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1 TENDER DOCUMENT State Level Evaluation Study of Mukhyamantri Amrutam (MA) Yojana Gujarat. Government of Gujarat Department of Health and Family Welfare Gandhinagar. Issued / Released on 10/01/2018 1

2 Fact Sheet Tender reference No Date of issue of Tender 10/01/2018 Pre-bid meeting venue Parivartan Hall, Commissionerate of H&FW,MS,ME, Block No.-5, Dr. Jivraj Mehta Bhavan, Gandhinagar. Phone: Date and Time for pre-bid meeting Last Date and Time for submission of Bids Date &Time and Venue, of opening Technical Bids Date & Time and Venue, of opening Financial Bids 18/01/2018, hrs. 31/01/2018, hrs. 01/02/2018, 12:00 Hrs. at Parivartan Hall, Commissionerate of Health, Family Welfare, Medical Service, Medical Education and Research, Block No.-5, Dr. Jivraj Mehta Bhavan, Gandhinagar. 01/02/2018, 15:00 Hrs. at Parivartan Hall, Commissionerate of Health, Family Welfare, Medical Service, Medical Education and Research, Block No.-5, Dr. Jivraj Mehta Bhavan, Gandhinagar. Contact Person, Phone No. Additional Director (MS), Phone no id Address for Communication: State Nodal Cell MA, Commissionerate of Health, Family Welfare, Medical Service, Medical Education and Research, 1 st Floor, Block No.-4, Dr. Jivraj Mehta Bhavan, Gandhinagar. Phone: , mayojanagujarat@gmail.com Complete Tender details Complete sets of tender documents will be available for free download by interested bidders from web portal and MA Yojana s web portal 2

3 It will be in the interest of the bidders to familiarize themselves with the e- Procurement system to ensure smooth preparation and submission of the tender documents. The bidders are advised to submit the bids well in advance of the deadline as the SNA- Gujarat will not be liable or responsible for non-submission of the bids on account of any technical glitches or any problems in connectivity services used by the bidder. 3

4 GOVERNMENT OF GUJARAT DEPARTMENT OF HEALTH AND FAMILY WALFARE TENDER NOTICE Mukhyamantri Amrutam Yojana Competitive Quotations are invited from agencies for evaluation study on the Mukhyamantri Amrutam (MA) Yojana; Enrollments and Utilization in all 33 districts of Gujarat. The tender document can be downloaded from the website The financial bid is to be submitted through online only on website. The technical bids should be submitted in a sealed cover and duly super-scribed. The Technical bids will be evaluated by the Committee duly constituted by the State Government of Gujarat. Financial bids of only technically acceptable offers shall be opened before the successful bidders by the Government for awarding of the contract. Following schedule will be observed in this regard. 1.Pre-Bid Meeting 2.Last date for submission of bids 3.Opening of technical bid 4.Opening of Financial bid 18/01/2018 (13:00 hrs.) 31/01/2018 (17:00 hrs.) 01/02/2018 (12:00 hrs.) 01/02/2018 (15:00 hrs.) All correspondence/communication regarding the scheme should be made at the address: Additional Director (MS), Commissionerate of Health, F.W, MS, ME, 1st Floor, Block No.- 5, Dr. Jivraj Mehta Bhavan, Gandhinagar, Gujarat. Phone: , gmail.com and newrsbygujarat201617@gmail.com 4

5 TENDER DOCUMENT GOVERNMENT OF GUJARAT MUKHYAMANTRI AMRUTAM (MA) YOJANA A number of studies have revealed that risk owing to low level of health security is endemic for informal sector workers. The vulnerability of the poor informal worker increases when they have to pay fully for their medical care with no subsidy or support. On the one hand, such a worker does not have the financial resources to bear the cost of medical treatment, on the other; the health infrastructure leaves a lot to be desired. Large numbers of people, especially those below poverty line, borrow money or sell assets to pay for the treatment in private hospitals. Thus, Health Assurance could be a way of overcoming financial handicaps, improving access to quality medical care and providing financial protection against high medical expenses. The Mukhyamantri Amrutam (MA) Yojana announced by the Gujarat Government attempts to address such issues. On 4 th September, 2012, State Government launched Mukhyamantri Amrutam (MA) Yojana with an objective to improve access of BPL families to quality medical and surgical care for the treatment of identified diseases involving hospitalization, surgeries and therapies through an empanelled network of health care providers (both private and public hospitals). The surgeries covered are of; Cardiac diseases, Neurological diseases, Burns, Poly Trauma, Cancer (Malignancies), Renal diseases, Neo-natal (newborn) diseases. A total 544 Procedures/Surgeries along with follow-up procedures are covered under the scheme. The Scheme benefits Below Poverty Line (BPL) families of all the 33 districts of Gujarat (as per the Rural Development and Urban Development Department). Currently, approximately 41 lakh BPL families are covered under MA Yojana. After successful implementation of MA Yojana on 15 th August, 2014, State Government extended Mukhyamantri Amrutum (MA) Yojana to MA Vatsalya Yojana, covering family with an annual income of below Rs.2.5 lakh per annum. Through this more than 62 lakh families were added under the umbrella of MA Yojana. 5

6 An enrolled MA beneficiary may go to any of the Network Hospital with a QR Coded Card and come out without making any payment to the hospital for the procedures covered under MA. The QR coded card contains photograph of head of the family/spouse, a unique registration no., biometric thumb impressions of all the enrolled family members, a QR Code for instant fetching of data from the central server along with the available card balance. The transaction for treatment is totally cashless. The total sum assured for the beneficiary family is of Rs.2,00,000/- per family per annum on family floater basis. A unit of five members (Head of family, spouse, and three dependents) of the beneficiary family is covered. Rs.300/- per hospitalization with a ceiling of maximum Rs.4,500/- per year is reimbursed as transportation cost to the beneficiary per hospitalization. For the evaluation of the scheme, Proposals are invited from the survey agencies. The agencies which are in agreement with scheme and its Terms of Reference, only need to participate in the bidding and any disagreement in this regard may invite disqualification / rejection of bid at technical level. Hence all the agencies are requested to go through the scheme carefully and submit their agreement in specific format given in the bid. Agency/Organization after qualifying the Technical bid will have to make a presentation. Finally, the study will be awarded to the agency/organization that is selected by the committee on the basis of both the Technical and Financial bid following due procedure. The selected Institution/Organization has to start the study immediately after its award, and each of the deliverables would be completed as per the time frame in the TOR. In case the selected Institute/Organization declines to take up the study after a notice of award has been issued, it would be barred from applying for any study, evaluation or assistance of any kind from Department of Health and Family Welfare, Gandhinagar, Gujarat for a period of 3 years from the date of award. The decision of the Bid Evaluation Committee shall be final, and no enquiries, or application for review, shall be entertained. 6

7 PART-1 TERMS OF REFERENCE FOR CONDUCTING EVALUATION STUDIES OF MUKHYAMANTRI AMRUTAM (MA) YOJANA AT STATE LEVEL A. Introduction State Government invite proposals for conducting household surveys related to MA Yojana. This request for proposals is for carrying out a post-hospitalization survey of MA beneficiaries of Gujarat State. This type of Household Survey Study will give idea about the Impact and experiences of beneficiaries. It will also give states information about the type of facilities provided to the beneficiaries when they receive the treatment under MA. All the benefits which are supposed to be given by the providers to the beneficiaries whether, they are getting those or not will come out through this survey. It will also provide limited information about the quality of health care provided. It will also provide results in terms of utilization pattern of public and private providers by the beneficiaries in the State of Gujarat. The districts to be covered for this survey are Ahmedabad, Gandhinagar, Surendranagar, Rajkot, Porbandar, Junagadh, Amreli, Anand, Aravalli, Kheda, Vadodara, Panchmahal, Bharuch, Dahod, Jamnagar, Valsad, Navsari, Surat, Kutch, Patan, Banaskantha, Dang, Narmada, Sabarkantha, Mehsana, Bhavnagar, Botad, Chhotaudepur, Devbhoomi Dwarka, Gir Somnath, Mahisagar, Morbi and Tapi district. Districtwise profile of number of families enrolled and hospitals empanelled are given below: Sr.No District Name Targeted Families "MA" Enrolment MA MAV No of Block Govt./ Grant in Aid Hospitals Private Hospitals 1 Ahmedabad 4,07,792 1,51,567 2,56, Amreli 93,804 59,071 1,05, Anand 1,85,195 68,741 81, Aravalli 68,404 51,756 84, Banaskantha 2,65,091 1,39,391 1,93, Bharuch 1,35,998 85,136 70, Bhavnagar 1,46,911 63,626 1,34, Botad 35,413 19,467 62, Chhotaudepur 1,15,563 68,603 43,

8 10 Dahod 2,40,175 1,22,061 17, Dangs 35,345 28,497 2, Devbhoomi 36,346 22,536 40, Dwarka 13 Gandhinagar 56,293 38,958 77, Gir Somnath 59,394 36,931 95, Jamnagar 1,41,817 45,898 74, Junagadh 73,797 45,810 1,22, Kheda 1,71,909 1,05,752 91, Kutch 1,27,174 60,159 70, Mahisagar 87,076 67,588 26, Mehsana 1,25,549 92,572 1,40, Morbi 55,485 30,857 32, Narmada 83,438 66,239 12, Navsari 68,740 44,637 72, Panchmahal 1,45,851 87,935 33, Patan 1,19,533 75,734 81, Porbandar 33,140 23,525 39, Rajkot 1,92,574 98,270 2,34, Sabarkantha 1,12,453 62,564 78, Surat 1,69,887 89,564 1,97, Surendranagar 1,53,340 82,739 85, Tapi 82,027 64,384 28, Vadodara 1,95,854 85,174 1,51, Valsad 1,29,117 78,548 44, Total 41,50,485 22,64,290 28,83, Proposals are invited from the Survey agencies (henceforth called consultants). The following activities are to be carried out as part of the post-enrollment survey: Implementation of a post-enrollment and hospitalization household survey in the selected districts. Completion of an implementation report on the household survey including cases of households not covered due to extenuating circumstances (e.g. inability to locate or household unwilling). 8

9 Completion of the database detailing responses to the household survey in appropriate format for subsequent analysis. Important information regarding the RFP has been given in Annexure - 3. B. Clarification and Amendment of RFP Document i) Consultants may request a clarification of any of the RFP document conditions within 7 days of the advertisement data. Any request for clarification must be sent in writing, or by standard electronic means to the State Nodal Cell. The State Nodal Cell will respond through an to the Consultant. Should the State Nodal Cell deem it necessary to amend the RFP as a result of a clarification, it shall do so following the procedure. ii) At any time before the submission of Proposals, the State Nodal Cell may amend the RFP by issuing an addendum in writing or by standard electronic means. The addendum shall be communicated through a public advertisement and will be binding on them. Consultants shall acknowledge receipt of all amendments. To give Consultants reasonable time in which to take an amendment into account in their Proposals the State Nodal Cell may, if the amendment is substantial, extend the deadline for the submission of Proposals. C. Qualifying Criteria s: A. The bidder should have a financial turnover of at least Rs. 50, 00,000 (fifty lakh Rupees only) in at least one of the past three years ( , , and ). B. The bidder should have conducted household survey with at least 10,000 households in Gujarat within past three years ( , , and ). C. Consortium of vendors for the project is allowed subject to the following conditions: a. The consortium parities will have to be indentified before submission of tender. 9

10 b. A copy of consortium agreement document (with prime bidder s name, address etc.) should be submitted along with the technical bid (must be a part of Annexure-3). c. All of the consortium partners shall be jointly and severally responsible for execution of the above package, if awarded. However, they are required to meet individually at least 40% of the turnover criteria and together they shall meet the total turnover indicated above in point A. d. Against point B. all of the consortium partners are required to meet individually at least 40% of the household survey criteria and together they shall meet the total household survey indicated above in point B. e. More than two partners are not allowed. f. Only bid from prime bidder will be accepted. g. Applicants should not be under a declaration of ineligibility for corrupt and fraudulent practices issued by Governments of Gujarat. A self-declaration certificate should be enclosed. Note: i. In absence of any one of the above, the offer will be treated as non-responsive and summarily rejected. ii. Relevant documents in support of the above criteria must be enclosed along with Pre- Qualification Bid documents failing which the bid will be liable to be rejected. iii. The technical & financial bids of the bidders, unsuccessful in pre-qualification bid shall not be considered for evaluation. D. Methodology for Evaluation Though consultant are required to provide their methodology for conducing the survey, main aspects of the methodology of the proposed survey is given as follows: For this survey only MA Yojana beneficiaries needs to be surveyed. MA Yojana beneficiaries who are enrolled in the scheme will be part of this survey. The sample of beneficiaries will include beneficiaries, who are eligible under the scheme but not enrolled, enrolled and have utilized the scheme, and beneficiaries who are enrolled but not taken the MA benefits. 10

11 a. Sampling of District in consultation with State Nodal Cell sampling exercise shall be carried out in all the districts where MA Yojana is implemented. b. Sampling For every 1,000 beneficiaries who are enrolled under MA Yojana in a district, at least 20 should be selected in the sample. Care should be taken that the beneficiaries who have utilized the scheme shall also be present in the sample. c. Location of Surveys The beneficiary in the sample should be sufficiently distributed among all the blocks of the district. Within the block also efforts should be there to have villages or clusters of villages distributed geographically. d. Duration of Surveys Survey training and field work shall take approximately three month. Another one month will be given to analyze the data and prepare the final report. e. Timelines The total completion of the study and submission of the final report will be of 4 months only. This period will start from the date of signing the Memorandum of understanding (MoU) with the State Nodal Cell, Mukhyamantri Amrutam (MA) Yojana, Gandhinagar to submission of final study report i.e. suppose State Government signs the MoU in 1 st February, 2018then the deadline for the submission of final report shall be 31 st May, f. Draft Tool for the Survey The draft tool for this type of survey is attached as Annexure-5 of this document. This tool may be modified before start of the final survey in consultation with the SNC. E. Submission of Technical and Financial Proposal: a. Technical Proposal shall be provided in the format given in Annexure -3: 11

12 i. The consultant shall provide in the technical proposal a description of the approach, methodology and work plan for performing the assignment covering the following subjects: technical approach and methodology, work plan, and organization and staffing schedule.the list of the proposed Professional staff team by area of expertise, the position that would be assigned to each staff team member, and their tasks. ii. iii. Estimates of the staff input (staff-months professionals) needed to carry out the assignment. The staff-months input should be indicated separately for home office and field activities. CVs of the Professional staff. iv. A detailed description of the proposed methodology and staffing for training. v. Format for evaluation of technical proposal has been given in Annexure 6. vi. Technical bid evaluation will be done in following steps: a. The bidders will be short listed after evaluation is done on the qualifying criteria. b. Short listed bidders will be asked to give a 10 minutes presentation in front of the technical evaluation committee on each criteria s mentioned in Annexure-6. c. After the presentation the bids will be evaluated on the other parameters as mentioned in the Desirable Criteria of the Technical Proposal d. All the successful bidders who qualifies after the technical bid evaluation will be eligible for the financial bid evaluation. vii. The Technical Proposal shall not include any financial information. A Technical Proposal containing financial information may be declared non responsive. 12

13 b. Financial Proposal: i. The Financial proposal shall take into account all costs associated with the assignment (Annexure-4) and is to be submitted through online only. ii. No other information shall be provided along with the financial proposal. F. Co-ordination with the State Nodal Cell (SNC) The agency will have to work closely with the State Nodal Cell, Gandhinagar in developing the methodology, training of the surveyors, and conducting the surveys. State Government will provide the necessary contact details and data for surveys. G. Ownership of the Survey The ownership of the survey tool and data shall lie with the State Government/ Nodal Cell. H. Payment Structure: The terms of payment will be as follows: 25% after submission of translated interview schedule and pilot study. 30% after submission of study draft report. Balance 45% after the submission of final report. I. Penalty Clause: In case of delay in submission of final report of the study within the TIME limit of 4 months, a fine at the rate of 5% of the total project cost will be levied for every month of delay. 13

14 PART II SUBMISSION OF BIDS/ PROPOSALS The Government of Gujarat/ Nodal Cell seeks detailed proposal from agencies interested in evaluating the Mukhyamantri Amrutam (MA) Yojana, in the State. The bid/proposal document should include the following: SECTION A TECHNICAL PROPOSAL QUALIFYING CRITERIA: A. The bidder should have a financial turnover of at least Rs.50,00,000 (Fifty lakh rupees only) in at least one of the past three years ( , , and ). The agency should attach a copy of the audit report for the same. (Annexure-1) B. The bidder has conducted household survey with at least 10,000 households in Gujarat within past three years ( , , and ). The agency should attach a copy of the work order. (Annexure-7) C. Consortium of vendors for the project is allowed subject to following conditions: a. The consortium parities will have to be indentified before submission of tender. b. A copy of consortium agreement document (with prime bidder s name, address etc.) should be submitted along with the technical bid (must be a part of Annexure-3). c. All of the consortium partners shall be jointly and severally responsible for execution of the above package, if awarded. However, they are required to meet individually at least 40% of the turnover criteria and together they shall meet the total turnover indicated above in point A). 14

15 d. All of the consortium partners are required to meet individually at least 40% of the household survey criteria and together they shall meet the total household survey indicated above in point B. e. More than two partners are not allowed. f. Only bid from prime bidder will be accepted. g. Applicants should not be under a declaration of ineligibility for corrupt and fraudulent practices issued by Government of Gujarat. A self-declaration certificate should be enclosed. Note: i. In the absence of any one of the above, the offer will be treated as non-responsive and summarily rejected. ii. Relevant documents in support of the above criteria must be enclosed along with pre-qualification Bid documents failing which the bid will be liable to be rejected. The Technical proposal should be sealed in envelop clearly marked in BOLD SECTION A TECHNICAL PROPOSAL and TECHNICAL PROPOSAL FOR Evaluation of MUKHYAMANTRI AMRUTAM (MA) YOJANA written on the top of the envelope. a. If the bidder fails to submit the supporting documents offline within time limit, the bidder is entitled for immediate disqualification. b. The financial bid should only be submitted through online (no hard copy) on or before the time stipulated in Tender notice at the web site c. Envelop should have the bidders Name and Address clearly written at the Left Bottom Corner of the envelope. d. The technical bid in physical form should be submitted before the due date and time at- Additional Director (MS), Commissionerate of Health and Family Welfare, MS and ME, 15

16 Block No. 5, Dr. Jivraj Mehta Bhavan, Gandhinagar, Phone: , Fax: , SECTION B FINANCIAL PROPOSAL (A) The Financial bid submission should be done on the website (electronic format) only (B) The online bids should be submitted on or before the time stipulated in tender notice at the website No tender will be accepted after prescribed closing time for submission of the same. The delay will not be condoned for any reason whatsoever including Network/Postal/Transit delay. However, if the last date of submission of tender is declared as a holiday by government, the last date of submission of tender will be extended to the next working day. The bids may be cancelled and not evaluated if the bidder fails to: a. Seal the envelope properly with sealing tape. b. Submit envelopes i.e. Technical Proposal in another large envelope. c. Give complete bids in all respects. d. Submit financial bids not as mentioned in the tender document- online. Deadline for Submission Bids / Proposals: Complete bid documents should be uploaded to by hours on 31/01/2018. Bid documents received later than the prescribed date and time will not be considered for evaluation. 16

17 IN NO CASES, RATES SHOULD BE QUOTED ANYWHERE EXCEPT ONLINE IN FINANCIAL BID Annexure-2 Instructions to the Consultants Paragraph Reference 1 Name and Address of the State Nodal Cell: Mukhyamantri Amrutam MA Yojana, Commissionerate of Health and Family Welfare, MS and ME, 1 st floor, Block No. 4, Dr. JivrajMehta Bhavan, Gandhinagar, Gujarat. Telephone: , mayojanagujarat@gmail.com 2 The physical submission of the technical bid document address is: Additional Director (MS), Commissionerate of Health and Family Welfare, MS and ME, 1 st floor, Block No. 5, Dr. Jivraj Mehta Bhavan, Gandhinagar, Gujarat. Phone: , Fax: mayojanagujarat@gmail.com Proposals must be submitted not later than the following date and time 31/01/2018 (17:00hrs) 3 Proposals must remain valid 180 days after the submission date 4 Proposals shall be submitted in the following language:- English 5 The format of the Technical Proposal to be submitted: As per the Annexure 6 Consultant must submit the original Technical Proposal with signature and seal on each page. 17

18 Details of the Technical Proposal Annexure-3 Technical approach, methodology and work plan are key components of the Technical Proposal. Please submit your Technical Proposal divided into the following three chapters: a) Technical Approach and Methodology, b) Work Plan, and c) Organization and Staffing, a) Technical Approach and Methodology. In this chapter understanding of the objectives of the assignment, approach to the services, methodology for carrying out the activities and obtaining the expected output, and the degree of detail of such output shall be explained. It should highlight the problems being addressed and their importance, and explain the technical approach that would be adopted to address them. It should also explain the methodologies which are proposed to be adopted and highlight the compatibility of those methodologies with the proposed approach. b) Work Plan. In this chapter the main activities of the assignment, their content and duration, phasing and interrelations, milestones, and delivery dates of the reports shall be proposed. The proposed work plan should be consistent with the technical approach and methodology, showing understanding of the TOR and ability to translate them into a feasible working plan. A list of the final documents, including reports, drawings, and tables to be delivered as final output, should be included here. c) Organization and Staffing. In this chapter the structure and composition of the team shall be proposed. It should list the main disciplines of the assignment, the key expert responsible, and proposed technical and support staff. 18

19 Evaluation of Mukhyamantri Amrutam (MA) Yojana Gujarat State, Districts A: ORGANISATIONAL PROFILE Name of organization Name and Designation of Contact Person Postal Address of the Organization (with PIN CODE) Physical Address, if different from postal address (With PIN CODE) Telephone with STD Code FAX No. with STD Code Mobile No. of Contact Person Address of Contact Person Name and Designation of Head of the Organization responsible for the Study Contract Establishment Details a. Year Established b. Type of Organization (Tick One); i. Educational & Research Institution ii. iii. Consulting Organization Any Other (give details) C. Regd. No. ; Name and Place of Registering Authority (Attach attested photocopy of Registration Certificate) B. EXPERIENCE Experience in conducting research studies in the field of rural & social development/welfare programmes/schemes/projects by the organization/agency in the past three years (20014 to calendar years) that are relevant for demonstrating its expertise in the area of proposed study (attach attested photo copy of the experience certificate): 19

20 B.1: Completed research project (s) (Extra-sheet may be used if activities are more than 5 in number) Sr. Title of the Name & Completion Duration of Value Name of No. research Address time/date the (Rs. Sample State project of Client (Month & project Lakh) (s) Year) completion As per TOR/ (in Months) Agreements Actual B.2: On-going research projects Sr. No. Title of the Name & Project Project Value Name of research Address starting completion (Rs. Sample project of Client date/time time as per Lakh) State (s) (Month & ToR/ Year) Agreement (in Months) C: HUMAN RESOURCE C. 1 Human Resources of the organization: (Do not attach CVs) Sr. No. Official Station (name of place) Professional/Technical (numbers) Supporting Staff (numbers) All 1 Fulltime Part-time Fulltime Part-time 20

21 2 3 C. 2 To be deployed for the proposed study/project (a)- KEY PROFESSIONALS ** (Do not attach CVs) Sr. No. Name Area Highest academic/ Length of No. of man (Team of key professional experience months Leader) expertise qualification in the (years) in the deployed for area of key area of key this study expertise expertise ** Note: Care may be taken to demonstrate that each area of expertise required for the study is covered by different key professionals in above table. (b)- SUPPORT AND FIELD STAFF Sr. No. Job profile (e.g. field investigator, data entry operator, analyst, etc. No. of personnel Total number of man months to be Deployed Format for Team Composition 1. Professional Staff Name of Staff Firm Area Expertise of Position Assigned Task Assigned 21

22 2. Support Staff Name of Staff Firm Area of Expertise Position Assigned Task Assigned D: Reasons for applying for this Region: Give in detail the capability of the organization/agency and the experience etc. to support the claim. E: Methodology and Organization of Study: The sample procedure, sample size and study tools are given in the TOR. Please suggest: i. Sample selections in detail; ii. Study tools refinements; iii. How you would complete the study in time? and iv. How to achieve quality? F: ANY OTHER DETAIL WHICH IS RELEVANT TO THE BID 22

23 Financial Bid Annexure-4 Evaluation of Mukhyamantri Amrutam (MA) YojanaGujarat State in Districts: Ahmedabad, Gandhinagar, Surendranagar, Rajkot, Porbandar, Junagadh, Amreli, Anand, Aravalli, Kheda, Vadodara, Panchmahal, Bharuch, Dahod, Jamnagar, Valsad, Navsari, Surat, Kutch, Patan, Banaskantha, Dang, Narmada, Sabarkantha, Mehsana, Bhavnagar, Botad, Chhotaudepur, Devbhoomi Dwarka, Gir Somnath, Mahisagar, Morbi and Tapi district Name of Bidder Agency/Organization with address: _ FINANCIAL BID Sr.No. Head Total Cost (Rs.) 1 Salary of key professionals 2 Salary of field staff and support staff 3 Travel for key person 4 Travel for Field & Secretariat staff 5 Contingent expenses 6 Office expenses** 7 Total ( ) 8 Institutional Overheads if any, and basis of charge 9 Applicable Government Tax, if any to be charged Grand Total (7+8+9) (In words ) ** Office expenses: Include expenses for required numbers of final report and 2 Compact Disks. Date: Place: Seal of the Organization: Authorized Signatory Name: Designation: 23

24 1. FORMAT FOR EVALUATION OF TECHNICAL & FINANCIAL PRAPOSAL Annexure-6 No. Criteria Specific experience of the Consultants in conducting Surveys: A) Household Survey (Number of Families) a) 10,001-20,000 = 3 Marks b) 20,001-30,000 = 5 Marks c) More than 30,000 = 10 Marks B) Surveys in Private Health Sector a) 1-3 = 3 Marks b) 4-6 = 5 Marks c) More than 7 = 10 Marks C) Surveys in Public Health Sector a) 1-3 = 3 Marks b) 4-6 = 5 Marks c) More than 7 = 10 Marks D) Surveys in Gujarat a) 1-3 = 5 Marks b) 4-6 = 10 Marks c) More than 7 = 20 Marks 2 Adequacy of the proposed methodology and work plan in responding to the Terms of Reference and demonstrating an understanding of MA Yojana a) Technical approach, methodology and reports/analysis = 15 Marks b) Organization and Staffing (Verify with Support Documents) - Total full time staff a) 0-50= 5 Marks b) = 10 Marks c) More than 101 = 15 Marks 3 Permanent office in Gujarat = 5 Marks Annual turnover of (in a single Year) 4 a) Rs. 1 Cr. - Rs. 5 Cr. = 5 Marks b) Rs. 5.1 Cr. - Rs.10 Cr = 10 Marks c) Rs Cr & above = 15 Marks Total 100 Total marks obtained 24

25 Note: Out of the total 100 marks minimum 60 marks are required to qualify the technical bid. Commercial opening will be done and on the basis of price quoted vendors will be termed as L1, L2, L3 and so on as per the rank of lowest price quoted. If commercial bids for bidder 1, 2, 3, 4 are taken as L1, L2, L3, L4 where Lmin. is the lowest bid then the weight age given to commercial bids would be; Lmin./L1, Lmin./L2, Lmin./L3, L4/Lmin. and so on... Similarly weight age will be calculated for Technical Evaluation; T1/Tmax., T2/Tmax., T3/Tmax., T4/Tmax. and so on for bidder 1, 2, 3, 4 respectively. Each proposal would be evaluated against the Criteria. This means 50% weight age will be given to Technical Proposal 50% to Financial Proposal. 2. AWARD Finally the technical and commercial scores obtained by all the vendors would be summed and the vendor with highest score would be AWARDED THE BID. The awarded bidder will have to sign an MOU with the State Nodal Cell, Mukhyamantri Amrutam (MA) Yojana. The final scores of the vendors would be as given below Bidder 1: (T1/Tmax)*0.5 + (Lmin/L1*0.5) Bidder 2: (T2/Tmax)*0.5 + (Lmin/L2*0.5) Bidder 3: (T3/Tmax)*0.5 + (Lmin/L3*0.5) Bidder 4: (T4/Tmax)*0.5 + (Lmin/L4) *0.5 The vendor with the highest marks computed above on cost and quality basis will be awarded the bid. 25

26 Form A Appraisal of the technical proposal Bidder No Bidder Name No. of Separate Documents Including Annexes No. Criteria 1 The bidder has a financial turnover of at least Rs.50,00,000 in at least one of the past three years ( , , and ). 2 The bidder has conducted household survey with at least 5,000 households in Gujarat within past three years ( , , and ). Any other remarks If the answer to any one of the above criteria is No, then the bid is rejected at this stage itself. There is no need to progress any further. ¹A document is considered separate if it is stapled/ bound as a single entity. Even a one page covering letter should be considered as a separate document. ²specific years must be mentioned. 26

27 CERTIFICATE It is certified that: 1. The information given above is TRUE to the best of my knowledge. The organization shall stand liable for any information given above which is later found to be FALSE, including the forfeiture of any payment due to it. 2. The information given above is COMPLETE to the best of my knowledge and I have not willingly suppressed any material information that might lead to misjudgments while evaluating this Technical Bid. 3. The professionals, staff, equipment and all requisite infrastructural facilities mentioned in this bid shall be made available for this study in due time. 4. Our agency/organization/institution is interested to undertake the proposed evaluation. 5. I am competent to sign this Certificate. Date: Authorized Signatory Place: Name: Seal of the Organization: Designation: Date: 27

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