5

FORM NO.3
Application for appointment / registration of ARCHITECT CUM PROJECT
MANAGEMENT CONSULTANT firms for the preparation of residential projects and
other buildings, its layout plans, building plans, 3-dimensional views, walk through
estimates, tender documents etc. And other similar design assignments if any and for
cross verification of architect works such as site conditions, approvals, planning, design
of structure, estimates, tender document & drawings, supervision & execution of work
and for supervision & execution of work etc.

1 Name of Architect Cum P.M.C. i.e.
proprietor of firm

:
2 Name of the Company

:
3 Type of firm

: i) Proprietor firm
ii) Partnership firm
iii) Pvt. Ltd.
iv) Public Ltd.

4 Company Registration no. & date

:
5 Name of Partners / Directors

:
6 Office Details
i) Address
ii) Type of Office (Rent / Own)
iii) Carpet area of office

:
7 Contact No. & e-mail

:
8 Experience in years to handle project
independently i.e. after establishment of
office

:
9 List of work carried out in since 5 years
with cost of project as a PMC
i) Buildings upto 4 stories
ii) Buildings upto 7 stories
iii) Buildings upto 15 stories
iv) Buildings upto & more than 25 stories
(specify clients name, location & year
excluding work of Police Housing
Corporation, Mumbai)
:
10 Certified copys of 3 years income tax
return
Year - 2010-11
Year - 2011-12
Year - 2012-13

:
11 Empanelment with other organization

:
12 Name of in-house consultants

:
13 PAN No. of Company & Proprietor :

14 Certificate issued by clients during last five

years against successful completion of
works.

:
15 At present number of Architect working
with firm (Excluding employee working on
contract or temporary or project basis)
i) working since more than 10 years with
firm -
Name & qualification, year of passing
ii) working since more than 5 & upto
10 years with firm -
Name & qualification, year of passing
iii) working since more than 3 & upto
5 years with firm -
Name & qualification, year of passing

:
16 At present number of Engineers working
with firm (Excluding employee working on
contract or temporary or project basis)
i) working since more than 10 years with
firm -
Name & qualification, year of passing
ii) working since more than 5 & upto
10 years with firm -
Name & qualification, year of passing
iii) working since more than 3 & upto
5 years with firm -
Name & qualification, year of passing

:


17 Software available with the Agency.

:
18 Willingness to provide services in following
Region:
1) Mumbai Range
2) Thane/Nashik/Konkan Range
3) Kolhapur/Aurangabad/Nanded Range
4) Nagpur/Amravati/Gadchiroli Range

:
19 Awards if any received to firm / Architect

:
I / We / the firm do hereby state that the above mentioned contents / information are true and
correct. If any information is found to be false / incorrect / misleading then I / we / the firm
shall be solely responsible for penal action.

Place :

Date :


Signature of Proprietor of Architect Cum
Project Management Consultant


Note :- (1) Application shall be submitted on the letter head of the applicant.
(2) Attested copies of the relevant documents shall be submitted.
(3) Joint venture is not allotted