SAMPLE FORM FOR FILLING ENCLOSURE-10(A) OF TENDER
Enclosure-10 (A)
DECLARATION CERTIFICATE FOR LOCAL CONTENT
This declaration serves as a declaration form for the bidders. (Before completing this
declaration, bidders must study the General Conditions, Definitions, Govt. Directives
applicable in respect of Local Content & prescribed tender conditions).
In cases of procurement for value in excess of Rs. 10 Crores, the bidders shall provide this
certificate from statutory auditor or cost auditor of the company (in case of companies) or
from a practicing cost accountant or practicing charted accountant (in respect of supplier
other than companies) giving the percentage of local content & applicable item wise custom
duty.
LOCAL CONTENT DECLARATION BY CHIEF FINANCIAL OFFICER OR OTHER LEGALLY
RESPONSIBLE PERSON NOMINATED IN WRITING BY THE CHIEF EXECUTIVE OR
SENIOR MEMBER/PERSON WITH MANAGEMENT RESPONSIBILITY (CORPORATION,
PARTNERSHIP OR INDIVIDUAL)
IN RESPECT OF BID/ TENDER No. 19000000XX
ISSUED BY: (Name of Firm): M/s XYZ Enterprises
NB: The obligation to complete, duly sign and submit this declaration cannot be transferred
to an external authorized representative, auditor or any other third party acting on behalf of
the bidder.
I, the undersigned, Mr. Omprakash Tyagi, do hereby declare, in my capacity as
PROPRIETOR of M/s XYZ Enterprises, the following:
(a) The facts contained herein are within my own personal knowledge.
(b) I have read and understood the requirement of local content (LC) and same is specified
as percentage calculated in accordance with the definition provided at clause 2 of revised
Public Procurement (preference to Make in India) Order2017.
“Local content” as per above order means the amount of value added in India which shall be
the total value of items procured (excluding net domestic indirect taxes) minus the value of
imported content in the item (including all customs duties) as a proportion of the total value
in percent.”
(c) I have satisfied myself that the goods/services/works to be delivered in terms of the
above specified bid comply with the local content requirements as specified in the tender for
‘Class- I Local Supplier’ / ‘Class-II Local Supplier’, and as above.
(d) I understand that a bidder can seek benefit of either Public Procurement Policy for
MSEs –Order 2012 or Public Procurement (preference to Make in India) Order 2017 and not
both and once the option is declared / selected it is not permitted to be modified
subsequently. Accordingly, I seek the benefit from the below declared purchase preference
policy only.
i. I seek benefits against the PPP MSE Order 2012 / PPP MII 2017
following policy only.
(strike off Not chosen option from above)
SAMPLE FORM FOR FILLING ENCLOSURE-10(A) OF TENDER
(e) I declare the following in respect of the goods/services/works to be delivered in terms
of the above-specified bid
i. Does any portion of the services, works or YES / NO
goods offered have any imported content?
ii. If yes, the rate(s) of exchange against the appropriate currency used in this bid to
calculate the local content are declared in the table below:
Currency Rates of exchange Date of exchange rate
US Dollar NA NA
Euro NA NA
Others NA NA
Attach separate sheet duly signed if space is not sufficient
(f) The local content calculated using the definition given above and the rates of exchange
indicated in paragraph (e) are as under:
Tender Item Sr Local content Imported Bid price in Location of
No calculated as content percentage only, value
above % including all excluding net addition
Custom duties domestic indirect
(%) taxes (%)
ALL ITEMS 100% 0% AS QUOTED INDIA
Attach separate sheet duly signed if space is not sufficient
(g) I accept that the Procurement Authority / Institution / MDL / Nodal Ministry has the
right to request that the local content be verified in terms of the requirements of revised
Public Procurement(preference to Make in India)Order 2017 dtd 04.06.2020 and I shall
furnish the document / information on demand. Failure on my part to furnish the data will
be treated as false declaration as per PPP MII Order 2017. In case of contract being
awarded, I undertake to retain the relevant documents for 7 years from date of execution.
(h) I understand that the submission of incorrect data, or data that are not verifiable as
described in revised Public Procurement (preference to Make in India) Order 2017, may
result in the Procurement Authority / Nodal Ministry / MDL imposing any or all of the
remedies as provided for in Clause 9 of the Revised Public Procurement (preference to Make
in India) Order 2017 dated 04.06.2020.
SIGNATURE: TO BE SIGNED BY AUTHORISED SIGNATORY STRICTLY AS PER TEF
CLAUSE NO. 41.3.i) & STAMPED
DATE:
Seal / Stamp of Bidder
