APPENDIX B-5

FORMAT OF CURRICULUM VITAE (CV) FOR PROPOSED PROFESSIONAL STAFF

Proposed Position : Senior Quantity Surveyor

Name of Firm : Wadia Techno Engineer Services Ltd.
Name of Staff : RAZAT KUMAR

Profession : Civil Engineer

Date of Birth : 15.06.1978
Year’s with Firm/Entity : Consent given to join on award of work.
Nationality : Indian
Membership of Professional Societies : Nil

Detailed Task Assigned : He will be reporting to the Team Leader and give input as and when required during the work. He will provide necessary guidance to the
Quantity Surveyor, and shall issue directions/procedures/formats of reporting to the Quantity Surveyor. He will act as a contract specialist also for the
construction package, even though the thrust of his responsibilities will be in the areas of quantity surveying/processing of the invoices etc. He will be responsible
for taking all measures required to control the project cost and time over-runs. He will examine the claims of the contractor, variation orders, if any, and will
approved the progress reports as per the project requirements. He will approve the measurement of all items of works executed in different stages for payment
purpose prepared by Quantity Surveyor.

S.No. Name of Employer Post Held Project Name Period Assignment in the Project Client of the Remarks
From To Project
1. M/s Euroestudios S.L Quantity Construction Service April Till As Quantity Surveyor, responsible PWD
JV Theme Engineering Surveyor for Construction 2015 Date for preparation of Interim Payment Uttrakhand
Service Pvt. Ltd. Supervision of Certificates (IPC), Make Area &
Improvement of
Volume Sheet of Granular Sub
Roads in Uttrakhand
(USRIP Project-3) Base, Water Bond Macadam,
CSC-4, (Phase - III) Bituminous Macadam, Dense
Km 180.215 Roads Bituminous Macadam, Bituminous
in Districts Dehradun Concrete, Paved Shoulder &
and Uttarkashi, ADB Earthen Shoulder etc., Make Grade
Funded Projects in Sheet, Layer Chart & Strip Chart,
Uttrakhand.
Prepare Daily Progress Report,
Weekly Progress Report, Monthly
S.No. Name of Employer Post Held Project Name Period Assignment in the Project Client of the Remarks
From To Project
Progress Report, Daily Stock Report
Etc., Responsible for Letter
dispatching and maintenance in files
& System, Weekly Bill Prepared For
Labour Contractor, Make RFI and
Measurement Sheet, Entry All Type
Data in Computer.

2. Egis India Consulting Quantity Improvement/ Feb March As Quantity Surveyor, responsible PWD
Engineers Pvt. Ltd. Surveyor Strengthening of 2014 2015 for preparation of Interim Payment Uttarakhand
Roads in Contract Certificates (IPC), Make Area &
Package No. 13 Volume Sheet of Granular Sub
(Phase - III) Km Base, Water Bond Macadam,
31.61 (Pkg-13) ADB Bituminous Macadam, Dense
Funded Projects in Bituminous Macadam, Bituminous
Uttrakhand; Project Concrete, Paved Shoulder &
Cost: INR 23.06 Earthen Shoulder etc., Make Grade
crore; Length: 31.61 Sheet, Layer Chart & Strip Chart,
Km Prepare Daily Progress Report,
Weekly Progress Report, Monthly
Progress Report, Daily Stock Report
Etc., Responsible for Letter
dispatching and maintenance in files
& System, Weekly Bill Prepared For
Labour Contractor, Make RFI and
Measurement Sheet, Entry All Type
Data in Computer.
3. NKG Infrastructure Ltd. Quantity Widening and Sept. Jan As Quantity Surveyor, responsible HPRIDC
Surveyor Strengthening of 2011 2014 for preparation of Interim Payment
Dramman- Sihunta Certificates (IPC), Make Area &
from Km 0.000 to Km Volume Sheet of Embankment,
24.050 (Pkg-09) 2 Subgrade, Granular Sub Base, Wet
Lane of World Bank Mix Macadam, Bituminous
Projects in Himachal Macadam, Dense Bituminous
Pradesh; Project Macadam, Bituminous Concrete,
Cost: INR 43 crore; Paved Shoulder & Earthen Shoulder
Length: 24.050 Km;. etc., Make Grade Sheet, Layer Chart
S.No. Name of Employer Post Held Project Name Period Assignment in the Project Client of the Remarks
From To Project
& Strip Chart, Prepare Daily
Progress Report, Weekly Progress
Report, Monthly Progress Report,
Daily Stock Report Etc., Responsible
for Letter dispatching and
maintenance in files & System,
Weekly Bill Prepared For Labour
Contractor, Make RFI and
Measurement Sheet, Entry All Type
Data in Computer.
4. Dilip Buildcon Pvt. Ltd. Quantity Widening and Jan Sep As Quantity Surveyor, involved in the HPRIDC
Surveyor Strengthening of 2010 2011 preparation of Interim Payment
Bhawarna- Certificates (IPC), Make Area &
Lambagaon from Km Volume Sheet of Embankment,
0.000 to Km 26.280 Subgrade, Granular Sub Base, Wet
(Pkg-10) 2 Lane of Mix Macadam, Bituminous
World Bank Projects Macadam, Dense Bituminous
in Himachal Macadam, Bituminous Concrete,
Pradesh; Project Paved Shoulder & Earthen Shoulder
Cost: INR 56 crore; etc., Make Grade Sheet, Layer Chart
Length: 26.280 Km & Strip Chart, Prepare Daily
Progress Report, Weekly Progress
Report, Monthly Progress Report,
Daily Stock Report Etc., Responsible
for Letter dispatching and
maintenance in files & System,
Weekly Bill Prepared For Labour
Contractor, Make RFI and
Measurement Sheet, Entry All Type
Data in Computer.
5. Dewas Bhopal Corridor Quantity Dewas – Bhopal May Jan As Quantity Surveyor, involved in the MPRDC
Pvt. Ltd Surveyor Road Project on 2007 2010 preparation of Interim Payment
Build Operate Certificates (IPC), Make Area &
Transfer (BOT) Basis Volume Sheet of Embankment,
from Bhopal To Subgrade, Granular Sub Base, Wet
Dewas Four Lanning Mix Macadam, Bituminous
Project, SH 18 Macadam, Dense Bituminous
Project length: Macadam, Bituminous Concrete,
S.No. Name of Employer Post Held Project Name Period Assignment in the Project Client of the Remarks
From To Project
142.64 Kms, 4 lane, Paved Shoulder & Earthen Shoulder
Project Cost: 480 etc., Make Grade Sheet, Layer Chart
crores; & Strip Chart, Prepare Daily
Progress Report, Weekly Progress
Report, Monthly Progress Report,
Daily Stock Report Etc., Responsible
for Letter dispatching and
maintenance in files & System,
Weekly Bill Prepared For Labour
Contractor, Make RFI and
Measurement Sheet, Entry All Type
Data in Computer.
6. MSK Projects Ltd. Asst. Quantity Strengthening & Feb Apr As Astt. Quantity Surveyor, Gujarat State
Surveyor Widening of 14/200 2005 2007 responsible for Make Grade Sheet, Road
to 52/400 Two Layer Chart & Strip Chart.Prepare Development
Lanning of SH-65 Daily Progress Report, Monthly
BOT Project. Project Progress Report, Daily Stock Report
length: 38.200 Kms, Etc. Responsible for Letter
2 lane, ,Project Cost: dispatching and maintenance in files
INR 76.54 crores; & System. Weekly Bill Prepared For
Labour Contractor. Entry All Type
Data in Computer.
7. KNR Construction Ltd. Asst. Quantity Strengthening, April Jan As Astt. Quantity Surveyor, P.W.D. Uttar
Surveyor Upgrading & 2003 2005 responsible for Make Grade Sheet, Pradesh
Rehabilitation of Layer Chart & Strip Chart. Prepare
Shahjahanpur to Daily Progress Report, Monthly
Farrukhabad (U.P.) Progress Report, Daily Stock Report
Project length: 82 Etc. Responsible for Letter
Kms, 2 lane, Funded dispatching and maintenance in files
by: P.W.D. Uttar & System. Weekly Bill Prepared For
Pradesh, Project Labour Contractor. Entry All Type
Cost: INR 180.00 Data in Computer
crores;
8. M/s Srinath JI Asst. Quantity Nagra to Rasra Road Oct. Mar As Astt. Quantity Surveyor, P.W.D. Uttar
Construction Co.Pvt. Surveyor repairing and 2000 2003 responsible for Make Grade Sheet, Pradesh
Ltd. maintenance. Project Layer Chart & Strip Chart. Prepare
length: 24 Kms, 2 Daily Progress Report, Monthly
S.No. Name of Employer Post Held Project Name Period Assignment in the Project Client of the Remarks
From To Project
lane, Funded by: Progress Report, Daily Stock Report
PWD Uttar Pradesh, Etc. Responsible for Letter
Project Cost: INR 39 dispatching and maintenance in files
crores; . & System. Weekly Bill Prepared For
Labour Contractor. Entry All Type
Data in Computer.

Education :
B. E. (Civil Engineering), M.S. Bidve Engineering College Latur (M.S.), 2001
Key Qualifications :
I am a Graduate in Civil Engineering having 16 years of extensive experience in the area of construction supervision, quality control of materials and execution of highway works.
I have been involved in monitoring day to day progress of work, participation of executed works and maintaining records therefore, quality control checks at site and progress monitoring of all field
activities, maintaining quality assurance processor, preparation of bill, selection of sub contractor and maintaining deployment of man power and construction machinery,-claims processing. Also
conversant with IS Codes, IRC Standard, MORT&H Specification for quality control of road projects.
Employed Record :

S.No. Name of Employer Post Held Project Name Period Assignment in the Project Client of the Remarks
From To Project
1. M/s Euroestudios S.L Quantity Construction Service April Till As Quantity Surveyor, responsible PWD
JV Theme Engineering Surveyor for Construction 2015 Date for preparation of Interim Payment Uttrakhand
Service Pvt. Ltd. Supervision of Certificates (IPC), Make Area &
Improvement of
Volume Sheet of Granular Sub
Roads in Uttrakhand
(USRIP Project-3) Base, Water Bond Macadam,
CSC-4, (Phase - III) Bituminous Macadam, Dense
Km 180.215 Roads Bituminous Macadam, Bituminous
in Districts Dehradun Concrete, Paved Shoulder &
and Uttarkashi, ADB Earthen Shoulder etc., Make Grade
Funded Projects in Sheet, Layer Chart & Strip Chart,
Uttrakhand.
Prepare Daily Progress Report,
Weekly Progress Report, Monthly
Progress Report, Daily Stock Report
Etc., Responsible for Letter
dispatching and maintenance in files
S.No. Name of Employer Post Held Project Name Period Assignment in the Project Client of the Remarks
From To Project
& System, Weekly Bill Prepared For
Labour Contractor, Make RFI and
Measurement Sheet, Entry All Type
Data in Computer.

2. Egis India Consulting Quantity Improvement/ Feb March As Quantity Surveyor, responsible PWD
Engineers Pvt. Ltd. Surveyor Strengthening of 2014 2015 for preparation of Interim Payment Uttarakhand
Roads in Contract Certificates (IPC), Make Area &
Package No. 13 Volume Sheet of Granular Sub
(Phase - III) Km Base, Water Bond Macadam,
31.61 (Pkg-13) ADB Bituminous Macadam, Dense
Funded Projects in Bituminous Macadam, Bituminous
Uttrakhand; Project Concrete, Paved Shoulder &
Cost: INR 23.06 Earthen Shoulder etc., Make Grade
crore; Length: 31.61 Sheet, Layer Chart & Strip Chart,
Km Prepare Daily Progress Report,
Weekly Progress Report, Monthly
Progress Report, Daily Stock Report
Etc., Responsible for Letter
dispatching and maintenance in files
& System, Weekly Bill Prepared For
Labour Contractor, Make RFI and
Measurement Sheet, Entry All Type
Data in Computer.
3. NKG Infrastructure Ltd. Quantity Widening and Sept. Jan As Quantity Surveyor, responsible HPRIDC
Surveyor Strengthening of 2011 2014 for preparation of Interim Payment
Dramman- Sihunta Certificates (IPC), Make Area &
from Km 0.000 to Km Volume Sheet of Embankment,
24.050 (Pkg-09) 2 Subgrade, Granular Sub Base, Wet
Lane of World Bank Mix Macadam, Bituminous
Projects in Himachal Macadam, Dense Bituminous
Pradesh; Project Macadam, Bituminous Concrete,
Cost: INR 43 crore; Paved Shoulder & Earthen Shoulder
Length: 24.050 Km;. etc., Make Grade Sheet, Layer Chart
& Strip Chart, Prepare Daily
Progress Report, Weekly Progress
Report, Monthly Progress Report,
S.No. Name of Employer Post Held Project Name Period Assignment in the Project Client of the Remarks
From To Project
Daily Stock Report Etc., Responsible
for Letter dispatching and
maintenance in files & System,
Weekly Bill Prepared For Labour
Contractor, Make RFI and
Measurement Sheet, Entry All Type
Data in Computer.
4. Dilip Buildcon Pvt. Ltd. Quantity Widening and Jan Sep As Quantity Surveyor, involved in the HPRIDC
Surveyor Strengthening of 2010 2011 preparation of Interim Payment
Bhawarna- Certificates (IPC), Make Area &
Lambagaon from Km Volume Sheet of Embankment,
0.000 to Km 26.280 Subgrade, Granular Sub Base, Wet
(Pkg-10) 2 Lane of Mix Macadam, Bituminous
World Bank Projects Macadam, Dense Bituminous
in Himachal Macadam, Bituminous Concrete,
Pradesh; Project Paved Shoulder & Earthen Shoulder
Cost: INR 56 crore; etc., Make Grade Sheet, Layer Chart
Length: 26.280 Km & Strip Chart, Prepare Daily
Progress Report, Weekly Progress
Report, Monthly Progress Report,
Daily Stock Report Etc., Responsible
for Letter dispatching and
maintenance in files & System,
Weekly Bill Prepared For Labour
Contractor, Make RFI and
Measurement Sheet, Entry All Type
Data in Computer.
5. Dewas Bhopal Corridor Quantity Dewas – Bhopal May Jan As Quantity Surveyor, involved in the MPRDC
Pvt. Ltd Surveyor Road Project on 2007 2010 preparation of Interim Payment
Build Operate Certificates (IPC), Make Area &
Transfer (BOT) Basis Volume Sheet of Embankment,
from Bhopal To Subgrade, Granular Sub Base, Wet
Dewas Four Lanning Mix Macadam, Bituminous
Project, SH 18 Macadam, Dense Bituminous
Project length: Macadam, Bituminous Concrete,
142.64 Kms, 4 lane, Paved Shoulder & Earthen Shoulder
Project Cost: 480 etc., Make Grade Sheet, Layer Chart
crores; & Strip Chart, Prepare Daily
S.No. Name of Employer Post Held Project Name Period Assignment in the Project Client of the Remarks
From To Project
Progress Report, Weekly Progress
Report, Monthly Progress Report,
Daily Stock Report Etc., Responsible
for Letter dispatching and
maintenance in files & System,
Weekly Bill Prepared For Labour
Contractor, Make RFI and
Measurement Sheet, Entry All Type
Data in Computer.
6. MSK Projects Ltd. Asst. Quantity Strengthening & Feb Apr As Astt. Quantity Surveyor, Gujarat State
Surveyor Widening of 14/200 2005 2007 responsible for Make Grade Sheet, Road
to 52/400 Two Layer Chart & Strip Chart.Prepare Development
Lanning of SH-65 Daily Progress Report, Monthly
BOT Project. Project Progress Report, Daily Stock Report
length: 38.200 Kms, Etc. Responsible for Letter
2 lane, ,Project Cost: dispatching and maintenance in files
INR 76.54 crores; & System. Weekly Bill Prepared For
Labour Contractor. Entry All Type
Data in Computer.
7. KNR Construction Ltd. Asst. Quantity Strengthening, April Jan As Astt. Quantity Surveyor, P.W.D. Uttar
Surveyor Upgrading & 2003 2005 responsible for Make Grade Sheet, Pradesh
Rehabilitation of Layer Chart & Strip Chart. Prepare
Shahjahanpur to Daily Progress Report, Monthly
Farrukhabad (U.P.) Progress Report, Daily Stock Report
Project length: 82 Etc. Responsible for Letter
Kms, 2 lane, Funded dispatching and maintenance in files
by: P.W.D. Uttar & System. Weekly Bill Prepared For
Pradesh, Project Labour Contractor. Entry All Type
Cost: INR 180.00 Data in Computer
crores;
8. M/s Srinath JI Asst. Quantity Nagra to Rasra Road Oct. Mar As Astt. Quantity Surveyor, P.W.D. Uttar
Construction Co.Pvt. Surveyor repairing and 2000 2003 responsible for Make Grade Sheet, Pradesh
Ltd. maintenance. Project Layer Chart & Strip Chart. Prepare
length: 24 Kms, 2 Daily Progress Report, Monthly
lane, Funded by: Progress Report, Daily Stock Report
PWD Uttar Pradesh, Etc. Responsible for Letter
Project Cost: INR 39 dispatching and maintenance in files
S.No. Name of Employer Post Held Project Name Period Assignment in the Project Client of the Remarks
From To Project
crores; . & System. Weekly Bill Prepared For
Labour Contractor. Entry All Type
Data in Computer.

Languages :

Language known Speaking Reading Writing

English Excellent Excellent Excellent
Hindi Excellent Excellent Excellent

Summary of Qualification & Experience vis-à-vis the requirements as per TOR

Requirement as per TOR Possessed by the Staff Member Break-up of experience
(Enclosed-B) Brief Description of Project Man-months provided
General Qualification including Total Professional Experience
(a) Graduate in Civil Engineering from a B. E. (Civil Engineering), M.S. Bidve Engineering College Latur (M.S.), 2001
recognized University.

(b)Total Professional Experience of 15 years 8 Project Construction Service for Construction Supervision of Improvement of Roads in 18 Months
in handling Highway Contracts Uttrakhand (USRIP Project-3) CSC-4, (Phase - III) Km 180.215 Roads in
Districts Dehradun and Uttarkashi, ADB Funded Projects in Uttrakhand.

Improvement/ Strengthening of Roads in Contract Package No. 13 (Phase - III) 13 Months

Km 31.61 (Pkg-13) ADB Funded Projects in Uttrakhand; Project Cost: INR
23.06 crore; Length: 31.61 Km.

Widening and Strengthening of Dramman- Sihunta from Km 0.000 to Km

24.050 (Pkg-09) 2 Lane of World Bank Projects in Himachal Pradesh; Project 28 Months
Cost: INR 43 crore; Length: 24.050 Km;.

Widening and Strengthening of Bhawarna- Lambagaon from Km 0.000 to Km

26.280 (Pkg-10) 2 Lane of World Bank Projects in Himachal Pradesh; Project 21 Months
Cost: INR 56 crore; Length: 26.280 Km.
 Requirement as per TOR
(Enclosed-B)
(c) At least 10 years experience as Quantity
Surveyor in Highway project.
Possessed by the Staff Member Break-up of experience
Brief Description of Project Man-months provided
Construction Supervision for Dewas – Bhopal Road Project on Build Operate
Transfer (BOT) Basis from Bhopal To Dewas Four Lanning Project, SH 18 33 Months
Project length: 142.64 Kms, 4 lane, Project Cost: 480 crores;
Strengthening & Widening of 14/200 to 52/400 Two Lanning of SH-65 BOT 26 Months
Project. Project length: 38.200 Kms, 2 lane, ,Project Cost: INR 76.54 crores;
Strengthening, Upgrading & Rehabilitation of Shahjahanpur to Farrukhabad 21 Months
(U.P.) Project length: 82 Kms, 2 lane, Funded by: P.W.D. Uttar Pradesh,
Project Cost: INR 180.00 crores;
Nagra to Rasra Road repairing and maintenance. Project length: 24 Kms, 2 29 Months
lane, Funded by: PWD Uttar Pradesh, Project Cost: INR 39
Construction Service for Construction Supervision of Improvement of Roads in 18 Months
Uttrakhand (USRIP Project-3) CSC-4, (Phase - III) Km 180.215 Roads in
Districts Dehradun and Uttarkashi, ADB Funded Projects in Uttrakhand.
Improvement/ Strengthening of Roads in Contract Package No. 13 (Phase - III) 13 Months
Km 31.61 (Pkg-13) ADB Funded Projects in Uttrakhand; Project Cost: INR
23.06 crore; Length: 31.61 Km.
Widening and Strengthening of Dramman- Sihunta from Km 0.000 to Km
24.050 (Pkg-09) 2 Lane of World Bank Projects in Himachal Pradesh; Project 28 Months
Cost: INR 43 crore; Length: 24.050 Km;.
Widening and Strengthening of Bhawarna- Lambagaon from Km 0.000 to Km
26.280 (Pkg-10) 2 Lane of World Bank Projects in Himachal Pradesh; Project 21 Months
Cost: INR 56 crore; Length: 26.280 Km.
Construction Supervision for Dewas – Bhopal Road Project on Build Operate
Transfer (BOT) Basis from Bhopal To Dewas Four Lanning Project, SH 18 33 Months
Project length: 142.64 Kms, 4 lane, Project Cost: 480 crores;
Strengthening & Widening of 14/200 to 52/400 Two Lanning of SH-65 BOT 26 Months
Project. Project length: 38.200 Kms, 2 lane, ,Project Cost: INR 76.54 crores;
 Requirement as per TOR
(Enclosed-B)
(d) He should have handled as Quantity
Surveyor in atleast two projects in
Construction Supervision of Two/four of laning
Highways.
(e) Not more than 60 years of age.
Possessed by the Staff Member
2 Projects
Break-up of experience
Brief Description of Project Man-months provided
Construction Service for Construction Supervision of Improvement of Roads in 18 Months
Uttrakhand (USRIP Project-3) CSC-4, (Phase - III) Km 180.215 Roads in
Districts Dehradun and Uttarkashi, ADB Funded Projects in Uttrakhand.
Construction Supervision for Dewas – Bhopal Road Project on Build Operate 33 Months
Transfer (BOT) Basis from Bhopal To Dewas Four Lanning Project, SH 18
Project length: 142.64 Kms, 4 lane, Projct Cost: 480 cr
38 Year

2) Preferential Qualifications.
a) Post Graduate Degree in Construction
Management/Engineering/certificate course in
management/ certificate course in construction Nil
management/certificate course in contract
management.

Certification by the Candidate :

I the undersigned, Mr. Razat Kumar, S/o Shri Gaya Prasad, Village Masani P/o. Maseni, Farukhabad (U.P.) - 209601 undertake that this CV correctly describes myself, my qualifications and
my experience and Employer would be at liberty to debar me if any information given in the CV, in particular the Summary of Qualification & Experience vis-à-vis the requirements as per TOR is
found incorrect. I further undertake that I have neither been debarred by NHAI or any other central/state government organization nor left any assignment with the consultants engaged by Employer
/ contracting firm (firm to be supervised now) for any continuing work of Employer without completing my assignment. I will be available for the entire duration of the current project “Consultancy
Services for Authority’s Engineering for Authority Engineer for Widening to two lane with paved shoulders including construction of CD structures from km 81 to 175, length 90.34 km
on NH-86 Ext. Vidish Sagar road on EPC mode in the state of Madhya Pradesh If I leave this assignment in the middle of the work, Employer would be at liberty to debar me from taking any
assignment in any of the Employer works for an appropriate period of time to be decided by the Employer. I have no objection if my services are extended by the Employer for this work in future.

I further undertake that my CV is being proposed for this project by Wadia Techno Engineer Services Ltd and I have not given consent to any other consultant(s) to propose my CV for any
position for this project.
I further undertake that if due to my inability to work on this project due to unavoidable circumstances, due to which consultant’s firm is forced to seek replacement. In such unavoidable
circumstances, I shall not undertake any employment in Employer projects during the period of assignment of this project and Employer shall consider my CV invalid till such time.

I undertake that I have no objection in uploading/hosting of my credentials by Employer in public domain.

For Key Personnel having intermittent inputs, add the following: I further certify that I am associated with the following assignments as on date (as on 7 days prior to due date for submission of
proposal) including those for which LOA has been received by the firm and the inputs in these assignments shall not effect the work of the current assignment.
 Name of Assignment Client Date of LOA Likely start (Month/ Year) Likely end (Month/ Year) Total input of the person (man-months)
NOT APPLICABLE

………………………………………….. Date : ………………..

(Signature of Key Personnel) (Day/Month/Year)

Certification by the firm

The undersigned on behalf of Wadia Techno Engineer Services Ltd. certify that the qualification and experience details of Mr. Razat Kumar, S/o Shri Gaya Prasad, Village Masani P/o.
Maseni, Farukhabad (U.P.) - 209601 as described in the CV has been checked and found to be correct. It is also certified that Mr. Razat Kumar, S/o Shri Gaya Prasad, Village Masani P/o.
Maseni, Farukhabad (U.P.) - 209601) to the best of our knowledge has neither been debarred by NHAI or any other Central/State Government organization nor left his assignment with any other
consulting firm engaged by the Employer / Contracting firm (firm to be supervised now) for the ongoing projects. We understand that if the information about leaving the past assignment is known to
the Employer, Employer would be at liberty to remove the personnel from the present assignment and debar him for an appropriate period to be decided by the Employer.

………………………………………….. Date : ……………………………..

(Signature of authorized representative of the Firm) (Day/Month/Year)