MAHARASHTRA LEGISLATURE

SECRETARIAT
TENDER DOCUMENT

Tender for selection of Insurance Company for Implementing

the Cashless Mediclaim Insurance Scheme for
Sitting and Ex MLA’s and MLC’s of Maharashtra Legislature
and their Family Members 2019-2020

Tender Ref. No. 001/MLS/H/Insurance/2019-20

23rd May, 2019

MAHARASHTRA LEGISLATURE SECRETARIAT

Vidhan Bhavan, Mumbai, Maharashtra

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 BID DOCUMENT

Tender Ref. No: 001/MLS/H/Insurance/2019-20

Tender for selection of Insurance Company for Implementing the “Cashless Mediclaim Insurance Scheme
for Sitting and Ex MLAs and MLCs of Maharashtra Legislature and their Family Members – 2019 -20”.
For Further details, Contact:

Office of the Secretary (I/C),

Maharashtra Legislature Secretariat,
Vidhan Bhavan, Nariman Point,
Mumbai-400 032.
Contact No.022-22026693, 22845072, 22028217

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 Part I
TENDER NOTIFICATION
Tender Ref. No: 001/ MLS / H/ Insurance/ 2019-20 Date: 23 /05/2019
Subject: Tender for selection of Insurance Company for Implementing the “Cashless Mediclaim Insurance
Scheme for Sitting and Ex MLAs and MLCs of Maharashtra Legislature and their Family Members – 2019
– 2020".
1) Tender documents shall be submitted by the PSU Insurance Companies in two separate sealed
envelopes containing Technical and Financial Bid within the due date and time mentioned in the
tender document.
2) Technical Bid will be opened at prescribed time and date in the Vidhan Bhavan Office of Secretary
(I/C) in presence of the Tender Scrutiny Committee, appointed Broker M/s. Life and General
Insurance and Reinsurance Brokers Pvt. Ltd. and the concerned Insurance Company officials.
3) PSU Insurance Companies shall submit documents to satisfy the pre-qualification criteria, within
the date and time mentioned in the tender document. Bidders shall carry copy of documents during
opening of Bid document.
4) Validity: The tender submitted shall be kept valid for 60 days from the date of opening of Technical
Bid.

Bid Opening and Closing Date & Time

Tender Name Tender for selection of Insurance Company & Premium Rates for
Implementing the “Cashless Mediclaim Insurance Scheme for
Sitting and Ex MLAs and MLCs of Maharashtra Legislature and
their Family Members – 2019 – 2020”.
Bid Reference No. 001/MLS/H/Insurance/2019-20
Date of tender document 23rd May, 2019
Last date of submission 27th May, 2019 (upto 15:00 hrs)
of Bid
Time & Date of opening 27th May, 2019 (upto 15:30 hrs)
of Technical and
Financial Bid
Place of opening of Bid Room No.712, 7th Floor, Vidhan Bhavan, Nariman Point,
Mumbai -400032
Address for Office of the Secretary (I/C)
Communication and Room No.021, Ground Floor,
Submission of Tender Vidhan Bhavan, Nariman Point,
document Mumbai-400021
Contact No. 022-22026693, 22845072, 22028217
Validity of the One year from the date of signing of Agreement
Insurance Tender

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 1. Introduction :
The MAHARASHTRA LEGISALATURE SECRETARIAT, Maharashtra has decided to renew
the scheme for providing Cashless Mediclaim Insurance Cover to the Sitting and Ex MLAs and MLCs with
their family members for the period from 1st June, 2019 to 31st May, 2020.
M/s. Life and General Insurance and Reinsurance Brokers Pvt. Ltd. have been appointed as Insurance
Broker to manage the scheme. Kindly contact the above mentioned appointed Broker for the Insurance
Tender participation and queries.
Tenders are being invited from IRDA Licensed Public Sector Insurance Companies for selection of
Insurance Company and Premium rates for the scheme, for the year 2019-20.
Terms and Conditions of the Policy:-

Sr.No TERMS & CONDITIONS OPTION

1. Eligibility Criteria & Sum Insured 1. Floater Family Sum Insured
Rs.10,00,000/- (Rs.9,50,000/- towards
hospitalisation and Rs.50,000/- towards
OPD).
2. After exhaustion of Sum Insured, the
Corporate Buffer of Rs.10 Crore will be
utilised by sub-limiting the Corporate
Buffer of Rs.8 crore towards IPD and Rs.2
crore towards OPD.
2. Number of Families 1,134 (Approximately 120 New Members
are likely to be added in November, 2019
post General Elections to Maharashtra
Legislative Assembly and, accordingly,
pro-rata premium will be calculated for
these Members for the remaining period till
expiry of policy.)
3. Family Definition 1+ Any 5 family members (i.e. Self, Spouse
+ 2 Children (Legitimate Children, Step
Children, Legally Adopted Children) OR 2
Grand Children + Father, Mother
(irrespective of their age).
Female member can cover their Parents-
In-Law or Parents (any one set).
4. Entry Age Limit No Age Limit for Self or any of the family
members.
5. Standard Hospitalisation Standard Hospitalisation: Hospitalisation
expenses for medical / surgical treatment at
any Registered Nursing Home / Hospital.
Coverage includes expenses incurred for
Room & Nursing, Intensive Care Unit,
Doctor Fees, Surgical Fees, Operating
Theatre, Anaesthesia, Anaesthetist fees,
Oxygen & their administration Charges.
Drugs & Medicines consumed during
hospitalisation period. Laboratory /
Pathology Charges, Radiotherapy,
Chemotherapy, Dialysis, Blood Transfusion
Cost. All type of Bandages, Hand / Leg

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 Pouch, Instrument Charges, Monitor
Charges and all such other items which are
necessary for the patients during the
treatment period is to be covered.
6. Cashless Hospitalisation Available through Network Hospitals of
TPA
7. Pre-Hospitalisation Expenses: If the Insured Covered
member is diagnosed with all Illness which results in
his / her Hospitalization and for which the Insurer
accepts a claim, the Insurer will also reimburse the
Insured Member's Pre-hospitalization Expenses.
Limit up to family sum insured.
8. Post-Hospitalisation Expenses: If the Insurer Covered
accepts a claim under Hospitalisation and
immediately following the Insured Member's
discharge, further medical treatment directly related
to the same condition for which the Insured Member
was Hospitalized is required, the Insurer will
reimburse the Insured Member's Post-hospitalisation
Expenses. Limit upto family sum insured.
9. Pre-Existing Diseases Covered from Day 1 for Hospitalisation /
OPD claim
10. 30 days Waiting Period Not Applicable
11. 1 year / 2 years / 3 years / 4 years waiting period Not Applicable
for certain listed ailment procedures
12. Domiciliary Hospitalisation Domiciliary Hospitalisation: Covered
Domiciliary Hospitalisation means medical
treatment for a period exceeding three days
for such an illness / disease / injury which in
the normal course would require care and
treatment at a hospital but is actually taken
while confined at home under any of the
following circumstances:
- The condition of the patient is such
that he / she is not in a condition to
be removed to a hospital or
- The patient takes treatment at home
on account of non-availability of
room in a hospital.
13. Out Patient Department (OPD) Consultation: Sublimit Rs.50,000/- per family per year
Consultation taken through any registered within family sum insured. Refer Point
Medical Practitioner / Doctor / Surgeon provided No.1 of Eligibility Criteria.
consultation note & payment receipt towards
consultation issued by the Medical Practitioner /
Hospital / Clinic including cost of diagnostic test
advised by the Medical Practitioner. Includes
Dental Treatment Expenses / Vaccination / Eye
check-up.
14. Ailment-wise / Surgery-wise / Procedure-wise Not applicable
capping
15. Separate bills / receipt not forming hospital final Payable
bill.

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16. Day Care Procedures Coverage for all Day Care Procedures. The
treatment is undertaken under general or
Local Anaesthesia in a hospital / Day Care
Centre in less than 24 hours because of
technological advancement and which
would have otherwise required a
hospitalisation of more than 24 hours.
17. Hospitalisation Less Than 24 Hours for listed Day Covered
Care Procedures
18. Internal & External Congenital Diseases Covered from Day 1 for Hospitalisation /
OPD claim
19. Room Rent Limit 2% for Normal and 4% for I.C.U.
20. Nursing / Attendant / Assistant Doctor / Dressing / Payable
Registration / Admission / Service Charges / Cess /
Surcharges expenses to be reimbursed as provided
by the Hospital.
21. Expenses for Diagnostic & Evaluation Purpose to Covered
be covered under hospitalization / OPD benefit
22. Maternity Benefit for 1st two pregnancies. Maternity Related Expenses are covered
(Without 9 Months Waiting Period) under Maternity Sublimit.
For Normal Delivery-Rs.50,000/-
For Caesarean Delivery-Rs,1,00,000/-
23. Pre & Post Natal Expenses Related to Maternity- Covered.
Covered either in Standard / OPD limit (Any complication arising during pre &
post-natal period covered within family
sum insured)
24. New Born Baby Expenses Covered within family sum insured from
Day 1
25. Vaccination Expenses Covered within Maternity sublimit
26. Emergency Ambulance Expenses Covered maximum upto Rs.5000 per
hospitalisation
27. Air Ambulance Expenses Covered. Covered from Corporate Buffer on
Exhaustion of Family Sum Insured.
28. All Eye surgery for non-cosmetic purpose, squint Covered under hospitalisation/OPD
correction, Cataract, Lasik Surgery, Laser
Surgery, Retina Correction Surgery.

29. Oral Chemotherapy and Home Dialysis to be Covered under hospitalisation/OPD

provided, Treatment taken from Ayurvedic,
Homeopathy, Unani procedures to be covered,
institution practicing alternative medicine therapy
also qualify as hospital is admissible in case when
the treatment is taken as in patient / OPD
30. Peritoneal / Residence Dialysis Covered under hospitalisation/OPD
31. Physiotherapy / Residence Physiotherapy also to Covered under hospitalisation/OPD
be covered if advised by Doctor post
hospitalisation.
32. Hospitalisation under BHMS / BAMS Doctors. Covered under hospitalisation/OPD

33. If a person is Hospitalized and has to use mobility Covered under hospitalisation/OPD
aids the same should be paid. If the person utilizes
day care and mobility aids are used the same to be
paid in day care. Any other to be claimed in OPD.
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34. Hearing Aides, Cochlear Implant – If a person is Covered under hospitalisation/OPD
Hospitalised for Hearing problems and is advice to
use a hearing aids the same should be paid in
hospitalisation. Due to advancement of technology
if the hospitalisation is less than 24 hours the same
should be paid in Hospitalisation. Any other to be
claimed in OPD.
35. Medical Emergency arising from pregnancy / Covered under hospitalisation/OPD
Sterilization/MTP
36. Testing equipment such as blood sugar monitors, Covered under hospitalisation/OPD
blood pressure monitor. Lens.
37. Terrorism related OPD / Hospitalisation Claims, Covered under hospitalisation/OPD
Robotic surgery, bone marrow transplant, Stem Cell
therapy & Cyber Knife procedures / hospitalisation to
be covered.
38. Circumcision Related Claim / Genetic Disorder / Covered under hospitalisation/OPD
Psychiatric Treatment / Morbid Obesity
39. Organ Transplant – Donor & Receiver expenses in case Covered under hospitalisation/OPD
of organ transplant to be covered. Including Organ
Cost, Limit up to Family Sum Insured
40. Infertility / Sterility / Test Tube Baby Expenses Covered under hospitalisation/OPD
related Treatment
41. RFQMR – Rotational field Quantum Magnetic Covered under hospitalisation/OPD
Resonance Device – Cytotron, C3R, Balloon
Sinuplasty, Bariatric surgery, Inj Avastin /
Lucentus / Macugen, Ozone Therapy, Enhanced
External Counter pulsation Therapy (EECP),
Rejuvenation therapy, Lasik Surgery, Cosmetic
Surgery Forming Part of Treatment / HIV & AIDS
related treatment.
42. GIPSA PPN Package Not Applicable
43. Claim Intimation Not Applicable
44. Claim Submission Till expiry of the policy & within 30 days
from date of discharge post expiry of policy
45. Deletion / Refund Clause In the event of any Member becoming the
Minister, the said Insurance Cover will
cease to operate from the date of his/her
holding the office of the Minister. In such
case, if the Member has not claimed then,
the Insurance Company is liable to pay the
refund of premium on pro-rata basis for the
balance period of the policy.
46. Addition Clause In the event of any Minister cease to hold
the office of the Minister, the said Insurance
Cover will be operational from the date of
his/her demitting the office of the Minister.
In such case, the Insurance Company will
calculate the premium on pro-rata basis and
intimate to the Maharashtra Legislature
Secretariat for making the payment for the
balance period of the policy.

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2. Invitation of e – BID:
Secretary (I/C), Maharashtra Legislature Secretariat, invites Insurance tender in technical &
financial format for Mediclaim Insurance Quotation for selection of Public Sector Insurance Company and
Premium rates for Maharashtra Legislature Secretariat, "Sitting and Ex MLAs and MLCs and their Family
Members 2019 – 20", as per the minimum criteria mentioned in this document. Complete set of Bid
documents are attached in the mail and the PSU Insurance Companies are requested to submit the technical
and financial bids in the sealed envelope. The summary of various activities with regard to this request or
proposal is listed in the above format enumerated under the calendar of events.

3. Eligibility Criteria for Bidders:

1. The bidder should have Registered Office under Companies Act, 1956 / Partnership Act, 1932 in the
State of Maharashtra. Detailed list of the office stating full postal address with contact number need to be
submitted.
2. The bidder must have valid IRDA Insurance license.
3. Should have the necessary infrastructure and staff to cover the entire Maharashtra State with Branch
Offices in Districts of Maharashtra.
4. Should have handled such or other work on behalf of for the Government or Semi Government
Institutions. The experience certificate/documentary proof should be submitted in Format B.
5. Following documents should be submitted by bidder signed by authorized signatory.
 PAN/TAN card.
 GST Registration.
 Company Registration Certificate/Partnership Deed duly registered, in case of firm.
6. The bidder should not have a record of having been black-listed by any Government/Public sector
organization. Self-declaration should be attached on Letter Head.
7. Should furnish last 3 years Audited Copy of Balance Sheets.
4. General Terms and Conditions:
1. The Maharashtra Legislature Secretariat reserves the right to accept or reject any or all tenders without
assigning any reason.
2. Any modification/amendment/extension of date/change of schedule/other clauses/details of tender will
be mailed to all Insurance Companies before the last date of submission of the tender.
3. Submission of any paper/hardcopy of the bid documents, unless specifically asked, in any form will not
be considered and may invalidate the concerned bid.
4. For any clarification, email supported by hard copy may be sent to tender.queries@Inginsurance.com.
After publication of Tender queries may be sent, but the authority will have no obligation to reply / comply
the same.
5. The Maharashtra Legislature Secretariat reserves the full right to cancel this Bid as a whole or at any part
or of any Public Sector Insurance Company without assigning any reason whatsoever at any stage.
6. Original certificates are to be produced for verification if selected, on order confirmation by the respective
bidder company.
7. The Insurance Company will perform in accordance with the MOU and agreement signed with
Maharashtra Legislature Secretariat.

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 Interested Insurance companies shall quote the rate of premium per family per year amount as below:
Format A
Cashless Mediclaim Insurance coverage for 1134 Sitting and Ex MLAs
and MLCs of Maharashtra Legislature and their family members.
(Approximately 120 New Members are likely to be added in November,
2019 post General Elections to Maharashtra Legislative Assembly and,
accordingly, pro-rata premium will be calculated for these Members for
the remaining period till expiry of policy.)
1134 Sitting and Ex MLAs
and MLCs of Maharashtra
Legislature and their family
members. (Approximately
120 New Members are likely
to be added in November,
2019 post General Elections
to Maharashtra Legislative
Assembly and, accordingly,
pro-rata premium will be
calculated for these Members
for the remaining period till
expiry of policy.)
Rate in Rs. (inclusive of GST
/ taxes, if any) The amount of
premium and GST/taxes
should also be shown
separately.

The firms should quote rates in Rupees only in the above format and upload it in financial folder only.
1. At the time of opening of tender, the authorized person may remain present personally or may
depute representative with letter of authorization.
2. The firm / company will have to enter in the Memorandum of Understanding with the Secretary
(I/C) Maharashtra Legislature Secretariat and Tri partite agreement with the appointed Insurance
Broker M/s. Life and General Insurance and Reinsurance Brokers Pvt. Ltd.
3. Decision of Tender Scrutiny Committee formed by the Maharashtra Legislature Secretariat for this
scheme shall be final.
4. Right to accept or reject any one or all tender is reserved by the Tender Accepting Authority without
any reason.
5. The Guidelines of the scheme are as per this Tender dated: 23rd May, 2019 will be the part and
parcel of the contract.
6. The commercial offer shall be on fixed price basis. Rates quoted should be inclusive of all taxes,
duties etc. No price escalation will be allowed due to any reason. The offer should be firm without
any uncertain liability.
7. Maharashtra Legislature Secretariat will not be liable to pay any fees / commission to the broker.
It is the Liability of the Insurance Company to pay the broker fees / commission as per IRDA
Norms.
8. The decision of Secretary (I/C) about any matter or dispute about the contract shall be final and
binding on the bidder.
9. No tender will be considered unless submitted in the prescribed form.
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 10. Conditional tenders will not be accepted.
11. Maharashtra Legislature Secretariat (MLS) reserves right to terminate the contract at any time
during execution period if the performance or progress of work is unsatisfactory, with prior notice
of one (1) month.
5. Payment Terms:-
The premium amount will be paid to the selected Insurance Company. The Agreement and MOU
should be signed before payment. The scheme will be in operation from 1st June, 2019 to 31st May, 2020.
However, 60% of the amount of the premium will be paid to the selected Insurance Company by 31st May,
2019 and the remaining 40% of the amount of the premium will be paid by 30th September, 2019.
6. Contents of Technical Bid and Financial Bid.
A. Technical Bid:
1. Application form (Bid Cover Letter) duly signed and stamped as given in the tender.
2. The firm should attach the attested copy of their company IRDA License.
3. The firm should furnish all the information about the availability of infrastructure required to
provide insurance services to Maharashtra Legislature Secretariat in the prescribed format.
4. Upload self-attested copy of GST Registration Certificate, copy of PAN card in the name of
company / firm or if PAN card is the name of Proprietor in that case attested copy of certificate of
firm registration is mandatory.
5. Information regarding previous experience in insurance services in Cashless Mediclaim
Insurance under any scheme of Government or semi government bodies in the State of Maharashtra.
The experience certificate/documentary proof should be submitted.
6. The Firm should provide the certificate of authorization from concerned company.
7. The Firm should submit audited copy of balance sheet of last 3 financial years.
Note: - The large volumes of financial reports may not be accepted in the tender. In such case abstract
should be submitted.
B. Financial Bid:
The financial quote must be in specified format as mentioned in tender document and should be submitted
in Separate Envelope mentioning Financial Bid. The rates should be quoted in the format duly signed and
stamped.
7. Bid Opening and Evaluations of Bids.
(a) Technical Evaluation.
(1) The Tender Scrutiny Committee will open the bids.
(2) After opening of technical bid Tender Scrutiny Committee will scrutinise the tender
documents.
(b) Evaluation of Commercial Bids.
The commercial bids of only technically successful bidders will be opened.
8. Award of Contract:
The Contract will be awarded to the Successful Bidder whose Bid has been determined to be
substantially responsive and has been determined as the Best Value Bid.

9. Termination of contract -
The Maharashtra Legislature Secretariat reserves the right to cancel the contract placed on the bidder if
(1) The bidder commits breach of any of the terms and conditions;
(2) The bidder goes into liquidation voluntarily or otherwise;
(3) The service is found unsatisfactory,

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10. Fraud and Corrupt Practices:
a. The Applicants and their respective officers, employees, agents and advisers shall observe the
highest standard of ethics during the Bidding Process. Notwithstanding anything to the contrary contained
herein, the Authority may reject an Application without being liable in any manner whatsoever to the
Applicant if it determines that the Applicant has, directly or indirectly or through an agent, engaged in
corrupt practice, fraudulent practice, coercive practice, undesirable practice or restrictive practice in the
Bidding Process.
b. Without prejudice to the rights of the Authority under this tender, if an Applicant is found by
the Authority to have directly or indirectly or through an agent, engaged or indulged in any corrupt practice,
fraudulent practice, coercive practice, undesirable practice or restrictive practice in the Bidding Process,
such Applicant shall not be eligible to participate in any tender or RFP issued by the Authority for a period
of 2 (two) years from the date such Applicant is found by the Authority to have directly or indirectly or
through an agent engaged or indulged in any corrupt practice, fraudulent practice, coercive practice,
undesirable practice or restrictive practice, as the case may be.
c. For the purposes of this Clause the following terms shall have the meaning hereinafter
respectively assigned to them :
(a) "Corrupt practice" means
i. the offering, giving, receiving, or soliciting, directly or indirectly, of anything of value to
influence the actions of any person connected with the Bidding Process (for avoidance of doubt, offering
of employment to, or employing, or engaging in any manner whatsoever, directly or indirectly any official
of the Authority who is or has been associated in any manner, directly or indirectly, with the Bidding
Process or the LOA or has dealt with matters concerning the Concession Agreement or arising there from,
before or after the execution thereof, at any time prior to the expiry of one year from the date such official
resigns or retires from or otherwise ceases to be in the service of the Authority, shall be deemed to constitute
influencing the actions of a person connected with the Bidding Process) ; or
ii. Save and except as permitted under sub clause (d) of Clause 2.2.1, engaging in any manner
whatsoever, whether during the Bidding Process or after the issue of LOA or after the execution of the
Concession Agreement, as the case may be, any person respect of any matter relating to the Project or the
LOA or the Concession Agreement, who at any time has been or is a legal, financial or technical adviser of
Authority in relation to any matter concerning the Project;
(b) "Fraudulent practice" means a misrepresentation or omission of facts or suppression of facts or
disclosure of incomplete facts, in order to influence the Bidding Process;
(c) "Coercive practice" means impairing or harming or threatening to impair or harm, directly or indirectly,
any person or property to influence any person's participation or action in the Bidding Process;
(d) "undesirable practice" means (i) establishing contact with any person connected with or employed or
engaged by the Authority with the objective of canvassing, lobbying or in any manner influencing or
attempting to influence the Bidding Process; or (ii) having a Conflict of Interest; and
(e) "Restrictive practice" means forming a cartel or arriving at any understanding or arrangement among
Applicants with the objective of restricting or manipulating a full and fair competition in the Bidding
Process.
…………..

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 Bid Cover Letter
(Should be submitted in Technical Document on Bidder's Letter Head.)
To, Date:
The Secretary (I/C),
Maharashtra Legislature Secretariat,
Vidhan Bhavan, Mumbai.

Sir,
Having examined the Bidding documents, I/We, the undersigned, offer to work as Insurer for
“Cashless Mediclaim Insurance Scheme for Sitting and Ex MLAs and MLCs of Maharashtra Legislature
and their Family Members 2019-20” for a period of one year i.e. from 1st June, 2019 to 31st May, 2020, as
mentioned in the scope of the work and in conformity with the said bidding documents for the same.
1. I/We have capacity to provide Insurance Services to Maharashtra Legislature Secretariat.
2. My / Our rates of Premium for “Cashless Mediclaim Insurance Scheme for Sitting and Ex
MLAs and MLCs of Maharashtra Legislature and their Family Members 2019-20” as
specified in Schedule of Terms and Conditions of this Expression of Interest will be
inclusive of all taxes and as per the statement enclosed of each item.
3. I / We have studied and understood the terms and conditions of the contract to provide
Insurance to Maharashtra Legislature Secretariat. I/ We agree to provide insurance services
to Maharashtra Legislature Secretariat with provisions contained there in the execution of
the contract.
4. I / We give the guarantee of providing insurance services to Maharashtra Legislature
Secretariat by me/us within the stipulated time period as per schedule.
5. I / We hereby assure that my/our organization is not black-listed by the Central/State
Government.
6. I / We undertake that the rates submitted in commercial bid are in conformity with the
terms and conditions prescribed.
7. I / We agree to abide by this bid. We agree to the terms and conditions mentioned in the
Tender document.

Signature & Address of the Witnesses: 1)

2)

Your faithfully,

(Seal & Signature, Address & Telephone No.)

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Tender for selection of Public Sector Insurance Company for “Cashless Mediclaim Insurance Scheme for
Sitting and Ex MLAs and MLCs of Maharashtra Legislature and their Family Members 2019-20”
Technical Bid Format
Sr. Item Compliance
No.
1 Application form (Bid Cover Letter) duly signed and stamped as
given in the tender

2 Attested copy of company IRDA License

3 Information regarding previous experience in Cashless Mediclaim

insurance under any scheme of any other Government (Format B)

4 Attested Copy of GST Registration Certificate, Copy of PAN card

5 Information about the availability of skilled manpower required to

provide insurance services to Maharashtra Legislature Secretariat in
the prescribed Format C.

6 Audited copy of balance sheet of last three financial years.

The above documents are uploaded in technical bid section.

Date Signature & Seal of the Tenderer

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Tender for selection of Public Sector Insurance Company for Implementing the “Cashless Mediclaim
Insurance Scheme for Sitting and Ex MLAs and MLCs of Maharashtra Legislature and their Family
Members 2019-20”

Format A
Financial Bid format
Cashless Mediclaim Insurance coverage for
1134 Sitting and Ex MLAs and MLCs of
Maharashtra Legislature and their family
members. (Approximately 120 New Members
are likely to be added in November, 2019 post
General Elections to Maharashtra Legislative
Assembly and, accordingly, pro-rata premium
will be calculated for these Members for the
remaining period till expiry of policy.)
1134 Sitting and Ex MLAs and MLCs of Maharashtra
Legislature and their family members. (Approximately
120 New Members are likely to be added in November,
2019 post General Elections to Maharashtra Legislative
Assembly and, accordingly, pro-rata premium will be
calculated for these Members for the remaining period
till expiry of policy.)
Rate in Rs. (inclusive of GST / taxes, if any) The
amount of premium and GST/taxes should also be
shown separately.

The company/firm should quote rates in Rupees only in the above format in sealed envelope separately
mentioning Financial Tender.

Date Signature & Seal of the Tenderer

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Tender for selection of Public Sector Insurance Company for Implementing the “Cashless Mediclaim
Insurance Scheme for Sitting and Ex MLAs and MLCs of Maharashtra Legislature and their Family
Members 2019-20”

Format B
Format for submitting about past experience

Sr. Government Sector Semi-Government Sector

No.
Name of Insurance No. of Name of Insurance No. of
Dept./Firm amount per persons Dept./Firm amount per persons
insured & person covered insured & person covered
period of period of
policy policy

Date Signature & Seal of the Tenderer

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