Request for Proposal (RFP)

For Appointment of Concurrent Auditor
forDistrict Health & Family Welfare Society
(DH&FWS) __Narnaul____________ for Audit
of all programmes under NHM& Non NHMfor
FY 2020-21

[2020-21]
REQUEST FOR PROPOSAL (RFP)

District Health & Family welfare Society(DH&FWS),__Narnaul__ seeks to
invite Proposal from CharteredAccountant(CA) Firms and Cost and
Management Accountant(CMA) Firms meeting the minimum eligibility
criteriafor conductingthe Concurrent audit of District Health & Family
Welfare Society, ___Narnaul________under the National Health Mission for
the financial year 2020-21.
This appointment will be for one year &can be renewable for next year
subject to the satisfactory performance of Concurrent Auditors.
A complete set of RFP specifying eligibility criteria, and other terms and
conditions applicable for the above said assignment can be downloaded from
Website www.etenders.hry.nic.in
Important Dates & Address are as follow:

Start Date & Time of Bid : 1-12-2020 9.00 Hours
Preparation & Submission : 4-12-2020 10.30 Hours
Pre Bid Meeting : 10-12-2020 11.00 Hours
Last Date & Time for Tender
Document Fees deposit ( non – : 10-12-2020 11.00 Hours
refundable) : 11-12-2020 11.00 Hours
Closing Date & Time of Bid
Preparation & Submission
Technical Bid opening

Particulars Address

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

the audit of District Health

Societies

Place for opening of Technical O/o Civil Surgeon of the concerned District

Bids for the Concurrent Audit

of District Health Societies

Contact number of DH&FWS ____________7015999077_________

E-mail ID of DH&FWS ______________________dam.mhn1@gmail.com
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 Programmes.

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 accountspertaining 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 conduct Concurrent Audit of Expenditure under the COVID-19
Package.

• 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 visits 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 7: DISTRICT AUDIT COMMITTEE

(1) Formation of District Audit Committee
(2) Functions of District Audit Committee
(1) Formation of District Audit Committee

A District audit committee should be constituted at each District for
monitoring and evaluation of Concurrent audit. The member of audit
committee should be the following:
Person Designation in
Committee

Civil Surgeon Member Secretary

Deputy Civil surgeon (NHM) Member

Deputy Civil surgeon (NCD) Member

Deputy Civil surgeon (Communicable disease) Member

District Accounts Manager Member

District programme Manager Member

District ASHA Coordinator Member

The District audit committee should function under the guidelines of
Director Finance and Accounts at State level. The District audit committee
should meet at least 6 times in a year.

(2) Functions of District Audit Committee

• Selection and appointment of District Concurrent auditors (in
concurrence with the state Audit Committee).

• Monitoring timely audits at District level and timely submission of
audit reports.

• As per D.O. Letter No. Z-18015/19/2020-NHM-II-Part (I) dated
06.08.2020 issued by MoH&FW, GoI, the District Audit Committee
must ensure that the auditor engaged for Concurrent Audit of NHM
also conducts Concurrent Audit of Expenditure under the COVID-
19 Package.
• DPM & DAC shall be responsible for providing the physical data to
the Auditors on or before their schedule so that the physical data
may be match with the financial data and auditors may report on
the same.

• Monitoring whether adequate follow up action is being taken on the
audit observations.

• Monitor whether ATR (Action taken report) has been prepared and
given to the auditors and whether the same has been vetted

• Carrying out an assessment of audits in case the auditors are being
considered to be reappointed with intimation to State audit
committee.

• Renewal of the Concurrent Auditors contracts with intimation to
State Audit committee.

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 specificallyconsider 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 i.e
monthly concurrent audit report for the month of December2020 shall be
submitted to the state head quarter on or before 15thJanuary 2021. 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, Ayushetcon
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 2020 to December 2020

Activity Timelines for submission of Concurrent

Audit Report and Executive summary

Report

Carrying out Concurrent Audit of State Submission of Quarterly Concurrent Audit

Health Society for the Period April 2020 Report and Quarterly Executive Summary

to June 2020. Report by Concurrent Auditor for the

period April 2020 to June 2020 to District

Health & Family Welfare Society on or

before 28.12.2020.

Carrying out Concurrent Audit of State Submission of Quarterly Concurrent Audit

Health Society for the Period July 2020 to Report and Quarterly Executive Summary

September 2020. Report by Concurrent Auditor for the

period July 2020 to September 2020 to

District Health& Family Welfare society

on or before 07.01.2021.
Carrying out Concurrent Audit of State Submission of Monthly Concurrent Audit

Health Society for the period October Report by Concurrent Auditor for the

2020 to December 2020. period October 2020 to December 2020 to

District Health & Family Welfare Society
on or before 19.01.2021.

Note: Action taken report for Audit observations for the period April 2020 to

December 2020 is required to be submitted to the State Head Quarter on or

before 28.01.2021.

Concurrent Audit from the Period January 2021onwards

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 2020-21 ( 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 2020 shall be submitted to the
State Head Quarter on or before 20th of

January 2020.

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 DHSalong 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 12: APPOINTMENT & SELECTION OF CONCURRENT
AUDITOR( INCLUDING GUIDELINES FOR SUBMISSION OF
PROPOSAL)

District level Auditors

• Appointment and selection of the District level concurrent auditors will be
done by the respective District Audit Committee. The advertisement for e-
Tender Should be made by the respective District.

• Interested Firms should upload their bids directly to the concerned district
e-tender portal in two parts –Technical and Financial bids. The Bidders should
submit the original copy of Technical Bids along with all related documents in
sealed envelopes to respective districts Tender Box kept at O/o Civil Surgeons
,respective districts. This should be opened in meeting of the District Audit
Committee.

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

• 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
Authorised signatory of the firm.

•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 70% and CA/CMA
firms scoring above the base minimum figure would be deemed to be considered
as technically qualified to undertake the job.

• 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.

•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.

•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.

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,Haryanacan 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

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 suomotu 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 Society( as applicable)

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
herebysubmitting 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.

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

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

1 Ambala 0 0

2 Bhiwani 0 0

3 CharkhiDadri 0 0

4 Faridabad 0 0

5 Fatehabd 0 0

6 Gurgaon 0 0

7 Hissar 0 0

8 Jind 0 0

9 Jhajjar 0 0

10 Karnal 0 0

11 Kaithal 0 0

12 Kurukshetra 0 0

13 Mewat 0 0

14 Narnaul 0 0

15 Palwal 0 0

16 Panchkula 0 0

17 Panipat 0 0

18 Rohtak 0 0

19 Rewari 0 0

20 Sirsa 0 0

21 Sonepat 0 0

22 Yamunanager 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
1/4/20includi during from Districts incurred as on the
ng interest up 2020-21( 1/4/20 during 2020- during last date
to 31/3/21( as up to the till the 21( till the end 2020-21( of
per the end of end of of reporting till the reporting
audited reporting reporting month end of month
balance month) month) reporting
sheet) month)

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

1 Ambala 0 0
2 Bhiwani
3 CharkhiDadri 0 0
4 Faridabad
5 Fatehabd 0 0
6 Gurgaon
7 Hissar 0 0
8 Jind
9 Jhajjar 0 0
10 Karnal
11 Kaithal 0 0
12 Kurukshetra
13 Mewat 0 0
14 Narnaul
15 Palwal 0 0
16 Panchkula
17 Panipat 0 0
18 Rohtak
19 Rewari 0 0
20 Sirsa
21 Sonepat 0 0

Yamunanage 0 0
22 r
0 0
Total
0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0 0 0 0 0
Monthly Fund Status of IDSP Grant

Figures in Rs.

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

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

1 Ambala 0 0
2 Bhiwani
0 0
CharkhiDad
3 ri 0 0
4 Faridabad
5 Fatehabd 0 0
6 Gurgaon
7 Hissar 0 0
8 Jind
9 Jhajjar 0 0
10 Karnal
11 Kaithal 0 0
12 Kurukshetra
13 Mewat 0 0
14 Narnaul
15 Palwal 0 0
16 Panchkula
17 Panipat 0 0
18 Rohtak
19 Rewari 0 0
20 Sirsa
21 Sonepat 0 0

Yamunanag 0 0
22 er
0 0
Total
0 0

0 0

0 0

0 0

0 0

0 0

0 0

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
31/3/21( as per reporting 1/4/20 2020-21( the end of of
the audited month) reporting reporting
balance sheet) till the till the end month) month

end of of

Name of reporting reporting
S.no District
month) month

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

1 Ambala 0 0
2 Bhiwani
3 CharkhiDadri 0 0
4 Faridabad
5 Fatehabd 0 0
6 Gurgaon
7 Hissar 0 0
8 Jind
9 Jhajjar 0 0
10 Karnal
11 Kaithal 0 0
12 Kurukshetra
13 Mewat 0 0
14 Narnaul
15 Palwal 0 0
16 Panchkula
17 Panipat 0 0
18 Rohtak
19 Rewari 0 0
20 Sirsa
21 Sonepat 0 0
22 Yamunanager
0 0
Total
0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0 0 0 0 0
APPENDIX-A (FINANCIAL REPORTING FOR NON- COMMUNICABLE DISEASE)

Monthly Fund Status of NPCDCS 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
31/3/21( as per reporting 1/4/20 2020-21( the end of of
the audited month) reporting reporting
balance sheet) till the till the end month) month

end of of

Name of reporting reporting
S.no District
month) month

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

1 Ambala 0 0
2 Bhiwani
3 CharkhiDadri 0 0
4 Faridabad
5 Fatehabd 0 0
6 Gurgaon
7 Hissar 0 0
8 Jind
9 Jhajjar 0 0
10 Karnal
11 Kaithal 0 0
12 Kurukshetra
13 Mewat 0 0
14 Narnaul
15 Palwal 0 0
16 Panchkula
17 Panipat 0 0
18 Rohtak
19 Rewari 0 0
20 Sirsa
21 Sonepat 0 0
22 Yamunanager
0 0
Total
0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0 0 0 0 0
Monthly Fund Status of NPHCE 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 ( last date
31/3/21( as per reporting 1/4/20 2020-21 ( till the end of
the audited month) of reporting reporting
balance sheet) till the till the month) month

end of end of

Name of reporting reporting
S.no District
month) month

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

1 Ambala 0 0
2 Bhiwani
3 CharkhiDadri 0 0
4 Faridabad
5 Fatehabd 0 0
6 Gurgaon
7 Hissar 0 0
8 Jind
9 Jhajjar 0 0
10 Karnal
11 Kaithal 0 0
12 Kurukshetra
13 Mewat 0 0
14 Narnaul
15 Palwal 0 0
16 Panchkula
17 Panipat 0 0
18 Rohtak
19 Rewari 0 0
20 Sirsa
21 Sonepat 0 0
22 Yamunanager
0 0
Total
0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0 0 0 0 0
Monthly Fund Status of NPCB 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 ( last date
31/3/21 ( as reporting 1/4/20 2020-21 ( till the end of
per the audited month) of reporting reporting
balance sheet) till the till the end month) month

end of of

Name of reporting reporting
S.no District
month) month

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

1 Ambala 0 0
2 Bhiwani
3 CharkhiDadri 0 0
4 Faridabad
5 Fatehabd 0 0
6 Gurgaon
7 Hissar 0 0
8 Jind
9 Jhajjar 0 0
10 Karnal
11 Kaithal 0 0
12 Kurukshetra
13 Mewat 0 0
14 Narnaul
15 Palwal 0 0
16 Panchkula
17 Panipat 0 0
18 Rohtak
19 Rewari 0 0
20 Sirsa
21 Sonepat 0 0
22 Yamunanager
0 0
Total
0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0 0 0 0 0

Monthly Fund Status of Mental Health
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
31/3/21 ( as reporting 1/4/20 2020-21( the end of of
per the audited month) reporting reporting
balance sheet) till the till the month) month

end of end of

Name of reporting reporting
S.no District
month) month

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

1 Ambala 0 0
2 Bhiwani
3 CharkhiDadri 0 0
4 Faridabad
5 Fatehabd 0 0
6 Gurgaon
7 Hissar 0 0
8 Jind
9 Jhajjar 0 0
10 Karnal
11 Kaithal 0 0
12 Kurukshetra
13 Mewat 0 0
14 Narnaul
15 Palwal 0 0
16 Panchkula
17 Panipat 0 0
18 Rohtak
19 Rewari 0 0
20 Sirsa
21 Sonepat 0 0
22 Yamunanager
0 0
Total
0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0 0 0 0 0
APPENDIX-A (FINANCIAL REPORTING FOR NON-NHM FUNDS)
Monthly Fund Status of ASHA/ANM State Budget

(figures in lacs)

Funds Mon Mont Incentive ANMs Incen Incent In Inc In Com Tot Bal
release thly hly for State tive ive for anc
Fix Adde Facilitatin Budg for Immu ce enti ce pen al
d by Hon d g Inst ANC nizati e
the for Incen Deliveries et Case. on nti ve nti sati Exp ava
State Asha tive -ASHA Sessio ila
Health for n ve for ve on end ble
Society ASHA wit
Openi for the for Inst for for itur h
ng payme Dis
S nt to HB itut Sp Emp e tric
Balan ASHAs ts
R ce As /ANMs PN ion aci loye as
On . out of on
. DISTRICTS 01- State C al ng e's 31.
04- Budget 03.
N NAME 2020 Ca Deli of Fam 20
. 21
O se. ver 2/ ily

. y 3

Jsy Ye

Cas ar

e s

Ca

se.

X.1 X.2 X.3 X.4 X.5 X.6 X.7 X.8 X.9 X_16

14=

1 2 3 4 5 6 7 8 9 10 11 12 13 1+2

-13

1 AMBALA

2 BIHWANI

CHARKHI
3 DADRI

4 FARIDABAD

FATEHABA
5 D

6 GURGAON

7 HISAR

8 JHAJJAR

9 JIND

1
0 KAITHAL

1
1 KARNAL

1 KURUkestr
2 a

1
3 MEWAT

1
4 NARNAUL

1
5 PALWAL

1
6 PANHKULA
1 0.00 0.00
7 PANIPAT
1
8 REWARI
1
9 ROHTAK
2
0 SIRSA
2
1 SONIPAT
2 YAMUNANA
2 GAR

TOTAL

Verified by Dy Civil Verified by the
the Civil surge Concurrent Auditor
Surgeo on
D n
A
M
Monthly Fund Status of Districts for IMR Grant

S.N Name of Openin Funds Funds Funds Interest Total (Figure in Closin
O. District g Transfer by transfe used by earned in funds Rs) g
Balanc State r by the IMR Bank available Expendit balanc
e as on exclusively the Districts Account( with ue e as on
01.04.2 for IMR Distric out of from 1.4.2020 District incurred the
020 Grant( from ts out common till the end of for IMR for imr last
includi 1.4.2020 till of pools reporting Activities( activities day of
ng the end of comm grant for month) as on the during reporti
interest reporting on making last date 2020-21( ng
up to month) pools payment 5 of from month
31.3.20 bank for IMR reporting 1.4.2020til availa
20( as 2 accoun Activities month) l the end ble
per t to ( i.e of with
Audite IMR payment 6=1+2+3+ reporting Distric
d Bank made by 4+5 month) t
balance Accou Districts under
sheet of nt( out of 7 IMR
2019- from Common Grant
20) 1.4.202 pool
0 till bank 8=6-7
1 the account
end of for IMR
reporti activities)
ng ( from
month 1.4.2020
) till the
end of
3 reporting
month)

4

1 Ambala 0.00 0.00
2 Bhiwani
0.00 0.00
CharkhiD
3 adri 0.00 0.00
4 Faridabad
5 Fatehabd 0.00 0.00
6 Gurgaon
7 Hissar 0.00 0.00
8 Jind
9 Jhajjar 0.00 0.00
10 Karnal
11 Kaithal 0.00 0.00

Kurukshet 0.00 0.00
12 ra
13 Mewat 0.00 0.00
14 Narnaul
15 Palwal 0.00 0.00

0.00 0.00

0.00 0.00

0.00 0.00

0.00 0.00
16 Panchkula 0.00 0.00
0.00 0.00
17 Panipat 0.00 0.00
0.00 0.00
18 Rohtak 0.00 0.00
0.00 0.00
19 Rewari
0.00
20 Sirsa 0.00 0.00

21 Sonepat 0.00
Yamunan

22 ager

Total 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

S.N Name of Opening Funds Funds Funds Interest Total (Figure Closing
O. District Balance as Transfer transfer used by earned in funds in RS) balance
on by State by the the the available Expendi as on
01.04.2020in exclusively Districts Districts Constructio with tue the last
cluding for out of out of n worker District incurred date of
interest up Constructi common common Bank for for reportin
to 31.3.2020( on worker pools pools Accounts( Constru Constru g month
as per Grant( bank grant from ction ction availabl
Audited from account for 1.4.2020 till worker worker e with
balance 1.4.2020 to making the end of Activitie during District
sheet of till the end Constru payment reporting s( on the 2020-21( under
2019-20) of ction for month) last day from Constru
reporting worker Constru of 1.4.2020 ction
1 month) Bank ction 5 reportin till the worker
Account worker g month end of Funds
2 ( from Activitie before reportin
1.4.2020 s ( i.e expendit g 8=6-7
till the payment ure) month)
end of made by
reportin Districts 6=1+2+3 7
g out of +4+5
month) Commo
n pool
3 bank
account
for
Constru
ction
worker
Activitie
s)( from
1.4.20
till the
end of
reportin
g
month)

4

1 Ambala 0.00 0.00

2 Bhiwani 0.00 0.00
Charkhi
0.00 0.00
3 Dadri
Faridaba 0.00 0.00

4 d 0.00 0.00
Fatehab
0.00 0.00
5 d
0.00 0.00
6 Gurgaon
0.00 0.00
7 Hissar

8 Jind

9 Jhajjar
10 Karnal 0.00 0.00
11 Kaithal
0.00 0.00
Kuruksh
12 etra 0.00 0.00
13 Mewat
14 Narnaul 0.00 0.00
15 Palwal
0.00 0.00
Panchkul
16 a 0.00 0.00
17 Panipat
18 Rohtak 0.00 0.00
19 Rewari
20 Sirsa 0.00 0.00
21 Sonepat
0.00 0.00
Yamuna
22 nager 0.00 0.00

Total 0.00 0.00

Verified by the 0.00 0.00

DAM 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

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

S.N Name of Opening Funds Funds Interest Total funds (Figure in Rs Closing
O. District Balance Tranfer by used by earned in available balance
as on State the the HUDA with District Expenditue as on
01.04.20 exclusively for Districts Grant for HUDA incurred for the last
20 HUDA Grant out of Bank Grant HUDA Grant date of
includin during 2020- common Accounts( Activities Activities reporti
g 21( from pools from during 2020- ng
interest 1/4/20 till the grant for 1/4/20 till 5=1+2+3+4 21( up to the month
up to end of making the end of end of availabl
31.3.202 reporting payment reporting reporting e with
0( as per month) for month) month) District
Audited HUDA under
balance 2 Grant 4 HUDA
sheet of Activitie Grant
2019-20) s( i.e
payment 6 7=5-6
1 made by
Districts
out of
Common
pool
bank
account
for
HUDA
Grant
Activitie
s)( from
1/4/20
till the
end of
reportin
g month)

3

1 Ambala 0.00 0.00

2 Bhiwani 0.00 0.00
CharkhiDad
0.00 0.00
3 ri
0.00 0.00
4 Faridabad
5 Fatehabd 0.00 0.00
6 Gurgaon
7 Hissar 0.00 0.00
8 Jind
9 Jhajjar 0.00 0.00

10 Karnal 0.00 0.00
11 Kaithal
0.00 0.00
Kurukshetr
12 a 0.00 0.00

0.00 0.00
13 Mewat 0.00 0.00
0.00 0.00
14 Narnaul 0.00 0.00
0.00 0.00
15 Palwal 0.00 0.00
0.00 0.00
16 Panchkula 0.00 0.00
0.00 0.00
17 Panipat 0.00 0.00

18 Rohtak

19 Rewari

20 Sirsa

21 Sonepat 0.00 0.00
Yamunana

22 ger

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.N Name of Opening Funds Funds Interest Total funds (Figure in Rs) Closing
O. District Balance Tranfer by used by earned in available with Expenditue balance
as on State the the PWD District for incurred for as on
01.04.20 exclusively for Districts Grant PWD Grant PWD Grant the last
20 PWD out of Bank Activities Activities date of
includin Activities common Accounts( during 2020- reporti
g during 2020- pools from 5=1+2+3+4 21( till the ng
interest 21( from grant for 1/4/20 till end of month
up to 1/4/2020 till making the end of reporting availabl
31.3.202 the end of payment reporting month) e with
0( as per reporting for PWD month) District
Audited month) Grant 6 under
balance Activitie 4 PWD
sheet of 2 s( i.e Grant
2019-20) payment
made by 7=5-6
1 Districts
out of
Common
pool
bank
account
for PWD
Grant
Activitie
s)( from
1/4/20
till the
end of
reportin
g month)

3

1 Ambala 0.00 0.00
2 Bhiwani
0.00 0.00
CharkhiDad
3 ri 0.00 0.00
4 Faridabad
5 Fatehabd 0.00 0.00
6 Gurgaon
7 Hissar 0.00 0.00
8 Jind
9 Jhajjar 0.00 0.00
10 Karnal
11 Kaithal 0.00 0.00

Kurukshetr 0.00 0.00
12 a
13 Mewat 0.00 0.00
14 Narnaul
0.00 0.00

0.00 0.00

0.00 0.00

0.00 0.00
15 Palwal 0.00 0.00

16 Panchkula 0.00 0.00

17 Panipat 0.00 0.00

18 Rohtak 0.00 0.00

19 Rewari 0.00 0.00

20 Sirsa 0.00 0.00

21 Sonepat 0.00 0.00
Yamunana
0.00 0.00
22 ger

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 Fun Fun Fun Fu Fun Fu Fun Fun Fun Interest Net Tota Expe Closi

N of nin ds ds ds nds ds nds ds ds ds credited in Fund l ndit ng

O District g rele tran use tra use tra use trans used the bank availabl fund ure balan

. Bal ase sfer d nsf d nsf d fer by accounts of e with s incu ce as

anc d by by by er by er by by the A, B and C( Districts avail rred on

e as Stat the the by the by the the Distr Districts,CH for able by the

on e to Dist Dist the Dist the Dist Distr icts C/DH/SDH/ RCH, with Distr last

01.0 Dist rict rict Dis rict Dis rict icts out PHC/SC Mission Distr icts day

4.20 rict s s tric s tric s out of level)( from and ict for of

20 s out out ts out ts out of com 1.4.2020 till routine for RCH repor

incl und of of out of out of com mon the end of immuni RCH , ting

udi er com com of com of com mon pools reporting zation , Miss mont

ng Co mo mo co mo co mo pools gran month) activitie Miss ion h

inte mm n n mn mn to t for s( i. e ion and avail

rest on pool poo mo poo mo poo Cons maki for Part and routi able

up pool s to ls n ls n ls truct ng A, B Rout ne with

to ( NU gra poo gra poo gra ion pay and C ine imm Distri

31.3 fro HM nt ls nt ls nt work ment Activitie imm unza ct

.202 m ban for to for ban for er for s) ( till unza tion unde

0( 1.4. k ma Pul ma k ma Ban Cons the end tion activ r

as 202 acc kin se kin acc kin k truct of Acti ities( RCH,

per 0till oun g Pol g oun g acco ion reportin vities i.e Missi

Au the ts( pay io pay t pay unts( work g ( i.e for on

dite end fro me Ba me to me from er month) for Part and

d of m nt nk nt IM nt 1.4.2 Acti Part A, B Routi

bal rep 1.4. for acc for R for 020 vities A, B and ne

anc orti 202 NU oun Pul Ba IM till ( i.e and C immu

e ng 0till HM ts( se nk R the pay C Acti nizati

she mo the ( i.e fro poli Acc Acti end ment Acti vities on(

et nth) end pay m o( oun viti of mad vities )( i.e for

of of me 1.4. i.e t( es( repo e by )( till from Part

201 rep nt 202 pay fro i.e rting Distr the 1.4.2 A, B

9- orti ma 0 me m pay mont icts end 020 and

20) ng de till nt 1.4. me h) out of till C

mo by the ma 201 nt of repo the Activ

nth) Dist end de 8 ma Com rting end ities)

rict of by till de mon mont of

s rep Dist the by pool h) repo

out orti rict end Dist bank ritng

of ng s of rict acco mont

Co mo out rep s unt h)

mm nth of orti out for

on ) Co ng of Cons

poo mm mo Co truct

l on nth mm ion

ban poo ) on work

k l poo er

acc ban l activ

oun k ban ities)

t acc k (

for oun acc from

NU t oun 1.40.

HM for t 020

acti Pul for till

viti se IM the

es)( poli R end

fro o acti of

m acti viti repo

1.4. viti es)( rting

202 es)( fro mont

0 fro m h)

till m 1.4.

the 1.4. 202

end 202 0

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=1
3-14
- +12
0.00
(3+4+5+

6+7+8+

9+10)

Amb 0.00 0.00
1 ala
0.00 0.00 0.00
Bhiw
2 ani 0.00 0.00 0.00

Char 0.00 0.00 0.00
khiD
3 adri 0.00 0.00 0.00
Farid
4 abad 0.00 0.00 0.00
Fate
5 habd 0.00 0.00 0.00
Gurg
6 aon 0.00 0.00 0.00
Hissa
7 r 0.00 0.00 0.00

8 Jind 0.00 0.00 0.00
Jhajj
0.00 0.00 0.00
9 ar
0.00 0.00 0.00
1 Karn
0 al 0.00 0.00 0.00

1 Kaith
1 al

Kuru
1 kshet
2 ra

1 Mew
3 at

1 Narn
4 aul
1 Palw

5 al 0.00 0.00 0.00

1 Panc

6 hkula 0.00 0.00 0.00

1 Pani

7 pat 0.00 0.00 0.00

1 Roht

8 ak 0.00 0.00 0.00

1 Rew

9 ari 0.00 0.00 0.00

2

0 Sirsa 0.00 0.00 0.00

2 Sone

1 pat 0.00 0.00 0.00

Yam
2 unan

2 ager 0.00 0.00 0.00

Total 0.00 0.00 0.00 0.00 0.0 0.0

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

S.N Name of Opening Funds Funds Interest Total funds (Figure in Rs Closin
O. District Balance as on transfer by used by earned in available Expenditue g
01.04.2020inclu the Districts the the with District incurred for balanc
ding interest out of Districts NUHM for NUHM NUHM e at the
up to common out of Bank Activities( Activities end of
31.3.2020( as pools bank commo Accounts( up to during 2020- reporti
per Audited account to n pools from reporting 21( from ng
balance sheet NUHM Bank grant 1.4.2020 month) 1.4.2020 till month
of 2019-20) Account( up for till the the end of for
to reporting making end of 5=1+2+3+4 reporting NUHM
1 month i.e paymen reporting month) funds
from t for month)
1.4.2020 to NUHM 6 7=5-6
the end of Activitie 4
reporting s( i.e
month) paymen
t made
2 by
Districts
out of
Commo
n pool
bank
account
for
NUHM
Activitie
s)( from
1.4.2020
till the
end of
reportin
g
month)

3

Ambala 0.00 0.00
2 Bhiwani
0.00 0.00
CharkhiDa
3 dri 0.00 0.00
4 Faridabad
5 Fatehabd 0.00 0.00
6 Gurgaon
7 Hissar 0.00 0.00

8 Jind 0.00 0.00

9 Jhajjar 0.00 0.00
10 Karnal
11 Kaithal 0.00 0.00

Kurukshetr 0.00 0.00
12 a
0.00 0.00

0.00 0.00
13 Mewat 0.00 0.00
14 Narnaul
15 Palwal 0.00 0.00
16 Panchkula
17 Panipat 0.00 0.00
18 Rohtak
19 Rewari 0.00 0.00
20 Sirsa
21 Sonepat 0.00 0.00

Yamunana 0.00 0.00
22 ger
0.00 0.00
Total
0.00 0.00
Verified by the
0.00 0.00
DAM
0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00

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: ………………………………….
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 RogiKalyanSaminites (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 District Name of Phone Number Number Number Number
Health Welfare DAM/AA Number of of CHC of DH of SDH of PHC
1 Society Dam/AA
2 Mr. Kunal 5 1 2 16
3 District Health & 7015996787 2
4 Family Welfare 1
5 Society , Ambala Mr. Jatinder 9215818018 10 3 34
6 District Health & Dull 1
Family Welfare
Society , Bhiwani Mr. 7015999136 4 1 0 12
District Health &
Family Welfare BharatBhushan 2
Society ,
CharkhiDadri Mr. Sandeep 7015996584 2 1 12
District Health & Jain
Family Welfare
Society , Mr. 9315611999 5 1 18
Faridabad
District Health & ArunBansal
Family Welfare
Society , Mr. Sandeep 701599687 3 2 10
Fathehabad
District Health &
Family Welfare
Society , Gurgaon

7 District Health & Mr. AmitGarg 7015999138 8 1 2 27

Family Welfare

Society , Hissar

8 District Health & Mr. 7015997456 6 1 2 22

Family Welfare PankajVerma

Society , Jhajjar

9 District Health & Mr. Hemant 7015996591 7 1 1 21

Family Welfare

Society , Jind

10 District Health & Mrs. Reena 9466829830 6 1 0 17

Family Welfare (AA)

Society , Kaithal

11 District Health & Mr. Ranbeer 9896730808 6 1 1 19

Family Welfare

Society , Karnal

12 District Health & Mr. Dinesh 9541131086 5 1 0 16

Family Welfare Saini

Society ,

Kurukshetra
13 District Health & Ms. 7015999077 7 1 1 18

Family Welfare Poojayadav

Society ,

Narnaoul

14 District Health & Mr. Rishi Raj 7015520635 3 1 0 15

Family Welfare

Society , Mewat

15 District Health & Mr. Jatinder 8930024765 7 1 2 13

Family Welfare

Society , Palwal

16 District Health & Mrs. Yogita 9729745110 4 1 0 16

Family Welfare

Society , Panipat

17 District Health & Mr. 8708718100 2 1 0 8

Family Welfare ManojBansal

Society ,

Panchkula

18 District Health & Mrs. Radha 7015999094 5 1 1 13

Family Welfare

Society , Rewari

19 District Health & Mr. Ajay 7015996596 7 1 0 16

Family Welfare Dhingra

Society , Rohtak

20 District Health & Mr. 7015996604 8 2 0 21

Family Welfare AnshuMunjal

Society , Sirsa

21 District Health & Ms. Supriya 7015999146 6 1 1 29

Family Welfare

Society , Sonipat

22 District Health & Mrs. Sunita 7015999148 7 1 1 12

Family Welfare

Society ,

Yamunanagar

Total 123 2 21 385
Appendix F: Technical Evaluation and Selection Methodology

S.no Particulars Notes Maximum Marks Obtained
Marks

No of Partners- 1 10

1 FCA/ACA/FCMA/ACMA

Year of experience( Partner

A+Partner B+ Partner C and 2 10

2 more)

3 No of Staff (Qualified CA) 3 10

Nature of Experience 4 20
(RCH,NRHM,NHM
Audit/Government
4 Concurrent Audit

5 Branches in State/Districts 5 10

Total Turnover of the firm for 6 10

previous three years i.e 2016-

6 17, 2017-18 & 2018-19)

Total 70

Note: 1.All the relevant documents must be attached with the Technical Proposal so that
Audit committee may analysis the proposal

Note2: Minimum Eligible marks : 70 % may be treated as minimum qualifying marks for
opening financial bids.
Notes:
1. 3marks 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. 5 marks for each Qualified CA/CMA subject to maximum 10 marks.

4. RCH,NRHM,NHM Audit/Government Audit
i) 5 marks for each RCH,NRHM,NHMComplete Concurrent audit subject to
maximum 10 Marks.
ii) 5 marks for each Government Complete Concurrent audit subject to
maximum 10 Marks.

5. (a) 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. However, 5 Marks for CA/CMA Firms having Head
Office/Branch in the State of Haryana
(b) In case of Concurrent audit of State Health Society: 10 marks for
CA/CMA Firm having Head Office/Branch in the Tricity(Panchkula, Mohali
and Chandigarh). However, 5 Marks for CA/CMA Firms having Head
Office/Branch in the State of Haryana

6. Average turnover for last Three Years upto 5 Lacs –NIL. 1 Marks for each
additions 1 Lacs , subject to maximum of 10 marks. (Note: Fractions should
be ignored)
Important notes:
1. The base minimum figures/threshold will be 70% 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 duly verified by Firms must be attached with the
proposal so that the Audit committees can analysis the proposal of Firms.
Appendixe- G(Yes/No )

Is

entri

Name es
of
are
SHS/
S DHS/ CA LED TRIA B STOC FIXE ADVA CHE SKS Miscell Fun Sala comp
r. GH / SH GER L R K D NCE QUE MEE aneous d ry leted
N SDH BO S REGI ISSUE TING Registe Regi
o / OK BAL REGI ASSE STER REGI REGI Reci ster in
ANC STER TS STER STER r ved Tally
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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 Clarical Staff (Please Specify)____________________________________________________
Turnover of the firm during past three years
2016-17 ________________________________
2017-18________________________________
2018-19 _______________________________
(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

Concurrent Audit) 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
Signature Not Verified

Digitally signed by SANJAY VISHNOI
Date: 2020.11.26 13:28:07 IST
Location: Haryana-HR