Civil Surgeon
Faridabad

Request for Proposal (RFP)
2020-21

E-tenders are invited on behalf of the Civil Surgeon Faridabad for
Appointment of Concurrent Auditor for District Health & Family Welfare Society
(DH&FWS) of Faridabad for Audit of all programs under NHM & Non NHM

The Civil Surgeon Faridabad shall have the authority to cancel the tender
process if does not find a suitable tender. Civil Surgeon Faridabad 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
Faridabad.
Request for Proposal (RFP)
[2020-21]

For Appointment of Concurrent Auditor for
District Health & Family Welfare Societies
(DH&FWS) Faridabad for Audit of all
programmes under NHM & Non NHM for FY
2020-21

REQUEST FOR PROPOSAL (RFP)

District Health & Family welfare Society (DH&FWS), Faridabad 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, Faridabad under the National Health Mission for the
financial year 2020-21.

1. Tender Value: Maximum ceiling for financial bid is Rs. 80,000/-.

2. Tender Fee: “As per mentioned on website” (Non-Refundable).

3. Processing Fee: “As per mentioned on website” (Non-Refundable).

4. Earnest Money Deposit (EMD):“As per mentioned on website” by way of Online
or demand draft/Banker‟s cheque, in favour of “DISTRICT HEALTH AND
FAMILY WELFARE SOCIETY FARIDABAD ” payable at “FARIDABAD” and
must have validity of at least 3 months.

4.1 The EMD shall be forfeited if the bidder withdraws his bid during the validity
period of the bid.

4.2 The EMD shall be forfeited if bidder founds to not abide by the DNIT Terms &
Conditions, at any level during the Tender finalization process.

4.3 The EMD shall be forfeited if successful bidder fails to furnish the required items/
deliver services within the specified time limit.
5. 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.

6. 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.

7. Pre-Bid Meeting: Pre-bid meeting will be held in meeting Hall of office of Civil
Surgeon Faridabad according to Time and date mentioned on e-tender website to hear
the query‟s of bidders.

8. 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 Faridabad.

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 Faridabad 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 (BOQ)

 Important Dates & Address are as follow:

Start Date & Time of Bid : 01-04-2021 11:00 hours
Preparation & Submission
Pre Bid Meeting : 05-04-2021 11:30 hours
Last Date & Time for Tender : 12-04-2021 11:00 hours
Document Fees deposit ( non –
refundable) : 12-04-2021 11:00 hours
Closing Date & Time of Bid : 12-04-2021 14:00 hours
Preparation & Submission
Technical Bid opening

Particulars Address

Place of pre bid conference for the O/o Civil Surgeon Faridabad

audit of District Health Societies

Place for opening of Technical Bids O/o Civil Surgeon Faridabad

for the Concurrent Audit of District

Health Societies

Contact number 9812352600

E-mail ID dhs.csfbd@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 8th 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

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 i.e

monthly concurrent audit report for the month of October, November and

December 2020 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
(a) 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 2020 to March 2021

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 2020 Report and Quarterly Executive Summary

to March 2021. Report by Concurrent Auditor for the

period April 2020 to March 2021 District

Health Society on or before 10.05.2021

Note: Action taken report for Audit observations for the period April 2020 to
March 2021 is required to be submitted to the State Head Quarter on or before
10.05.2021
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 at least 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 Suo motu 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 Transmitter

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

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 order. 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.

Name of Opening Fund Interest Total Expenditure Closing
S.no District Balance received earned ( Fund incurred balance as
as on during from available during on the last
1/4/20 2020-21( 1/4/20 till with 2020-21( till date of
including up to the the end of Districts the end of reporting
interest end of reporting during reporting month
up to reporting month) 2020-21( month)
31/3/21( month) till the
as per end of
the reporting
audited month
balance
sheet)

1 2 3 4=1+2+3 5 6=4-5

1 Faridabad 0 0
Total
0 0 0 0 0 0

Monthly Fund Status of NLEP Grant

Figures in Rs.

S.n Name of Opening Fund Interest Total Fund Expendit Closing
o District Balance as on received earned ( available with ure balance
1/4/20 during from Districts incurred as on the
including 2020-21( 1/4/20 during 2020- during last date
interest up to up to the till the 21 till the end 2020-21( of
31/3/21( as end of end of of reporting till the reporting
per the reporting reportin month end of month
audited month) g month) reporting
balance sheet) month)

1 2 3 4=1+2+3 5 6=4-5

1 Faridabad 0 0
Total
0 0 0 0 0 0
Monthly Fund Status of IDSP Grant

Figures in Rs.

Name of Opening Balance Fund Interest Total Fund Expenditur Closing
S.no District as on 1/4/20 received earned ( available e incurred balance as
including during from with Districts during on the last
1 Faridabad interest up to 2020-21( up 1/4/2020 during 2020- 2020-21( till date of
Total 31/3/2021( as per to the end till the end 21( till the the end of reporting
the audited of reporting of end of reporting month
balance sheet) month) reporting reporting month)
month) month

1 2 3 4=1+2+3 5 6=4-5

0 0

0 0 0 0 0 0
Monthly Fund Status of NVBDCP Grant

Figures in Rs.

Total

Fund

available

Fund Interest with
received
Opening during earned ( Districts Expenditure Closing
Balance as on 2020-21( incurred balance
1/4/20including up to the from during during as on the
interest up to end of 2020-21( till last date
31/3/2021( as reporting 1/4/20 till 2020-21( the end of of
per the audited month) reporting reporting
balance sheet) the end till the month) month

of end of

Name of reporting reporting
S.no District
month) month

1 2 3 4=1+2+3 5 6=4-5

1 Faridabad 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.

Name of Opening Fund Interest Total Fund Expenditure Closing
S.no District Balance as received earned ( available incurred balance
on 1/4/20 during from with during as on the
including 2020-21( 1/4/20 till Districts 2020-21( till last date
interest up up to the the end of during the end of of
to end of reporting 2020-21( till reporting reporting
31/3/2021( reporting month) the end of month) month
as per the month) reporting
audited month
balance
sheet)

1 2 3 4=1+2+3 5 6=4-5

1 Faridabad 0 0
Total
0 0 0 0 0 0
Monthly Fund Status of NPHCE Grant

Figures in Rs.

Name of Opening Fund Interest Total Expenditure Closing
S.no District Balance received earned ( Fund incurred balance
as on during 2020- from available during as on the
1/4/2020 21 up to the 1/4/2020 with 2020-21 ( till last date
including end of till the Districts the end of of
interest reporting end of during reporting reporting
up to month) reporting 2020-21 ( month) month
31/3/2021( month) till the
as per the end of
audited reporting
balance month
sheet)

1 2 3 4=1+2+3 5 6=4-5

1 Faridabad 0 0
Total
0 0 0 0 0 0
Monthly Fund Status of NPCB Grant

Figures in Rs.

Name of Opening Fund Interest Total Fund Expenditure Closing
S.no District Balance received earned ( available incurred balance
as on during from with during as on the
1/4/2020 2020-21( 1/4/2020 Districts 2020-21 ( till last date
including up to the till the during the end of of
interest end of end of 2020-21 ( reporting reporting
up to reporting reporting till the end month) month
31/3/2021 month) month) of
( as per reporting
the month
audited
balance
sheet)

1 2 3 4=1+2+3 5 6=4-5

1 Faridabad 0 0
Total
0 0 0 0 0 0
Monthly Fund Status of Mental Health

Figures in Rs.

Name of Opening Fund Interest Total Expenditure Closing
S.no District Balance received earned ( Fund incurred balance
as on during from available during as on the
1/4/2020 2020-21( 1/4/2020 with 2020-21( till last date
including up to the till the Districts the end of of
interest end of end of during reporting reporting
up to reporting reporting 2020-21( month) month
31/3/2021( month) month) till the end
as per the of
audited reporting
balance month
sheet)

1 2 3 4=1+2+3 5 6=4-5

1 Faridabad 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)

SR. DISTRICTS Ope Funds Interest Total Monthly Mont Incent Pay Total Closing
NO. NAME ning released earned availa fixed hly ives to ment Expend balance
Bala by the bity adde ASHA as on the
FARIDABA nce on honorari d to iture last date
1 D State ASHA/ of um to incen for AN on
as Health ANM funds ASHA( tives facilita Ms( of
on Society funds( with X1) to out ASHA/ reportin
01.0 exclusivel from DHS ASH ting of ANM g month
4.20 y for the 1.4.202 As( institu State State availabl
20 payment for X2) ional Budg Budget e with
inclu 0 till paym deliver et) ( from Districts
ding to the end ent to (X4) 1.4.202
inter ASHAs/A ASH ies( 0 till for
est NMs out of X3) 8 the end making
up of State reporti A, payment
to Budget( ANM of
31.3. ng s out reporti to
2021 from month) ASHAs/
( as 1.4.2020 of ng ANMs
per till the State month) out of
Audi end of Budg
ted reporting 9=5+6+ State
bala month) et 7+8 Budget
nce
shee 2 3 4=1+ 5 6 7 0.00 10=4-9
t of 2+3
2019 0.00
-20)

1

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 Closin

O. of g Transfer by transfe used by earned in IMR funds e incurred g

Distric Balance State r by the Bank Account( available for imr balanc

t as on exclusively the Districts from 1.4.2020 with activities e as on

01.04.20 for IMR Distric out of till the end of District during the last

20 Grant( from ts out common reporting for IMR 2020-21( day of

includin 1.4.2020 till of pools month) Activities( from reporti

g the end of commo grant for as on the 1.4.2020 ng

interest reporting n pools making last date till the end month

up to month) bank payment of of availab

31.3.202 accoun for IMR reporting reporting le with

1( as t to Activities( month) month) Distric

per IMR i.e t under

Audited Bank payment IMR

balance Accou made by Grant

sheet of nt( Districts

2015- from out of

16) 1.4.202 Common

0 till pool

the end bank

of account

reporti for IMR

ng activities)(

month) from

1.4.2020

till the

end of

reporting

month)

1 2 3 4 5 6=1+2+3+ 7 8=6-7

4+5

Faridab 0.00 0.00
1 ad

Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Verified by
the

DAM Dy Civil Civil Verified by the Concurrent
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

Distric Balanc State by the the Construction available incurred as on the

t e as on exclusively Districts Districts worker Bank with for last date

01.04.2 for out of out of Accounts( District Construct of

020 Constructio common common from 1.4.2020 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 2020-21( with

up to the end of to payment Activities( from District

31.3.20 reporting Construc for on the last 1.4.2020 under

20( as month) tion Construc day of till the Construc

per worker tion reporting end of tion

Audite Bank worker month reporting worker

d Account( Activities before month) Funds

balance from ( i.e expenditu

sheet of 1.4.2020 payment re)

2019- till the made by

20) end of Districts

reporting out of

month) Common

pool

bank

account

for

Construc

tion

worker

Activities

)( from

1.4.2020

till the

end of

reporting

month)

1 2 3 4 5 6=1+2+3+ 7 8=6-7

4+5

Farida 0.00 0.00
1 bad

Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Verified by
the

DAM Dy Civil Civil Verified by the Concurrent
Surgeon surgeon Auditor
Monthly Fund Status of District for HUDA Grant

S.NO Name Opening Funds Tranfer Funds Interest Total funds (Figure in Rs Closing
. of Balance by State used by earned in available with balance
Distric as on exclusively for the the HUDA District for Expenditue as on
t 01.04.202 HUDA Grant Districts Grant HUDA Grant incurred for the last
0 during 2020- out of Bank Activities HUDA Grant date of
including 21( from common Accounts( Activities reportin
interest 1/4/2020 till pools from 5=1+2+3+4 during 2020-21 g month
up to the end of grant for 1/4/2020 up to the end of availabl
31.3.2021 reporting making till the end reporting e with
( as per month) payment of month) District
Audited for HUDA reporting under
balance 2 Grant month) HUDA
sheet of Activities( Grant
2019-20) i.e 4
payment 6 7=5-6
1 made by
Districts
out of
Common
pool bank
account
for HUDA
Grant
Activities)
( from
1/4/2020
till the end
of
reporting
month)

3

Faridab 0.00 0.00
1 ad

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

S.NO Name of Opening Funds Tranfer Funds Interest Total funds (Figure in Rs) Closing
. District Balance by State used by earned in available with balance
as on exclusively for the the PWD District for Expenditue as on
01.04.202 PWD Activities Districts Grant PWD Grant incurred for the last
0 during2020-21 out of Bank Activities PWD Grant date of
including from 1/4/2020 common Accounts( Activities reportin
interest till the end of pools from 5=1+2+3+4 during 2020- g month
up to reporting grant for 1/4/2020 till 21( till the end availabl
31.3.2021 month) making the end of of reporting e with
( as per payment reporting month) District
Audited 2 for PWD month) under
balance Grant PWD
sheet of Activities 4 Grant
2019- ( i.e
2020) payment 6 7=5-6
made by
1 Districts
out of
Common
pool
bank
account
for PWD
Grant
Activities
)( from
1/4/2020
till the
end of
reporting
month)

3

Faridaba 0.00 0.00
1 d

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 Ope Fu Fun Fun Fun Fun Fun Fun Fund Fund Interest Net Total Expe Closin
N of
O. Distri ning nd ds ds ds ds ds ds s s credited Fund funds nditu g

ct Bala s tra use tra use tra use trans used in the available avail re balan

nce rel nsfe d by nsfe d by nsfe d by fer by bank with able incur ce as

as eas r the r the r the by the account Districts with red on the

on ed by Dist by Dist by Dist the Distr s of A, for Distr by last

01.0 by the rict the rict the rict Distr icts B and RCH, ict Distr day of

4.20 Sta Dist s Dist s Dist s icts out C( Mission for icts report

20 te rict out rict out rict out out of District and RCH for ing

incl to s of s of s of of com s,CHC/ routine , RCH mont

udin Dis out com out com out com com mon DH/SD immuniz Missi , h

g tri of mo of mo of mo mon pools H/PHC/ ation on Missi availa

inte cts co n co n co n pools grant SC activities and on ble

rest un mm pool mm pool mm pool to for level)( ( i. e for Routi and with

up de on s on s on s Cons maki from Part A, ne routi Distri

to r poo gra poo gra poo gra truct ng 1.4.2020 B and C imm ne ct

31.3. Co ls nt ls nt ls nt ion pay till the Activitie unzat imm under

2021 m to for to for ban for work ment end of s) ( till ion unzat RCH,

( as mo NU ma Pul ma k ma er for reportin the end Activ ion Missi

per n HM kin se kin acc kin Bank Cons g of ities( activi on

Aud po ban g Poli g oun g acco truct month) reportin i.e ties( and

ited ol( k pay o pay t to pay unts( ion g month) for i.e Routi

bala fro acc men Ban men IM men from work Part for ne

nce m oun t for k t for R t for 1.4.2 er A, B Part immu

shee 1.4 ts( NU acc Puls Ban IM 020 Activ and A, B nizati

t of .20 fro HM oun e k R till ities( C and on( i.e

2019 20 m ( i.e ts( poli Acc Acti the i.e Activ C for

-20) till 1.4. pay fro o( oun vitie end pay ities)( Activ Part

the 202 men m i.e t( s( of ment till ities)( A, B

en 0 t 1.4. pay fro i.e repo made the from and C

d till ma 202 men m pay rting by end 1.4.2 Activi

of the de 0 t 1.4. men mont Distr of 020 ties)

re end by till ma 202 t h) icts repor till

po of Dist the de 0 ma out ting the

rti rep rict end by till de of mont end

ng orti s of Dist the by Com h) of

mo ng out rep rict end Dist mon repor

nt mo of orti s of rict pool itng

h) nth Co ng out rep s bank mont

) mm mo of orti out acco h)

on nth Co ng of unt

pool ) mm mo Co for

ban on nth mm Cons

k pool ) on truct

acc ban pool ion

oun k ban work

t for acc k er

NU oun acc activi

HM t for oun ties)(

acti Puls t for from

vitie e IM 1.4.2

s)( poli R 020

fro o acti till

m acti vitie the

1.4. vitie s)( end

202 s)( fro of

0 fro m repo

till m 1.4. rting

the 1.4. 202 mont

end 202 0 h)

of 0 till

rep till the

orti the end

ng end of

mo of rep

nth) rep orti

orti ng

ng mo

mo nth)

nth)

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)

Farida

1 bad 0.00 0.00 0.00

0.0 0.0 0.0 0.0

Total 0.00 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.N Name of Opening Funds transfer Funds Interest Total funds Expenditue Closing

O. District Balance by the Districts used by earned in available with incurred for balance

as on out of common the the NUHM District for NUHM at the

01.04.202 pools bank Districts Bank NUHM Activities end of

0 account to out of Accounts( Activities( up during 2020- reportin

including NUHM Bank common from to reporting 21( from g month

interest Account( up to pools 1.4.2020 till month) 1.4.2020 till the for

up to reporting grant for the end of end of NUHM

31.3.2021 month i.e from making reporting reporting funds

( as per 1.4.2020 to the payment month) month)

Audited end of for

balance reporting NUHM

sheet of month) Activities

2019-20) ( i.e

payment

made by

Districts

out of

Common

pool

bank

account

for

NUHM

Activities

)( from

1.4.2020

till the

end of

reporting

month)

1 2 3 4 5=1+2+3+4 6 7=5-6

Faridaba 0.00 0.00
1 d

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 Total funds Expendit Closin

O. of g transfer by transfe used by earned in the available ue g

Distric Balance the State to r by the Pulse polio with incurred balanc

t as on Districts the Districts Bank District for for Pulse e as on

01.04.20 exclusively Distric out of Accounts( Pulse polio polio the last

20 for Pulse ts out common from 1/4/2020 Activities( Activities date of

includin polio of pools till the end of as on last during reporti

g Activities( commo grant for reporting date of 2020-21( ng

interest from n pools making month) reporting till the month

up to 1/4/2020 till bank payment month end of availab

31.3.202 the end of accoun for Pulse before reporting le with

1( as reporting t to polio expenditur month) Distric

per month) Pulse Activities( e) t under

Audited Polio i.e Pulse

balance Bank payment polio

sheet of Accou made by

2019- nt( Districts

20) from out of

1/4/202 Common

0 till pool

the end bank

of account

reporti for Pulse

ng polio

month) Activities)

( from

1/4/2020

till the

end of

reporting

month)

1 2 3 4 5 6=1+2+3+4 7 8=6-7

+5

Faridab 0.00 0.00
1 ad

Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Verified by
the

DAM Dy Civil Civil Verified by the Concurrent
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: Faridabad.
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 Samiti (District 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
DH&FWS, Faridabad DH&FWS, Faridabad
APPENDIX-D Detail of Health Institution Under NHM

Sr. Name of Name of Phone Numbe Numbe Numbe Number of PHC

No. District DAM/A Number r of r of r of /UPHC/UHC/FR

Health A of CHC DH SDH Us

Welfare Dam/AA

Society

1 District Mr. 98123526 2 1 1 30

Health Sandeep 00

& Jain

Family

Welfare

Society ,

Faridaba

d

Total 2 1 1 30
Appendix F: Technical Evaluation and Selection
Methodology

S.no Particulars Notes Maximum Marks
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

2017-18, 2018-19 & 2019-

6 20)

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 2017-18, 2018-19 and 2019-20 (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:-
2017-18- 4.00 Lakh
2018-19- 5.00 Lakh
2019-20- 6.00 Lakh
The Average Turnover of Raj & Associates is 4+5+6 = 5 Lakh
3

Then, marks allotted to Raj & Associates is as follow:

Turnover Marks Alloted

2 lakh 2 marks

2 lakh 2 marks

1 lakh NIL (any fractions of 2 lakh will

be ignored)

Total- 5 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

Nam are
e of
SHS C com
S /DH AS
r S/ H LE TRI B STO FIXE ADV CHE SKS Miscel Fu Sal plete
. GH / B DG AL R CK D ANC QUE MEE laneo nd ary d in
N SDH O ER BAL S REG ISSU TIN Rec Reg Tall
o/ O ANC ISTE ASS E us ive iste
CH K E R ETS REG E G Regist d r y
C / REG ISTE REG REG Reg Soft
PHC ISTE ISTE ISTE er iste war
R r e up
R R R to

repo

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 01.01.2020

4. Number of Full time Chartered Accountant as on 1st January
2020………………………………………….

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 Clerical Staff (Please
Specify)____________________________________________________

Turnover of the firm during past three years
2017-18 ________________________________
2018-19________________________________
2019-20 _______________________________
(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 Yes/No
legal case against the firm?
(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