Anneure-V

Specialized Work with Unit allotted for each work

SNo Description of Work Units
1 Antenna Orientation & Tilt per sector
0.5
2 Dismantling of Antenna, per antenna
0.8
3 Dismantling of Antenna Fixture, per fixture (for phase diversity antenna)
1
4 Dismantling of Antenna Fixture, per fixture (for space diversity antennae)
1.6
5 Installation of Antenna, per antenna
1
6 Fixation of Antenna Fixture, per fixture (for phase diversity antenna)
1
7 Fixation of Antenna Fixture, per fixture (for space diversity antenna)
1.5
8 Height lowering/raising of Phase Diversity Antenna along with fixture, per sector
2.2
9 Hoisting of RF Cable including connectorization, per 10 meter
0.3
10 Removing of RF Cable, per 10 meter
0.1
11 VSWR fault rectification per sector (includes reconnectorization, jumper cable change &
weather proofing) 0.8
12 Weather Proofing, per Site
0.7
13 Checking & correction of RF cable swap, per site/ replacement of SFP/OVP
0.5
14 Installation of Microwave Dish (Mini Link), per Antenna
2
15 Removing of Microwave Dish (Mini Link), per Antenna
1.5
16 Microwave Link LOS work (Per Link) including ODU replacement
1
17 ODU Replacement for Minilink, per Antenna
0.6
18 Installation of Micro BTS Equipment per unit
0.9
19 Laying of RF Cable per 10 meter for Micro BTS (50M /site)
0.2
20 Installation of Splitter including connectorization
0.2
21 Installation of Patch/Panel / Omni antenna with connectorization
0.2
22 RF Repeater Installation including Yagi / Panel Antenna & RF Cable of 25M
1
23 Wall mount antenna installation :: Fixing of wall mounting fixture, per fixture
1
24 Wall mount antenna installation::: Installation of RF cable tray for wall mounting Antenna
per 10 meter 0.4
25 Removal of honey bee/wasp nest
1.34
26 Removal of Bird nest per site
1
27 Dismantling and packing of single BTS/NodeB/eNodeB rack without ant/RF cable
4
 Specialized Work with Unit allotted for each work
SNo Description of Work Units
28 Dismantling and packing of more than one BTS rack without ant/RF cable
6
29 Dismantling and packing of BTS rack with ant/RF cable
9
30 Dismantling and packing of more than one BTS rack with ant/RF cable
12
31 Installation of of single BTS rack without ant/RF cable
4
32 Installation of of more than one co located BTS rack without ant/RF cable
6
33 Installation of single BTS rack with ant/RF cable fixtures 12

34 Installation of more than one colocated BTS rack with ant/RF cable and Ant fixtures 15

35 Power Plant Installation incl handling

1.5
36 Battery Installation 200_300 incl handling
1.5
37 Battery Installation 400-600 incl handling
2
38 New Earthing at Site ( description )
12
39 New Earthing at site ( material will be supplied by BSNL)
3
40 Removal / installation of one faulty RFmodule from tower and packing
1
41 Removal /installation of 9U Rack /System Module
0.5
42 Installation and setting up of Cell-On-Wheels at a given site
12
43 De-Installation and packing of Cell-On-Wheels at a given site
7
44 Transportation of Cell-On-Wheels from a given site to another : Every 50 Kms or part
thereof 6
45 Dismantling of battery bank (200-400AH) or A/C unit or servo stabilizer or power plant or 1.5
such an item in site and its packing & loading
46 Dismantling of DG of 15KvA or less at site and puting back AC supply with proper joint 3
kit and its packing & loading
47 Dismantling of existing tower foundation & removal of Steel at RTT sites and disposal of 2.5
debris from site excluding transport
48 Installation, Testing and commissioning of 10KVA/15KVA DG excluding foundation incl 4
handling
49 Installation, Testing and commissioning of 10KVA/15KVA DG excluding foundation, incl 5.5
installation material cable, lugs, glands etc. incl handling
50 Replacement of CPRI cable on tower 1

51 RCC foundation per cubic meter for BTS/PP/BATT 5.5

52 Erection/installation of runway/cable tray per meter with support (runway material will be 0.2
provided by BSNL)
53 Dismantling of a prefab shelter and loading for transportation to store 6
 Format of invoice to be submitted by Vendor

Sr. No. Description of work/Items SAC/HSN Code Quantity Rate Amount

1 BTS site maintenance
2 Diesel filling
3 Specialised work(Rigger)
4 L1 mtce of BTS
Comprehensive mtce of DG(15
5 KVA)
Comprehensive mtce of DG(10
6 KVA and less)
7 Civil and Electrical site mtce
One Time fixed cost DG
8 restoration
9 Transportation of material
BSNL/ VENDOR NAME Page 2 of 25
SITE SURVEY SHEET
Appendix-1
BSNL/ VENDOR NAME SITE SURVEY SHEET
Zone Take Over Date
SSA RFE Date
Site type BTS/BSC Landlord Name
Site Name Landlord Contact No.
Site ID Care Taker Name
Address Care Taker Cont. No.
Site Type
TSP Name ID/OD/RBSC/Rpt/Others
Nokia /Alu
Nokia /Alu 2G Yes/No 3G Yes/No

BSNL Anchor No. of BTS's / TRX

Shared with OPCO 2nd-
Name No. of BTS's / TRX
Shared with OPCO 3rd -
Name No. of BTS's / TRX
Base Type ( Tick) RTT / GBT Tower Type (Tick) Delta / Angular / Pole
Building Height ( Mtr) Tower Height ( Mtr)
Diesel Generator Make Rating (KVA) Sr.No.
Mfg. Date
DG Sub-unit Make Rating/Capacity Model Sr.No Status (Ok/Not OK/Details)
Engine
Alternator
Canopy
Canopy Locking Argmnt.
DG Battery
Exhaust Fan
Starter Motor
Stop Solenoid
LLOP Sensor
HCT Sensor
HMR
Charging alternator
Fuel Sensors
HWT Sensor
Fuel Tank
Fuel Level Gauge
DG Platform and Steps -
Service Impacting
Discrepancy if any

Other Remark / Punch

points
AMF Panel Make Type Sr.No.

AMF Sub-units Make Type Model Sr.No Status(Ok/Not OK/Details)

LVM
GCU
Contactors
Battery Charger
Alarm cable
Status of Other Electricals in AMF Panel
Remote Switch in AMF (Tick) Yes / NO )
Other Remark / Punch points
BSNL/ VENDOR NAME Page 3 of 25
SITE SURVEY SHEET

Note : At RBSC & any other BTS location where 2nd DG is available, 2nd DG Details should be captured in a separate sheet using page NO. 1 of the this format
PIU/PMU/ACPDU Make Rating Sl.No.
Sub-unit s of Model
PIU/PMU/ACPDU Make Nos. Name Sl.No Status(Ok/Not OK/Details)
CPU
GCU
MCBs Ratings
Contactors
Phase Selection Card
SVR/LCU Card
Isolation Transformer
Battery Charger
Fire Smoke Alarm Card
Fire Smoke Alarm Sensor
Alarm Cable
Over all Functionality
Automation Status
Additional details of
AVR/Servo if any
Servo/AVR - Make Rating Sr.No.
Servo/AVR - Status Ok / Not OK Fault Details
Air-Conditioner Make Rating Sr.No.

Aircon Sub-units Make Rating Model Sr.No. Status(Ok/Not OK/Details)

A/C 1 Compressor
A/C 2 Compressor
Controller Unit
AC-1 Evaporator Blower
AC-2 Evaporator Blower
AC-1 Condenser Blower
AC-2 Condenser Blower
Stabiliser-1
Stabiliser-2
Thermostat
Filters Status
Input Air-Temp. Output Air-Temp.
Alarms Functionality

Free-Cooling Functionality if installed

Shelter Make Size Roof Type Single / Double

Availability
Shelter Sub-units (Tick Applicable) Ok/Not Ok/Status/Details
Step ladder YES NO
Lock Status YES NO
IGB YES NO
EGB YES NO
Shelter Punch points Continues……………………..
Any Air Gap Visible YES NO
BSNL/ VENDOR NAME Page 4 of 25
SITE SURVEY SHEET
Damages
Any issue visible
in Door YES NO
Operation YES NO
Door Canopy Provided YES NO
Cage Size Status
Cage Sub-units Availability (Tick Applicable) Status(Ok/Not OK/Details)
platform
Any issue in Door YES NO
Operation YES NO
Any issue in roof & Wall YES NO

Fire Extinguisher Make Expiry Date Status

Power Plant ( SMPS) Make Rating Sr.No.
Total Faulty Individual
Total Ok Modules Modules Module Rating Model/Versio
Power Plant Sub-units Available Available (A) n Name Status(Ok/Not OK/Details)
Rectifiers
SMPS Others Make Rating Model Sl.No Status(Ok/Not OK/Details)
SPD" C" Class
LVD-I
LVD II
Controller Module
Status of Backplane
Alarm Card Status
Alarm cable
Grounding Status
Symmetry Sensing status

Active Equipment Load ………...Amps Float Vol …………V Boost Vol. …………V
Other Issues
Battery Banks
No. of faulty Date of Installation if
Battery Bank Sub-Units Make Rating Voltage 24/48 cells other than RFE Date Remarks
Bank 1
Bank 2

Bank-1 Faulty Cell locations

Bank-2 Faulty Cell locations

Overall Backup of site on existing load (Hrs)

Physical Damages if any visible
Any Other
Earth Pits

Construction Earth Earth Pits

Unit Funnel Status Quality Resistance Covers Status Remarks
Earth Pit 1
Earth Pit 2
Earth Pit 3
Other Observations
Other Information's
Status
Unit (Ok/Not OK) Remarks
LT - Panel Status
Emergency Lamp
Surge Protectors
BSNL/ VENDOR NAME Page 5 of 25
SITE SURVEY SHEET
Indoor Tube Lights
Outdoor Light
Tower Mountings
Tower Foundation
Tower Grounding

Tower Other visible faults

Boundary wall/Fence
Boundary Gate
Boundary Door
Other Civil status
Site Hygiene Status
B/Door Locking
Arrangement
First Aid Box

A Class lightening Arrester

Aviation Lamp Type AC/DC Other info
EB Meter Status EB Kwh Reading
3 Phase/ Average EB
EB Connection Connection 1 Phase/ No. of Phases Functional Availability/Day
Functionality Type (Tick) Temp. (Tick) 1 / 2 / 3 …………….Hrs
Make &
EB Transformer Rating KVA Type
Status of EB Transformer & Functionality :
DG HMR PMU/PIU HMR
DIESEL IN TANK (LTR) FILLED TODAY ( LTR)
DG FUEL TANK CAP. FINAL STATUS OF TANK
DG Key handed
No. of Keys handed over to CO&M Representative Over YES / NO
Warranty Rights
Handover Status
OTHER OBSERVATIONS IF ANY :

Technician
Date: Name: BSNL Rep. Sign:
Company
Name: BSNL Rep. Name:
Mob. No: Mob. No:
 Appendix-2
SITE WISE LOG BOOK FOR work/obervation by Visiting person
Site Name Site ID

Work
S.N Date Name of the Person Time -IN Done/Observation Time -OUT Signature
 Appendix-3
[For compliance check of rectification of issues wrt infra of sites ]
[To be prepared site-wise by the service provider and signed in confirmation by BSNL. Can be
started soon after the WO is issued and completed for all sites within 3 months]

Ser # Item Clause Ref. Status

(Ok/Not Ok)
1 All BTS infrastructure related alarms [min 8 as per BSNL Sec-3-B,
approval] need to be made functional and to be extended Clause-2(q)
upto OMCR.
2 Repair of Electrical fittings at sites i.e. minor faults like Sec-3-B,
MCB/ Switches/ Fuse/ light/ tube light/LED light Clause-2(b)
changeover replacement
3 Cleanliness including bush cutting etc
4 Making the DG functional, including auto start with
regular B Check, diesel filling wherever DG is made over.
DG start timer set as per battery back up available.

5 BTS cleaning including air filter, eqpt harness so that the

door is kept is kept closed with proper airflow for normal
working
6 All modules of PP functional including controller. Battery
charging current set at 5/10 rating for VRLA appropriately
and upto 50% for Li-Ion based on PP capacity. Battery cut-
off function is correctly functioning.

7 Battery backup checked and made at least ½ hr to 1 hr by

rearrangement of modules etc. or new battery installation.

8 Check and measurement of earth. Ensuring its continuity

upto eqpt. Improve as required. Lay new earth if required.

9 Ensure that the leakages, if any, in the prefab shelter are

arrested..
10 Fire alarm system is checked and made operational.
11 EMF board as per DoT norms are maintained
12 Lightning arrestor and associated installations are proper.

13 2 SIMs [ BSNL and other] are given to technicians

14 Log-book is maintaining electronically
 Appendix-4

Team for verification of sites within 3 months after rectification done by vendor as per
the format-1

Zone SSA Officer from Circle office/NWOCM Officer from SSA

1 Ahmednagar Balkrishna Bhoir SDE Vikram Bhawsar

1 Beed Balkrishna Bhoir SDE Gulam Ambiya
2 Akola C R Dhole SDE JTO Mobile
2 Amravati DG Poke AGM NWOCM JTO Mobile
2 Yavatmal DG Poke AGM NWOCM Suryavanshi SDE
3 Aurangabad Srinivas Gite JE M Budhewar SDE
3 Buldhana Vishal Shinde JE M Randhir Kumar JTO M
3 Jalna Kiran Sakpale JTO M Abhishek Kumar JE
4 Bhandara DG Poke AGM NWOCM JTO Mobile
4 Chandrapur DG Poke AGM NWOCM Jaiswal SDE
4 Gadchiroli DG Poke AGM NWOCM Khurana SDE
4 Wardha DG Poke AGM NWOCM JTO Mobile
5 Goa Prakash Korate JTO M Mansoor SDE
5 Sindhudurg Anilkumar Dubey AGM NWP-CM SR Bhise
6 Dhule Manish Suryavanshi SDE M Sudhir P Deshmukh JTO M
6 Jalgaon Manish Suryavanshi SDE M Amit Kulkarni JTO M
7 Kalyan Anilkumar Dubey AGM NWP-CM Prashan B Jadhav SDE M
7 Raigad Shende JTO Kalyan Pramod Patil JTO Mobile
8 Kolhapur Abhinav Sharma JE SDE M
8 Ratnagiri Anilkumar Dubey AGM NWP-CM Umesh Shirshat SDE
9 Nagpur R S Wankhade JTO IP Vikrant JTO
10 Latur Anilkumar Yadav SDE SDE M
10 Nanded M Sarath JTO Mobile SDE M
10 Parbhani Anilkumar Yadav SDE JTO Mobile
11 Nasik S A Chavan SDE SDE Vaidya
12 Pune kailash Barde SDE CM Deo JTO M +1
13 Sangli Haris Kumar JTO JTO Mobile
13 Satara Haris Kumar JTO SDE Mali
14 Osmanabad Ashok Trimbake SDE M Pandey ji JTO
14 Solapur Ashok Trimbake SDE M Kolarkar SDE Mobile
 Appendix - 5

Statement with respect to Auditing of IP Leased In sites

( To ascertain the Occupancy Details)

SSA : _________ Month : _________

Vendor : ________

Ref WORK ORDER NO. : _________

No. of
sharing Names of the sharing operators
Sl.No. Site ID Site Name Name of IP operators
(Excluding BSNL)
(Excluding
BSNL)
1
2
3
4
5

** Changes detected are highlighted

Sign Of Nodal Incharge with stamp

Date
Name of Nodal Incharge
Designation
HRMS NO
Mobile No
Email ID
 Appendix - 6

Statement with respect to Auditing of BSNL Leased Out sites

( To ascertain the Occupancy Details)

SSA : _________ Month : _________

Vendor : ________

Ref WORK ORDER NO. : _________

No. of Names of the

sharing sharing
Sl.No. Site ID Site Name operators operators
(Excluding (Excluding
BSNL) BSNL)
1
2
3
4
5

** Changes detected are highlighted

** Format for Physical Verification of sites Appendix-13 to be submitted.

Sign Of Nodal Incharge with stamp

Date
Name of Nodal Incharge
Designation
HRMS NO
Mobile No
Email ID
 Appendix -7

Statement with respect to One time DG restore

SSA : _________ Month : _________

Vendor : ________

Ref WORK ORDER NO. : _________

** Please give the details of one time DG restore, if done,

alongwith approval notesheet from SSA head,
as per the charges mentioned in tender.
Otherwise NILL report.

Sign Of Nodal Incharge with stamp

Date
Name of Nodal Incharge
Designation
HRMS NO
Mobile No
Email ID
 Appendix - 8

Statement with respect to Comprehensive Maintenance of DG

( DG 15 KVA and DG 10 KVA & less)

SSA : _________ Month : _________

Vendor : ________

Ref WORK ORDER NO. : _________

For DG 15 KVA

Serial No. of
Sl.No. Site ID Site Name From Date To Date Satisfactory/Unsatisfactory
DG
1
2
3
4
5

For DG 10 KVA and Less

Serial No. of
Sl.No. Site ID Site Name From Date To Date Satisfactory/Unsatisfactory
DG
1
2
3
4
5

Certified that the Comprehensive Maintenance work has been done satisfactory
except for the DGs mentioned unsatisfactory.

Sign Of Nodal Incharge with stamp

Date
Name of Nodal Incharge
Designation
HRMS NO
Mobile No
Email ID
 Appendix - 9
Statement with respect to Diesel Filling at BTS sites

SSA : _________ Month : _________

Vendor : ________

Ref WORK ORDER NO. : _________

Date of
Quntity of
Sl.No. Site ID Site Name Diesel Voucher/Receipt No for diesel Filled
Diesel filled
Filling
1
2
3
4
5
6
7
8
9
10

Certified that :
1. The Diesel filling work has been done satisfactory for the sites mentioned.
2. Statement for Petrocard reconcilation,
(Appendix-12 : Recovery/Reimbursement of diesel cost) is filled up.
3. The loss caused to BSNL due to loss/misuse of petro/Fleet card by the vendor is :
NILL / Rs._____

Sign Of Nodal Incharge with stamp

Date
Name of Nodal Incharge
Designation
HRMS NO
Mobile No
Email ID
 Date
Place
7
6
5
4
3
2
1
S.N

Date

Time

Name and contact no of person

filling the diesel

Signature of BSNL Site incharge

Signature of the person filling
the diesel

Diesel available in tank before

B

filling ( in Ltrs)

Diesel filled

Total Diesel aviable after filling

A

the diesel using Dip stick ( ltrs)

Signature

Diesel Consumed
C=A-B
E
D

DG HMR READING
Name and address of contractor
MONTHLY SITE WISE LOGBOOK FOR DIESEL FILLING

Hours run between consecutive

F=E-D

diesel fill

DG KWH reading at the time of

G

diesel filling

DG KWH between consecutive

I=H-G

diesel fill

Diesel Consuption/ Hr ( in ltrs)

J=C/F

Petro card, Pump, receipt no,

date , Qty of diesel,amount,
balance amount etc
Appendix-10

Remark if any
 Appendix - 11

Monthly reconciliation of Petrocard

SSA : _________ Month : _________

Vendor :________

Ref WORK ORDER NO. : _________

PETRO CARD NO : __________

CONSUMP
TION AS
OPEN METER CLOSE METER DG RUN CALCULATED PER LOG
SITE ID & READING(OMR)[ READING(CMR)[ TIME(B- CONSUMPTION BOOK LOWER OF
SL NO NAME MAKE TYPE A] B] A=C) CPH(D) (E=C/D) ENTRY[F] E,F

TOTAL[G]

CONSUMPTION IN
PETROCARD[H]
PAYABLE [LOWER OF G,H]
If payable consumption in petrocard is more than calculated based on CPH, difference to
be recovered
RECOVERY AMOUNT

Sign Of Nodal Incharge with stamp

Date
Name of Nodal Incharge
Designation
HRMS NO
Mobile No
Email ID
 Appendix-12
PROFORMA FOR REIMBURESMENT OF DIESEL COST

PERIOD FROM ------- TO -------------------- Dtd:

MULTIPLICATIONFACTOR(B)

LITREDIESELINRUPEES.(C)

TOTAL AMOUNT IN
DG RUN TIME(A)
SITE ID & NAME

READING(OMR)

READING(CMR)

RUPEES=A*B*C
CLOSE METER
OPEN METER
DG MAKE

RATE PER
SL NO.

TYPE

Signature ofSignature of the BSNL

the representative representative
of Bidder Signature of the representative of Vendor
 Format for Diesel purchase by petrocard and Data to be mailed to SDE incharge after each transection using
petrocard/fleet card

Diesel
Bill no of Date of
Quantity Amount Petro Diesel filledTotal HMR
S.N Petrocard transectio RP ID Site Name
in Ltrs ( Rs) Card No available Diesel in reading
transection n
tank

Date
Place Signature
Name and address of contractor
Signature of BSNL Site incharge
 Appendix - 14

Statement with respect to BTS site Maintenance

( Mobile Infrastructure + Access Equipment Maintenance)

SSA : _________ Month : _________

Vendor : ________

Ref WORK ORDER NO. : _________

Sl.No. Site ID Site Name From Date To Date Satisfactory/Unsatisfactory

1
2
3
4
5
6
7
8
9
10

Certified that the BTS site Maintenance( Mobile Infrastructure + Access Equipment Maintenance) work
has been done satisfactory except for the sites mentioned unsatisfactory.

Sign Of Nodal Incharge with stamp

Date
Name of Nodal Incharge
Designation
HRMS NO
Mobile No
Email ID
 Appendix -15

Statement with respect to Specialised works

( Rigger Activities)

SSA : _________ Month : _________

Vendor : ________

Ref WORK ORDER NO. : _________

Units Required
Specialised Rigger activity Work Completion to complete the
Sl.No. Site ID Site Name Ordered Date No of activity work Total Units
1
2
3
4
5
6
7
8
9
10

Certified that the above mentioned Specialised works( Rigger Activities) have been done satisfactory.

Sign Of Nodal Incharge with stamp

Date
Name of Nodal Incharge
Designation
HRMS NO
Mobile No
Email ID
 Appendix - 16

Statement with respect to L1 Maintenance of BTS

SSA : _________ Month : _________

Vendor : ________

Ref WORK ORDER NO. : _________

Sl.No. Site ID Site Name From Date To Date Satisfactory/Unsatisfactory

1
2
3
4
5
6
7
8
9
10

Certified that :

1. the L1 Maintenance work has been done satisfactory except for the sites mentioned unsatisfactory.
2. Auditing of IP Leased In sites has been carried out and Occupancy Report (Appendix-8) has been submitted
to O/o PGM(NOW-CM), Pune
3. Auditing of Leased Out sites has been carried out and Occupancy Report (Appendix-9) has been submitted
to O/o PGM(NOW-CM), Pune

Sign Of Nodal Incharge with stamp

Date
Name of Nodal Incharge
Designation
HRMS NO
Mobile No
Email ID
 Appendix - 17

Statement with respect to Civil and Electrical Site Maintenance

SSA : _________ Month : _________

Vendor : ________

Ref WORK ORDER NO. : _________

Sl.No. Site ID Site Name From Date To Date Satisfactory/Unsatisfactory

1
2
3
4
5

Certified that the Civil and Electrical site Maintenance work has been done satisfactory
except for the sites mentioned unsatisfactory.

Sign Of Nodal Incharge with stamp

Date
Name of Nodal Incharge
Designation
HRMS NO
Mobile No
Email ID
 Appendix - 18 Date:
Time:
Format for Physical Verification of leased out sites
SSA: Site Name:
BSNL Site ID: Owned/rented:
Tower: Type/Height/Bldg Height (in case RTT/Pole):

Sr Description Operator Name:

1 Operator Site ID

2 Services Deployed (2G/CDMA/3G/4G-TDD/4G-FDD/MW Repeater Only)

3 No Of Racks along with footprint dimensions (L*W) in mm
4 Rack position (Indoor/Outdoor)
5 Any other equipment installed on floor
6 No Of RF antennae on tower & height of RF antennae (AGL)

7 Whether all RF antennae are installed at same height on tower? (Yes/No)

8 MW Antennae( Size and number)
9 No of MW IDUs
10 No of RRU/RRH/RF modules installed on tower/separate poles

11 No Of BBU/System/Control modules installed on tower/separate poles

12 Any other equipment installed on tower with details
13 Supply extended by BSNL to operator (ac/DC/No)

Battery Capacity:
In case ac supply is extended to operator, specify battery and PP capacity No Of Sets: PP Module
14 & no of sets installed by sharing operator Capacity: Working Modules:

In case ac supply is extended to operator, whether DC supply is obtained

15 from sharing operator's PP for BSNL and other operators BTS? (Yes/No)
Sharing operators total DC Current consumption (Amps) and
16 corresponding DC Voltage(V) at the time of reading Current: DC Voltage:
17 Whether DG backup is provided to the operator? (Yes/No)

18 Whether operator has laid OFC at the site, if yes no of PLB pipes laid.

SDE/JTO(BSS) Sign Sharing operator representative Sign

Name:
Mobile:
 Appendix - 19

Statement with respect to SLA Achievement

( For Major and Minor deviations)

SSA : _________ Month : _________

Vendor
________
:

Ref WORK ORDER NO. : _________

Faults Clerance

Ref. Clause : Section 5 B Clause 4

A. Site failure for more than 1 hour due to non-availability of Diesel in DG where the filling is under the scope of the service provider.

B. SiteBTS failure for more than 3 hours due to Non-working of DG where the DG is under maintenance of the service provider.

C. Site failure due to unsatisfactory support in Site upkeep activities which leads to prolonged outage for more than 24 hrs.

D. Fault for more than 48 hours in DG reported but no site outage due to availability of battery backup or MSEB power availability.

E. Non-compliance to the Site upkeep activities as listed in Section 3. Up to 24 hrs related to a specific instance will be treated as 1 minor deviation.

F. Non-completion of ordered rigger activity within one week of intimation and making available site permission or necessary inputs. Every one week
delay will be treated as one instance.

G. Non-extension of infrastructure alarm within 3 months of award of work [ issue of work order]. Every ten days
delay in each site will be counted as one instance of minor deviation

Sl.N Site ID and Fault Cat. Reported Time Method of Intimation To Whom Fault clear Time Fault
o. Name Discription A,B,C,D,E to intimated Date Duration
,F,G Agency_D
ate

Sign Of Nodal Incharge with stamp

Date
Name of Nodal Incharge
Designation
HRMS NO
Mobile No
Email ID
 Appendix - 20

Statement with respect to Transportation of material

SSA : _________ Month : _________

Vendor : ________

Ref WORK ORDER NO. : _________

** Please give the details of transportaion, if done as per the charges mentioned in tender.
Otherwise NILL report.

Sign Of Nodal Incharge with stamp

Date
Name of Nodal Incharge
Designation
HRMS NO
Mobile No
Email ID
 Appendix-21
Quarterly Performance Report
Name of Subdivision: Period:

Type of Work : Diesel Filling/ Upkeep

Type of Deviation Duration in

Date Name of Site (Major/Minor) case *Remarks

of Major

Total Duration of Major Total

Deviation (in hours): instances of
minor

It is certified that the performance in ………………activity in …………….subdivision of the

Quarterly period …………..was satisfactory for the vendor………………..except for the deviations
listed above
Signed by : Sub divisional Engineer (Mobile)

Countersigned by : Divisional Engineer (Mobile)

*Note :Deviation in Diesel Filling or BTS Maintenance Activities are to be clearly

distinguished in the Performance report