Firm Details
Constitution of Firm*	-Select- Proprietor Partnership Firm Private Limited Public Limited Limited Firm Co-operative Institution Society NGO Trust Others	Specify Other*
Registration No. of Firm
Name of Firm*		Status of Premises*	-Select- Rented Lease Self Owned Others
Office Number*		Official Email ID*

Authorized Person Details
First Name*	--- Mr. Mrs. Ku.	Last Name *
Father's/Husband's First Name*		Father's/Husband's Last Name*
Date of Birth*		Mobile Number*
Email ID*		Designation*
Password*		Confirm Password*
Registered Address of Firm
House No. *		Colony
District*	-Select- AGAR ALIRAJPUR ANUPPUR ASHOK NAGAR BADWANI BALAGHAT BETUL BHIND BHOPAL BURHANPUR CHHATARPUR CHHINDWARA DAMOH DATIA DEWAS DHAR DINDORI GUNA GWALIOR HARDA HOSHANGABAD INDORE JABALPUR JHABUA KATNI KHANDWA KHARGONE MANDLA MANDSOUR MORENA NARSINGHPUR NEEMUCH PANNA RAISEN RAJGARH RATLAM REWA SAGAR SATNA SEHORE SEONI SHAHDOL SHAJAPUR SHEOPUR SHIVPURI SIDHI SINGRAULI TIKAMGARH UJJAIN UMARIA VIDISHA	Area/ Village *
Tehsil*		Pincode*
Are Registered Address and Local Address same?
Local Address of Firm
House No. *		Colony
District*	-Select- AGAR ALIRAJPUR ANUPPUR ASHOK NAGAR BADWANI BALAGHAT BETUL BHIND BHOPAL BURHANPUR CHHATARPUR CHHINDWARA DAMOH DATIA DEWAS DHAR DINDORI GUNA GWALIOR HARDA HOSHANGABAD INDORE JABALPUR JHABUA KATNI KHANDWA KHARGONE MANDLA MANDSOUR MORENA NARSINGHPUR NEEMUCH PANNA RAISEN RAJGARH RATLAM REWA SAGAR SATNA SEHORE SEONI SHAHDOL SHAJAPUR SHEOPUR SHIVPURI SIDHI SINGRAULI TIKAMGARH UJJAIN UMARIA VIDISHA	Area/ Village*
Tehsil*		Pincode*

Documents Upload
1. Photograph of Authorized Person*
2. Address Proof (Form 18, Certification of Incorporation, Electricity Bill, Telephone Bill etc.)*
3. Authority Letter issued to Authorized Person (Applicable for All Tenders)*
4. Any other related document

Declaration
* I hereby declare that all the details furnished in the form are valid and correct, in case any detail found to be incorrect/ invalid, I will be responsible and the Department has the right to reject this application. I understand that In case of rejection, fee would not be refunded under any circumstances.