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Part-I - General details of the entity andtechnical details of the project (to be submitted in a properlyearmarked, sealed and separate envelop)
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| 1 |
Details of the entity. |
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| A |
Name of the entity |
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| B |
Type of firm - Public Limited Company/PrivateLimited Company/Partnership firm/Proprietorship firm/others(please specify and attach copy of Articles of Association orPartnership deed, etc., as applicable).
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| C |
Date of incorporation and date of commencement of business. |
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| D |
Address of registered office. |
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| E |
Name, addresses, telephone, numbers, e-mail IDof all directors/partners/proprietor (please provide full detailswith STD Code and Pin Code).
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| 2 |
Business activities of the entity |
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| A |
Give names of all existing city gas distribution network of the entity, if any, and its installed capacity, capital cost incurred till date, status of .start of operations, year wise gas volumes transported in the network in the past 3 years. alongwith details of customers enrolled, distribution network map showing details of - existing' facilities and future plan and natural gas connectivity details. |
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| B |
Details of tie-up or collaboration with any entity for naturalgas supply and marketing
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| C |
Details of other business, if any, being carriedout by the promoters for the last five years.
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| 3 |
Ownership and affiliate details |
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| A |
Details of Promoters |
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| B |
Details of all affiliates of the entitymentioning of thebusiness relationship between the entity and the affiliates("affiliate means as defined in the relevant regulations foraffiliate code of conduct).
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| C |
The entity undertakes to produce all relevant recordsor documents of itself and its related entities on demand by theBoard.
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Yes/No |
| D |
[Is the entity a company registered under Companies Act, 1956 or Companies Act, 2013?] |
Yes/No |
| E |
[Is the entity promoted by a company registered under CompaniesAct, 1956 or Companies Act, 2013? ]
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Yes/No |
| F |
[The entity undertakes to become a company, incase it is not a company at the time of submission of thisapplication-cum-bid, under the Companies Act, 2013 on beingselected for grant of authorization.]
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Yes/No |
| G |
[Promoters undertaking in the form of letter ofcomfort stating that promotes contribution in the project shall be infused in a phased manner as per the project financing schedule as per the format given in the application cum bid document.]
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Yes/No |
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| 4 |
Technical details of the proposed CGD network project |
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| A |
Name of the proposed CGD network project. |
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| B |
Details of the city, town or area earmarked in developmental zones in respect of the proposed CGD network project along with a sketch showing facilities proposed. |
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| C |
Technical specifications of the project attaching the copy of the feasibility report and covering full details of pipeline design, pressure, length of network, pipeline diameter, pipeline thickness, route, corrosion protection arrangements, city gate station, natural gas source, tap-off points, main block valves, isolation valves, emergency shutdown valves, odourization facilities, metering arrangements, CNG stations, HSE measures, etc. |
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| D |
Development plan envisaged for the proposed CGD network project-design and installed capacity of the CGD network along with details of phased-out capital expenditure plans including the projected dates of commencement of operations phase-wise and the details of the activities or targets associated with the completion of the project to enclosed. |
Yes |
| E |
Estimates of volume of natural gas including supplies to CNGstations before compression proposed to be transported and sold.Also, give details of projected anchor volumes, if any
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| F |
Sources of supply of natural gas a capacitytie-up with the natural gas pipeline including connectivity andthe details of tie-up phase wise, if any.
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| G |
Whether the State or the Union Territory, inwhose jurisdiction the proposed CGD network is located, hasenacted any legislation or has taken administrative action topromote the use of natural gas in the said geographical area? Ifthe reply to the question is yes, then provide copy of the saidenactment or the administrative order.
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Yes/ No |
| H |
Are all applicable technical standards,specifications including safety standards and specifications,including safety standards have been considered and complied within designing the CGD network? Provide full details.
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Yes/No |
| I |
Attach copy of the Disaster Management Plan. |
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| J |
Is the project entitled to any subsidy,exemption, deferment or waiver of any statutory levy from theCentral or the State Governments? If yes, give complete detailsindicating the year-wise utilization plan if the entity.
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Yes/No |
| K |
Non-refundable Application fee under the regulation 5(6) |
Rs. <..........................................................................> |
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Demand draft or pay order |
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Demand draft or pay order number and date |
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Name of issuing bank and branch |
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| L |
Bid bond |
Rs.<..........................................................................> |
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Demand draft or pay order |
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Demand draft or pay order number and date |
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Name of issuing bank and branch |
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