in payment of tender fee for bidders having registration with MSME, NSIC, etc.

EMD is exempted for the vendors who are registered with MSME, NSIC and National Institute of

Technology, Warangal. They have to submit registration certificate along with Technical Bid. The Vendor

whose EMD or exemption certificate is not submitted by due date their bid will be rejected.

Tender Cost : Rs. 1,000/- + GST @ 18% = 1,180/-

EMD : Rs. 2,00,000/-

The Institute GSTN/IEC details are as follows.

GST No. 36AACAN7241H2ZK

I. GENERAL CONDITIONS OF CONTRACT (GCC):

1. Validity of the offer: The Offer shall be valid for 120 days from the date of opening.

2. Clarification of bids: During opening or evaluation, the purchaser may at its discretion, seek the

required clarification from the bidders. However, no change in prices or substance of the bid shall be

sought, offered or permitted. If the bid is not substantially responsive, it will be rejected by the Purchaser

and may not subsequently be made responsive by the Bidder by correction of the non-conformity.

Unsigned communication/ bids will not be accepted and will be rejected summarily.

3. EMD: EMD for the specified amount shall be submitted along with the offer by NEFT Beneficiary

name: DIRECTOR NITW, Account No. 52109375198, IFSC Code: SBIN0020149, Bank Name: State

Bank of India, Branch address: NIT COMPLEX, HNK-KAZIPET MAIN ROAD, WARANGAL -

506004. The proof of NEFT details along with a forwarding letter are required to be submitted to the

Director, NITW. No interest will be paid on the EMD. The EMD will be forfeited, if the bidder withdraws

his tender during the validity period of the bid.

4. Prices: As per the Format under the heading FINANCIAL BID is enclosed to this bid document.

Concessions extended to Educational Institutions, if any shall be mentioned in the offer.

5. GST: Inclusive/Exclusive, Indicate prevailing tax on percentage basis. GOI Notification No. 47/2017,

dated 14-11-2017 Central Tax & 45/2017 GoMs No. 250 (TS), dated 21-11-2017 as amended from time

to time and certified copy of Certificate along with a covering letter signed by the Director will be

arranged after receiving the order Acknowledgement.

6. Rates: a) FOR Destination / Ex-works, b) Estimated packing, Forwarding and Freight Charges in case

of E-works only, may be mentioned on percentage basis.

7. Insurance: Inclusive/Exclusive: indicate on percentage basis, in case payable by the Institute.

8. Payment: Payment will be made through RTGS/NEFT upon receipt of ordered item and its satisfactory

performance and on production of bank guarantee at the rate of 10% of the order value wherever

applicable.

9. Liquidity Damage (LD) Clause: The supplies shall be effected as per agreed specifications, quality

and other terms & conditions within the stipulated delivery period. If not delivered in stipulated delivery

period it will attract Liquidity Damage (LD) clause as late delivery charges @ 0.5% per week or part

thereof to maximum of 10% will be deducted from basic price of order item.

10. Evaluation: Evaluation of the Bids shall be made strictly in terms of provisions and criteria disclosed

in the bidding document for the quantities mentioned in the bid. However, the Institute reserves the right

whether to purchase the total quantities or in part thereof.

Notwithstanding the above, the Purchaser reserves the right to accept or reject any quotation, cancel the

bidding process and reject all quotations at any time prior to the award of the contract. Also, the Director

reserves the right to cancel the purchase order if the firm fails to comply with the delivery schedules

without any notice and bid security/EMD will be forfeited accordingly.

11. Security deposit cum Performance Security: The successful tenderer will have to deposit @ 3% of

the order value within 07 days of issuance of LOI/order towards Security Deposit cum Performance

Bank Guarantee for a warranty period in the form of Demand Draft or Bank Guarantee. Else the offer

is liable for rejection and the EMD will be forfeited.

12. Corrupt or Fraudulent practices: The bidders shall observe the highest standard of ethics during the

whole transaction. Contrary to the above the offer will be rejected for award of contract and firms will

be declared as ineligible even for further period as deemed fit by the Institute.

13. JURISDICTION: The Courts of Warangal alone will have the jurisdiction to try and any matter dispute

or reference between the parties arising of this agreement/contract.

In addition, the Special Conditions of Contract (if mentioned along with the specifications of the

item) shall supplement these General Conditions of Contract. Wherever there is a conflict, the

provisions mentioned in the SCC shall prevail over these General Conditions of Contract.

Please note that the institute reserves the right to accept or reject any bid and to annul the bidding

process and reject all bids at any time prior to the award of contract, without thereby incurring

any liability to the affected Bidder or bidders.

II. SPECIAL CONDITIONS OF CONTRACT (SCC)

DESCRIPTION OF THE PARTS OF ISLAND BENCH AND WALL BENCH

DESCRIPTION UNIT TOTAL

QTY

ISLAND BENCH

140X150X90CM NO 1

2cm THICK JET-BLACK GRANITE WORKTOP WITH 9MM THICK PLYBASE (150 CM DEPTH) RMT 1.4

UNDER BENCH 1 DRAWER/STORAGE CABINET 60cm WIDE,60cm Height 48cm DEPTH WITH LOCKS

NO 2

DRAWER 60CM WIDE WITH INNER STORAGE SPACE NO 2

SIDE FRAME ,70CM DEPTH, 86CM HEIGHT NO 4

6 CM HEIGHT FRONT RAIL RM 2.7

BACK FRAME,132CM LONG NO 2

12MM THICK BACK KNEE SPACE PANEL, HIGH RM 2.6

VERTICAL SERVICE BOX 30CM HIGH NO 1

REAGENT RACK, SERVICE BOX 140 CM LONG NO 1

REAGENT RACK, SERVICE STUDS NO 2

16MM THICK JET-BLACK DOUBLE SIDE POLISHED GRANITE WITH STOPPER, 140CM LONG SHELF

NO 2

SERVICE PANEL 60CM HIGH NO 2

6/16 AMPS ELECTRICAL SWITCH SOCKET & MODULE PLATE NO 4

WALL BENCH

140X75X75CM NO 1

2cm THICK JET-BLACK GRANITE WORKTOP WITH 9MM THICK PLYBASE (75 CM DEPTH) RMT 1.4

UNDER BENCH 1 DRAWER/STORAGE CABINET 60cm WIDE,48cm DEPTH WITH LOCKS NO 1

DRAWER 60CM WIDE WITH INNER STORAGE SPACE NO 1

SIDE FRAME ,70CM DEPTH, 71CM HEIGHT NO 2

6 CM HEIGHT FRONT RAIL RM 1.35

BACK FRAME,132CM LONG NO 1

12MM THICK BACK KNEE SPACE PANEL, HIGH RM 1.3

SERVICE PANEL 45CM HIGH NO 2

SINGLE SIDED MS POWDER COATED ELECTRIC TRUNKING BOX NO 2

6/16 AMPS ELECTRICAL SWITCH SOCKET & MODULE PLATE NO 2

TECHNICAL SPECIFICATION FOR FABRICATION, SUPPLY, INSTALLATION, TESTING, VALIDATION AND

HANDING OVER OF LABORATORY FURNITURE

IMPORTANT NOTE: - All specifications shall be read in conjunction with the attached drawings &

bill of quantities (BOQ).

Specifications for Island Bench & Wall bench

a. Worktop:

The Island Bench and Wall Bench Worktop shall be made of 2cm thickness, high-quality Jet-Black Granite

with proper surface sealing with 9mm thick plywood base.

b. Cantilever /C- Framework: Framework shall be of 90cm for standing height for Island Bench and 75cm

for Wall Bench. Worktop shall be supported on heavy duty cantilever steel frame work. All frame work

shall be made of appropriate sections as given in the drawings and made of cold rolled mild steel

(TATA/Jindal or equivalent superior brands) of 3mm thickness or higher. Frame shall be of rectangular

cross section. Frame work shall be designed for safe loading of worktops of up to 210 kilograms per square

meter and to keep service space between wall and under bench units. Frames shall be connected to each

other by means of a front runner of 60mm. Steel frames shall have following dimensions.

Vertical frame of minimum 60x40mm

Horizontal frame top 60x40mm

Horizontal frame bottom 80x40mm

Horizontal Front Rail 60x30mm

All frame works shall be phosphated, primed and polyester powder coated in required color to a thickness

of 60-90 microns and hardened at 260 degrees Celsius. Each cantilever leg shall have adjustable threaded

foot of non-abrasive material such as tough plastic, Nylon etc.

Bottom frame end should be cornered and smoothened for safety.

c. Under bench Storage cabinet and drawer unit:

Under bench storage cabinets and drawers shall be of modular type (detachable from the bench). Under

bench storage cabinets and drawers shall be mounted without being obstructed by the cantilever

frames.

The size of the under-bench cabinet (W x H x D):

600x600x480 mm. (for Island bench).

600x450x480mm (for wall bench).

The complete under bench storage cabinet and drawer unit shall be made of BWP- Boiling Water Proof

(BWP) calibrated plywood or better grade of 16mm thickness and without knot holes or other

imperfections. Thickness of the plywood for the under-bench storage cabinet Bottom, Top, Back, Doors,

Drawer and front shall be 16mm thickness. Plywood shall be laminated with melamine of 1mm thickness

or better. All doors shall be fitted with heavy-duty corrosion-proof snap on hinges that open at least 165

degrees and can be adjusted for alignment in 4 directions. No door catches or magnets should be used.

Hinges should be nickel coated. Doors and drawers shall be fitted with Aluminum grab rail polyester

powder coated. Drawer shall be fitted with epoxy coated steel sides and slide runners with nylon gliders.

Under bench cabinets shall be provided with one adjustable shelf. Adjustable shelf shall be made of

16mm thick furniture grade BWP or higher grades of calibrated plywood without knot holes or other

imperfections and laminated on both sides with 1mm thick melamine and all the exposed edges of the

plywood body should be sealed with machine pressed 2mm thick PVC edging.

All under bench cabinets shall be provided with anti-corrosive locks, one for the drawer and the other

one for the door shutter as per requirements and suitable for laboratory conditions. All the exposed

edges of the plywood body should be sealed with machine pressed 2mm thick PVC edging. All services

shall be covered by sliding panels made up of plywood (16mm and melamine of 1mm) where ever there

is knee space. Drawer shall be fitted with epoxy coated steel sides and slide runners with nylon gliders.

Vertical service box with 30cm height shall be made up of 16mm thick BWP grade plywood with 16mm

thickness and melamine of 1mm.

All the plywood constructions shall be made up of Boiling Water Proof (BWP) calibrated plywood

or better grade (Greenply/Century ply or equivalent superior brands) without knot holes or other

imperfections.

Heavy-duty corrosion-proof snap on hinges, steel sides and slide runners with nylon gliders should

be used superior brands like Hettich, Ebco or equivalent superior brands.

Anti-corrosive locks with key for drawers, under bench cabinets should be used superior brands

like Hettich, Ebco, Godrej or equivalent superior brands.

Plywood shall be laminated with melamine of 1mm thickness or better.

All the exposed edges of the plywood body should be sealed with machine pressed 2mm thick PVC

edging.

Any kind of metal fastens should not be used for the construction of the cabinet, drawers and

service box.

SPECIFICATION AND TESTING METHOD OF BOILING WATER PROOF (BWP) PLYWOOD AS PER IS 710: 2010

THE TECHNICAL SPECIFICATION OF LAMINATE SHALL BE AS MENTIONED BELOW: MINIMUM

SPECIFICATION FOR HIGH PRESSURE LAMINATE

TEST STANDARD UNIT RESULTS

Resistance to surface wear

ISO 4586/II EN 438/IIC

Revs. > 400

Resistance to boiling water % < 8

Resistance to staining - Groups 1-2=5

Resistance to dry heat 1800 C - No Alteration

Resistance to burn Class > 3

Resistance to color change in Xenon light

Blue wool scale < 6

Transverse Electrical resistance

NFPA 99 Ohm 1.108 ÷ 1.10

11

Resistance to fire BS 476 Class 2

d. Reagent Rack & Service Channel for Island bench: -

Reagent racks shall be made of 30x30 mm cold rolled mild steel tubular vertical frame (TATA/Jindal or

equivalent superior brands). Frames shall be fully welded and polyester powder coated. Shelf for reagent

racks shall be 16mm thick double-sided polished Jet-Black Granite with stopper. All piping and outlets

shall be installed in a service channel made from 16mm thick plywood with 1mm thick laminates both

sides which shall be incorporated into reagent shelving to leave maximum space on the worktops. All

the exposed edges of the plywood body should be sealed with machine pressed 2mm thick PVC edging. Any

kind of metal fastens should not be used for the construction of service channel.

Electrical Fittings: 6/16 amps Sockets and switches complete with internal wiring. Fittings are mounted on

plywood service channel.

e. Electric Trunking Box for Wall Bench: -

Trunking Box shall be made of 150x95 mm CRCA polyester powder coated trunking box with 6/16 amps

electrical switch socket & modular plate with internal wiring.

Sockets and switches should be used superior brands like Schneider Electric, L&T, Wipro Northwest,

Havells, Legrand or equivalent superior brands

Special Notes for works in client’s scope:

1 Provision of safe storage area within the site premises.

2 Provision of electrical cable from main junction till Island and wall benches

3 Approval of all colors and layout and General arrangement drawings within a week

from the date of order confirmation

GENERAL NOTES FOR PRICING: -

1

All applicable taxes & duties shall be clearly mentioned in the offer. No extra amount or deviation amount due to non-consideration of any specification, item, taxes, duties or

charges etc., shall not be entertained at any stage during starting from order till final

completion and handing over of the project.

2 The prices shall include complete fabrication, supply, installation, commissioning,

testing and validation of laboratory furniture.

3 All additional charges such as packing, transportation, loading & unloading,

installation,

commissioning, testing and validation etc., shall be clearly mentioned in the offer.

4 All items and components shall have warranty for 12 months from the date of

completion of installation.

5 Validity of the offers shall be for 90 days from the date of submission.

6 Delivery period shall be clearly mentioned in the offer (time for delivery + extra

required time for installation).

Page 14 of 21

VENDOR QUALIFICATIONS REQUIREMENT

Vendors of appropriate class of those who have carried out similar work in Govt. and Semi

Govt. Institutes, Organizations, Pharma/biotech industry R&D Centers, are eligible as per the

minimum requirements defined as below: -

1. This being a prestigious project, we invite the vendors, who are reputed manufacturers/ of the Laboratory Furniture and observing ISO / international standards of Quality for participating the tender.

2. Manufacturer/ their authorized agent should have valid ISO-9001-2015, ISO-14001-2015 and should also have active SEFA Membership and in lack of any evidence as mentioned above, the bid will liable to be rejected.

3. Manufacturer/their authorized agent should have a valid factory license for Manufacturing, Assembling and Supply of Laboratory Furniture.

4. Manufacturers/their authorized agent should have their own modern and sophisticated manufacturing facility having strict quality checks at every level.

5. The vendor will be selected on the basis of the credential and eligibility conditions provided in the technical part. Price bids of the successful bidders who have qualified in the Technical part will only be opened. The minimum eligibility criteria for their capacity shall be as: Sales Turnover - Manufacturer should have minimum annual turnover of Rs. 6 Crores

in last Five years. High Value Order Execution - Manufacturer should have also successfully executed

minimum three similar works each costing not less than Rs. 50 lakh or completed two similar works each costing not less than Rs 75 Lakh or completed one similar work costing not less than Rs 100 lakh for the Supply and Erection of Laboratory Furniture in Govt. Institute & Enterprises, Semi-Government, R & D laboratories.

6. The vendor should be Lab Furniture manufacturing since last 05 Years to prove their standing in the market, experience and quality supply.

7. The vendor should not have been blacklisted by any state / Central Government department PSUs/Autonomous bodies during the last 7 years of its operations. Affidavit shall be made in current date after the date of invitation of the tender shall be furnished on a ‘Non-Judicial’ stamp paper worth Rs.100/-otherwise the tender shall be rejected.

Vendor should submit third party test certificates of SEFA approved laboratory for Laboratory

Furniture.

Page 15 of 21

Modular Computer lab table Specifications

The worktop, horizontal, vertical partitions and key board shall be made of BWP - Boiling

Water Proof (BWP) calibrated plywood or better grade (Greenply/Century ply or equivalent

superior brands) without knot holes or other imperfections.

Plywood should be laminated on both sides with 1mm thick melamine and all the exposed

edges of the plywood body should be sealed with machine pressed 2mm thick PVC edging.

Thickness of the Melamine Laminated Worktop: 24mm

600 mm width x 5200 mm length

18mm Thick Vertical Partition 1200mm Height

18mm Thick Horizontal Partition 1050 Mm Height

Keyboard Tray 60cm Wide with Cable Manager

The keyboard tray shall be fitted with epoxy coated steel sides and slide runners with nylon

gliders (Hettich, Ebco or equivalent superior brands).

6/16 amps electrical switch socket & module plate (Schneider Electric, L&T, Wipro

Northwest, Havells, Legrand or equivalent superior brands) and Ethernet port for internet

at required places.

Electrical wiring and internet cable raceway

Leveling jack at required places.

No metal fastens should not used for joining of the plywood.

Trolley for CPU:

Specifications

Load carrying capacity in Kg 20 +/- 2 Kg

CPU Trolley body average thickness of 1.6 mm steel member conforming to commercial quality

designation CR-1, grade 340 of IS: 513/Latest

Dimension

Width in mm (fully extended): 250±5mm

Width in mm (Fully Compressed): 180±5mm

Depth in mm 300 ±5mm

Length in mm 275 ±5mm

Castor wheel diameter in 40 mm

Castor wheel should be made up of ABS Material

All the steel sections to be painted with black in colour with powder coating 40-50 micron

thickness

Page 16 of 21

Required quantity 1. Modular Computer Lab Table (MCLT) - 20 Units (Each unit - 6 seating) 2. Island Benches (IB)- 50 Units 3. Wall benches (WB) – 80 Units

Page 17 of 21

ANNUAL TURNOVER

Sig. of the Chartered Account with seal

The relevant documents are enclosed as Page Nos.

Certified copies of ITRs are enclosed as page Nos.

Sig. of the tendered with Seal

Annexure I (Format for declaration &

to be enclosed as last page of the bid document)

Annexure-II

(Format for Annual Turnover)

Note: (i) Documentary evidence shall be submitted along with the format

(ii) Certified copies of ITRs of the above years shall be enclosed.

Sl.

No.

Annual turnover w.r.t. above Lab. Furniture Remarks if

any 2018-19 2019-20 2020-21

(1) (2) (3) (4) (5)

Name and Signature

of the competent Authority of the

firm

Date & Seal

DECLARATION

(To be furnished by the supplier on company’s Letter Head)

I/we hereby solemnly declare and affirm that the above documentary

evidence/declarations are true and correct to the best of my knowledge and beliefs. No part

of it is false and nothing has been concealed therein.

Page 18 of 21

Annexure III

(Format for Bank details)

Bank details of the Tenderer for Refund of EMD & for making payment in case L-1

Name of the Beneficiary (fill in Capital Letter)

As per Bank account

Bank Account No. (Beneficiary)

Name of the Bank:

Name of the Branch:

IFSC Code of the Branch

Swift Code/BIC Code (if needed)

PAN No.

Mobile No.

Email ID:

Signature

Name: _____________________

Designation: ________________

Date & Seal of the competent authority of the firm

Page 19 of 21

Signature of the authorized

Signatory of the firm Date & Seal

FORMAT FOR FINANCIAL BID/PRICE BID

Supply of Laboratory Furniture items

Sl. No.

DESCRIPTION TOTAL

QTY Basic Price

GST Total

Amount

1 Island Benches (IB) 50

2 Wall benches (WB) 80

3

Modular Computer Lab Table (MCLT) (Each unit - 6 seating)

20

FINANCIAL BID FOR SUPPLY OF LABORATORY FURNITURE ITEMS

Page 20 of 21

Annexure IV

(Format for Bid Security Declaration form)

BID SECURITY DECLARATION FORM

(In lieu of EMD, as per the directions of MOF, DOE, and GOI. OM No.F.9/4/2020-PPD dated

12.11.2020)

Date: ________

To

The Registrar,

National Institute of Technology, Warangal.

Tender No. ____________

Sir/Madam,

I/We. The undersigned, declare that:

I/We understand that, according to your conditions, bids must be supported by a Bid Security

Declaration.

I/We accept that I/We may be disqualified from bidding for any contract with you for a period of

one year from the date of notification if I am/We are in a breach of any obligation under the

bid conditions, because I/We

(a) have withdrawn/modified/amended, impairs or derogates from the tender, my/our Bid

during the period of bid validity specified in the form of Bid; or

(b) having been notified of the acceptance of our Bid by the purchaser during the period of bid

validity (i) fail or refuse to execute the contract, if required, or (ii) fail or refuse to furnish

the performance Security, in accordance with the Instructions to Bidders.

I/We understand this Bid Securing Declaration shall cease to be valid if I am/we are not the

successful Bidder, upon the earlier of (i) the receipt of your notification of the name of the

successful Bidder; or (ii) thirty days after the expiration of the validity of my/our Bid.

Signature:

In the capacity of: _

Name:

Duly authorized to sign the bid for an on behalf of

M/s. Dated on day of (insert date of signing)

Corporate Seal:

Page 21 of 21

Annexure V

(Format for Bank Guarantee)

FORMAT FOR EMD BANK GUARANTEE

(To be submitted on non-judicial stamp paper of appropriate value purchased in the name of the

issuing Bank)

1. Whereas ………………………………………………………………………….……

(hereinafter called the “tenderer”) has submitted their offer dated……………………for the

supply of ……………………………………………………………………………………

(hereinafter called the “tender”) against the Purchaser’s tender enquiry No.

…………………………………………….

1. KNOW ALL MEN by these presents that WE………………………………………… of

………………………………………….…………………. having our registered office at

……………………………………………….………………. are bound unto

…………………. (hereinafter called the “Purchaser”) in the sum of …………….………

…………………………… for which payment will and truly to be made to the said Purchaser,

the Bank binds itself, its successors and assigns by these presents. Sealed with the Common Seal

of the said Bank this…………… day of ................................................... 20……

2. CONDITIONS OF THIS OBLIGATION ARE:

(i) If the tenderer withdraws or amends, impairs or derogates from the tender in any respect within

the period of validity of this tender.

(ii) If the tenderer having been notified of the acceptance of his tender by the Purchaser during

the period of its validity: -

a. If the tenderer fails to furnish the Performance Security for the due performance of the contract.

b. Fails or refuses to accept/execute the contract.

3. WE undertake to pay the Purchaser up to the above amount upon receipt of its first written

demand, without the Purchaser having to substantiate its demand, provided that in its demand the

Purchaser will note that the amount claimed by it is due to it owing to the occurrence of one or

both the two conditions, specifying the occurred condition or conditions.

4. This guarantee will remain in force up to and including 45 days after the period of tender validity

and any demand in respect thereof should reach the Bank not later than the above date.

…………………………….

(Signature of the authorized officer of the Bank)

………………………………………………………….

Name of the officer

………………………………………………………….

Designation of the officer ………………………………………………………….

Seal, name & address of the Bank and address of the Branch