Performa for empanelment of
experts/organizations as evaluators for undertaking concurrent evaluation of
projects and other studies supported by NAEB.
|
1. |
Name
of organization |
|
|
2. |
Name
and Designation of Contact Person |
|
|
3. |
Postal
Address of the Organization (with PIN CODE) |
|
|
4. |
Physical
address, if different from postal address (With PIN CODE) |
|
|
5. |
Telephone
with STD Code |
|
|
6. |
FAX
No. with STD Code |
|
|
7. |
Mobile
No. of Contact Person |
|
|
8. |
E-mail
Address of Contact Person |
|
|
9. |
Name
and Designation of Head of the Organization responsible for the Study
Contract |
|
|
10. |
Establishment
Details |
|
|
a. |
Year
Established |
|
|
b. |
Type
of Organization (Tick
One) |
Educational
& Research Institution/Consulting Organization/Any Other (give details)
……………………. |
|
c. |
Regd.
No. Name and Place of Registering Authority |
(Attach
attested photocopy of Registration Certificate) |
|
d. |
No.
of full time employees |
|
11. Field of Expertise (May tick more than one;
supporting details to be given in col. 8 of Sl. No. 12).
12. Key
activities undertaken by the Organization in the past 3 (three) years.
(In brief, extra-sheet may be used if
activities are more than 5 in number)
|
S.No. |
Type
of activity (technical consultancy/research/study) |
Name
and Address of Client |
Duration
(From - To) |
Cost
(Rs. Lakh) |
Location |
Sector
(see sl. no. 11) & Main Outputs. |
|
1 |
2 |
3 |
4 |
5 |
6 |
8 |
|
(i) |
|
|
|
|
|
|
|
(ii) |
|
|
|
|
|
|
|
(iii) |
|
|
|
|
|
|
|
(iv) |
|
|
|
|
|
|
|
(v) |
|
|
|
|
|
|
Attach a copy of original written work produced by
the organization as a proof of its course competence relevant to the proposed
assignment (to be returned by the Ministry after screening of bids).
13. Any other details
Date
…………………………………….
Signature(Team Leader)…………………..
Place
………………………………….
Name ……………………………………………..
Designation ……………………………………….