Postal address with Telephone, mobile, fax nos. and email ids
502, The Sungrace Mall Above The Westside, Visat Gandhinagar Road Motera, Ahmedabad-380005, Gujarat
a ) Head Office/Registered Office
502, The Sungrace Mall Above The Westside, Visat Gandhinagar Road Motera, Ahmedabad-380005, Gujarat
b ) Branches/Sales Office
GUJARAT HEYDRABAD ASSAM PUNE MUMBAI
c ) Factory
KALOL
d ) Godown
AHMEDABAD
3 . Registration is sought as
MANUFACTURER
a ) Floor area of Factory (ies) in square meters
2 FLOOR
b ) No. of workers employed
1-100
c ) No. of staff employed
1-50
d ) List of machinery in your factory(ies)
50
e ) List of testing facilities at your end
YES
b ) Whether you are usually holding ample stock of item(s) for which registration is sought
YES
c ) Whether you have adequate facilities for after Sales Services, give details
YES
a ) Whether you always hold adequate stock of the items for which registration is sought
YES
b ) Whether you have adequate facilities for after sales service, give details.
YES
7 . Whether firm is ISO certified or any other certification, mention details and documentary evidence
8. Group of Items/service for which registration is sought <a href="sites/default/files/ANNEXURE_c.pdf" target="_blank">(Refer Annexure-C for Group details)</a>
I
a ) if a Limited concern, name & addresses of Directors & Managing Director
--
b ) If Single Owner, name & addresses of Proprietor & Manager, if any
VISHNU SANKAR SHUKLA & 058 GUJARAT HOUSING BOARD CHANDKHEDA GANDHINAGAR 382424
c ) If Partnership, name & addresses of Partners
--
Registered Options
(iii) Any Act if not who are the Owners (please give full names & addresses)
12. Sales Tax Registration No. (attach copies of GST Certificates)
13. Are you registered under NSIC and submit NSIC registration as a proof
14 . Are you registered under MSME and submit “Udyam Registration Certificate” as a proof
15 . Are you on the list of approved/registered supplier in Dept. of Atomic Energy or any of its units/any Govt./Semi-Govt. dept./GeM (Govt. e-Market)
16 . Bankers Name, address, Account no
Declaration
| Sr. No. | Name | Position(Whether Proprietor, Partner or Share Holder) | Contact Details Email ID/Phone Number |
|---|---|---|---|
| 1 | |||
Place :
VISHNU SANKAR SHUKLA
Signature with Official seal
Declaration
a.We (name of the firm) do hereby declare that the entries made in this application are true to the best of our knowledge.
b. We also declare that all the material/documents provided by ITER-India, IPR shall be treated as CONFIDENTIAL and no information shall be passed on to any unauthorized person/firm without written permission of ITER-India, IPR
c. We also undertake to inform all subsequent changes affecting the accuracy of the answers given in this registration form will be promptly communicated to your organization
d. Ms/Mr. whose signatures are given below is an authorized representative of this firm
a. We
EPSILON ENTERPRISE
d. Ms/Mr.
VARSHA LEUVA