ANNEXURE-1

DECLARATION SHEET

I,…………………………………………………………………………… declare that all the information and data furnished by me with regard to this Tender Specification No. BECL/……………………….………… are true and complete to the best of my knowledge.

I have gone through the specifications, conditions and stipulations in detail and agree to comply with the requirements and intent of specification, including reinsurance arrangements.

I further certify that I am the duly authorized representative of the under mentioned Bidding Insurance Company and a valid power of attorney to this effect, if required, will be submitted.

Signature of the Authorized Representative
Name :
Office Address :
Stamp of the Bidding Insurance Company

ANNEXURE – 2

DEVIATION STATEMENT

(Pl. strike off the clause which is not applicable and tick the other)

1)THIS IS TO DECLARE THAT WE DO NOT HAVE ANY DEVIATIONS IN THE STIPULATIONS OF YOUR TENDER AND ACCORDINGLY ACCEPT ALL THE STIPULATIONS WITHOUT ANY RESERVATIONS WHATSOEVER.

OR

2)WE HAVE TAKEN FOLLOWING DEVIATIONS IN THE COVERAGE.

Sr. No / Type of Policy / Deviation taken

Authorized representative’s signature with name and address

ANNEXURE – 3

Insurance Service Contract between

BECL and ______Insurance Company Ltd .

Consequent upon enquiry floated by BECL for various operational policies in respect of their 2x250 MW lignite based Thermal Power Project at village Padva, Tal Ghogha. District Bhavnagar, Gujarat and for establishment of good understanding and to ensure quality & deficiency free service and furthermore the provision of efficient and satisfactory services by the underwriters, this contract has been signed between M/s ______(Name of Insurer ) having their office ______and having its branch at Ahmedabad/Gandhinagar ( hereinafter referred as underwriter in single and / or underwriters in plural or the leader of the consortium ) and Bhavnagar Energy Co. Ltd (BECL) having its office at Block No. 8, 3rd Floor, UdyogBhavan, Sector – 11, Dist.: Gandhinagar, Gujarat, India – 390007. The Parties, hereby, agree as follows:

A. Documentation

1.The underwriter will issue the Premium Receipt and the Cover note for the desired coverage, immediately on receipt of the necessary premium cheque and / or Bank Guarantee by them as the case may be.

2.The corresponding policy documents will be issued by the underwriter to BECL within 3 working days of the receipt of the premium cheque or /Bank Guarantee.

3.Any amendment or endorsement in the policies shall be confirmed by issuing amendment /endorsement within 1 working days of the receipt of the necessary request / information, if needed the necessary premium from BECL. In case of emergency BECL has right to ask for the amendment / endorsement on Telephone and the same shall be acted upon by the underwriter, however later on written request may be sent to Underwriter.

B. Claims

1.A panel of approved Surveyors, to be utilized in case of all losses/damages for which necessary claims are to be lodged, shall be finalised by mutual discussions within 15 days of signing of this agreement or such date as may be mutually be agreed upon.

2.All claims lodged on the underwriter shall be promptly settled as per the following understanding.

a)Irrespective of the amount of claim, "On Account Payment" of 75% of the claimed amount shall be made by the underwriter without any demur within 3 days of the occurrence of the insured peril. For the sake of brevity it is clarified that documents required to be obtained from govt. agencies like FIR, Final Report from Police authorities and Fire Brigade Report etc. shall not be binding for release of On Account Payment.

b)Rest 25% claim amount (Final payment of the claim) shall be made within 5 days of receipt of Final Survey Report and all necessary supporting documents/information from BECL.

c)In case of delay beyond 30 days in settlement of any Claim, the underwriter shall be liable to pay interest at a rate 2% per month.

d)In the event of a loss, the underwriter shall appoint Surveyor/ Loss Adjustor immediately on the receipt of notification, however online intimation or intimation on Phone by BECL to the authorized person of the underwriter shall be construed as valid intimation under the policies. Furthermore, a dedicated person from the claim department of the Underwriter shall be allocated to BECL and his telephone, fax and ID shall be intimated.

3.BECL has been authorised for Self Survey in respect of claims with estimated loss upto amount of Rs. 20,000 or such higher amount as mentioned in Insurance Act 1938 or rule made there under from time to time.

4.The underwriter has agreed to provide to BECL with a comprehensive procedure and documents to be followed in case of claims, within 30 days of commencement of insurance of BECL’s risk.

C. Others/ Miscellaneous.

  1. The underwriters confirm that the premium quoted is final and are as per the internally / Board approved guidelines or underwriting policy and that there is no violation of any or other mandatory guidelines/rules. Any upward revision, other than due to tariff revision and govt. levies and duties, in the premium, if found at later date, will be borne by the underwriter. The benefit due to downward revision, due to tariff revision and Govt. levies, in the premium shall be passed on to M/s. BECL. An undertaking towards this must be submitted as given in Annexure 7.
  1. The Leader has appointed following persons to service directly BECL account in respect of all matters including underwriting or / and claim. Their present address and contact Nos. are as under ;

(a)

(b)

  1. The underwriter agrees and undertakes to carryout minimum three visits/inspections by their experienced Risk Engineers or TAC accredited professional during the policy period.
  1. The underwriter has further agreed to hold one seminar/training every year exclusively for BECL employees to update them with latest trends in Insurance.
  1. BECL shall be dealing/interacting directly with the leader of the consortium namely M/s ______for all relating matters and the leader shall, in turn, interact, with the co insurers, if any. ______shall be responsible for all acts/duties as there is/were single insurance company providing insurance cover to BECL.
  1. The underwriter hereby agree to include Unit II during the currency of the policy on pro-rata basis.
  1. The underwriter unequivocally agrees that during the year / tenure of Policy, BECL can increase or decrease the Sum Insured of any of the assets / liability etc. of any of the policies in order to make it match with market conditions and for that only pro-rata rate shall be applicable not short period rates.
  1. The underwriter unequivocally agrees that there may be some spill over of sum insured amount from one part of the assets into another part of the same asset or of some other asset but in the same category then no underinsurance shall be applicable. Which means excess of some assets, if done by BECL on account of its judgment, may be set off against the short value of other assets.
  1. The Underwriter agrees to refund the pro rata premium on account of Business Interruption if the audited Annual Gross Profit ending 31-03-2017 happens to be lower than what has been taken in the Policy. It also agrees to refund the pro rata premium of Industrial Liability if the audited Turn Over for 31-03-2017 happens to be lower than what has been taken in the said Policy.
  1. It is agreed that the Surveyor shall be appointed with the consent of BECL.
  1. BECL has not engaged any intermediary (any agent or broker) for purchase of insurance & that all policies are being placed directly to Insurers by BECL. Please provide your declaration/undertaking vide Annexure 8 stating that all benefits towards this shall be passed on to BECL.
  1. Underwriter agrees to provide the following value added risk advisory services to BECL:
  1. Portfolio Analysis.
  2. Safety Audit
  3. Methodology for valuation of assets.
  4. Hazop Study
  5. Certification of FEA installations.

D. Breach of the contract.

In case of breach or violation of any of the provisions of this agreement/ contract, the underwriter shall have to pay penalty of such amount as may have suffered by BECL whether actual or notional and furthermore it shall have such rights as may be deemed fit by BECL.

E. Indemnity.

In addition to clause D, underwriter shall also indemnify BECL of all actual or notional or consequential losses which BECL may suffer as a result of breach of underwriters of the underwriting policy /guidelines/ directives / rules by underwriter. This means that the underwriter shall make all losses, actual or notional or consequential, good to BECL in the event of breach of any of the guidelines

For,For,

Bhavnagar Energy Company Limited ______-

Sign:Sign:

Name:Name:

Designation:Designation:

Date :

Place :

Accepted, agreed and noted.

Other Consortium Members.Signature.

ANNEXURE - 4

CERTIFICATE OF CONFIRMATION OF IRDA / TAC GUIDELINES.

I……………………………………………hereby certify on behalf of ……..………… that our offer No. ……………... dated…………...against Tender Specification No…………..…….. does not breach Insurance Act / IRDA guidelines.

“We state that the rates of premium and the various discounts offered by us are strictly as per the approval of IRDA and the file and use guidelines of IRDA. We have included all necessary taxes, cess+ levies which are required to be collected from BECL. The insurance premium quoted by us is full and final and there will be no recovery on any account or any reason.

Subject to this we further undertake that in case of any claim under the policy , the recovery of premium from BECL and the applicability of discount also the calculation of terrorism premium and service tax etc , will not be an impediment nor will it jeopardize in any manner in the settlement of claim, if any, lodged by BECL.”

Further we certify that there is no change in policy wordings from existing tariff wordings and our offered bids are not ULTRA VIRUS to IRDA guidelines as on date of BID submission.

Signature of the Authorized Representative
Name :
Office Address :
Stamp of the Bidding Insurance Company

ANNEXURE - 5

COMMITMENT FOR ACCEPTANCE OF CO- INSURANCE SHARE.

I / We of ______Company hereby confirm on behalf of ______and in pursuance of my / our Offer No. ______dtd ______against tender specification No. ______dtd ______that I / We accept share in co-insurance business if any and as is deemed fit by the Bhavnagar Energy Company Ltd. Further, I / We confirm that my / our acceptance as above will be without any condition on the part of Bhavnagar Energy Company Ltd.

Signature of the Authorized Representative
Name :
Office Address :
Stamp of the Bidding Insurance Company

ANNEXURE - 6

Experience in servicing Thermal Power Plant

Sr. No. / Terchnical details / 2013-14 / 2014-15 / 2015-16
1 / No. of clients served as a lead insurer in IAR policy/ policies for Single Insured for a minimum Material damage Sum Insured of Rs. 500 crores.
-No. of Client
-Sum Insured
2 / Gross written premium
3 / Reinsurance Arrangement
4 / Solvency margin
5 / Registration with GGIF
Signature of the Authorized Representative
Name :
Office Address :
Stamp of the Bidding Insurance Company

ANNEXURE - 7

Undertaking regarding premium quoted

“We state that the rates of premium and the various discounts offered by us in our offer for BECL’s Power Plants are strictly as applicable as per IRDA Guidelines. We have indicated separately all necessary taxes, cess + levies, which are required to be collected from BECL. The insurance premium quoted by us is full and final and there will be no recovery on that account. We further undertake that in case of any claim under the policy, the recovery of premium from BECL and the applicability of discount and service tax etc. will not be an impediment nor will it jeopardize in any manner in the settlement of claim, if any, lodged by BECL”.

Signature of the Authorized Representative
Name :
Office Address :
Stamp of the Bidding Insurance Company

ANNEXURE - 8

DECLARATION SHEET

We,………………… have noted that BECL has not engaged any intermediary (any agent or broker) for purchase of insurance & that All policies are being placed directly to Insurers by BECL. Accordingly, we have not considered any commission payable to any intermediary in our premium quote and we undertake not to pass on any such commission/brokerage to any intermediary.

Signature of the Authorized Representative
Name :
Office Address :
Stamp of the Bidding Insurance Company