State Health Society,
National Health Mission,
HEALTH DEPARTMENT, HARYANA
BAYS NO. 55-58, SECTOR-2, PANCHKULA
Tel. No. 0172-2573922/ Fax: 0172-2562939
E-TENDER for Appointment of Concurrent Auditor for State Health Society,
Haryana for Audit of all programmes under NHM & Non NHM
Cost of Tender Document: Rs. 500/-
National Health Mission, Haryana
Bays no 55-58 Sec-2
Panchkula
e-TENDER NOTICE
Tender notice no. 5935 Dated:-28.11.2018
TENDER for Appointment of Concurrent Auditor for State Health Society, Haryana
E-tenders are invited online by the o/o Mission Director, National Health Mission,
Panchkula Haryana in two bid system (i.e. Part-I: Technical Bid and Part II: Financial Bid) for
hiring of services of Chartered Accountant Firms & Cost Accountant Firms for carrying out
Concurrent Audit of Accounts Records of State Health Societies , Haryana for 2018-19.
1. The detailed tender document can be downloaded from the website
www.etenders.hry.nic.in & filled up from 03-12-2018 to 18.12.2018 (upto 1.00 PM)
2. Important dates for the tender are as follows:-
Start Date & Time of Bid Preparation & : 03-12-2018 10:30 hours
Submission
Pre Bid Meeting : 11-12-2018 11:30 hours
Last Date & Time for Tender Document : 18-12-2018 11:00 hours
Fees deposit ( non refundable)
Closing Date & Time of Bid Preparation : 18-12-2018 13:00 hours
& Submission
Technical Bid opening : 18-12-2018 15:00 hours
Date and time of Opening financial Bids Opening date of Financial Bid Will be
intimated later on after evaluation of
Technical Bid
Email address for communication for dfa.rhm@gmail.com
any queries/clarifications.
3. The interested CA/CMA Firms may submit the tenders online at
www.etenders.hry.nic.in(i.e. Part-I: Technical Bid and Part II: Financial Bid) in the
prescribed Performa. All the documents in support of eligibility criteria etc. are also to
be scanned and uploaded during tender preparation and at submission stage. Tenders
should be submitted online only, however The Bidders shall also dropped original copy
of Technical Bids along with related documents and Demand Drafts for Tender Fee in
tender box kept at O/o Mission Director, NHM, Sector-2, Panchkula on or before the
last date and time of submission of the E-tender on portal.
4. 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.
5. The Bidder must be registered in e-procurement portal (www.etenders.hry.nic.in) and
obtain valid class III Digital Signature Certificate (DSC) as per Information Technology
(IT) Act,2000.
6. The Bidder is responsible for checking the e-procurement portal on regular basis for
notification/amendments to the tender(if any).
Proposal documents without tender fee will be rejected.
-sd-
Mission Director
National Health Mission, Haryana
INTRODUCTION
National Health Mission is a mission of Government of India to address the health needs
of rural areas and Urban areas. NHM essentially focuses on strengthening health facilities
and services up to the district level in urban and rural areas. NHM envisages achievement
of universal access to equitable, affordable& quality health care services that are
accountable and responsive to people's needs. In order to strengthen better
communication facilities with the health functionaries at basic health care level viz:
SCs,PHCs,CHCs, Urban Health Centers etc. and to facilitate monitoring and supportive
supervision of various health activities, programmes under NHM as a part of routine
procurement process,
IMPORTANT INFORMATION
1. Tender Inviting Authority, Designation Mission Director, National Health Mission, Bays
and Address No. 55-58, Sector-2, Panchkula. Tel. No. 0172-
2573922/ Fax: 0172-2562939
Name of Work E-TENDER for Appointment of Concurrent
Auditor for State Health Society, Haryana for Audit
of all programmes under NHM & Non NHM.
Tender reference No. NHM/E-tender/Con.Audit/2018/-19/_______
Publication of Tender document and Tender document & notice are available at
Tender Notice on Website www.etenders.hry.nic.in from 03-12-2018 by 10:30
am
Tender document availability for 03-12-2018 by 10:30 am onwards
bidding
2. Cost of Bidding (a). The payment for Tender Document fee Rs 500/-
( Rupees Five Hundred Only) can be deposited in
the form of DD/Banker Cheque in favour of State
Health Society, Haryana payable at Panchkula by
the Bidders who apply for the Concurrent Audit of
State Health Society, Haryana. The bid fees shall be
deposited in the O/o Mission Director, NHM,
Sector-2, Panchkula on or before the last date and
time of Tender Fees submission.
(b) The bidder shall submit the scanned copy of
DD/banker cheque along with technical bid online.
The bid fee is non-refundable. The bidder shall bear
all costs associated with preparation and submission
of bids and NHM Haryana will not be liable for the
cost incurred, regardless of the outcome of the
bidding process.
4. Queries/clarifications/suggestions May be send in writing through e-mails at below
related to tender document. mentioned e-mail IDs (dfa.rhm@gmail.com) latest
by 08-12-2018 till 4:00 pm
Note:- No queries/clarification will be entertained
after 08-12-2018.
a) Email address for communication dfa.rhm@gmail.com
5. for any queries/clarifications
b) Clarification to vendor query 13-12-2018 till 4:00 pm.
/release of corrigendum/ (if required
by Committee)
6. Last date & time for submission of e- 18-12-2018 till 1:00 pm
Tender
7. Date and Time of Opening of 18-12-2018 at 3:00 pm
Technical Bids
8. Date and time of Opening Commercial/ Will be intimated later on
financial Bids
9. Validity of e-bids 90 days from the date of opening of e-bids
10. Validity of price bid after finalization 1 Year from date of award of work order
of successful bidder
11. i. Eligibility Criteria: Refer to Tender Document.
ii. Two Bid system i.e. Stage- 1 Prequalification cum Technical Bid:
Stage 2 Financial Bids.
iii. Bidder(s) will submit the sealed hard copy of technical bid as uploaded on above
mentioned website upto the last date and time of submission of e-tender i.e.18-12-2018
till 1:00 p.m. The hard copy must be submitted in the O/o National Health Mission ,
Bays no 55-58 Sector-2 Panchkula ( Haryana) by the Bidders who apply for the
Concurrent Audit of State Health Society, Haryana .
v. Final decision will be as per the description of Technical & Financial evaluation.
Sd/-
Mission Director
National Health Mission, Haryana
Procedures for submitting Tenders
1. Under this process, the Technical online bid Application as well as online
Price Bid shall be invited online at single stage i.e. Technical & Financial
Bid. Eligibility and qualification of the Applicant will be first examined
based on the details submitted online under first cover (Technical Bids)
with respect to eligibility and qualification criteria prescribed in this
Tender document. The Price Bid under the second cover shall be opened
for only those applicants whose Technical Bids Applications are
responsive to eligibility and qualifications requirements as per Tender
document.
2. The Bidders shall have to submit their Bids online in Electronic Format
with Digital Signatures. For participation in the e-tendering process, the
Bidders need to register themselves on www.etenders.hry.nic.in & for
registration, they will be provided with a user ID and a system generated
password enabling them to submit their Bids online using Digital System
Certificates (DSC).
3. Tenders without digital signatures will not be accepted by the Electronic
Tendering System. No Tender will be accepted in physical form and in
case, it has been submitted in the physical form, it shall be rejected
straightway. The interested CA/CMA firms have to submit the tenders
through e-procurement portal as per required packet/cover contents,
however hard copy must be submitted in the O/o National Health
Mission , Bays no 55-58 Sector-2 Panchkula ( Haryana) by the Bidders
who apply for the Concurrent Audit of State Health Society, Haryana
upto the last date and time of submission of e-tender i.e.18-12-2018 till
1:00 p.m.
4. Bids will be opened online as per time schedule mentioned above.
5 National Health Mission, Haryana will not be responsible for any delay
in online submission of the Bids due to any reason whatsoever.
6. The conditional bids shall not be considered and may be out rightly
rejected in very first instance. The Bidders are required to upload self-
attested & scanned copies of the relevant documents required as per
Terms & Conditions, failing which their bids may be out-rightly rejected
and will not be considered.
7. The Financial Bid through e-tendering of only those bidders shall be
opened who will qualify in the technical bid.
8. Technical bid should be in the format given in Appendix-H, duly filling
in all required details and duly signed by the bidder/his authorized
signatory on each page.
9. All the requisite documents must be attached with the Technical bid
duly signed by AUTHORISED SINGNATURED AS SPECIFICED
IN Appendix-H
Evaluation of Technical bids:
Technical Evaluation
The NHM Haryana may incorporate any changes in the RFP based on
acceptable suggestions received from the Vendors. The decision of the
NHM Haryana regarding acceptability of any suggestion shall be final
in this regard and shall not be called upon to question under any
circumstances. The prospective bidders shall submit their
queries/questions in writing through e-mail on dfa.rhm@gmail.com to
reach NHM Office on or before 08-12-2018 up to 4:00 pm.. No
queries/clarifications will be entertained after 08-12-2018. The
responses will be conveyed to all the prospective bidders through
NHM's official website posting by way of information regarding
amendments / clarifications at NHM Haryana website
http://www.nrhmharyana.gov.in and no participant would be
intimated individually about the response of the NHM Haryana.
The eligibility criteria will be first evaluated as defined in Request for
Proposal (RFP) for each bidder. Detailed technical evaluation will be
taken up in respect of only those bidders, who meet with the
prescribed eligibility criteria. Scrutiny of the tender document will be
done by the Audit Committee to determine whether the documents
have been properly signed, Tender Fees paid and all relevant papers
submitted. Tenders not conforming to such requirements will be prima
facie rejected.
General Terms and Conditions
1. E-Bids shall remain valid for 90 days after the date of opening of e-Bids
prescribed by the NHM, Haryana. An e-Bid with validity of a shorter period
than specified shall be rejected by the NHM , Haryana as non-responsive.
2. At any time prior to the date of submission of bid, NHM may for any reason,
whether at its own initiative or in response to a clarification sought/requested
by a prospective bidder, modify the bidding documents by an amendment. All
prospective bidders who have received the bidding document will be notified
of the amendment in writing/through e-mail/website and same will be binding
on them. In order to allow reasonable time, for taking the amendment into
account, NHM may at its discretion, extend the date and time for submission
of bids.
3. NHM Haryana reserves the right to cancel this invitation and / or invite fresh
Proposals with or without amendments to this invitation, without liability or
any obligation for such invitation and without assigning any reason.
Request for Proposal
(RFP)
For Appointment of Concurrent Auditor for
State Health Society, Haryana for Audit of all
programmes under NHM & Non NHM
[2018-19]
REQUEST FOR PROPOSAL (RFP)
State Health Society Haryana, 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 State Health Society ,Haryana under the National Health
Mission for the financial year 2018-19.
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 OR www.nrhmharyana.gov.in
Important Dates & Address are as follow:
Start Date & Time of Bid : 03-12-2018 10:30 hours
Preparation & Submission
Pre Bid Meeting : 11-12-2018 11:30 hours
Last Date & Time for Tender : 18-12-2018 11:00 hours
Document Fees deposit ( non
refundable)
Closing Date & Time of Bid : 18-12-2018 13:00 hours
Preparation & Submission
Technical Bid opening : 18-12-2018 15:00 hours
Particulars Address
Place of pre bid conference for the audit O/o Mission Director, NHM Haryana,
of State Health Society, Haryana Bay No 55-58, Paryattan Bhawan, Sec-
2 Panchkula-134109
Place for opening of Technical & Fin O/o Mission Director, NHM Haryana,
Bids for the Concurrent Audit of State Bay No 55-58, Paryattan Bhawan, Sec-
Health Societies 2 Panchkula-134109
Contact number of State Health 0172-2581516
Societies
E-mail ID of State Health Societies dfa.rhm@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 State Health Society,Haryana
Section 5: Frequency of Concurrent Audit
Section 6: State Audit Committee
Section 7: Auditing Standards to be followed by the CA/CMA Firms
Section 8: Terms for appointment of Concurrent Auditor
Section 9: Content of Concurrent Audit Report & Executive Summary Report
Section 10: Key Timelines
Section 11: Appointment & Selection of Concurrent Auditor (including guidelines
for submission of proposal)
Section 12: District wise detail of Health Institutions Under NHM,HARYANA
Section 13: Responsibility of District Health Societies.
Section 14: Facilitation of the Audit
Section 15: Some important Issues
Section 16: Monitoring & Evaluation
Section 17: Technical evaluation & selection methodology.
Section 18: Monthly Financial Reporting at District level.
Section 19: 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 and Cost & Management Accountant Firms are needed to
be appointed at State level to undertake monthly audit of National Health
Mission( NHM) & Non NHM Programmes.
SECTION 2: BACKGROUND 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 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 State
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 State Health Societies and
expenditure incurred by the SHS.
To audit of Financial Statements of SHS.
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 SHS 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 SHS 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.
Important Note: (1) Concurrent auditor of state health society will function as
nodal auditor for the NHM who will oversee the work of all District
Concurrent Auditors. For ensuring quality and timely completion of the whole
audit exercise, the District Auditors are expected to cooperate and comply with
the directions of the nodal auditor as and when given and will provide
necessary information when demanded.
(2) It must be noted first of all the District Health Society shall compiled the
expenditure report of all health institution on or before 8 th of month and then
concurrent auditors will start monthly audit between 9th to 12th of each month.
(3) Concurrent auditors of State 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 12 th 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 6: STATE AUDIT COMMITTEE
(1) Formation of State Audit Committee
(2) Functions of State Audit Committee
(1) Formation of State Audit Committee
An audit committee is required to be formed at State level for monitoring and
evaluation of Concurrent audit. The member of audit committee should be the
following:
Person Designation in
Committee
Director Finance & Accounts Member Secretary
Deputy Director (NCD) Member
Deputy Director (RNTCP) Member
Programme Officer (NUHM) Member
Sr. Account Officer (NHM) Member
State Finance Manager Member
IPAI Consultant Member
(YOGENDER KUMAR KAUSHIK)
(2) Functions of State Audit Committee
· Selection and appointment of State Concurrent auditors
· Issue of advertisement for appointment of District concurrent
auditor and State Concurrent auditor.
· Final concurrence for the appointment of District concurrent
auditors.
· Monitoring timely audits at State & District level and timely
submission of audit reports.
· Discuss the key audit findings with state concurrent auditor and
suggest appropriate actions.
· Monitoring whether adequate follow up action is being taken by the
State Finance Personnel on the audit observations.
· Authorize the payment of remuneration to the auditor (only after
approving the Action taken report on the issues highlighted during
the course of audit).
· Carrying out an assessment of audits in case the auditors are being
considered to be reappointed.
The State Health Committee should meet at least 4 times in a year.
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
State Level
1. At the state level, the concurrent auditor appointed once can be retained
reappointed for a maximum 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 review of auditor's
performance.
Section 10: Content of Monthly Concurrent Audit Report &
Quarterly Executive Summary Report
(1) Contents of Monthly Concurrent Audit Report &
Quarterly Quarterly Executive Summary Report for State
level Auditors
(1) Content of Monthly Concurrent Audit Report and Quarterly
Executive Summary Report for State level Auditor
It may be noted that the Concurrent Audit Report of a State Health Societies
is required to be submitted on monthly basis and the Executive Summary
Report of State Health Societies is required to be submitted on quarterly
basis.
(a) Content of Monthly Concurrent Audit Report of SHS
(b) Content of Quarterly Executive Summary Report of SHS
(a) Content of monthly concurrent audit report of SHS
The monthly Concurrent Audit report of SHS should contain the following
reports and documents:
· Audited Trail Balance of State Health Societies( including Non
Communicable Disease & Communicable Diseases
Programmes)
· Bank Reconciliation Statement of SHS of all banks including
Non NHM Banks(including Non Communicable Disease &
Communicable Diseases Programmes)
· List of advances of SHS (including Non Communicable
Disease & Communicable Diseases Programmes)
Audited FMR(including Non Communicable Disease &
Communicable Diseases Programmes)
Mandatory Books of Accounts Status(Yes/No format as per
Appendix G)
· Observations and recommendations of auditors particularly covering
the following aspects:
i. Deficiencies noticed in internal control
ii. Suggession to improve the internal control
iii. Extent of non compliance with guidelines issued by GOI.
· Action taken by State Health Societies(including Non Communicable
Disease & Communicable Diseases Programmes) on the previous
audit observations, along with his observations on the same.
Important Notes:.
· 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. 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 SHS
As per Appendix C
SECTION 11: KEY TIMELINES
The Key Timelines which need to be adhered to are summarized below:
Concurrent Audit for the Period April 2018 to December 2018
Activity Timelines for submission of Concurrent
Audit Report and Executive summary
Report
Carrying out Concurrent Audit of State Submission of Quarterly Concurrent Audit
Health Society for the Period April 2018 Report and Quarterly Executive Summary
to June 2018. Report by Concurrent Auditor for the
period April 2018 to June 2018 to State
Health society on or before 11.01.2019.
Carrying out Concurrent Audit of State Submission of Quarterly Concurrent Audit
Health Society for the Period July 2018 to Report and Quarterly Executive Summary
September 2018. Report by Concurrent Auditor for the
period July 2018 to September 2018 to
State Health society on or before
21.01.2019.
Carrying out Concurrent Audit of State Submission of Quarterly Concurrent Audit
Health Society for the Period October to Report and Quarterly Executive Summary
December 2018. Report by Concurrent Auditor for the
period October to December 2018 to State
Health society on or before 31.01.2019
Note: Action taken report for Audit observations for the period April 2018 to
December 2018 is required to be submitted to the State Head Quarter on or
before 15.02.2019
Concurrent Audit from the Period January 2019 onwards
Activity Timelines
Carrying out concurrent audit Monthly
Submission of Audit Report by Auditor to 15th of the next month
SHS
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)
State Level Auditors
· Appointment and selection of the state level concurrent auditor will be done by
the State Audit Committee through e-Tender System. The tender document
would be advertised through a central advertisement at the state level.
· Interested Firms should upload their bids directly at e-tender portal in two parts
Technical and Financial bids. The Bidder should upload scan copy of 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
by dropping in Tender Box kept at O/o Mission Director, NHM, Sector-2,
Panchkula. This should be opened in meeting of the State Audit Committee.
· The Bidder should upload to signed bids documents (all page) technical and
financial bids.
·The State 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.
· 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.
· 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.
·State Health Society (SHS) reserves the right to accept or reject any proposal
without giving any explanation and can change the evaluation criteria as per its
requirements in the interest of the organization.
·CA/CMA Firm 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.
·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].
· Chartered Accountant Firms and Cost & Management Accountant firms are
eligible for participating in tender.
· The bids will be opened by the 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.
Technical & Financial Proposal will consist:
i. Letter of Transmittal ( Form T-1) attached below
ii. Details of the Firm along with Details of Partners (Form T-2 attached at Appendix H)
iii. Financial Bid (Form F-1) attached below
Important note: (1) State Health Society (SHS) reserves the right to accept or
reject any proposal without giving any explanation and 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.
Section 13: DISTRICT WISE DETAIL OF HEALTH
INSTITUTIONS UNDER NHM,HARYANA
Detail attached at Appendix D
Section 14: RESPONSIBILITIES OF STATE HEALTH
SOCIETIES
· Compliance of Audit Observations
The members of State 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
State Health Society 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
SHS 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.
SECTION 15: FACILITATION OF THE AUDIT
The following arrangements need to be made for the auditors by the 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 State Audit Committee Shall meet at least 4 times in a year (i.e. once
every 3 months ) for follow up on the observations made by the auditor.
SECTION 17: MONITORING & EVALUATION
· 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 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 State Level fails to complete the work as
per RFP/TOR or instructions given by the State 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 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 Mission Director
State Health Society(NHM)
Dear Sir/Madam,
We, the undersigned, offer to provide the audit services for State Health Societies 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.
Opening
Balance
as on
1/4/18 Total Fund
including available
interest Fund with
up to received Interest Districts Expenditure
31/3/19( during earned ( during incurred Closing
as per 2018-19( from 2018-19( during balance as
the up to the 1/4/18 till till the end 2018-19( till on the last
audited end of the end of of the end of date of
Name of balance reporting reporting reporting reporting reporting
S.no District sheet) month) month) month month) month
1 2 3 4=1+2+3 5 6=4-5
1 Ambala 0 0
2 Bhiwani 0 0
3 Faridabad 0 0
4 Fatehabd 0 0
5 Gurgaon 0 0
6 Hissar 0 0
7 Jind 0 0
8 Jhajjar 0 0
9 Karnal 0 0
10 Kaithal 0 0
11 Kurukshetra 0 0
12 Mewat 0 0
13 Narnaul 0 0
14 Palwal 0 0
15 Panchkula 0 0
16 Panipat 0 0
17 Rohtak 0 0
18 Rewari 0 0
19 Sirsa 0 0
20 Sonepat 0 0
21 Yamunanager 0 0
Total 0 0 0 0 0 0
Monthly Fund Status of NLEP Grant
Figures in Rs.
Opening
Balance as on Expendit
1/4/18 Fund Interest ure
including received earned ( Total Fund incurred Closing
interest up to during from available with during balance
31/3/19( as 2018-19( 1/4/18 Districts 2018-19( as on the
per the up to the till the during 2018- till the last date
audited end of end of 19( till the end end of of
S.n Name of balance reporting reporting of reporting reporting reporting
o District sheet) month) month) month month) month
1 2 3 4=1+2+3 5 6=4-5
1 Ambala 0 0
2 Bhiwani 0 0
3 Faridabad 0 0
4 Fatehabd 0 0
5 Gurgaon 0 0
6 Hissar 0 0
7 Jind 0 0
8 Jhajjar 0 0
9 Karnal 0 0
10 Kaithal 0 0
11 Kurukshetra 0 0
12 Mewat 0 0
13 Narnaul 0 0
14 Palwal 0 0
15 Panchkula 0 0
16 Panipat 0 0
17 Rohtak 0 0
18 Rewari 0 0
19 Sirsa 0 0
20 Sonepat 0 0
Yamunanag
21 er 0 0
Total 0 0 0 0 0 0
Monthly Fund Status of IDSP Grant
Figures in Rs.
Total Fund
Fund Interest available with Expenditure
Opening Balance received earned ( Districts incurred Closing
as on 1/4/18 during 2018- from during 2018- during 2018- balance as
including interest 19( up to 1/4/18 till 19( till the 19( till the on the last
up to 31/3/19( as the end of the end of end of end of date of
Name of per the audited reporting reporting reporting reporting reporting
S.no District balance sheet) month) month) month month) month
1 2 3 4=1+2+3 5 6=4-5
1 Ambala 0 0
2 Bhiwani 0 0
3 Faridabad 0 0
4 Fatehabd 0 0
5 Gurgaon 0 0
6 Hissar 0 0
7 Jind 0 0
8 Jhajjar 0 0
9 Karnal 0 0
10 Kaithal 0 0
11 Kurukshetra 0 0
12 Mewat 0 0
13 Narnaul 0 0
14 Palwal 0 0
15 Panchkula 0 0
16 Panipat 0 0
17 Rohtak 0 0
18 Rewari 0 0
19 Sirsa 0 0
20 Sonepat 0 0
Yamunanag
21 er 0 0
Total 0 0 0 0 0 0
Monthly Fund Status of NVBDCP Grant
Figures in Rs.
Opening
Balance
as on
1/4/18 Total Fund
including Fund available
interest received Interest with Expenditure
up to during earned ( Districts incurred Closing
31/3/19( 2018-19( from during during balance as
as per the up to the 1/4/18 till 2018-19( till 2018-19( till on the last
audited end of the end of the end of the end of date of
Name of balance reporting reporting reporting reporting reporting
S.no District sheet) month) month) month month) month
1 2 3 4=1+2+3 5 6=4-5
1 Ambala 0 0
2 Bhiwani 0 0
3 Faridabad 0 0
4 Fatehabd 0 0
5 Gurgaon 0 0
6 Hissar 0 0
7 Jind 0 0
8 Jhajjar 0 0
9 Karnal 0 0
10 Kaithal 0 0
11 Kurukshetra 0 0
12 Mewat 0 0
13 Narnaul 0 0
14 Palwal 0 0
15 Panchkula 0 0
16 Panipat 0 0
17 Rohtak 0 0
18 Rewari 0 0
19 Sirsa 0 0
20 Sonepat 0 0
21 Yamunanager 0 0
Total 0 0 0 0 0 0
APPENDIX-A (FINA NCIAL REPORTING FOR NON- COMMUNICABLE DISEASE)
Monthly Fund Status of NPCDCS Grant
Figures in Rs.
Opening
Balance as
on 1/4/18 Total Fund
including Fund available
interest up received Interest with Expenditure Closing
to during earned ( Districts incurred balance
31/3/19( 2018-19( from during during as on the
as per the up to the 1/4/18 till 2018-19( till 2018-19( till last date
audited end of the end of the end of the end of of
Name of balance reporting reporting reporting reporting reporting
S.no District sheet) month) month) month month) month
1 2 3 4=1+2+3 5 6=4-5
1 Ambala 0 0
2 Bhiwani 0 0
3 Faridabad 0 0
4 Fatehabd 0 0
5 Gurgaon 0 0
6 Hissar 0 0
7 Jind 0 0
8 Jhajjar 0 0
9 Karnal 0 0
10 Kaithal 0 0
11 Kurukshetra 0 0
12 Mewat 0 0
13 Narnaul 0 0
14 Palwal 0 0
15 Panchkula 0 0
16 Panipat 0 0
17 Rohtak 0 0
18 Rewari 0 0
19 Sirsa 0 0
20 Sonepat 0 0
21 Yamunanager 0 0
Total 0 0 0 0 0 0
Monthly Fund Status of NPHCE Grant
Figures in Rs.
Opening
Balance
as on Total Fund
1/4/18 available
including Interest with
interest Fund earned ( Districts Expenditure Closing
up to received from during incurred balance
31/3/19( during 2018- 1/4/18 2018-19 ( during as on the
as per the 19( up to the till the till the 2018-19 ( last date
audited end of end of end of till the end of
Name of balance reporting reporting reporting of reporting reporting
S.no District sheet) month) month) month month) month
1 2 3 4=1+2+3 5 6=4-5
1 Ambala 0 0
2 Bhiwani 0 0
3 Faridabad 0 0
4 Fatehabd 0 0
5 Gurgaon 0 0
6 Hissar 0 0
7 Jind 0 0
8 Jhajjar 0 0
9 Karnal 0 0
10 Kaithal 0 0
11 Kurukshetra 0 0
12 Mewat 0 0
13 Narnaul 0 0
14 Palwal 0 0
15 Panchkula 0 0
16 Panipat 0 0
17 Rohtak 0 0
18 Rewari 0 0
19 Sirsa 0 0
20 Sonepat 0 0
21 Yamunanager 0 0
Total 0 0 0 0 0 0
Monthly Fund Status of NPCB Grant
Figures in Rs.
Opening
Balance
as on
1/4/18 Total Fund
including Fund available
interest received Interest with Expenditure Closing
up to during earned ( Districts incurred balance
31/3/19 ( 2018-19( from during during as on the
as per the up to the 1/4/18 till 2018-19 ( 2018-19 ( last date
audited end of the end of till the end till the end of
Name of balance reporting reporting of reporting of reporting reporting
S.no District sheet) month) month) month month) month
1 2 3 4=1+2+3 5 6=4-5
1 Ambala 0 0
2 Bhiwani 0 0
3 Faridabad 0 0
4 Fatehabd 0 0
5 Gurgaon 0 0
6 Hissar 0 0
7 Jind 0 0
8 Jhajjar 0 0
9 Karnal 0 0
10 Kaithal 0 0
11 Kurukshetra 0 0
12 Mewat 0 0
13 Narnaul 0 0
14 Palwal 0 0
15 Panchkula 0 0
16 Panipat 0 0
17 Rohtak 0 0
18 Rewari 0 0
19 Sirsa 0 0
20 Sonepat 0 0
21 Yamunanager 0 0
Total 0 0 0 0 0 0
Monthly Fund Status of Mental Health
Figures in Rs.
Opening
Balance as Total Fund
on 1/4/18 available
including Fund with
interest received Interest Districts Expenditure Closing
up to during earned ( during incurred balance
31/3/19 ( 2018-19 ( from 2018-19( during as on the
as per the up to the 1/4/18 till till the end 2018-19( till last date
audited end of the end of of the end of of
Name of balance reporting reporting reporting reporting reporting
S.no District sheet) month) month) month month) month
1 2 3 4=1+2+3 5 6=4-5
1 Ambala 0 0
2 Bhiwani 0 0
3 Faridabad 0 0
4 Fatehabd 0 0
5 Gurgaon 0 0
6 Hissar 0 0
7 Jind 0 0
8 Jhajjar 0 0
9 Karnal 0 0
10 Kaithal 0 0
11 Kurukshetra 0 0
12 Mewat 0 0
13 Narnaul 0 0
14 Palwal 0 0
15 Panchkula 0 0
16 Panipat 0 0
17 Rohtak 0 0
18 Rewari 0 0
19 Sirsa 0 0
20 Sonepat 0 0
21 Yamunanager 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)
Openi
ng
Funds
Balan Closing
released Total
ce as balance
by the availa Total
on as on the
State Interest bity Expend
01.04. last date
Health earned of iture
2018 Incent Pay of
Society on funds Mont on
includ ives to ment reportin
exclusivel ASHA/ with hly ASHA/
ing ASHA to g month
y for the ANM DHS Monthly adde ANM
intere for AN availabl
payment funds( for fixed d State
st up facilita Ms( e with
SR. DISTRICT to from paym honorari incen Budget
to ting out Districts
NO. S NAME ASHAs/A 1.4.201 ent to um to tives ( from
31.3.2 institu of for
NMs out 8 till ASH ASHA( to 1.4.201
019( ional State making
of State the end A, X1) ASH 8 till
as per deliver Budg payment
Budget( of ANM As( the end
Audit ies( et) to
from reporti s out X2) of
ed X3) (X4) ASHAs/
1.4.2018 ng of reporti
balan ANMs
till the month) State ng
ce out of
end of Budg month)
sheet State
reporting et
of Budget
month)
2017-
18)
4=1+ 9=5+6+
1 2 3 5 6 7 8 10=4-9
2+3 7+8
1 AMBALA 0.00 0.00 0.00
2 BIHWANI 0.00 0.00 0.00
FARIDAB
3 AD 0.00 0.00 0.00
FATEHAB
4 AD 0.00 0.00 0.00
GURGAO
5 N 0.00 0.00 0.00
6 HISAR 0.00 0.00 0.00
7 JHAJJAR 0.00 0.00 0.00
8 JIND 0.00 0.00 0.00
9 KAITHAL 0.00 0.00 0.00
10 KARNAL 0.00 0.00 0.00
KURUkest
11 ra 0.00 0.00 0.00
12 MEWAT 0.00 0.00 0.00
NARNAU
13 L 0.00 0.00 0.00
14 PLWAL 0.00 0.00 0.00
PANHKU
15 LA 0.00 0.00 0.00
16 PANIPAT 0.00 0.00 0.00
17 REWARI 0.00 0.00 0.00
18 ROHTAK 0.00 0.00 0.00
19 SIRSA 0.00 0.00 0.00
20 SONIPAT 0.00 0.00 0.00
YAMUNA
21 NAGAR 0.00 0.00 0.00
TOTAL 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Verified by the
Dy Civil Civil Verified by the
DAM Surgeon surgeon Concurrent Auditor
Monthly Fund Status of Districts for IMR Grant
(Figure in
Rs)
S.N Name of Openin Funds Funds Funds Interest earned Total Expenditu Closin
O. District g Transfer by transfe used by in IMR Bank funds e incurred g
Balance State r by the Account( from available for imr balanc
as on exclusively the Districts 1.4.2018 till the with activities e as on
01.04.2 for IMR Distric out of end of District during the
018 Grant( from ts out common reporting for IMR 2018-19( last
includi 1.4.2018 till of pools month) Activities( from day of
ng the end of comm grant for as on the 1.4.2018 reporti
interest reporting on making last date till the ng
up to month) pools payment of end of month
31.3.20 bank for IMR reporting reporting availa
19( as accoun Activities month) month) ble
per t to ( i.e with
Audite IMR payment Distric
d Bank made by t
balance Accou Districts under
sheet of nt( out of IMR
2015- from Common Grant
16) 1.4.201 pool
8 till bank
the account
end of for IMR
reporti activities)
ng ( from
month 1.4.2018
) till the
end of
reporting
month)
1 2 3 4 5 6=1+2+3+ 7 8=6-7
4+5
1 Ambala 0.00 0.00
2 Bhiwani 0.00 0.00
3 Faridabad 0.00 0.00
4 Fatehabd 0.00 0.00
5 Gurgaon 0.00 0.00
6 Hissar 0.00 0.00
7 Jind 0.00 0.00
8 Jhajjar 0.00 0.00
9 Karnal 0.00 0.00
10 Kaithal 0.00 0.00
Kurukshet
11 ra 0.00 0.00
12 Mewat 0.00 0.00
13 Narnaul 0.00 0.00
14 Palwal 0.00 0.00
15 Panchkula 0.00 0.00
16 Panipat 0.00 0.00
17 Rohtak 0.00 0.00
18 Rewari 0.00 0.00
19 Sirsa 0.00 0.00
20 Sonepat 0.00 0.00
Yamunan
21 ager 0.00 0.00
Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Verified by the
Dy Civil Civil Verified by the Concurrent
DAM Surgeon surgeon Auditor
Monthly Fund Status of Districts for Construction worker Grant
(Figure in
RS)
S.N Name of Openin Funds Funds Funds Interest Total Expendit Closing
O. District g Transfer by transfer used by earned in the funds ue balance
Balanc State by the the Construction available incurred as on the
e as on exclusively Districts Districts worker Bank with for last date
01.04.2 for out of out of Accounts( District Construc of
018 Constructio common common from 1.4.2018 for tion reporting
includi n worker pools pools till the end of Construc worker month
ng Grant( from bank grant for reporting tion during available
interest 1.4.2018 till account making month) worker 2018-19( with
up to the end of to payment Activities from District
31.3.20 reporting Construc for ( on the 1.4.2018 under
19( as month) tion Construc last day till the Construc
per worker tion of end of tion
Audite Bank worker reporting reporting worker
d Account( Activities month month) Funds
balanc from ( i.e before
e sheet 1.4.2018 payment expenditu
of till the made by re)
2017- end of Districts
18) reporting out of
month) Common
pool
bank
account
for
Construc
tion
worker
Activities
)( from
1.4.16 till
the end
of
reporting
month)
1 2 3 4 5 6=1+2+3 7 8=6-7
+4+5
1 Ambala 0.00 0.00
2 Bhiwani 0.00 0.00
3 Faridabad 0.00 0.00
4 Fatehabd 0.00 0.00
5 Gurgaon 0.00 0.00
6 Hissar 0.00 0.00
7 Jind 0.00 0.00
8 Jhajjar 0.00 0.00
9 Karnal 0.00 0.00
10 Kaithal 0.00 0.00
Kurukshe
11 tra 0.00 0.00
12 Mewat 0.00 0.00
13 Narnaul 0.00 0.00
14 Palwal 0.00 0.00
Panchkul
15 a 0.00 0.00
16 Panipat 0.00 0.00
17 Rohtak 0.00 0.00
18 Rewari 0.00 0.00
19 Sirsa 0.00 0.00
20 Sonepat 0.00 0.00
Yamunan
21 ager 0.00 0.00
Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Verified by the
Dy Civil Civil Verified by the
DAM Surgeon surgeon Concurrent Auditor
Monthly Fund Status of District for HUDA Grant
(Figure in Rs
S.N Name of Opening Funds Tranfer Funds Interest Total funds Expenditue Closing
O. District Balance by State used by earned in available incurred for balance
as on exclusively for the the HUDA with District HUDA Grant as on
01.04.20 HUDA Grant Districts Grant for HUDA Activities the last
18 during 2018- out of Bank Grant during 2018- date of
includin 19( from common Accounts( Activities 19( up to the reporti
g 1/4/18 till the pools from 1/4/18 end of ng
interest end of grant for till the end reporting month
up to reporting making of month) availabl
31.3.201 month) payment reporting e with
9( as per for month) District
Audited HUDA under
balance Grant HUDA
sheet of Activities Grant
2017-18) ( i.e
payment
made by
Districts
out of
Common
pool
bank
account
for
HUDA
Grant
Activities
)( from
1/4/18 till
the end
of
reporting
month)
1 2 3 4 5=1+2+3+4 6 7=5-6
1 Ambala 0.00 0.00
2 Bhiwani 0.00 0.00
3 Faridabad 0.00 0.00
4 Fatehabd 0.00 0.00
5 Gurgaon 0.00 0.00
6 Hissar 0.00 0.00
7 Jind 0.00 0.00
8 Jhajjar 0.00 0.00
9 Karnal 0.00 0.00
10 Kaithal 0.00 0.00
Kurukshetr
11 a 0.00 0.00
12 Mewat 0.00 0.00
13 Narnaul 0.00 0.00
14 Palwal 0.00 0.00
15 Panchkula 0.00 0.00
16 Panipat 0.00 0.00
17 Rohtak 0.00 0.00
18 Rewari 0.00 0.00
19 Sirsa 0.00 0.00
20 Sonepat 0.00 0.00
Yamunanag
21 er 0.00 0.00
Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Verified by the
Dy Civil Civil Verified by the Concurrent
DAM Surgeon surgeon Auditor
Monthly Fund Status of Districts for PWD Grant
(Figure in Rs)
S.N Name of Opening Funds Tranfer Funds Interest Total funds Expenditue Closing
O. District Balance by State used by earned in available with incurred for balance
as on exclusively for the the PWD District for PWD Grant as on
01.04.20 PWD Districts Grant PWD Grant Activities the last
18 Activities out of Bank Activities during 2018- date of
includin during 2018- common Accounts( 19( till the end reporti
g 19( from pools from 1/4/18 of reporting ng
interest 1/4/2018 till grant for till the end month) month
up to the end of making of availabl
31.3.201 reporting payment reporting e with
9( as per month) for PWD month) District
Audited Grant under
balance Activities PWD
sheet of ( i.e Grant
2017-18) payment
made by
Districts
out of
Common
pool
bank
account
for PWD
Grant
Activities
)( from
1/4/18 till
the end
of
reporting
month)
1 2 3 4 5=1+2+3+4 6 7=5-6
1 Ambala 0.00 0.00
2 Bhiwani 0.00 0.00
3 Faridabad 0.00 0.00
4 Fatehabd 0.00 0.00
5 Gurgaon 0.00 0.00
6 Hissar 0.00 0.00
7 Jind 0.00 0.00
8 Jhajjar 0.00 0.00
9 Karnal 0.00 0.00
10 Kaithal 0.00 0.00
Kurukshetr
11 a 0.00 0.00
12 Mewat 0.00 0.00
13 Narnaul 0.00 0.00
14 Palwal 0.00 0.00
15 Panchkula 0.00 0.00
16 Panipat 0.00 0.00
17 Rohtak 0.00 0.00
18 Rewari 0.00 0.00
19 Sirsa 0.00 0.00
20 Sonepat 0.00 0.00
Yamunanag
21 er 0.00 0.00
Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Verified by the
Dy Civil Civil Verified by the Concurrent
DAM Surgeon surgeon Auditor
APPENDIX-A (FINANCIAL REPORTING FOR PART A,B,C ,POLIO & NUHM)
Monthly Fund Status of Districts for RCH, Mission & Routine immunization activities
(Figure in Rs
S.N Name of Opening Funds Funds Interest Total funds Expenditue Closing
O. District Balance transfer by the used by earned in available with incurred for balance
as on Districts out the the NUHM District for NUHM at the
01.04.20 of common Districts Bank NUHM Activities end of
18 pools bank out of Accounts( Activities( up during 2018- reporti
includin account to common from to reporting 19( from ng
g NUHM Bank pools 1.4.2018 till month) 1.4.2018 till month
interest Account( up to grant for the end of the end of for
up to reporting making reporting reporting NUHM
31.3.201 month i.e from payment month) month) funds
9( as per 1.4.2018 to the for
Audited end of NUHM
balance reporting Activities
sheet of month) ( i.e
2017-18) payment
made by
Districts
out of
Common
pool
bank
account
for
NUHM
Activities
)( from
1.4.2018
till the
end of
reportin
g month)
1 2 3 4 5=1+2+3+4 6 7=5-6
1 Ambala 0.00 0.00
2 Bhiwani 0.00 0.00
3 Faridabad 0.00 0.00
4 Fatehabd 0.00 0.00
5 Gurgaon 0.00 0.00
6 Hissar 0.00 0.00
7 Jind 0.00 0.00
8 Jhajjar 0.00 0.00
9 Karnal 0.00 0.00
10 Kaithal 0.00 0.00
Kurukshetr
11 a 0.00 0.00
12 Mewat 0.00 0.00
13 Narnaul 0.00 0.00
14 Palwal 0.00 0.00
15 Panchkula 0.00 0.00
16 Panipat 0.00 0.00
17 Rohtak 0.00 0.00
18 Rewari 0.00 0.00
19 Sirsa 0.00 0.00
20 Sonepat 0.00 0.00
Yamunanag
21 er 0.00 0.00
Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Verified by the
Dy Civil Civil Verified by the Concurrent
DAM Surgeon surgeon Auditors
Monthly Fund Status of District for Pulse Polio
(Figure in
Rs)
S.N Name of Openin Funds Funds Funds Interest Total Expendit Closin
O. District g transfer by transfe used by earned in the funds ue g
Balance the State to r by the Pulse polio available incurred balanc
as on Districts the Districts Bank with for Pulse e as on
01.04.2 exclusively Distric out of Accounts( District for polio the last
018 for Pulse ts out common from 1/4/2018 Pulse polio Activities date of
includi polio of pools till the end of Activities( during reporti
ng Activities( comm grant for reporting as on last 2018-19( ng
interest from on making month) date of till the month
up to 1/4/2018 till pools payment reporting end of availa
31.3.20 the end of bank for Pulse month reporting ble
19( as reporting accoun polio before month) with
per month) t to Activities( expenditur Distric
Audite Pulse i.e e) t
d Polio payment under
balance Bank made by Pulse
sheet of Accou Districts polio
2017- nt( out of
18) from Common
1/4/201 pool
8 till bank
the account
end of for Pulse
reporti polio
ng Activities)
month ( from
) 1/4/2018
till the
end of
reporting
month)
1 2 3 4 5 6=1+2+3+4 7 8=6-7
+5
1 Ambala 0.00 0.00
2 Bhiwani 0.00 0.00
3 Faridabad 0.00 0.00
4 Fatehabad 0.00 0.00
5 Gurgaon 0.00 0.00
6 Hissar 0.00 0.00
7 Jind 0.00 0.00
8 Jhajjar 0.00 0.00
9 Karnal 0.00 0.00
10 Kaithal 0.00 0.00
Kurukshet
11 ra 0.00 0.00
12 Mewat 0.00 0.00
13 Narnaul 0.00 0.00
14 Palwal 0.00 0.00
15 Panchkula 0.00 0.00
16 Panipat 0.00 0.00
17 Rohtak 0.00 0.00
18 Rewari 0.00 0.00
19 Sirsa 0.00 0.00
20 Sonepat 0.00 0.00
Yamunan
21 ager 0.00 0.00
Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Verified by the
Dy Civil Civil Verified by the Concurrent
DAM Surgeon surgeon Auditors
Appendix B: Quarterly Executive Summary report of DHS
(To be submitted to FMG wing of State Haryana by the District Audit
Committee, District Health & Family Welfare Society.)
Name of District: ........................................
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
Appendix-C: Quarterly Executive summary Report of State Health Society, Haryana
(To be submitted to FMG, MoHFW, GoI by the State Programme Management Support Unit, State
Health Society)
Name of the State HARYANA
For the Quarter ended on ............
Part A: State level issues:
Books of Accounts Reply
1. Whether books of accounts of SHS are
computerized ? if yes, whether any ERP
system has been implemented?-
2. Whether registers related to budget
receipt and control, advances, staff
payments, stock investments etc. are
being maintained properly?
3. Whether the Quarterly FMRs and
Statement of Fund Position are based on
books of accounts and prepared in the
prescribed format?
4. Whether the Quarterly FMR and
Statement of Fund Position are audited by
the concurrent auditor?
Disbursement & utilization of funds
5. Provide a list of advances and total
amount involved which are outstanding
for more than a year. Mention the follow
up action taken for the same.
6. Whether the Provisional Utilization
Certificates sent to GOI have been audited
by the concurrent auditor?
7. Whether there is any significant delay
in disbursing the funds to Districts, after
their receipts from GOI?
8. Whether the posts of State Finance Manager
and State Accounts Manager are filled up? If
vacant, since when?
Monitoring & evaluation Reply
9. Whether the state audit committee has been
meeting at regular intervals? (Indicate the
number of meetings held during the period)-
10. Whether audit observations of the
concurrent auditor have been complied with?-
11. Whether Action Taken Report on
observations has been submitted regularly?
12. Whether the SHS has sent the Acton Taken
Report (ATR) on the last concurrent audit
report of the DHS to the GOI?
Others
13. Whether unification of financial and
accounting processes as per GOI Notification
No.107/FMG/2005-06 dated 14.12.2006 has
been completed?-
14. Whether delegation of Administrative and
Financial powers have taken place as per GOI
guidelines (circulated vide D.O. No. 118/RCH-
Fin/2006-07 dated 1st May, 2007).
Part-B: District Level issues:
Coverage
15. Name of the Districts where monthly
concurrent audit has not taken place (specify
the reason).
16. 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).
17. Number of blocks (district wise) where the
peripheral units have not been visited-.
18. Number of Rogi Kalyan Samities (district
wise) last annual audit has not been done.
Books of Accounts:
Reply
19. Name of the Districts where books of
accounts are not computerized. Provide a
district wise breakup of health facilities for the
same.
20. 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.
21. Name of the Districts where Bank
Reconciliation is not being done on a monthly
basis. Provide a district wise breakup of health
facilities for the same.
Reporting
22. Name of the Districts which have not
submitted the Statement of Fund Position in
the last three months.
23. Name of districts that have not submitted
their Concurrent Audit Report on time. Also
mention the extent of delay.
24. Name of the District which have not
submitted FMRs/ SOEs in the last three months.
25. Name of the Districts where SOEs/ FMRs
are not being submitted in prescribed format..
26. Whether the SOE/FMR submitted by the
districts includes the SOE from all the
Block/CHC/PHC etc. on regular basis and on the
basis of the Books of Accounts only? Report the
exceptions to the same.
27. 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 Reply
28.Number of Districts where Audit Committee
has not been constituted/is not meeting as
regular intervals (Indicate the names).
Others
29. Number of Districts where unification of
finance and accounting processes has not
taken place as per GOI guidelines-.
30. Number of Districts where post of District
Accounts Manager has been vacant more then
3 months.- .
31. Number of districts where Delegation of
Administrative and Financial Powers have not
taken place as per Guidelines
Part-C: 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 , DIRECTOR (FINANCE & ACCOUNTS)
(MISSION DIRECTOR)
State Health Society
ANNEXURE Executive Summary
(To be submitted to FMG, MoHFW, GoI by the State Programme Management Support Unit,
State Health Society)
Name of the District________________________
For the Quarter (due dates: 31st July/31st Oct/31st January/30th April)/ Year
Note: Based on_ the three monthly reports, this report has to be submitted along with the
Quarterly Financial Monitoring Report
Part:-A District level issues:
Coverage
1. Name of the Districts where monthly concurrent audit has not taken
place. (specify the reason)
2. Number of districts where all the blocks have not been covered at least
once in the course of audit. (indicate the numbers in each district)
3. Number of blocks (district wise)where the peripheral units have not been
visited.
4. Number of Rogi Kalyan Saminites (distrct wise) where last annual audit
has not been done.
Book of Accounts
5. Name of the Districts where books of accounts are computerized. Provide
a district wise breakup of health facilities for the same.
6. Name of the Districts where Cash Books are not being maintained/closed
on a daily basis. Provide a district wise breakup of health facilities for the
same.
7. Name of the Districts where bank reconciliations is not being done on a
monthly basis Provide a district wise breakup of health facilities for the
same.
Reporting
8. Name of the Districts which have not submitted the Statement of Fund
Position in the last three months.
9. Name of districts that have not submitted their concurrent audit reports
on time. Also mention the extent of delay.
10. Name of the Districts which have not submitted FMRs/SOEs in the last
three months.
11. Name of the Districts where the SOEs/FMRs are not being submitted in
prescribed format.
12. Whether the SOE/FMR submitted by the districts includes the SOE from
all the Blocks/CHC/PHC etc. on regular basis and on the basis of the Books
of Accounts only? Report the exceptions to the same.
13. Provide a list of advances and total amount involved District- wise which
are outstanding for more than a year. Mention the follow up action taken
for the same.
Audit Committee
14. Number of districts where audit committee has not been constituted/ is
not meeting at regular intervals (Indicate names).
Others
15. Number of Districts where unification of finance and accounting
processes has not taken place as per GOI guidelines.
16. Number of districts where posts of District Accounts Manager has been
vacant for more than 3 months.
17. Number of Districts where Delegation of Administrative and Financial
powers have not taken place as per GOI guidelines (circulated vide D.O.
No 118/RCH-Fin 2006-07 dated 1st may, 2007)
Part-B: Pending issues:
Whether the issues raised in the last Quarterly Executive Summary have been
addressed? List down the details of major pending issues.
CONCURRENT AUDITOR, DISTRICT ACCOUNTS MANAGER
DISTRICT HEALTH & FAMILY WELFARE SOCIETY DISTRICT HEALTH & FAMILY WELFARE SOCIETY
APPENDIX-D Detail of Health Institution Under NHM
Sr. No. Name of District Name of Phone Number Number Number Number
Health Welfare DAM/AA Number of of CHC of DH of SDH of PHC
Society Dam/AA
1 District Health Mr. Kunal 7027822049 5 1 2 16
& Family
Welfare Society ,
Ambala
2 District Health Mrs. Tina 7027817639 10 2 3 34
& Family Singla
Welfare Society ,
Bhiwani
3 District Health Mr. Sandeep 9654218152 2 1 1 12
& Family Jain
Welfare Society ,
Faridabad
4 District Health Mr. Arun 7027819680 5 1 1 18
& Family Bansal
Welfare Society ,
Fathehabad
5 District Health Mr. Sandeep 9654230570 3 2 2 10
& Family
Welfare Society ,
Gurgaon
6 District Health Mr. Parmod 7027830285 8 1 2 27
& Family Saini
Welfare Society ,
Hissar
7 District Health Mr. Virender 7027813707 6 1 2 22
& Family Goyal
Welfare Society ,
Jhajjar
8 District Health Mr. Hemant 7027812056 7 1 1 21
& Family
Welfare Society ,
Jind
9 District Health Mrs. Reena 7027828330 6 1 0 17
& Family
Welfare Society ,
Kaithal
10 District Health Mr. Ranbeer 7027825897 6 1 1 19
& Family
Welfare Society ,
Karnal
11 District Health Mr. Dinesh 7027824418 5 1 0 16
& Family Saini
Welfare Society ,
Kurukshetra
12 District Health Ms. 7027841746 7 1 1 18
& Family Khushboo
Welfare Society , Garg
Narnaoul
13 District Health Mr. Rishi Raj 7027838984 3 1 0 15
& Family
Welfare Society ,
Mewat
14 District Health Mr. Jatinder 7027840457 7 1 2 13
& Family
Welfare Society ,
Palwal
15 District Health Mrs. Yogita 7027826979 4 1 0 16
& Family
Welfare Society ,
Panipat
16 District Health Mr. Manoj 8558897643 2 1 0 8
& Family Bansal
Welfare Society ,
Panchkula
17 District Health Mrs. Radha 7027810788 5 1 1 13
& Family
Welfare Society ,
Rewari
18 District Health Mr. Ajay 7027816596 7 1 0 16
& Family Dhingra
Welfare Society ,
Rohtak
19 District Health Mr. Anshu 7027831551 8 2 0 21
& Family Munjal
Welfare Society ,
Sirsa
20 District Health Ms. Tanisha 7015010266 6 1 1 29
& Family
Welfare Society ,
Sonipat
21 District Health Mrs. Sunita 7027823369 7 1 1 12
& Family
Welfare Society ,
Yamunanagar
Total 119 24 21 373
Appendix F: Technical Evaluation and Selection Methodology
Maximum
S.no Particulars Notes Marks Marks Obtained
No of Partners- 1 10
1 FCA/ACA/FCMA/ACMA
Year of experience( Partner
A+ Partner B+ Partner C and 2 10
2 more)
No of Staff (Qualified CA/Semi
3 10
3 Qualified/Other 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
6 10
previous three years i.e 2015-
6 16, 2016-17 & 2017-18)
Total 70
Note: All the relevant documents must be attached with the Technical Proposal so that Audit
committee may analysis the proposal
Notes:
1. 3 marks for each FCA/FCMA partner and 2 marks for each ACA/ACMA
Partner, subject to maximum of 10 marks. In case of Sole Proprietorship 3
marks in case of FCA/FCMA and 2 marks in case of ACA/ACMA .
2. 1 marks for each 1 completed year experience of each partner with maximum
5 marks for each partner, subject to overall limit of 10 marks for all partners.
In case of sole proprietorship 1 marks for each 1 completed year experience,
subject to maximum 5 marks.
3. i) 3 marks for each Qualified CA/CMA.
ii) 2 marks for each Semi Qualified CA/CMA .
iii)1 marks for each Other clerical Staff
subject to maximum 10 marks.
4. RCH,NRHM,NHM Audit/Government Social Sector Audit/ Other Social
Sector Audits/NGOs - 5 marks for each Complete audit subject to maximum
20 Marks.
5. (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.
6. (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).
7. 2 Marks for each 2 Lakh of Average Turnover for previous three years i.e.
FY 2015-16, 2016-17 and 2017-18 (Any fractions of 2 lakhs will be
ignored), subject to maximum of 10 marks. For Example: Raj & Associates
having turnover for the previous three Financial as follow:-
2015-16- 4.00 Lakh
2016-17- 6.00 Lakh
2017-18- 7.00 Lakh
The Average Turnover of Raj & Associates is 4+5+6 = 5.66 Lakh
3
Then, marks allotted to Raj & Associates is as follow:
Turnover Marks Alloted
2 lakh 2 marks
2 lakh 2 marks
1.66 lakh NIL (any fractions of 2 lakh will be
ignored)
Total- 5.66 lakh Total Marks-4
Important notes:
1. The base minimum figures/threshold will be 60% and CA firms scoring above
the base minimum figure would be deemed to be considered as technically
qualified to undertake the job.
2. Financial bids of only technically qualified firms would be opened by the
committee and audit should be awarded on the basis of Quality cum cost based
selection (QCBS) process, 70% weightage would be given to the Technical
Evaluation and 30% weightage would be given to the financial bid.
3. All the relevant documents must be attached with the proposal so that the Audit
committees can analysis the proposal of Firms.
Appendixe- G(Yes/No )
Is
entri
es
Name
are
of
comp
SHS/ FIXE Fun
TRIA CHE SKS leted
S DHS/ CA STOC D ADVA Miscell d Sala
L B QUE MEE in
r. GH / SH LED K ASSE NCE aneous Reci ry
BAL R ISSUE TING Tally
N SDH BO GER REGI TS REGI Registe ved Regi
ANC S REGI REGI Softw
o / OK STER REGI STER r Regi ster
E STER STER are
CHC STER ster
up to
/
repor
PHC
ting
mont
h?
Appendix:H
Expression of Interest for short listing of Chartered Accountant Firms/Cost & Management
Accountant Firms for the audit of accounts of State Health Societies and District Health
Societies on Monthly basis.
Status of Firm Partnership Sole Proprietorship
1. (a) Name of the Firm (in Capital Letters)_________________________________________________________
(b) Address of the Head Office ____________________________________________________________________
(With Telephone no. & e-mail address)________________________________________________________
________________________________________________________________________________________________
(c) PAN of the Firm ________________________________________________________________________________
2.ICAI/CMA Registration No.___________________________________Region Name__________________________
Region Code __________________________
3. Date of constitution of the firm:_______________________________________________________________
Note: Please attach the copy of the Firm's constitution certificate issued by ICAI/Institute of
Cost Accountant of India as on 01.01.2018
4. Number of Full time Chartered Accountant as on 1st January
2018.................................................
Number of audit staff employed full time with the firm
Articles/Audit Clerks/Trainees _____________________________________________________________
Other Audit Staff (With knowledge of book keeping & accountancy &
Tally)_______________________
Other Clarical Staff (Please Specify)____________________________________________________
Turnover of the firm during past three years
2015-16 ________________________________
2016-17________________________________
2017-18 _______________________________
(Please provide copy of ITR and Profit and loss Statement duly verified for the relevant
Financial Year.)
Number of Branches if any (Please mention Places & Locations)
___________________________________________________________________________________________________________________
______________________________________________________________________________________________
Whether the firm engaged in any internal Or External (RCH,NRHM,NHM Audit/Government
social Sector Audit/ Other Social Sector Audits/NGOs)? Yes/No
(If yes, then please provide detail with documentary evidence)
Whether there are any court/arbitration/any other
legal case against the firm? Yes/No
(If yes, give a brief note of the case indicating
its present status)
Undertaking
I/We do hereby declare that the above mentioned information are true & correct and I/We
also undertake to aid the terms & conditions of the contract and would make the compliance
of term laid down in the contract if executed by us with the State Health Society
(NHM)/District Health & Family welfare Society.
Date: Signature of Partner/
Place: Sole Proprietor with stamp
FORMAT OF FINANCIAL BID
PARTICULARS TOTAL AMOUNT(In Rupees)
AUDIT FEES Both in Numeric and in Words
1 Audit Fees (Including Cost of TA/DA)
Rs._____________________________________
2 GST
(Rupees _______________________________
3 Total Fees (1+2) ______________________________________)
Note 1: Percentage of funds involved shall not be a basis of quoting the Audit Fee.
Note2: In case of change in the rate of GST the revised GST shall be paid.
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