APPLICATION FORM FOR REGISTRATION OF CONTRACTORS

(Please attach the documents as per Annexure Numbers mentioned in the form)

Name of the Contractor

Postal Address

(Office)

BASIC INFORMATION
:

Telephone No : Factory / Office

Fax No.

: Factory / Office

Contact Person

Mobile No

E-mail
3

Factory Address

Telephone

Fax No.

Mobile No

E-mail

Name of Representative

Address

Telephone

Fax No.

Mobile No

E-mail

:
DETAILS OF REGISTRATION SOUGHT FOR

Page 1 of 11

8
9
1
0
1
1
1
2
1
3
1
4

1
5
1
6
1
7

Category
of
works
for
which
vendor
registration is being sought (Please refer
uploaded list of category separate for Refinery
and other than Refinery)
Please indicate financial class to which
registration is sought
Class I
Rs. 200 Lakhs - Rs. 500 Lakhs
Class II
Rs. 100 Lakhs - Rs. 200 Lakhs
Class III Rs. 50 Lakhs - Rs. 100 Lakhs
Class IV Rs. 25 Lakhs - Rs. 50 Lakhs
Class V
Rs. 10 Lakhs - Rs. 25 Lakhs
Class VI Rs.
5 Lakhs - Rs. 10 Lakhs
Class VII Rs.
2 Lakhs - Rs. 5 Lakhs
Class VIII Less Than Rs. 2 Lakhs

Indicate the minimum value of work that

should be awarded (Rs. In Lakhs)
Please specify whether Registration is sought
for any specific SBU / Entity in BPCL. Please
specify the Region also.
ORGANISATIONAL DETAILS
Constitution

Sole
Proprietorship
/ :
Partnership / Pvt Ltd / Public Ltd. / Public Sector
Names of Proprietor/ Partners / Directors / :
Executives (Attach as Annexure-I)
Registration Certificate / Partnership deed / :
Article of Association and Memorandum of
Association (Attach Photo copies as AnnexureII)
Year of Establishment & Establishment :
Certificate (Attach Photo copies as Annexure
III)
Current financial year solvency certificate from :
any Scheduled Bank (Attach original or
attested by issuing bank as Annexure-IV)
REGISTRATION WITH STATUTORY AUTHORITIES
Whether registered under SSI / NSIC / MSME :
(Attach Photo copy as Annexure-V)
Whether holding valid license for the trade, if
so give details. For electrical contractors,
whether the applicant possesses valid
Electrical Licenses for LT / HT Works (Attach
documents as Annexure VI)
Registration with PF / ESI
Confirm
Deposits
in
contribution
and
deductions with PF / ESI are in line
(Attach Photo Copy as Annexure-VII)
PAN No.
(Attach Photo Copy as Annexure-VIII)
TIN No. (VAT) State wise
(Attach Photo Copy as Annexure IX)

:
:

Page 2 of 11

1
8

CST Registration State wise (Attach Photo

Copy as Annexure X)

1
9
2
0

Service Tax Registration Certificate (Attach :

Photo Copy as Annexure-XI)
Works Contract Registration Certificate (Attach :
Photo Copy as Annexure XII)
PAST EXPERIENCE
a) Last 3 Years Turnover
:

2
1

b) Last 3 Years Accounts - Balance Sheet with

Auditors note and P & L A/c. (Attach copies as
Annexure XIII)
2
2

Maximum value of single work executed in the

last 5 years (3 years for Refinery) as prime
contractor
(Separate details on single work executed
required for different job categories for which
registration is being sought)

:
:

Work order copy and completion certificate

2
3

(Attach documents as Annexure XIV)

PAST WORK / CLIENT REFERENCES
a) List of Clients (Attach list preferably :
indicating work done /supplies made to
Hydrocarbon
and
Chemical
Process
Industries as Annexure XV)
:
b) Purchase Order of Clients (Attach Photo
copies for major items supplied as Annexure
XVI). Please also attach a summary of jobs
executed
:

2
5

c) Details of work in progress (Please attach

relevant documents as Annexure XVII)
Registration with other organizations
a. Name of the organization
b. Value of Registration
c. Nature / Category of Work
Registration Certificates to be enclosed as
Annexure XVIII
Whether the applicant is already registered for
any other category in BPCL. If Yes, provide

2
6

Class of Registration
Category of Registration
Region
Whether the applicant has any sister concern
registered in BPCL. If Yes, provide

2
4

Class of Registration
Category of Registration

Page 3 of 11

2
7

2
8

2
9
3
0

Whether the applicant has been blacklisted /

removed /holiday listed / deregistered from the
approved list or demoted to a lower class by
BPCL in the past.

Date of Blacklisting
Whether
the
applicant
has
gone
for :
Arbitration / Litigation for any of the past work
with BPCL.
Nature of Work
Nature of Arbitration
Whether the applicant has any dismissed :
employee of BPCL in his employment. If yes,
Name
E-TENDERING
Whether Digital Signature Certificate available :
for participating in e-tender

I / We certify that I/we will not get myself/ourselves registered as contractor(s) in the
Undertaking under more than one name.
I / We hereby confirm that the above information is true to the best of my / our
knowledge & belief.
I / We also undertake that, if at any stage, the above information are found to be
incorrect, the Corporation shall reserve the right to cancel my /our registration, at any
time, without notice, at its discretion.
I / We certify that I/our partners / directors did not retire as an employee of Bharat
Petroleum Corporation Limited during the last two years. I / We also certify that I have
neither such persons under my employment nor shall I / we employ such persons
within two years of his / her retirement from this organization except with prior
permission.
I / We certify that I / our partners / directors are not relatives of the Managerial,
Accounts, Engineering or Materials employee of Bharat Petroleum Corporation Limited
(A near relative may include wife, husband, parent, children, grand children, brothers,
sisters, uncles, aunts, cousins and their corresponding in laws).

Date :
Place :
representative.

Signature of the Proprietor/Partner / Authorized

Seal of the Firm

NOTE: All relevant documents must necessarily accompany the application

form and should be attested by Gazetted officers / Notary Public.
Non-submission of any of the documents as mentioned in the application
form or incomplete form may lead to summarily rejection.

Page 4 of 11

This form is first stage application form and additional information may be
sought by specific department where registration is applied.

Page 5 of 11

Our Offices for submitting filled application form and annexures

1.

Engineering & Projects

Engineering & Projects - Corporate office
2nd floor, A 5&6, sector-1, Noida 201301 U.P.
Telephone: (0120) 2474201 / 2474210/2474213
Fax : (0120) 2474384, 2474386, 2474388
Engineering & Projects Northern Region
Monitoring & Services Deptt
BPCL, Northern Region Office
9th floor, A 5&6, sector-1, Noida 201301 U.P.
Telephone: (0120) 2474914
Fax : (0120) 2474982
Engineering & Projects Eastern Region
Monitoring & Admin Deptt
BPCL ,Eastern Region Office
Bharat Bhavan , 2nd Floor , Wing 2
Plot No.31, KIT Scheme No. 118
Prince Gulam Md. Shah Road,
Golf Green, Kolkata-700095
Telephone: (033) 24293245/24293058
Fax: 033- 24293252
Engineering & Projects Western Region
Monitoring & Services section
Western Region Office
BPCL, A Installation, Sewree Fort road, Sewree (East), Mumbai - 400 015
Telephone: 022- 24136117/24176206
Fax: 022-24168001
Engineering & Projects Southern Region
Monitoring & Services section
Southern Regional Office,BPCL
No,1, Ranganathan Gardens, Off. 11th main road,
PB NO. 1212 & 1213, Annanagar, Chennai - 40
Telephone: 044- 26142361/ 26142308 / 26142318
Fax : 044- 26215460
2. Human Resources
HR Western Region
Mr. Anil Ahir Sr. Mgr (Admin. Fac.), West 4th floor, Bharat Bhavan II, 4 & 6
Currimbhoy Road, Ballard Estate, Mumbai.
HR Eastern Region
Mr. Subrato Saha Dy. Mgr. (Admin. ) Eastern Regional Office Bharat Bhavan, Plot
No. 31, Prince Gulam Md. Shah Road, Golf Green Kolkata.
HR Southern Region

Page 6 of 11

Mr. Suresh Kumar Manager Admin. South Southern Regional office - 1,Ranganathan
Garden, Off 11th Main Road, Annanagar, Chennai
HR Northern Region
Mr. Mukesh Nangia, Chief Manager (Admin), North Northern Regional Office Plot No.
A-5 and A-6, Sector -1 Udyog Marg, Noida.
HR Corporate Office
Mr. Vijay Dsouza Sr. Mgr. (Admin.), HRS Admin. Dept - 1st floor, Bharat Bhavan I, 4 &
6 Currimbhoy Road, Ballard Estate, Mumbai.
3. Lubes Plant / Region Wise
Mr. G Srinivasulu ,
Manager Engineering & HSSE
Bharat Petroleum corporation ltd
Wadilube Installation, Malet Road,
Wadibunder, Mumbai 400009
Mr. Manish David Singh (3149) ,
Dy Manager Egg & HSSE ,
Bharat Petroleum Corporation Ltd,
Hastinapur Yojna, Village - Teelashavajpur,
Lubes Plant, P.O. Loni
Loni (UP)
Mr. Ranjan Mullick (1019),
Manager Engg & HSSE,
Bharat Petroleum Corporation Ltd,
2, Graham Road,
Dist. 24-Parganas [South]
Budge Budge-700137
West Bengal
Mr. Danny John Bejoy, (9239)
Asst Manager ( Lubes),
Tondiarpet Installation,
Post Box No.1152,
Vaidyanatha Mudali St, Tondiarpet
Chennai-600081
(Tamil Nadu)
Mr. Joydip Majumdar, (1851),
Bazaar Channel Mgr (Lubes WR),
Sewree Fort Road,
Sewree (East)-400015
Mumbai
(Maharashtra)
Mr. K R Muralidhara, (1253) ,
Sr Manager Transport,
SCM Setup (Lubes)
Sewree Fort Road,
Sewree (East)-400015
(Maharashtra)

Page 7 of 11

4. Aviation
Manager Technical Services Aviation
Aviation SBU, 4th Floor
Bharat Petroleum Corp. Ltd.
A 5&6, Sector 1
Noida 201 301
5. Mumbai Refinery
Chief Manager - Procurement & Contract Services,
BPCL, Mumbai Refinery,
2nd Floor, Admin. Building - South Block,
Mahul, Mumbai - 400 074
6. LPG
LPG Equipment Only
Mr. K. Raghunath,
Manager LPG Procurement
Bharat Petroleum Corporation Limited,
LPG equipment department,
A installation,
Sewree fort road,
Sewree East, Mumbai 400 015.
LPG NR
Mr. M.R.Mohanty
Sr. Manager Ops & HSSE (LPG), North
Bharat Petroleum Corporation Limited,
Plot No. A-5&6, Sector -1,
Noida-201301
(UP)
LPG ER
Mr. S. Mazumdar
Manager Ops & HSSE (LPG)
Bharat Petroleum Corporation Limited
Bharat Bhavan,
Plot No- 31, Prince Gulam Md.
Shah Road, Golf Green
Kolkata-700095
LPG SR
Mr. S. Shunmugam
Ch. Manager Ops.
Infrastruct. Development (LPG)
Southern Regional Office,
1, Ranganathan Garden, Off.11TH Main Road,
Post Box No.1212&1213,
Anna Nagar (Tamil Nadu)
LPG WR
Mr. S. S. Gangopadhaya
Ch. Manager Ops. & HSSE (LPG), West

Page 8 of 11

Bharat Petroleum Corporation Limited

Sewree Fort Road,, Sewree (East)
Mumbai-400015
Maharashtra
7. IIS Computer and related equipments / software
Mr. Swaminathan K.S.
Executive (IIS Proc.& Contracts)
BPCL Chairmans Office,
Bharat Bhavan,
4 & 6 Currimbhoy Road,
Ballard Estate,
Mumbai 400 001
OR
Mr. Shyam Sawant
Dy. Manager (IIS), Communications
BPCL Chairmans Office,
Bharat Bhavan,
4 & 6 Currimbhoy Road,
Ballard Estate,
Mumbai 400 001
8. I & C
I&C NR
P.K.Taluja
Dy Manager Logistics (Industrial) NR
C/o Territory Manager (Industrial) , Delhi
Bharat Petroleum Corporation Ltd.
A 5 & 6, Sector 1
NOIDA 201301
DIST. G . B. NAGAR ( U.P)
TEL NO 0120 - 2474176
M +91 9654320246
E mail talujapk@bharatpetroleum.in
I&C WR
Mr Arun R. Tirodkar.
North Block, 4th Floor
Old Admin Building,
BPCL Refinery,
Chembur, Mahul,
Mumbai - 400074
I&C SR
Ms. M Malarkodi
Manager Logistics (Industrial) South
1, Ranganathan Gardens,
Off 11th Main Road,
Annanagar,
Chennai 600 040
I&C ER
P. P. Pramanick
Bharat Bhavan,

Page 9 of 11

Plot No - 31,
Prince Gulam Md. Shah Road , Golf Green,
Kolkata 700 095
I&C HQ
Mr Suneel Sharma
Room no 415, 4th Floor
Old Admin Building
BPCL Refinery
Mahul
Mumbai - 400074
D. Chandrashekhar
Ch. Mgr. Logistics (I&C), HQ
Bharat Petroleum Corpn. Ltd.,
Bharat Bhavan-1,
4&6, Currimbhoy Road,
Ballard Estate, Mumba-400 001.
S.P.Ghan
Ch. Mgr. Logistics & HSSE (I&C), HQ
Bharat Petroleum Corpn. Ltd.,
Bharat Bhavan-1,
4&6, Currimbhoy Road,
Ballard Estate, Mumbai-400 001.
9. Retail
Retail - Northern Region
SR.MANAGER (RETAIL ENGINEERING)-NORTH
BPCL
PLOT NO. A-5 AND A-6, SECTOR -1, UDYOG MARG.
NOIDA, U.P-201301
Retail - Eastern Region
SENIOR MANAGER RETAIL ENGINEERING, EAST
BPCL
BHARAT BHAVAN, PLOT NO- 31, PRINCE GULAM MD. SHAH ROAD, GOLF GREEN
KOLKATTA-700095
Retail - Southern Region
CHIEF MANAGER RETAIL ENGG. (SOUTH)
BPCL
SOUTHERN REGIONAL OFFICE, 1,RANGANATHAN GARDEN, OFF.11TH MAIN ROAD, POST
BOX NO.1212&1213 , ANNA NAGAR
CHENNAI 600040
Retail - Western Region
SR. MANAGER (RETAIL) ENGG., WEST
BPCL
E & F, MAKER TOWERS,, CUFFE PARADE,
MUMBAI-400005
10. Kochi Refinery
Ch. MgrContract Services (P&CS)
BPCL Kochi Refinery

Page 10 of 11

Post Bag-2
Ambalamugal
Kochi-682302
Kerala

Page 11 of 11