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National Rural Health Mission, Faridabad - Haryana
December, 27th 2018
                         Civil Surgeon
                          Gurugram
                        Request for Proposal (RFP)
                                 2018-19
E-tenders are invited on behalf of the Civil Surgeon Gurugram for Appointment of
Concurrent Auditor for District Health & Family Welfare Society (DH&FWS) of
Gurugram for Audit of all programs under NHM & Non NHM
The Civil Surgeon Gurugram shall have the authority to cancel the tender process if
does not find a suitable tender. Civil Surgeon Gurugram shall have the right to call for
fresh tender in these circumstances, where in prior bidders shall have the right to
participate in the fresh process.

Please note that tender is to be uploaded on e-tender website of Haryana government
https://etenders.hry.nic.in before closing date mentioned on the same website.



                                                                        By the order of

                                                                          Civil Surgeon
                                                                             Gurugram.
                 Request for Proposal (RFP)
                          [2018-19]
For Appointment of Concurrent Auditor for
District Health & Family Welfare Societies
(DH&FWS) of State Haryana for Audit of all
programs under NHM & Non NHM
REQUEST FOR PROPOSAL (RFP)

District Health & Family welfare Society (DH&FWS), Gurugram seeks to invite Proposal from
Chartered Accountant (CA) Firms and Cost and Management Accountant(CMA) Firms
meeting the minimum eligibility criteria for conducting the Concurrent audit of District
Health & Family Welfare Society, Gurugram under the National Health Mission for the
financial year 2018-19.

   1. Tender Value: Maximum ceiling for financial bid is Rs78000/- (Exclusive of GST).

   2. Tender Fee: Rs. 500/- (Non-Refundable) by way of demand draft/Banker's cheque/ in
       favor of  "District Health & Family Welfare Society Gurugram" payable at
       Gurugram and must have validity of at least 3 months.

   3. Performance Security:- On selection, the Successful bidder/L-1 agency's shall
       deposit performance security @ 5% of estimate cost and same will be refunded after 6
       months of successful completion of the contract period mentioned in the Award of
       Contract (AOC).

   4. Period of Validity of Bid: The bid shall remain valid for a period of at least 90 days.
       In the case of the successful bidder, rates quoted shall be valid for the entire period of
       the contract.

   5. The time period of contract: 1 year from date of AOC and shall be extendable for a
       period of one more year at the same rate, terms and conditions, only if the services of
       the auditor are found satisfactory during the normal period of contract.

   6. Pre-Bid Meeting: Pre-bid meeting will be held in meeting Hall of office of Civil
       Surgeon Gurugram according to Time and date mentioned on e-tender website to hear
       the query's of bidders.
   7. Tender process details:
   1. Bids must be uploaded on e-tender website of Haryana government
      https://etenders.hry.nic.in before closing date as mentioned on website. Crossed
      Demand Draft with Technical Bids and also original copy of Technical Bids along
      with all related documents & DD will be submitted in sealed envelopes in Tender
      Box kept at O/o Civil Surgeons Gurugram.

   2. The Bidder should upload to signed bids documents (all page) technical and financial
      bids.

   3. The Technical Proposal shall be marked "ORIGINAL" or "COPY" as appropriate. All
      required copies of the Technical Proposal are to be made from the original. If there are
      discrepancies between the original and the copies of the Technical Proposal, the
      original governs. Each page, Form, Annexure and Appendices of the Technical and
      Financial Proposal must be signed by the Authorized signatory of the firm.

   4. The District Audit Committee would first download the technical bids from e-Tender
      portal and evaluate them on the basis of the criteria as prescribed in the guidelines. The
      base minimum figures/threshold will be 60% and CA/CMA firms scoring above the
      base minimum figure would be deemed to be considered as technically qualified to
      undertake the job.

   5. Financial bids of only technically qualified firms would be opened by the committee
      and audit should be awarded on the basis of Quality cum cost based selection (QCBS)
      process, 70% weightage would be given to the Technical Evaluation and 30%
      weightage would be given to the financial bid.

   6. CA/CMA Firms shall have to depute one dedicated team consisting of at least one
      Qualified Chartered Accountant/Qualified CMA and at least one Semi Qualified
      Chartered Accountant/Assistant/Trainees of CMA for successful completion of
      Concurrent audit as per the requirement of RFP.

   7. The bids will be opened by the District Audit Committee as per Date and time
      mentioned above in the presence of the authorized representatives of the bidders. The
      representatives attending the bid opening proceedings must bring an authorization
      letter from the bidders

   8. Tender Fee must be submitted in office of Civil Surgeon in a single envelop super
      subscribed with details of E-tender i.e. Tender Title, Tender ID. I any bidders fail to do
      the same then his/her bid shall be thoroughly rejected or depend upon the discretion of
      committee members

   9. The financial bids of only those bidders will be opened and considered, who are
      technically qualified by the technical evaluation committee.

Date and time of opening of financial bid shall be conveyed to the technically qualified
bidders through email / telephone one day in advance or through the website
"https://etenders.hry.nic.in".
Important note: (1) Distrcit Health Society (SHS) reserves the right to
accept or reject any proposal without giving any explanation after taking
approval from State Audit Committee and State Health Society,Haryana
can change the evaluation criteria as per its requirements in the interest of
the organization.

(2)If the required constitution of the team is not deployed or Audit is not
performed as per guidelines of RFP, the state may take appropriate action
as it deems fit (including blacklisting of the firm) against the firm, keeping
the Ministry informed.

· If the lowest financial bidder does not agree to undertake the audit work within
the prescribed audit fee or the audit committee deems it unfit for any reason
(reasons to be recorded in writing), the job may be awarded to the next eligible
bidder if the firm agrees to undertake the job. However, the work may only be
awarded to a technically qualified bidder (the firms which are above the base
minimum figure of the technical evaluation)

· The firm or any partners of the firm should not be black listed by any PSUs or
Government. Company or any other organization in respect of any assignment or
behavior. [Self attested affidavit on Rs.100/- stamp paper to be given in this
regard by the authorized person of the firm].


· The final appointment will be done only after obtaining the concurrence of
State Audit Committee and Director Finance in the prescribed format.

· Chartered Accountant Firms and Cost Accountant firms are eligible for
participating in tender.




        Technical & Financial Proposal will consist:

  i.    Letter of Transmittal ( Form T-1) ­ format attached below

 ii.    Details of the Firm along with Details of Partners (Form T-2 attached at Appendix
        H).

 iii.   Financial Bid (Form F-1) attached below
   Important Dates & Address are as follow:

Start Date & Time of Bid               :   13-12-2018     10:30 hours
Preparation & Submission
Pre Bid Meeting                        :   17-12-2018     11:30 hours
Last Date & Time for Tender            :   28-12-2018     11:00 hours
Document Fees deposit ( non ­
refundable)
Closing Date & Time of Bid             :   28-12-2018     13:00 hours
Preparation & Submission
Technical Bid opening                  :   28-12-2018     15:00 hours

Particulars                            Address
Place of pre bid conference for the    O/o Civil Surgeon Gurugram
audit of District Health Societies
Place for opening of Technical Bids    O/o Civil Surgeon Gurugram
for the Concurrent Audit of District
Health Societies
Contact number                         0124-
                                       2322412,8586976898,9654230570
E-mail ID                              dhs.csgur@hry.nic.in
Terms of Reference (ToR)

Following Sections must be read carefully:
Section 1: Introduction of Concurrent Audit
Section 2: Background of National Health Mission
Section 3: Object of Concurrent Audit
Section 4: Scope & Coverage of Concurrent Audit of District Health Societies
Section 5: Frequency of Concurrent Audit
Section 7: District Audit Committee
Section 8: Auditing Standards to be followed by the CA/CMA Firms
Section 9: Terms for appointment of Concurrent Auditors (including maximum
numbers of District Health Societies by one CA/CMA Firm)
Section 10: Content of Concurrent Audit Report & Executive Summary Report
Section 11: Key Timelines
Section 12: Appointment & Selection of Concurrent Auditors (including
guidelines for submission of proposal)
Section 13: District wise detail of Health Institutions Under NHM,HARYANA
Section 14: Responsibility of District Health Societies.
Section 15: Facilitation of the Audit
Section 16: Some important Issues
Section 17: Monitoring & Evaluation
Section 18: Technical evaluation & selection methodology.
Section 19: Monthly Financial Reporting at District level.
Section 20: Penalty Clause
SECTION 1: INTRODUCTION OF CONCURRENT AUDIT
      Concurrent Audit is a systematic examination of financial transactions on
      regular basis to ensure accuracy, authenticity, compliance with procedures
      and guidelines. The emphasis under concurrent audit is not on test
      checking but on substantial checking of transactions. Independent
      Chartered Accountant firms/Cost and Management Accountant Firms are
      needed to be appointed at District level to undertake monthly audit
      National Health Mission (NHM) & Non NHM Programs.

SECTION         2:     BACKGROUD            OF      NATIONAL           HEALTH
MISSION
1. National Rural Health Mission (NRHM)( at present known as National
   Health Mission) of the Ministry of Health & Family Welfare was launched on
   12th April, 2005 by the Government of India to improve medical facilities in
   all the area in the country. The NHM seeks to provide accessible, affordable
   and quality health care to the population, especially the vulnerable sections. It
   also seeks to reduce the Maternal Mortality Ratio (MMR) in the country from
   407 to 100 per 1,00,000 live births, Infant Mortality rate (IMR) from 60 to 30
   per 1000 live births and the Total Fertility Rate (TFR) from 3.0 to 2.1 within
   the 7 year period of the Mission. It has now been termed as National Health
   Mission (NHM). NHM is overarching NUHM also and includes Non-
   Communicable Diseases (NCD) as well.

2. One of the visions of the Mission is to increase public spending on health
   from 0.9% to 2-3% of GDP, with the improved arrangement for community
   financing and risk pooling. The NHM has provided an umbrella under which
   the existing Reproductive and Child Health Programme (RCH) and various
   National Disease Control Programmes (NDCPs) have been repositioned.
   National Urban Health Mission (NUHM) has also been added as submission
   of National Health Mission.
3. At present the following Programmes/Schemes falls under the National
   Health Mission:

         A. NHM-RCH Flexible Pool:
               ·     RCH Flexible Pool (including Routine Immunization (RI),
                     Pulse Polio Immunization (PPIP) & National Iodine
                     Deficiency Disease Control Programme (NIDDCP)
                 ·   Health System Strengthening (including AYUSH, National
                     Programme for Prevention and Control of Deafness
                     (NPPCD), National Oral Health Programme (NOHP),
                     National Programme for Palliative Care (NPPC), Assistance
                     to State for Capacity building (Burn Injury), National
                     Programme for Fluorosis(NPF).

          B. National Urban Health Mission (NUHM).

          C. Flexible Pool for Communicable Disease:

                  National Vector Borne Disease Control Programme (NVBDCP)
                  Revised National Tuberculosis Control Programme (RNTCP)
                  National Leprosy Eradication Programme (NLEP)
                  Integrated Disease Surveillance Project (IDSP)

          D. Flexible Pool for Non-Communicable Disease:

                  National Programme for Control of Blindness (NPCB)
                  National Mental Health Programme (NMHP)
                  National Programme for Health Care of the Elderly (NPHCE)
                  National Tobacco Control Programme (NTCP)

                  National Programme for control of Deafness

                  National Programme for Prevention and Control of Cancer, Diabetes,
                   Cardiovascular Diseases and Stroke (NPCDCS)

       In addition to the above programmes covered under the umbrella of NHM, the following
       Non NHM Grants are also handled by the State as well as District Health Societies:
       (1) HUDA Grant
       (2) Construction worker Grant
       (3) IMR Grant
       (4) TFC/PWD Grant
       (5) ASHA/ANM State Budget

   4. Funding & Accounting Arrangements:

    Funds are transferred by the State Health Societies to the District Health Societies under
the common pool Grant and funds are further transfer by the Districts to the
DH/SDH/CHC/PHC/SC under the common pool, however NHM funds are to be utilized as
per approved RoP of respective District and Non NHM funds are to be utilized as per the
guidelines of the respective Programme.
      5. Constitutions of State Health Societies and District Health Societies:


      At the state level State Health Mission has been constituted under the
Chairmanship of Honorable Chief Minister while the State Health Society has
been constituted under the chairmanship of Chief Secretary of Haryana.
Similarly at the district level District Health Mission has been constituted under
the chairmanship of Honorable Minister In-charge of the district while District
Health Society (DHS) has been formed under the Chairmanship of Deputy
Commissioner.

For achievement of NHM goals and for effective implementation of NHM
activities additional resources and capacities at various levels have been created,
viz., State Programme Management Unit (SPMU) ­ at the state level, District
Programme Management Unit (DPMU) at district level and Block Programme
management (BPMU) at block level.

SECTION 3: OBJECTIVE OF CONCURRENT AUDIT

(i)      The primary objective of the monthly concurrent audits is to enable the
         concurrent auditors to examine the accounts pertaining to the National
         Health Mission programme & Non NHM funds maintained by the State
         Health Societies & District Health Societies on a continuous basis,
         provide necessary technical and hand holding support with a view to
         ensure timely preparation of accounts and financial Monitoring reports
         (FMRs), reliability of information, effective monitoring of programme
         activities and advances, etc.
(ii)     Inter unit reconciliation
(iii)    Verification of Monthly Financial Reporting (as per Appendix A).
(iv)     Others key objectives:-
              To ensure voucher/ evidence based payments to                       improve
              transparency,
              To ensure accuracy and timeliness in maintenance of                 books of
              accounts,
              To ensure timeliness and accuracy of periodical                     financial
              statements,
              To improve accuracy and timeliness of financial                     reporting
              especially at sub-district levels ,
         To ensure compliance with laid down systems, procedures and
         policies,
         To regularly track, follow up and settle advances on a priority basis,
         To access & improve overall internal control systems.


SECTION 4: SCOPE OF CONCURRENT AUDIT

 1. The scope of audit covers all activities being implemented by the District
    Health Societies, viz.
  - RCH Flexipool
  - Mission Flexipool( including AYUSH)
  - Routine immunization
  - Pulse Polio
  - NUHM
  - RNTCP
  - NLEP
  - IDSP
  - NVBDCP
  - NPCDCS
  - NPHCE
  - NPCB
  - NMHP
  - NPCD
  - HUDA Grant
  - IMR Grant
  - TFC/PWD Grant
  - Construction worker Grant
  - ASHA/ANMs State Budget


 2. The concurrent auditors are required:
    To review of the Books of Accounts of District Health Societies and
    expenditure incurred by the DHS
    To audit of Financial Statements of DHS
    To verification of the Monthly Financial Reporting of District Health
    Societies ( as per Appendix A)
    To review and analysis of the Age wise and Party wise Advances Report.
    To comparison between financial and physical performance and analysis
    To filling in the checklist provided.
     To vetting of the District ATRs and providing observations thereon
     To examine and ensure that the books of accounts of DHS are maintained
     accurately and in are updated in a timely manner as per operational
     guidelines for financial management.
     To express an opinion on whether the expenditure reported by the DHS
     to the higher authorities for the NHM project through the Financial
     Management Report (FMR)/ statement of expenditure (SOE), presents
     fairly and accurately, in all material aspects.
     To any other evaluation work, as desired by the Audit committee.

  3. Specific work of CHCs/PHCs/SDH/DH

District  Concurrent   auditor     shall     visit     to       sample
CHCs/PHCs/SDH/DH/FRUs/DTC      (in   a     way     to     cover    all
CHCs/PHCs/SDH/DH/FRUs/DTC in a year). Following is essential works of
CHCs/PHCs/SDH/DH

   Checking of transaction posted by Accounts Assistant in tally EPR- 9
   customized software.
   Audit of at least 2 sub-centres located within the CHC every month.
   Verification of Mandatory books of accounts( Yes/No format as mentioned
   at Appendix G)

Important Note: (1) Concurrent auditor of state health society will function
as nodal auditor for the NHM who will oversee the work of all District
Concurrent Auditors. For ensuring quality and timely completion of the
whole audit exercise, the District Auditors are expected to cooperate and
comply with the directions of the nodal auditor as and when given and will
provide necessary information when demanded.
(2) It must be noted first of all the District Health Society shall compiled the
expenditure report of all health institution on or before 8 th of month and
then concurrent auditors will start monthly audit between 9th to 12th of each
month.

(3) Concurrent auditors of District Health Societies shall start audit between
15 to 20 of every month subject to exception as mentioned in the notes of
key timelines section.
SECTION 5: FREQUENCY OF AUDIT
       Concurrent Audit will be carried out on a "Monthly basis". Districts shall
complied the monthly Financial Reporting( including Tally Data) on or before
8th of month immediately succeeding the relevant month and the concurrent
auditor shall visit for the Audit between 9th to 12th of month immediately
succeeding the reporting month. After the completion of Audit and after making
rectification entries as recommended by the Concurrent Auditors, DHS shall
send the monthly FMR to the SHS on or before 12th of month immediately
succeeding the reporting month. State level auditors shall visit for audit between
15th to 20th of every month subject to the exception mentioned in the notes of key
timelines.

Section 8: Auditing Standards to be followed by the CA/CMA
Firms

The audit will be carried out in accordance with Engagement & Quality Control
Standards (Audit & Assurance Standards) issued by the Institute of Chartered
Accountants of India in this regard. The auditor should accordingly consider
materiality when planning and performing (except where a certain minimum
coverage of implementing units is specified) the audit to reduce the risk to an
acceptable level that is consistent with the objective of the audit. In addition the
auditor should specifically consider the risk of material misstatements in the
financial statements resulting from fraud.



Section 9: Terms for appointment of Concurrent Auditors
(including maximum numbers of District Health Societies by one
CA Firm)
    District level
    1. At the District level, the concurrent auditor appointed once can be
      retained/ reappointed for a maximum total term of two financial years i.e.
      current year and next year.
    2. However, the contract awarded should be for one year at a time and
      should be renewed next year on the basis of auditor's performance review.

    3. A CA/CMA Firm may take the audit of maximum three Districts subject
      to approval of State Audit Committee.

Section 10: Content of Monthly Concurrent Audit Report &
Quarterly Executive Summary Report

    (1) Contents of Monthly Concurrent Audit Report & Quarterly
       Executive Summary Report for District level Auditors

    It may be noted that the Concurrent Audit Report of a District Health
    Society is required to be submitted on monthly basis and the Executive
    Summary Report of District Health Society is required to be submitted on
    quarterly basis.

    (a) Content of Monthly Concurrent Audit Report of DHS
    (b) Content of Quarterly Executive Summary Report of DHS

  (a) Content of monthly concurrent audit report of DHS

The monthly Concurrent Audit report of DHS should contain the following
reports and documents:

  · Audited Trail Balance of DHS

  · Audited Monthly FMR

  · Age wise List of Advances of DHS

  · Bank Reconciliation Statement of all the banks(NHM & Non NHM) of
    DHS

  · Audited Monthly Financial Reporting( as per Appendix A)

  · Mandatory Books of Accounts Status(Yes/No format as per Appendix G)

  · Observations and Recommendations of the auditor(including observations
    on CHCs/PHCs/SDH/DH/DTC/FRUs visited)
   · Action taken by District Health Society on the previous audit
     observations, along with his observations on the same.

Important Notes:

   · The District level Concurrent Auditors shall submit their monthly
       concurrent audit report( both soft and hard copies) to the District Health
       Society on or before 15th of month immediately succeeding the reporting
       month and District Health Society shall submit the soft copy of
       Concurrent Audit Report to State head quarter on quarterly basis ie
       monthly concurrent audit report for the month of october, November and
       december 2018 shall be submitted to the state head quarter on or before
       15th January . It must further be noted that the soft copy of Monthly Audit
       Report be submitted at dfa.rhm@gmail.com & also the concern
       Programme Division mail id e.g RNTCP, NLEP, NPCB, NVDBCP, IDSP,
       NPCDCS,NPHCE, Ayush etc on quarterly basis.
       ·      The Audit observations & recommendations must be classified into
       the following categories so that the same may be monitor by the concerned
       Programme Officer:
        i) RCH Flexipool, Mission Flexipool( including AYUSH). Routine
       immunization, Pulse Polio and Non NHM Grant.
       ii) Non Communicable Disease.
       iii) Communicable Diseases.
       iv) NUHM
   (b) Content of Quarterly Executive Summary Report of DHS

Attached at Appendix B

SECTION 11: KEY TIMELINES
The Key Timelines which need to be adhered to are summarized below:

Concurrent Audit for the Period April 2018 to December 2018

Activity                                  Timelines for submission of Concurrent
                                          Audit Report and Executive summary
                                          Report
Carrying out Concurrent Audit of District Submission of Quarterly Concurrent Audit
Health Society for the Period April 2018 Report and Quarterly Executive Summary
to June 2018.                             Report by Concurrent Auditor for the
                                           period April 2018 to June 2018 District
                                           Health Society on or before 11.01.2019
Carrying out Concurrent Audit of District Submission of Quarterly Concurrent Audit
Health Society for the Period July 2018 to Report and Quarterly Executive Summary
September 2018.                            Report by Concurrent Auditor for the
                                           period July 2018 to September 2018 to
                                           District Health Society on or before
                                           21.01.2019
Carrying out Concurrent Audit of District Submission of Quarterly Concurrent Audit
Health Society for the Period October to Report and Quarterly Executive Summary
December 2018.                             Report by Concurrent Auditor for the
                                           period October to December 2018 to
                                           District Health Society on or before
                                           31.01.2019
Note: Action taken report for Audit observations for the period April 2018 to
December 2018 is required to be submitted to the State Head Quarter on or
before 15.02.2019

Concurrent Audit from the Period January 2018 onwards

Activity                                     Timelines
Carrying out concurrent audit                Monthly
Submission of Audit Report by Auditor to     15th of the next month
DHS
Submission of soft copy of District Audit    On Quarterly basis( on or before 15th of the
report of previous three month to the        month immediately succeeding the relevant
Director Finance & Accounts at State         quarter)
level
Submission of Hard Copy of District          On Quarterly basis( on or before 20th of the
Concurrent audit reports of previous three   month immediately succeeding the relevant
month to the SHS                             quarter)
Submission of scanned soft copy( duly        20th of the month immediately succeeding
verified by the Civil Surgeon, Concurrent    the reporting Quarter. e.g the soft copy of
Auditor & DAM) of Quarterly Executive        Quarterly Executive summary for the third
Summary Report of DHS along with the         quarter of Financial year 2018-19 ( Oct-
Action taken Report on the Audit Paras of    Dec) along with the Action taken report on
previous three months by the District        the Audit paras of the concurrent audit
Health Societies to the State Head Quarter   report for October, November and
at dfa.rhm@gmail.com                         December 2018 shall be submitted to the
                                             State Head Quarter on or before 20th of
                                          January 2019.
Submission of Hard copies ( duly verified 25th of the month immediately succeeding
by the Civil Surgeon, Concurrent Auditor the reporting Quarter
& DAM) of Quarterly Executive
summary Report of DHS along with the
Action Taken report on Audit Paras of
previsous three month by the DHS to the
State Head quarter at dfa.rhm@gmail.com
Submission of soft copy of the Quarterly 25th of the month immediately succeeding
Executive summary (SHS & DHS) & the reporting quarter
Action taken report of previous three
month Audit Report by the SHS to the
Mission Director, MoHFW, GoI
Submission of Hard copy of the 30th of the month immediately succeeding
Quarterly Executive summary (SHS & the reporting month
DHS) & Action taken report of previous
three month Audit Report by the SHS to
the Mission Director, MoHFW, GoI


Section 13: DISTRICT WISE DETAIL                           OF     HEALTH
INSTITUTIONS UNDER NHM,HARYANA

Detail attached at Appendix D


Section 14: RESPONSIBILITIES OF DISTRICT HEALTH
SOCIETIES

   · Compliance of Audit Observations

           The members of District Audit Committee shall be responsible for
           compliance of audit observations made in the audit report within the
           limit prescribed.

   · Timely Closure of Books of Accounts

           District Health Societies' finance personnel need to ensure timely
           closure of books of accounts. All the relevant records belong to the
           section of content of Audit Report should be prepared and kept
           ready. This will facilitate in commencing audit quickly.

  · Production of relevant documents for Audit

           DHS along with CHCs/PHCs and other RCH Programme
           implementing agencies shall be under obligation to provide the
           following:

  · Books of Accounts

  · Prescribed registers

  · Files regarding purchase of all types of goods/items

  · Files of Construction works

  · Any other document requested by auditor in support/ reference of the
    above. The responsibility for the same shall lie with District Audit
    Committee at the District level.

SECTION 15: FACILITATION OF THE AUDIT
The following arrangements need to be made for the auditors by the District
Audit Committee:

  · To provide proper space for sitting during conduct of audit.

  · To provide requisite explanations & documents on the queries raised by
    the auditor during audit.

  · To provide auditors with ATRs on previous audit observations without
    any delay.

  · To arrange payments to the auditor on Quarterly basis after fulfillment of
    conditions as mentioned in section 13.








SECTION 16: SOME IMPORTANT ISSUES
    · In case of districts/ blocks visited during the audit, the audit report should
      contain a separate checklist for each unit covered and respective
      observations should also be included.

    · The audit report should also cover qualitative issues emerging from the
      audit other than the financial statements.

    · The District Audit Committee Shall meet atleast 6 times in a year ( i.e.
      once every 2 months) for follow up on the observations made by the
      auditor.

SECTION 17: MONITORING & EVALUATION


    · In order to ensure follow up of observations at the CHC/PHC/SDH/DH
      level, discussion on the audit observation and the way forward should be
      carried out during the monthly meeting convened by the CMO held at the
      district in the presence of District accounts Manager.

·      In order to effectively handle the audit observations, they should be
classified as `material' and `non- material' based on their impact. Observations
related to system deficiency should also be separately noted for system
improvements.

SECTION 18: TECHNICAL EVALUATION & SELECTION
METHODOLOGY
Attached at Appendix F
SECTION 19: MONTHLY FINANCIAL REPORTING AT
DISTRICT LEVEL
Attached at Appendix A

SECTION 20: PENALTY CLAUSE

       a. The State Audit Committee/ District Audit Committee may impose
          penalty up to 10% of the respective month audit fee, if monthly /
   quarterly concurrent audit report is not submitted by the concurrent
   auditor in stipulated period.
b. In case concurrent auditor at District Level fails to complete the work
   as per RFP/TOR or instructions given by the District Audit Committee
   or latter on if any major point/ serious irregularities pointed out by the
   Statutory Auditor/ Divisional / State level Audit Team which the
   concurrent auditor expected to report in their report, then State Audit
   Committee on suomoto or on recommendation received from the
   District Audit Committee may decide to black list the firm for the audit
   of National Health Mission work for three years.
                                                                                 Form T-1

                                    Letter of Transmittal

To,
The Civil Surgeon
District Health & Family Welfare Society Gurugram


Dear Sir/Madam,

       We, the undersigned, offer to provide the audit services for District Health Society ( as
applicable) in accordance with your Request for Proposal dated [Insert Date]. We are hereby
submitting our Proposal, having details about the firm and proposed audit fees.

       We hereby declare that all the information and statements made in this Proposal are true
and accept that any misinterpretation contained in it may lead to our disqualification.

        The Fees quoted by us is valid for 1 Year from date of award of work oder. We confirm
that this proposal will remain binding upon us and may be accepted by you at any time before the
expiry date.

       Prices have been arrived independently without consultation, communication, agreement
or understanding (for the purpose of restricting competition) with any competitor.

      We agree to bear all costs incurred by us in connection with the preparation and
submission of the proposal and to bear any further pre-contract costs.

       We understand that State Health Society, Haryana is not bound to accept the lowest
or any proposal or to give any reason for award, or for the rejection of any proposal.

       I confirm that I have authority of [Insert Name of the C.A. /CMA Firm] to submit the
proposal and to negotiate on its behalf.

                                                                                Yours faithfully,

                                                                          (                     )
       APPENDIX-A (FINANCIAL REPORTING FOR COMMUNICABLE DISEASE)

                 Monthly Fund Status of RNTCP Grant
                                                          Figures in Rs.
                     Opening
                     Balance
                     as on                                          Total
                     1/4/18                                         Fund
                     including                                      available
                     interest        Fund                           with
                     up to           received     Interest          Districts   Expenditure
                     31/3/19(        during       earned (          during      incurred            Closing
                     as per          2018-19(     from              2018-19(    during              balance as
                     the             up to the    1/4/18 till       till the    2018-19( till       on the last
                     audited         end of       the end of        end of      the end of          date of
     Name of         balance         reporting    reporting         reporting   reporting           reporting
S.no District        sheet)          month)       month)            month       month)              month

                             1              2                   3 4=1+2+3                  5 6=4-5
  1 Gurgaon                                                                 0                                     0
    Total                    0              0                   0           0              0                      0


                 Monthly Fund Status of NLEP Grant
                                                         Figures in Rs.
                   Opening                                                           Expendit
                   Balance as on      Fund           Interest       Total Fund       ure
                   1/4/18             received       earned (       available with   incurred         Closing
                   including          during         from           Districts        during           balance
                   interest up to     2018-19(       1/4/18         during 2018-     2018-19(         as on the
                   31/3/19( as        up to the      till the       19( till the     till the         last date
                   per the            end of         end of         end of           end of           of
S.n   Name of      audited            reporting      reportin       reporting        reporting        reporting
o     District     balance sheet)     month)         g month)       month            month)           month

                                 1               2              3 4=1+2+3                       5 6=4-5
  1 Gurgaon                                                                      0                                0
    Total                        0               0              0                0              0                 0
                  Monthly Fund Status of IDSP Grant
                                                      Figures in Rs.

                                                                 Total Fund
                  Opening Balance   Fund           Interest      available        Expenditur
                  as on 1/4/18      received       earned (      with Districts   e incurred      Closing
                  including         during         from          during 2018-     during          balance as
                  interest up to    2018-19( up    1/4/18 till   19( till the     2018-19( till   on the last
                  31/3/19( as per   to the end     the end of    end of           the end of      date of
       Name of    the audited       of reporting   reporting     reporting        reporting       reporting
S.no   District   balance sheet)    month)         month)        month            month)          month

                                1              2             3   4=1+2+3                      5   6=4-5
   1   Gurgaon                                                                0                             0
       Total                    0              0             0                0               0             0
              Monthly Fund Status of NVBDCP Grant
                                                Figures in Rs.
                  Opening
                  Balance
                  as on
                  1/4/18                              Total Fund
                  including                           available
                  interest    Fund                    with
                  up to       received    Interest    Districts      Expenditure
                  31/3/19(    during      earned (    during         incurred        Closing
                  as per      2018-19(    from        2018-19(       during          balance as
                  the         up to the   1/4/18 till till the end   2018-19( till   on the last
                  audited     end of      the end of of              the end of      date of
     Name of      balance     reporting   reporting reporting        reporting       reporting
S.no District     sheet)      month)      month)      month          month)          month

                          1           2           3 4=1+2+3                     5 6=4-5
  1 Gurgaon                                                      0                            0
    Total                 0           0           0              0              0             0
APPENDIX-A (FINA NCIAL REPORTING FOR NON- COMMUNICABLE DISEASE)

                Monthly Fund Status of NPCDCS Grant
                                                    Figures in Rs.
                    Opening
                    Balance as                              Total Fund
                    on 1/4/18     Fund                      available
                    including     received    Interest      with            Expenditure     Closing
                    interest up   during      earned (      Districts       incurred        balance
                    to 31/3/19(   2018-19(    from          during          during          as on the
                    as per the    up to the   1/4/18 till   2018-19( till   2018-19( till   last date
                    audited       end of      the end of    the end of      the end of      of
     Name of        balance       reporting   reporting     reporting       reporting       reporting
S.no District       sheet)        month)      month)        month           month)          month

                              1          2             3 4=1+2+3                       5 6=4-5
  1 Gurgaon                                                            0                           0
    Total                     0          0             0               0               0           0
                Monthly Fund Status of NPHCE Grant
                                                  Figures in Rs.
                   Opening
                   Balance
                   as on                                   Total
                   1/4/18                                  Fund
                   including                               available
                   interest                    Interest    with
                   up to       Fund            earned (    Districts   Expenditure      Closing
                   31/3/19(    received        from        during      incurred         balance
                   as per      during 2018-    1/4/18 till 2018-19 (   during           as on the
                   the         19( up to the   the end     till the    2018-19 ( till   last date
                   audited     end of          of          end of      the end of       of
     Name of       balance     reporting       reporting reporting     reporting        reporting
S.no District      sheet)      month)          month)      month       month)           month

                           1               2           3 4=1+2+3                   5 6=4-5
  1 Gurgaon                                                        0                           0
    Total                  0               0           0           0               0           0
                Monthly Fund Status of NPCB Grant
                                                     Figures in Rs.
                  Opening
                  Balance
                  as on                                      Total Fund
                  1/4/18                                     available
                  including    Fund                          with
                  interest     received        Interest      Districts      Expenditure      Closing
                  up to        during          earned (      during         incurred         balance
                  31/3/19 (    2018-19(        from          2018-19 (      during           as on the
                  as per the   up to the       1/4/18 till   till the end   2018-19 ( till   last date
                  audited      end of          the end of    of             the end of       of
     Name of      balance      reporting       reporting     reporting      reporting        reporting
S.no District     sheet)       month)          month)        month          month)           month

                           1               2            3 4=1+2+3                       5 6=4-5
  1 Gurgaon                                                             0                           0
    Total                  0               0            0               0               0           0
                Monthly Fund Status of Mental Health
                                                      Figures in Rs.
                   Opening
                   Balance                                    Total
                   as on                                      Fund
                   1/4/18                                     available
                   including    Fund                          with
                   interest     received        Interest      Districts      Expenditure     Closing
                   up to        during          earned (      during         incurred        balance
                   31/3/19 (    2018-19 (       from          2018-19(       during          as on the
                   as per the   up to the       1/4/18 till   till the end   2018-19( till   last date
                   audited      end of          the end of    of             the end of      of
     Name of       balance      reporting       reporting     reporting      reporting       reporting
S.no District      sheet)       month)          month)        month          month)          month

                            1               2             3 4=1+2+3                     5 6=4-5
  1 Gurgaon                                                             0                           0
    Total                   0               0             0             0               0           0
              APPENDIX-A (FINA NCIAL REPORTING FOR NON- NHM FUNDS)

                               Monthly fund status of ASHA, ANM State budget
                                                         (figures
                                                         in lacs)
                   Ope
                  ning
                  Bala
                   nce
                            Funds
                     as                                                                                         Closing
                           released                 Total
                    on                                                                                          balance
                            by the                  availa                                            Total
                   01.0                                                                                        as on the
                             State       Interest    bity                                           Expend
                   4.20                                                                                        last date
                            Health        earned       of                                             iture
                    18                                                           Incent     Pay                     of
                            Society         on      funds               Mont                            on
                  inclu                                                          ives to    ment               reportin
                          exclusivel     ASHA/       with                 hly                       ASHA/
                  ding                                                           ASHA         to               g month
                           y for the       ANM       DHS     Monthly    adde                         ANM
                  inter                                                             for      AN                availabl
                          payment         funds(      for      fixed       d                          State
                    est                                                          facilita   Ms(                  e with
SR.   DISTRICTS                to          from     paym     honorari   incen                       Budget
                    up                                                             ting      out               Districts
NO.     NAME              ASHAs/A        1.4.201    ent to    um to      tives                       ( from
                     to                                                          institu      of                   for
                          NMs out          8 till    ASH      ASHA(        to                       1.4.201
                  31.3.                                                           ional     State               making
                           of State      the end       A,       X1)     ASH                           8 till
                  2019                                                           deliver    Budg               payment
                           Budget(           of     ANM                   As(                       the end
                   ( as                                                            ies(      et)                    to
                             from        reporti     s out                X2)                           of
                   per                                                             X3)      (X4)               ASHAs/
                           1.4.2018         ng         of                                           reporti
                  Audi                                                                                          ANMs
                            till the     month)     State                                               ng
                    ted                                                                                          out of
                            end of                  Budg                                            month)
                  bala                                                                                           State
                          reporting                    et
                   nce                                                                                          Budget
                            month)
                  shee
                   t of
                  2017
                   -18)
                                                    4=1+                                            9=5+6+
                   1          2             3                   5         6         7        8                  10=4-9
                                                    2+3                                               7+8
  1   GURGAON                                        0.00                                              0.00        0.00
      TOTAL        0.00           0.00               0.00        0.00    0.00       0.00     0.00      0.00        0.00


Verified by the

                          Dy Civil                           Civil               Verified by the
          DAM             Surgeon                            surgeon             Concurrent Auditor
                                      Monthly Fund Status of Districts for IMR Grant
                                                                                                          (Figure in
                                                                                                          Rs)
S.N    Name     Openin     Funds               Funds      Funds          Interest          Total          Expenditu      Closing
O.     of       g          Transfer by         transfe    used by        earned in IMR     funds          e incurred     balanc
       Distri   Balance    State               r by       the            Bank Account(     available      for imr        e as on
       ct       as on      exclusively         the        Districts      from 1.4.2018     with           activities     the last
                01.04.20   for IMR             District   out of         till the end of   District       during         day of
                18         Grant( from         s out of   common         reporting         for IMR        2018-19(       reporti
                includin   1.4.2018 till       commo      pools          month)            Activities(    from           ng
                g          the end of          n pools    grant for                        as on the      1.4.2018       month
                interest   reporting           bank       making                           last date of   till the end   availab
                up to      month)              accoun     payment                          reporting      of             le with
                31.3.201                       t to       for IMR                          month)         reporting      District
                9( as                          IMR        Activities(                                     month)         under
                per                            Bank       i.e                                                            IMR
                Audited                        Accoun     payment                                                        Grant
                balance                        t( from    made by
                sheet of                       1.4.201    Districts
                2015-                          8 till     out of
                16)                            the end    Common
                                               of         pool bank
                                               reporti    account
                                               ng         for IMR
                                               month)     activities)(
                                                          from
                                                          1.4.2018
                                                          till the
                                                          end of
                                                          reporting
                                                          month)
                       1                   2         3               4                 5   6=1+2+3+                  7   8=6-7
                                                                                           4+5

       Gurga
   1   on                                                                                         0.00                      0.00
       Total        0.00               0.00       0.00           0.00               0.00          0.00           0.00       0.00

Verified by
the

                           Dy Civil                       Civil          Verified by the Concurrent
       DAM                 Surgeon                        surgeon        Auditor
                            Monthly Fund Status of Districts for Construction worker Grant
                                                                                                        (Figure in
                                                                                                        RS)
S.N    Name     Openin     Funds             Funds       Funds          Interest          Total         Expendit     Closing
O.     of       g          Transfer by       transfer    used by        earned in the     funds         ue           balance
       Distri   Balance    State             by the      the            Construction      available     incurred     as on the
       ct       as on      exclusively       Districts   Districts      worker Bank       with          for          last date
                01.04.2    for               out of      out of         Accounts(         District      Construct    of
                018        Constructio       common      common         from 1.4.2018     for           ion          reporting
                includi    n worker          pools       pools          till the end of   Construct     worker       month
                ng         Grant( from       bank        grant for      reporting         ion           during       available
                interest   1.4.2018 till     account     making         month)            worker        2018-19(     with
                up to      the end of        to          payment                          Activities(   from         District
                31.3.20    reporting         Construc    for                              on the last   1.4.2018     under
                19( as     month)            tion        Construct                        day of        till the     Construc
                per                          worker      ion                              reporting     end of       tion
                Audite                       Bank        worker                           month         reporting    worker
                d                            Account(    Activities                       before        month)       Funds
                balance                      from        ( i.e                            expenditu
                sheet of                     1.4.2018    payment                          re)
                2017-                        till the    made by
                18)                          end of      Districts
                                             reporting   out of
                                             month)      Common
                                                         pool
                                                         bank
                                                         account
                                                         for
                                                         Construct
                                                         ion
                                                         worker
                                                         Activities
                                                         )( from
                                                         1.4.16 till
                                                         the end of
                                                         reporting
                                                         month)
                      1                 2            3              4                 5   6=1+2+3+               7   8=6-7
                                                                                          4+5

       Gurga
   1   on                                                                                       0.00                         0.00
       Total       0.00               0.00        0.00          0.00               0.00         0.00          0.00           0.00

Verified by
the

                           Dy Civil                      Civil          Verified by the Concurrent
       DAM                 Surgeon                       surgeon        Auditor
                                  Monthly Fund Status of District for HUDA Grant
                                                                                                (Figure in Rs
S.NO    Name      Opening     Funds Tranfer     Funds         Interest         Total funds      Expenditue          Closing
.       of        Balance     by State          used by       earned in        available with   incurred for        balance
        Distric   as on       exclusively for   the           the HUDA         District for     HUDA Grant          as on
        t         01.04.201   HUDA Grant        Districts     Grant            HUDA Grant       Activities          the last
                  8           during 2018-      out of        Bank             Activities       during 2018-        date of
                  including   19( from 1/4/18   common        Accounts(                         19( up to the       reportin
                  interest    till the end of   pools         from 1/4/18                       end of              g month
                  up to       reporting         grant for     till the end                      reporting           availabl
                  31.3.2019   month)            making        of reporting                      month)              e with
                  ( as per                      payment       month)                                                District
                  Audited                       for                                                                 under
                  balance                       HUDA                                                                HUDA
                  sheet of                      Grant                                                               Grant
                  2017-18)                      Activities
                                                ( i.e
                                                payment
                                                made by
                                                Districts
                                                out of
                                                Common
                                                pool
                                                bank
                                                account
                                                for
                                                HUDA
                                                Grant
                                                Activities
                                                )( from
                                                1/4/18 till
                                                the end of
                                                reporting
                                                month)
                          1                 2             3               4    5=1+2+3+4                        6   7=5-6


        Gurgao
    1   n                                                                                0.00                           0.00
        Total          0.00              0.00         0.00              0.00             0.00               0.00        0.00




Verified by the

                              Dy Civil                        Civil            Verified by the Concurrent
        DAM                   Surgeon                         surgeon          Auditor
                                   Monthly Fund Status of Districts for PWD Grant
                                                                                                  (Figure in Rs)
S.NO    Name      Opening     Funds Tranfer       Funds         Interest         Total funds      Expenditue         Closing
.       of        Balance     by State            used by       earned in        available with   incurred for       balance
        Distric   as on       exclusively for     the           the PWD          District for     PWD Grant          as on
        t         01.04.201   PWD Activities      Districts     Grant            PWD Grant        Activities         the last
                  8           during 2018-        out of        Bank             Activities       during 2018-       date of
                  including   19( from            common        Accounts(                         19( till the end   reportin
                  interest    1/4/2018 till the   pools         from 1/4/18                       of reporting       g month
                  up to       end of              grant for     till the end                      month)             availabl
                  31.3.2019   reporting           making        of reporting                                         e with
                  ( as per    month)              payment       month)                                               District
                  Audited                         for PWD                                                            under
                  balance                         Grant                                                              PWD
                  sheet of                        Activities                                                         Grant
                  2017-18)                        ( i.e
                                                  payment
                                                  made by
                                                  Districts
                                                  out of
                                                  Common
                                                  pool
                                                  bank
                                                  account
                                                  for PWD
                                                  Grant
                                                  Activities
                                                  )( from
                                                  1/4/18 till
                                                  the end of
                                                  reporting
                                                  month)
                          1                   2             3               4    5=1+2+3+4                       6   7=5-6


        Gurgao
    1   n                                                                                  0.00                          0.00
        Total          0.00               0.00          0.00              0.00             0.00               0.00       0.00




Verified by the

                              Dy Civil                          Civil            Verified by the Concurrent
        DAM                   Surgeon                           surgeon          Auditor
APPENDIX-A (FINANCIAL REPORTING FOR PART ­A,B,C ,POLIO & NUHM)

                            Monthly Fund Status of Districts for RCH, Mission & Routine immunization activities


S.   Name     O     Fu     Fun    Fun     Fun    Fun      Fun    Fun     Fund     Fund     Interest          Net          Total     Expe      Closi
N    of       p     nd     ds     ds      ds     ds       ds     ds      s        s        credited in       Fund         funds     nditu     ng
O.   Distri   e     s      tra    use     tra    use      tra    use     trans    used     the bank          available    avail     re        balan
     ct       ni    rel    nsfe   d by    nsfe   d by     nsfe   d by    fer      by       accounts of       with         able      incur     ce as
              n     eas    r      the     r      the      r      the     by       the      A, B and C(       Districts    with      red       on the
              g     ed     by     Dist    by     Dist     by     Dist    the      Distr    Districts,CH      for          Distr     by        last
              B     by     the    ricts   the    ricts    the    ricts   Distr    icts     C/DH/SDH/P        RCH,         ict       Distr     day of
              al    Sta    Dist   out     Dist   out      Dist   out     icts     out      HC/SC level)(     Mission      for       icts      repor
              a     te     rict   of      rict   of       rict   of      out      of       from 1.4.2018     and          RCH       for       ting
              n     to     s      com     s      com      s      com     of       com      till the end of   routine      ,         RCH       mont
              ce    Dis    out    mon     out    mon      out    mon     com      mon      reporting         immuniz      Missi     ,         h
              as    tri    of     pool    of     pool     of     pool    mon      pools    month)            ation        on        Missi     availa
              o     cts    co     s       co     s        co     s       pools    grant                      activities   and       on        ble
              n     un     mm     gra     mm     gra      mm     gra     to       for                        ( i. e for   Routi     and       with
              0     de     on     nt      on     nt       on     nt      Cons     maki                       Part A,      ne        routi     Distri
              1.    r      poo    for     poo    for      poo    for     tructi   ng                         B and C      imm       ne        ct
              0     Co     ls     mak     ls     mak      ls     mak     on       paym                       Activitie    unzat     imm       under
              4.    m      to     ing     to     ing      ban    ing     work     ent                        s) ( till    ion       unzat     RCH,
              2     mo     NU     pay     Pul    pay      k      pay     er       for                        the end      Activ     ion       Missi
              0     n      HM     men     se     men      acc    men     Bank     Cons                       of           ities(    activi    on
              1     po     ban    t for   Poli   t for    oun    t for   acco     tructi                     reportin     i.e       ties(     and
              8     ol(    k      NU      o      Puls     t to   IM      unts(    on                         g month)     for       i.e       Routi
              in    fro    acc    HM      Ban    e        IM     R       from     work                                    Part      for       ne
              cl    m      oun    ( i.e   k      poli     R      Acti    1.4.2    er                                      A, B      Part      immu
              u     1.4    ts(    pay     acc    o(       Ban    vitie   018      Activ                                   and       A, B      nizati
              di    .20    fro    men     oun    i.e      k      s(      till     ities(                                  C         and       on( i.e
              n     18     m      t       ts(    pay      Acc    i.e     the      i.e                                     Activ     C         for
              g     till   1.4.   mad     fro    men      oun    pay     end      paym                                    ities)(   Activ     Part
              in    the    201    e by    m      t        t(     men     of       ent                                     till      ities)(   A, B
              te    en     8      Dist    1.4.   mad      fro    t       repor    made                                    the       from      and C
              re    d      till   ricts   201    e by     m      mad     ting     by                                      end       1.4.2     Activi
              st    of     the    out     8      Dist     1.4.   e by    mont     Distr                                   of        018       ties)
              u     re     end    of      till   ricts    201    Dist    h)       icts                                    repor     till
              p     po     of     Co      the    out      8      ricts            out                                     ting      the
              to    rti    rep    mm      end    of       till   out              of                                      mont      end
              3     ng     orti   on      of     Co       the    of               Com                                     h)        of
              1.    mo     ng     pool    rep    mm       end    Co               mon                                               repor
              3.    nt     mo     ban     orti   on       of     mm               pool                                              itng
              2     h)     nth    k       ng     pool     rep    on               bank                                              mont
              0            )      acco    mo     ban      orti   pool             acco                                              h)
              1                   unt     nth    k        ng     ban              unt
              9(                  for     )      acco     mo     k                for
              as                  NU             unt      nth    acco             Cons
              p                   HM             for      )      unt              tructi
              er                  acti           Puls            for              on
              A                   vitie          e               IM               work
              u                   s)(            poli            R                er
              di                  fro            o               acti             activi
              te                  m              acti            vitie            ties)(
              d                   1.4.           vitie           s)(              from
              b                   201            s)(             fro              1.4.2
              al                  8              fro             m                018
              a                   till           m               1.4.             till
              n                   the            1.4.            201              the
              ce                  end            201             8                end
              sh                  of             8               till             of
              ee                  rep            till            the              repor
              t                   orti           the             end              ting
              of                  ng             end             of               mont
              2                   mon            of              rep              h)
              0                   th)            rep             orti
              1                                  orti            ng
              7-                                 ng              mon
              1                                  mon             th)
              8)                                 th)
                1     2      3       4      5         6     7       8        9       10                11    12=2+11      13=1          14    15=13
                                                                                                             -            +12                 -14
                                                                                                             (3+4+5+
                                                                                                             6+7+8+9
                                                                                                             +10)
     Gurga
 1   on                                                                                                           0.00     0.00                 0.00
        0.
         0   0.0   0.0          0.0          0.0
Total    0     0     0   0.00     0   0.00     0   0.00   0.00   0.00   0.00   0.00   0.00   0.00
                                  Monthly Fund Status of Districts for NUHM Grant
                                                                                                 (Figure in Rs
S.NO    Name      Opening     Funds transfer     Funds         Interest         Total funds      Expenditue          Closing
.       of        Balance     by the Districts   used by       earned in        available with   incurred for        balance
        Distric   as on       out of common      the           the NUHM         District for     NUHM                at the
        t         01.04.201   pools bank         Districts     Bank             NUHM             Activities          end of
                  8           account to         out of        Accounts(        Activities( up   during 2018-        reportin
                  including   NUHM Bank          common        from             to reporting     19( from            g month
                  interest    Account( up to     pools         1.4.2018 till    month)           1.4.2018 till the   for
                  up to       reporting          grant for     the end of                        end of              NUHM
                  31.3.2019   month i.e from     making        reporting                         reporting           funds
                  ( as per    1.4.2018 to the    payment       month)                            month)
                  Audited     end of             for
                  balance     reporting          NUHM
                  sheet of    month)             Activities
                  2017-18)                       ( i.e
                                                 payment
                                                 made by
                                                 Districts
                                                 out of
                                                 Common
                                                 pool
                                                 bank
                                                 account
                                                 for
                                                 NUHM
                                                 Activities
                                                 )( from
                                                 1.4.2018
                                                 till the
                                                 end of
                                                 reporting
                                                 month)
                          1                  2             3               4    5=1+2+3+4                        6   7=5-6


        Gurgao
    1   n                                                                                 0.00                           0.00
        Total          0.00               0.00         0.00              0.00             0.00                0.00       0.00




Verified by the

                              Dy Civil                         Civil            Verified by the Concurrent
        DAM                   Surgeon                          surgeon          Auditors
                                      Monthly Fund Status of District for Pulse Polio
                                                                                                        (Figure in
                                                                                                        Rs)
S.N    Name     Openin     Funds               Funds     Funds         Interest earned   Total funds    Expendit     Closin
O.     of       g          transfer by         transfe   used by       in the Pulse      available      ue           g
       Distri   Balance    the State to        r by      the           polio Bank        with           incurred     balanc
       ct       as on      Districts           the       Districts     Accounts(         District for   for Pulse    e as on
                01.04.20   exclusively         Distric   out of        from 1/4/2018     Pulse polio    polio        the last
                18         for Pulse           ts out    common        till the end of   Activities(    Activities   date of
                includin   polio               of        pools         reporting         as on last     during       reporti
                g          Activities(         commo     grant for     month)            date of        2018-19(     ng
                interest   from                n pools   making                          reporting      till the     month
                up to      1/4/2018 till       bank      payment                         month          end of       availab
                31.3.201   the end of          accoun    for Pulse                       before         reporting    le with
                9( as      reporting           t to      polio                           expenditure    month)       Distric
                per        month)              Pulse     Activities(                     )                           t under
                Audited                        Polio     i.e                                                         Pulse
                balance                        Bank      payment                                                     polio
                sheet of                       Accou     made by
                2017-                          nt(       Districts
                18)                            from      out of
                                               1/4/201   Common
                                               8 till    pool bank
                                               the end   account
                                               of        for Pulse
                                               reporti   polio
                                               ng        Activities)
                                               month)    ( from
                                                         1/4/2018
                                                         till the
                                                         end of
                                                         reporting
                                                         month)
                      1                    2         3             4                5    6=1+2+3+4               7   8=6-7
                                                                                         +5

       Gurga
   1   on                                                                                       0.00                    0.00
       Total        0.00              0.00        0.00         0.00               0.00          0.00          0.00      0.00

Verified by
the

                           Dy Civil                      Civil         Verified by the Concurrent
       DAM                 Surgeon                       surgeon       Auditors
Appendix B: Quarterly Executive Summary report of DHS

(To be submitted to FMG wing of State Haryana by the District Audit
Committee, District Health & Family Welfare Society.)
Name of District: Gurugram.
For the Quarter ended........................................
Question no 1 to 4 related with Coverage of Audit
Question no 1: Whether monthly Concurrent Audit has been taken?
Question no 2: Mentioned the name of SKS where field visit made by the Concurrent Auditors
during this quarter ?
Question no 3: Mentioned the number of SKS where filed visit not made by Auditors.
Question no 4: Mentioned the list of SKS where mandatory books of Accounts not maintained as per
the MoHFW, Guidelines and where no audit has been done in the previous year.
Question no 5 to 9 related with Books of Accounts:
Question no 5: Name of DHS/CHC/DH and SDH where books of Accounts not maintained in Tally
ERP 9 Customized software.
Question no 6: Name of Health Institution (DHS/CHCs/PHCs/DH/SDH/FRUs) where Manual Cash
book is not being maintained.
Question no 7: Name of Health Institution ( DHS/CHCs/PHCs/DH/SDH/FRUs) where BRS is not
maintained on monthly basis.
Question no 8: Name of Health Institutions( DHS/CHCs/PHCs/DH/SDH/FRUS) where ledger is not
maintained properly.
Question no 9: Name and number of Health Institutions( DHS/CHCs/PHCs/SDH/DH/FRUs) where
trail balance is not maintained on monthly basis.
Questions no 10 to 13 related with Reporting
requirement & guidelines
Question no 10: Name of Health Institutions ( CHCs/PHCs/SDH/DH/FRUs) that have not submitted
the monthly financial reports.
Question no 11: Whether audit report has been submitted by the concurrent auditor within the
prescribed time limit, if no then mentioned the extent of delay along with reasons.
Question no.12: Provide CHC/PHC list of Advances which are outstanding for more than a year.
Question no. 13: Whether delegation of Adminstrative & Financial powers have been taken place as
per the instruction of State Health Society?
Question no 14 related with District Level Audit
Committee
Question no 14: Mentioned the number of meeting held by District level audit Committee during the
current financial year.


DAM           Dy Civil Surgeon               Civil Surgeon                 Concurrent Auditor
                                 ANNEXURE Executive Summary
(To be submitted to FMG, MoHFW, GoI by the State Programme Management
Support Unit, State Health Society)

                Name of the District________________________
  For the Quarter (due dates: 31st July/31st Oct/31st January/30th April)/ Year
 Note: Based on_ the three monthly reports, this report has to be submitted along with
                     the Quarterly Financial Monitoring Report


Part:-A District level issues:

       Coverage

                   1. Name of the Districts where monthly concurrent audit has not
                      taken place. (specify the reason)
                   2. Number of districts where all the blocks have not been covered
                      at least once in the course of audit. (indicate the numbers in each
                      district)
                   3. Number of blocks (district wise)where the peripheral units have
                      not been visited.
                   4. Number of Rogi Kalyan Saminites (distrct wise) where last
                      annual audit has not been done.

       Book of Accounts

                   5. Name of the Districts where books of accounts are
                      computerized. Provide a district wise breakup of health facilities
                      for the same.
                   6. Name of the Districts where Cash Books are not being
                      maintained/closed on a daily basis. Provide a district wise
                      breakup of health facilities for the same.
                   7. Name of the Districts where bank reconciliations is not being
                      done on a monthly basis Provide a district wise breakup of
                      health facilities for the same.





       
Reporting 8. Name of the Districts which have not submitted the Statement of Fund Position in the last three months. 9. Name of districts that have not submitted their concurrent audit reports on time. Also mention the extent of delay. 10. Name of the Districts which have not submitted FMRs/SOEs in the last three months. 11. Name of the Districts where the SOEs/FMRs are not being submitted in prescribed format. 12. Whether the SOE/FMR submitted by the districts includes the SOE from all the Blocks/CHC/PHC etc. on regular basis and on the basis of the Books of Accounts only? Report the exceptions to the same. 13. Provide a list of advances and total amount involved District- wise which are outstanding for more than a year. Mention the follow up action taken for the same. Audit Committee 14. Number of districts where audit committee has not been constituted/ is not meeting at regular intervals (Indicate names). Others 15. Number of Districts where unification of finance and accounting processes has not taken place as per GOI guidelines. 16. Number of districts where posts of District Accounts Manager has been vacant for more than 3 months. 17. Number of Districts where Delegation of Administrative and Financial powers have not taken place as per GOI guidelines (circulated vide D.O. No 118/RCH-Fin 2006-07 dated 1st may, 2007) Part-B: Pending issues: Whether the issues raised in the last Quarterly Executive Summary have been addressed? List down the details of major pending issues. CONCURRENT AUDITOR, DISTRICT ACCOUNTS MANAGER DISTRICT HEALTH & FAMILY WELFARE SOCIETY DISTRICT HEALTH & FAMILY WELFARE SOCIETY APPENDIX-D Detail of Health Institution Under NHM Sr. No. Name of Name of Phone Number Number Number Number District DAM/AA Number of of CHC of DH of SDH of PHC Health Dam/AA Welfare Society 1 District Mr. 9654230570 3 2 2 10 Health & Sandeep Family Welfare Society , Gurgaon Total 3 2 2 10 Appendix F: Technical Evaluation and Selection Methodology Maximum Marks S.no Particulars Notes Marks Obtained No of Partners- 1 10 1 FCA/ACA/FCMA/ACMA Year of experience( Partner A+ Partner B+ 2 10 2 Partner C and more) No of Staff (Qualified CA/Semi Qualified/Other 3 10 3 Clerical Staff) Nature of Experience (RCH,NRHM,NHM Audit/Government social 4 20 Sector Audit/ Other Social 4 Sector Audits/NGOs) 5 Branches in Districts 5 10 Total Turnover of the firm for previous three years i.e 6 10 2015-16, 2016-17 & 2017- 6 18) Total 70 Note: All the relevant documents must be attached with the Technical Proposal so that Audit committee may analysis the proposal Notes: 1. 3 marks for each FCA/FCMA partner and 2 marks for each ACA/ACMA Partner, subject to maximum of 10 marks. In case of Sole Proprietorship ­ 3 marks in case of FCA/FCMA and 2 marks in case of ACA/ACMA . 2. 1 marks for each 1 completed year experience of each partner with maximum 5 marks for each partner, subject to overall limit of 10 marks for all partners. In case of sole proprietorship 1 marks for each 1 completed year experience, subject to maximum 5 marks. 3. i) 3 marks for each Qualified CA/CMA. ii) 2 marks for each Semi Qualified CA/CMA . iii)1 marks for each Other clerical Staff subject to maximum 10 marks. 4. RCH,NRHM,NHM Audit/Government Social Sector Audit/ Other Social Sector Audits/NGOs - 5 marks for each Complete audit subject to maximum 20 Marks. 5. In case of Concurrent audit of District Health Society: 10 marks for CA/CMA Firm having Head Office/Branch in the District where Audit is to be conducted. 6. 2 Marks for each 2 Lakh of Average Turnover for previous three years i.e. FY 2015-16, 2016-17 and 2017-18 (Any fractions of 2 lakhs will be ignored), subject to maximum of 10 marks. For Example: Raj & Associates having turnover for the previous three Financial as follow:- 2015-16- 4.00 Lakh 2016-17- 6.00 Lakh 2017-18- 7.00 Lakh The Average Turnover of Raj & Associates is 4+5+6 = 5.66 Lakh 3 Then, marks allotted to Raj & Associates is as follow: Turnover Marks Alloted 2 lakh 2 marks 2 lakh 2 marks 1.66 lakh NIL (any fractions of 2 lakh will be ignored) Total- 5.66 lakh Total Marks-4 Important notes: 1. The base minimum figures/threshold will be 60% and CA firms scoring above the base minimum figure would be deemed to be considered as technically qualified to undertake the job. 2. Financial bids of only technically qualified firms would be opened by the committee and audit should be awarded on the basis of Quality cum cost based selection (QCBS) process, 70% weightage would be given to the Technical Evaluation and 30% weightage would be given to the financial bid. 3. All the relevant documents must be attached with the proposal so that the Audit committees can analysis the proposal of Firms. Appendixe- G(Yes/No ) Is entri es are Nam com e of Fu plete SHS C FIXE CHE SKS ADV nd d in S /DH AS TRI STO D QUE MEE Miscel Sal ANC Rec Tall r S/ H LE AL B CK ASS ISSU TIN laneo ary E ive y . GH / B DG BAL R REG ETS E G us Reg REG d Soft N SDH O ER ANC S ISTE REG REG REG Regist iste ISTE Reg war o / O E R ISTE ISTE ISTE er r R iste e up CH K R R R r to C/ repo PHC rtin g mon th ? Appendix:H Expression of Interest for short listing of Chartered Accountant Firms/Cost & Management Accountant Firms for the audit of accounts of State Health Societies and District Health Societies on Monthly basis. Status of Firm Partnership Sole Proprietorship 1. (a) Name of the Firm (in Capital Letters)_________________________________________________________ (b) Address of the Head Office ____________________________________________________________________ (With Telephone no. & e-mail address)________________________________________________________ ____________________________________________________________________________ ____________________ (c) PAN of the Firm ____________________________________________________________________________ ____ 2.ICAI/CMA Registration No.___________________________________Region Name__________________________ Region Code __________________________ 3. Date of constitution of the firm:_______________________________________________________________ Note: Please attach the copy of the Firm's constitution certificate issued by ICAI/Institute of Cost Accountant of India as on 01.01.2018 4. Number of Full time Chartered Accountant as on 1st January 2018................................................. Number of audit staff employed full time with the firm Articles/Audit Clerks/Trainees _____________________________________________________________ Other Audit Staff (With knowledge of book keeping & accountancy & Tally)_______________________ Other Clarical Staff (Please Specify)____________________________________________________ Turnover of the firm during past three years 2015-16 ________________________________ 2016-17________________________________ 2017-18 _______________________________ (Please provide copy of ITR and Profit and loss Statement duly verified for the relevant Financial Year.) Number of Branches if any (Please mention Places & Locations) ____________________________________________________________________________ ____________________________________________________________________________ _________________________________________________________ Whether the firm engaged in any internal Or External (RCH,NRHM,NHM Audit/Government social Sector Audit/ Other Social Sector Audits/NGOs)? Yes/No (If yes, then please provide detail with documentary evidence) Whether there are any court/arbitration/any other legal case against the firm? Yes/No (If yes, give a brief note of the case indicating its present status) Undertaking I/We do hereby declare that the above mentioned information are true & correct and I/We also undertake to aid the terms & conditions of the contract and would make the compliance of term laid down in the contract if executed by us with the State Health Society (NHM)/District Health & Family welfare Society. Date: Signature of Partner/ Place: Sole Proprietor with stamp Form -F-1 FORMAT OF FINANCIAL BIDS PARTICULARS TOTAL AMOUNT(In Rupees) AUDIT FEES Both in Numeric and in Words 1 Audit Fees (Including Cost of TA/DA) 2 GST Rs._____________________________________ 3 Total Fees (1+2) 0 (Rupees _______________________________ ______________________________________) Note 1: Percentage of funds involved shall not be a basis of quoting the Audit Fee. Note2: In case of change in the rate of GST the revised GST shall be paid. Signature Not Verified Digitally signed by SHIV KUMAR PARASHAR Date: 2018.12.12 14:31:37 IST Location: Haryana
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