F O R M - B

DIRECTORATE GENERAL OF SUPPLIES & DISPOSALS

(QUALITY ASSURANCE WING)

Application form for registration of firms as

authorised agents/distributors of manufacturers for indigenous stores

or as stockists of indigenous natural products.

(To be submitted in duplicate)

1. Category under which registration a) Authorised Agent

sought:( tick as appropriate) b) Distributor

c) Stockist of natural product

2. Information relating to

manufacturer(s)

a) Particulars of manufacturers

Name/address/telephone/fax/E-mail nos.

i) Office

ii) Works

b) Indicate date of agreement/expiry

and territorial jurisdiction

productwise if any. Attach copy of

valid agreement with the

manufacturer duly notarised:

c) Whether the manufacturer has

entered into such agreement with any

other firm for their products or for

different territory.If yes,give

details.

d) If the manufacturer is regd.

with DGS&D, enclose copy of

regn.certificate and indicate the

date upto which the regn.

is valid.

If not, state whether they have

applied for the same.

e) If the Manufacturer is willing to

offer his product for inspection at

his premises for contracts placed on

you, give address & phone no. of

the premises where stores will be

offered for inspection.

3. Information relating to

applicant

i) Name of Applicant firm:

ii) Address/telephone/fax/E-mail

Nos.of

a) Regd. office :

b) Head Office :

c) Other offices:

d) Godown :

iii) Status of applicant firm

a) Date of incorporation:

b) Constitution of the firm:

i) Proprietorship / Partnership

(attach copy of Partnership deed and

Form-A or equivalent entry

certificate from Registrar of Firms

duly notarised)

ii) Public Limited/Pvt.Limited.

(Attach Memorandum/Article of

Association and copy of signed

certificate of incorporation duly

notarised)

c) Names,addresses and telephone

nos.of Proprietor/Partners/Directors

having interest in the firm:

d) If the firm is a subsidiary of an

Indian/ foreign company, give

particulars of parent/holding

company?

e) If there are other susidiaries of

the same parent company in India,

give full particulars.

f) If the Directors/ Partners/

Proprietor have financial interests

or are represented on Board(s) of

other companies give details .

g) Income-tax Circle/Ward/District

in which the applicant firm is

assessed to income-tax. (Please

indicate GIR/PAN No.)

h) Sales Tax registration no(s).

4. Stores for which registration is required:

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Sl No Brief Ref. of IS Model Limiting Territorial

Description Specification /Brand size/ jurisdiction

capacity/

rating

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(1) (2) (3) (4) (5) (6)

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5. If the products require after

sales service, give names &

addresses of places where such

facilities are available and

indicate value/ extent of spare

parts maintained and staff employed.

6. If already registered with DGS&D

and/or any other Govt organisation,

give particulars and furnish

copy(ies) of such registration:

7. State if the applicant has

entered into an agency agreement

with the manufacturers as per the

Note (1) hereunder. If yes submit

copy of such agreement duly

notarised.

Stockists of natural products to

furnish details of arrangements made

to procure the product with

documentary proof.

8. Details of past supplies made

for the items for which registra

tion has been sought in proforma as

in Annexure-4

9. Annual turnover of applicant for

the last three years duly supported

by relevant Balance Sheet.

10.Name and address of the bankers:

(Indicate account No. with each

bank and submit Bankers report in

original as per proforma in

Annexure-6)

11.Name and designation of the

signatory of this application

(Enclose a copy of Power of Attorney

where applicable).

Place: Authorised signatory(ies)

Date: with seal

NOTES:

1. If the firm is seeking registration as an agent/distributor of more

than one manufacturer, separate application shall be submitted for each

of the manufacturer.

2. It is essential that firm seeking registration with DGS&D as

authorised agent/distributor ensure that the Indian manufacturer is

registered with DGS&D and a copy of their registration certificate shall

be enclosed.

3. For the registration of an Indian firm as authorised agent/

distributor, the firm shall furnish agency agreement and the

undertakings from the manufacturers as well as from their own side

as per the following details.

a) From the manufacturers

i) That he does not have sufficient marketing arrangements in respect of

the specified territory or set of items to participate in Central

Government/DGS&D purchases.

ii) that he will accept the responsibility for the satisfactory

execution of orders placed on the authorised agents/distributors.

iii) that he will provide requisite inspection and testing facilities at

his works in respect of orders placed on authorised agents/distributors.

iv) that the price quoted by the authorised agents/distributors will not

exceed that which the manufacturer would have quoted.

v) that the manufacturer will declare the quantum of commission or the

margin of profit to which authorised agent/ distributor is entitled.

vi) that the inpsection request submitted by the Agents would be

accompanied by a certificate from the manufacturer that the stores

covered under the request have been manufactured by them and the stores

offered and supplied would bear the trade mark of manufacturer and that

he would stand by Guarantee/Warranty of the product.

b) From the applicant

i) that he will be responsible for all the contractual obligations

including quality aspects, replacement of parts/items and

warranty/guarantee obligations.

ii) that he will be responsible for providing after-sale service where

necessary.

iii) that he will indicate besides the quoted prices, the manufacturer's

price to him.

4. Stockists of natural products shall furnish information against the

5. Registering authorities will accept only notarised copies of the

various agreements/undertakings furnished.

6. All Annexures/Enclosures/documents, supporting the application

should be authenticated under signatures of the applicant in ink with

seal of the firm.

7. This form is to be accompanied by the statements/ declaration etc as

in Annexures 1, 3A, 4 & 6. The applicants must also complete the

checklist as given below to ensure that the application is complete in

all respects.The applications with incomplete infomation/documents are

liable to be rejected.

Check list :

1. Application form fee coupon of Rs.100/- or Indian Postal Order for

Rs.100/- payable to DGS&D, New Delhi in lieu of application form fee

alongwith processing fee Rs.5000/- + Service Tax & Educational Cess as applicable(presently @12.36%) for non SSI unit, Rs.3500/- + Service Tax & Educational Cess as applicable(presently @12.36%) for SSI unit irrespective of category of registration, in form of Demand Draft

payable to DGS&D, New Delhi. For additional items full registration

charges will be leviable. (No application form-fee charges will be

applicable if the application form is downloaded from the website).

2. Affidavit as per Annexure-3A duly notarised.

3. Statement of Profit & Loss and Balancesheet for the last three

years.

4. Notarised copy of General Power of Attorney in case in favour of

person signing the application is authorised signatory.

5. Performance statement as per Proforma Annexure-4 of the application.

6. Notarised copy of ownership documents of the premises or copy of

lease deed (valid for a minimum period of three year).

7. Bankers' Report in original giving details of financial status of

the applicant firm.

8. Item for which registration required with detailed specification.

9. Documentary proof of the status of the firm:

a. For the limited companies

i) Copy of Memorandum and Articles of Association duly notarised.

ii) Signed copy of Certificate of incorporation authenticated by Notary

Public.

b) Partnership firms.

i) Copy of Partnership deed duly authenticated by notary public.

ii) Power of Attorney in respect of partner, if any duly notarised.

iii) Certified copy of Entry Form-A or equivalent from the Registrar of

firm, duly notarised.

10. Copy of ISO 9000 (Optional).

11. Copy of Registration Certificate if registered with any NSIC/other

Govt. organisation.

12. Copy of agreement with manufacturer as per detailed note 3(a) &

3(b) duly notarised.

13. Copy of registration certificate of your manufacturer with DGS&D.

14. Copy of documentary proof for procuring the natural product if you

apply as a stockist duly notarised.

15. List of places where after sales service (if applicable) are

available.