RFQ Cum RFP Hospital Lucknow

DEVELOPMENT OF MANYAVAR SHRI

KANSHIRAMJI SUPER SPECIALTY HOSPITAL IN LUCKNOW

Under Integrated Urban Rejuvenation Plan

ON DESIGN, BUILD, FINANCE, OWN AND OPERATE BASIS UNDER PUBLIC PRIVATE PARTNERSHIP (PPP)

REQUEST FOR QUALIFICATION CUM PROPOSAL DOCUMENT

JUNE 2009

Nodal Agency

AWAS BANDHU, UTTAR PRADESH, HOUSING & URBAN PLANNING DEPARTMENT,

GOVERNMENT OF UTTAR PRADESH

IST FLOOR, JANPATH MARKET, LUCKNOW-226001

TEL: 0522-2237161 FAX:0522-2612098, E-MAIL: [email protected]

WEB: awas.up.nic.in

Project Consultants Darashaw & Company Private Limited

RFQ cum RFP for Design, Build, Finance, Own and Operate Manyavar Shri Kanshiramji Super Specialty Hospital in Lucknow

RFQ cum RFP – Volume I- Instruction to Bidder Page 1

NOTICE INVITING REQUEST FOR QUALIFICATION CUM REQUEST FOR PROPOSAL

DEVELOPMENT OF MANYAVAR SHRI KANSHIRAMJI SUPER SPECIALTY HOSPITAL IN LUCKNOW as part of IURP Uttar Pradesh, India on DBFOO basis

Government of Uttar Pradesh proposes development of Manyavar Shri Kanshiramji Super Specialty Hospital in Lucknow. Awas Bandhu UP is the nodal agency for the project. There is a need to develop a Super Speciality Hospital in Lucknow. The Hospital is expected to be developed as per the International standards/ Indian Public Health Standards. It is envisioned to provide Health care facilities in selected disciplines. The broad scope of work is to develop of a 500 bed hospital at a site identified by LDA. The Hospital may be upgraded to have research institutes along with training courses for nursing and paramedical staff. Lucknow Development Authority has identified and earmarked total 15 acres of plot situated in between Sultanpur road and Gomti River on Amar Shaheed Path in Lucknow. The site shall be given on lease for a concession period of 90 years and the lease is renewable twice during the concession period at every 30 years. The successful bidder shall Design, Build, Finance, Own and Operate Manyavar Shri Kashiramji Super Specialty Hospital on the 15 acre of plot earmarked for the purpose over the concession period of 90 years, after which the facility will be transferred to Lucknow Development Authority (LDA). GoUP invites bids from the eligible developers either on their own or in consortium of up to four members for the project in response to this RFQ cum RFP document. The Eligibility Criteria and other terms and conditions are given in RFQ cum RFP Document. The RFQ cum RFP may be obtained at the address given below on payment of Rs 25,000/- (Rupees Twenty Five Thousand only), through account payee Demand Draft in favour of Awas Bandhu payable at Lucknow. The RFQ cum RFP may also be downloaded from the web http//awas.up.nic.in and the Demand Draft as mentioned above shall be submitted along with the Proposal. The last date for submission of RFQ cum RFP is 1300 Hrs on 03.07.2009.

For further details please contact The Executive Director, Project Coordinator, Awas Bandhu, Uttar Pradesh, Darashaw & Co. Pvt. Ltd., Housing & Urban Planning Department, 12th Floor, Regent Chambers, Government Of Uttar Pradesh 208, Nariman Point, Mumbai – 400021 Ist Floor, Janpath Market, Lucknow-226001 Tel: 022-66388900 Fax: 022-67470549 Tel: 0522-2237161 Fax:0522-2612098, [email protected] E-Mail: [email protected], Web : awas.up.nic.in

Awas Bandhu, Uttar Pradesh, Housing & Urban Planning Department,

Government of Uttar Pradesh



Disclaimer 1. Though adequate care has been taken in the preparation of this RFQ cum RFP Document (Volumes I and II),

the Bidder should satisfy himself that the Document is complete in all respects including its legal validity. 2. Neither Awas Bandhu, UP nor their employees or consultants make any representation or warranty as to the

accuracy, reliability or completeness of the information in this RFQ cum RFP (Volumes I and II) and it is not possible for Awas Bandhu, UP to consider the investment objectives, financial situation and particular needs of each party who reads or uses this document. Each prospective Bidder should conduct his own investigations and analysis and check the accuracy, reliability and completeness of the information in this RFQ cum RFP and obtain independent advice from appropriate sources.

3. Neither Awas Bandhu, UP nor their employees or consultants will have any liability to any prospective bidder or any other person under the law of contract, tort, the principles of restitution or unjust enrichment or otherwise for any loss, expense or damage which may arise from or be incurred or suffered in connection with anything contained in this RFQ cum RFP, any matter deemed to form part of this RFQ cum RFP, the award of the Project, the project information and any other information supplied by or on behalf of Awas Bandhu UP, LDA or their employees, any consultants or otherwise arising in any way from the selection process.

4. Awas Bandhu, UP reserves the right to reject any or all of the proposals submitted in response to this RFQ cum RFP at any stage without assigning any reasons whatsoever.

5. Awas Bandhu, UP reserves the right to change any or all of the provisions of this RFQ cum RFP prior to Proposal Due Date. Such changes would be intimated to all the parties being issued this RFQ cum RFP.

6. Awas Bandhu, UP reserves the right to change, modify, add to or alter the Selection Process including inclusion of additional evaluation criteria at later stage, which in no event shall be later than the Proposal Due Date. Any change in the Selection Process shall be intimated to all concerned parties.



1 RFQ cum RFP DOCUMENT

Schedule of Bidding Process

(This RFQ cum RFP is issued to the applicant in response to the advertisement dated 04/06/2009)

1. Last date for receipt of queries 25.06.2009 at 1000 hrs 2.Last date for submission of RFQ Cum RFP 03.07.2009 at 1300 hrs at the office of the

Executive Director, Awas Bandhu, Uttar Pradesh, Housing & Urban Planning Department, Government Of Uttar Pradesh Ist Floor, Janpath Market, Lucknow-226001

3.Date and time of Opening of RFQ cum RFP 03.07.2009 1400 hrs

4.Document Fees Rs. 25000 (Rupees Twenty Five Thousand), through account payee Demand Draft in favour of Awas Bandhu payable at Lucknow.



Table of Contents 1 RFQ cum RFP DOCUMENT 3 2 Salient Information 7 3 Abbreviations 8 4 Definitions 9 5 INTRODUCTION 12 5.1 Background of Lucknow 12 5.2 Lucknow Development Authority 12 5.3 Scope of the Project 12 5.4 Cost of the Project 14 5.5 Commercial Consideration 14 5.6 Project Implementation Mechanism 15 6 INFORMATION AND INSTRUCTION TO BIDDERS 16 6.1 Scope of Application 16 6.2 Eligible Bidders 16 6.3 Changes in Consortium Composition 17 6.4 Number of Applications 17 6.5 Application Preparation Cost 17 6.6 Project Inspection and Site Visit 17 6.7 Right to Accept or Reject any or all Applications 18 6.8 Contents of RFQ cum RFP Document 18 6.9 Clarifications 18 6.10 Amendment of RFQ cum RFP 18 6.11 Language 19 6.12 Currency 19 6.13 Validity of Application 19 6.14 Format and Signing of Application 19 6.15 Sealing and Marking of Applications 20 6.16 Submission of Bid 21 6.17 Application Due Date 21 6.18 Late Applications 21 6.19 Modifications/ Substitution/ Withdrawal of Proposals 21 6.20 Evaluation of Application - Due Date 21 6.21 Evaluation of Application - Criteria 22 6.22 Evaluation of Application - Supporting Documents 22 6.23 Evaluation of Application - Right to Reject 22



6.24 Confidentiality 22 6.25 Tests of responsiveness 22 6.26 Clarifications 23 6.27 Qualification and Notification 23 6.28 RFQ cum RFP Document 23 6.29 Fees of the Consultants 23 7 Other Instructions 25 7.1 General Provisions 25 7.2 Confidentiality 25 7.3 Communication between Bidders and Awas Bandhu, UP 25 7.4 Interpretation of Documents 26 7.5 Enquiries concerning the RFQ cumRFP / Draft Concession Agreement 26 7.6 Amendment of RFQ cum RFP 26 7.7 Submission of Bids 27 7.8 Bid Opening 27 7.9 Earnest Money Deposit 27 7.10 Performance Security 28 7.11 Sources of Funds 29 8 DESCRIPTION OF THE SELECTION PROCESS 30 8.1 CRITERIA FOR EVALUATION 30 8.2 Evaluation of Financial Proposal (Assessment of Envelope B) 33 9 RULES REGULATING THE CONSORTIUM 34 9.1 Consortium of Bidders 34 10 METHODOLOGY & CRITERIA FOR EVALUATION OF FINANCIAL BID (ENVELOP B)

36 10.1 Financial Proposal Evaluation 36 APPENDICES 38 APPENDIX 1A FORMAT FOR POWER OF ATTORNEY FOR SIGNING PROPOSAL 38 APPENDIX 1B FORMAT FOR POWER OF ATTORNEY FOR LEAD MEMBER OF CONSORTIUM

38 APPENDIX 2 DETAILS OF BIDDER 40 APPENDIX 3 FORMAT FOR LETTER OF APPLICATION 41 APPENDIX 4 INFORMATION RELATED TO EXPERIENCE 43 APPENDIX 5 FORMAT FOR ESTABLISHING FINANCIAL CAPABILITY OF THE BIDDER46 APPENDIX – 6 (INTENTIONALLY LEFT BLANK) 48 APPENDIX 7 GUIDELINES FOR PROVIDING INFORMATION RELATED TO FINANCIAL

CAPABILITY 49 APPENDIX 8 FORMAT FOR ANTI-COLLUSION CERTIFICATE 51



APPENDIX 9A FORMAT FOR PROJECT UNDERTAKING [To be submitted on the letter heads of the bidders separately] 52

APPENDIX 9B FORMAT FOR PROJECT UNDERTAKING [In case of Consortium] 53 APPENDIX 10 FORMAT FOR MEMORANDUM OF UNDERSTANDING (MOU) 54 APPENDIX-11 (INTENTIONALLY LEFT BLANK) 56 APPENDIX-12 CONSULTANCY AND SUCCESS FEE COMMITMENT TO DARASHAW &

COMPANY PRIVATE LIMITED 57 APPENDIX-13 FORMAT OF LETTER OF ACCEPTANCE 58 APPENDIX-14 FORMAT OF LETTER OF COMMITMENT 60 APPENDIX-15 FINANCIAL PROPOSAL (Format for Information Submission) 62 APPENDIX-16 PROFORMA FOR BANK GUARANTEE FOR PERFORMANCE SECURITY TO

LUCKNOW DEVELOPMENT AUTHORITY 63 EXHIBIT I PRINCIPLES OF THE MEMORANDUM OF UNDERSTANDING TO BE EXECUTED

BETWEEN THE MEMBERS OF A CONSORTIUM 65 CHECKLIST FOR PROPOSAL SUBMISSION 66 Annexure A - PROJECT SITE 67 Annexure B - TECHNICAL SCHEDULES 69



2 Salient Information Following are the salient aspects of information regarding this bid document (RFQ cum RFP):

i. This bid document comprises the following: a. Information to Bidders (RFP Document-Vol I) b. Draft Concession Agreement (RFP Document-Vol II) c. Technical Schedule (RFP Document-Vol II) TEFR is available with the Bid Documents for reference of the bidders.

ii. The following shall be the Schedule of the Bidding Process.

MILESTONE DATE Issue of RFQ cum RFP Document to Bidders 04.06.2009 Last Date for request for clarifications/suggestions 25.06.2009 at 1000 hrs Last Date for Submission up to 13:00 hrs. (Proposal Due Date)

03.07.2009 at 1300 hrs at the office of the Executive Director, Awas Bandhu, Uttar Pradesh, Housing & Urban Planning Department, Government Of Uttar Pradesh Ist Floor, Janpath Market, Lucknow-226001

Opening of Envelope A 03.07.2009 1400 hrs Opening of Envelope B 06.07.2009 1400 hrs



3 Abbreviations ABUP Awas Bandhu, UP BEC Bid Evaluation Committee COD Commercial Operation Date EMD Earnest Money Deposit EOI Expression of Interest EPC Engineering, Procurement and Construction FDI Foreign Direct Investment FAR Floor Area Ratio GoI Government of India GoUP Government of Uttar Pradesh Ha. Hectare or Hectares JCI Joint Commission International LCM Lead Consortium Member LOI Letter of Intent LOA Letter of Award LDA Lucknow Development Authority MOU Memorandum of Understanding RFP Request for Proposal RFQ Request for Qualification SPV Special Purpose Vehicle TEFR Techno-Economic Feasibility Report UP Uttar Pradesh



4 Definitions Associates For a Bidding Company or a Consortium Member, only those entities would be “Associates” who control and is controlled by or is under the common control with such applicant/consortium member.

Bid Document “Bid Document” shall mean any document issued by Awas Bandhu, UP as part of the Bid Process. Bid Process “Bid Process” shall mean various activities taken up by Awas Bandhu, UP leading up to the selection of the Successful Bidder/s. Bidder(s) “Bidder(s)” shall mean Bidding Company or Bidding Consortium that has submitted a Proposal in response to this RFP Document. Bidding Company “Bidding Company” shall mean a corporate entity (Public or Private Limited) registered under the Companies Act, 1956 or equivalent International law1 satisfying the basic eligibility criteria of bidding. Bid Validity Period “Bid Validity Period” shall mean the period stipulated in Clause 6.13 of Section 6 of this RFP Document, for which the Proposal submitted is valid. Bank “Bank” shall mean any SBI, Nationalised Bank and Indian Scheduled Commercial Bank whose networth is not less than Rs. 300 crores as on 31st March 2008. Consortium “Consortium” shall mean Group of Entities that have jointly submitted the proposal for the project. Consortium Member Each entity in the Bidding Consortium shall be referred to as a Consortium Member. Earnest Money Deposit “Earnest Money Deposit or Bid Security” shall have the meaning as referred in Section 7.10 of this document. Effective Date

“Effective Date” means the date on which all the Conditions Precedent are satisfied or waived in writing by both the Parties as per the Concession Agreement. Floor Area Ratio

1 Relevant Act as applicable has to be provided along in Envelope A with extract of relevant sections attached to the Act.



Floor Area Ratio means the quotient of the floor space excluding the area specifically exempted from computation under these regulations that can be constructed in a plot to the plot area. FAR = Total covered floor area on all floors

Plot area Financial Bid / Financial Proposal “Financial Bid / Financial Proposal” shall mean the information submitted as per Appendix 15 of this document. Good Industry Practice Good Industry Practice shall mean practices, methods, techniques and standards as changed from time to time that are generally accepted for use in the infrastructure, construction and real estate industry or any other good industry practice which is relevant to the said project. Lead Member / Lead Consortium Member (LCM) In case of a Bidding Consortium, the Lead Member / Lead Consortium Member (LCM) shall be that Consortium Member vested with the prime responsibility of developing the Project and holding not less than 51% stake in the consortium. Letter of Acceptance “Letter of Acceptance” shall have a meaning as referred in Appendix 13 of this Document. It means Letter submitted by the bidder accepting the Award or Intention to Award the Project to the bidder. Letter of Commitment “Letter of Commitment” shall have a meaning as referred Appendix 14 of this Document. Project “Project” shall mean Design, Build, Finance, Own and Operate the Manyavar Shri Kashiramji Super Specialty Hospital in Lucknow more specifically as mentioned under Clause 5.3 of Section 5. Project Site shall mean the area as given in annexure A. Proposal “Proposal” shall mean the Technical and Financial Proposal to be submitted by the Bidders in response to this Request for Qualification cum Request for Proposal. Proposal Due Date “Proposal Due Date” shall have the same meaning as referred to in Clause 6.17 section 6 of this Document.



Responsiveness / Non-responsive “Responsiveness / Non-responsive” shall mean as referred in Clause 6.25 of Section 6 of this document. Revenue of the Hospital “Revenue of the Hospital” shall mean registration fees, hospital bed revenue, diagnostics – laboratory tests, consultation charges, operation charges and lease rental from the commercial facilities like bank, restaurant etc. of that Financial Year. Revenue of the Hospital shall not include revenue from pharmacy, service apartments, training institutes and consumables cost directly reimbursed by the patients. Request for Qualification cum Proposal (RFQ cum RFP) “Request for Qualification cum Request for Proposal” shall mean this document issued to Bidders inviting the submission of “Proposal” to Design, Build, Finance, Own and Operate the Manyavar Shri Kanshiramji Super Specialty Hospital in Lucknow. Selection Process “Selection Process” shall have the same meaning as the 'Bid Process'. Subsidiary/Subsidiaries For a Bidding Company or a Consortium Member, Subsidiary / subsidiaries shall mean only those entities in which the Bidding Company / Consortium Member” hold(s) more than 50% of the voting securities directly. Successful Bidder The Successful Bidder shall mean the bidder who has been issued Letter of Intent by Awas Bandhu, UP and Letter of Award by LDA indicating him as the Successful Bidder.



5 INTRODUCTION

5.1 Background of Lucknow Lucknow is the capital of India’s most populous state, Uttar Pradesh and is situated about 500 km southeast of New Delhi in the heart of the state. The city lies at an average altitude of 110 meters above mean sea level and generally slopes to the east. Lateral slopes are towards the River Gomti, which flows from north-west to south-east through the heart of the city, dividing it into the Trans-Gomti and Cis-Gomti regions. The position of the City as the only large urban centre amidst a number of small towns in the surrounding districts makes it an attractive destination for job seekers and people in need of

education and health facilities. Lucknow is known for its cultural heritage. Some of the well-known historical buildings, which occupy a pride of place, include the Residency, Bara Imambara, Rumi Darwaza, Husainabad Imambara, the Picture Gallery, Sikandarabagh, Dilkusha Palace, Kaiserbagh Palace, the Hussainabad Clock Tower etc. Area of Lucknow is 337.5 Sq. Km. The present population is around 32 lakhs. It is well connected by air and rail connectivity is also very good with all the major stations in India.

5.2 Lucknow Development Authority Lucknow Development Authority was established in 1974 under the Uttar Pradesh Urban Planning & Development Act 1973. LDA has progressed from small beginnings to embrace an overreaching authority in the development scenario of Lucknow. In consonance with the aspirations of modern India, LDA aims at coordinated and planned development of a historical city: to enable Lucknow to achieve pride of place as the worthy capital of the largest State of the country which has played a very important role in the Freedom Struggle, to extend urban infrastructure to absorb the pressures of a rapidly changing society, and to provide an environment which would enable the utmost satisfaction level of all sections of its inhabitants. To fulfil its role, the Authority seeks to coordinate in accordance with a comprehensive Master Plan along with the work of various other agencies involved in the creation and extension of urban infrastructure. Taking forward this development process and to redress the lack of Super Speciality Hospital in the State of UP, LDA has proposed to set-up a 500 Bed Super Speciality Hospital in its capital-Lucknow.

5.3 Scope of the Project Government of Uttar Pradesh (GoUP) through U.P. Awas Bandhu Lucknow intends to undertake various infrastructure projects for implementation on Public Private Partnership (PPP) Mode under “Integrated Urban Rejuvenation Plan” (IURP) scheme for selected cities of the state. Projects to be developed on PPP mode are being identified, developed and implemented in various cities of Uttar Pradesh namely Ghaziabad, Meerut, Agra, Aligarh, Allahabad, Varanasi, Lucknow and Kanpur.



Under this a need to develop a Super Speciality Hospital in Lucknow was felt, which shall be named as Manyavar Sri Kanshiramji Super Specialty Hospital. Developers’ brand name as suffix will be allowed in the name of Hospital. The Hospital is expected to develop as per the International standards/ Indian Public Health Standards. It is envisioned to provide Health care facilities in selected disciplines and free/ subsidized treatment to BPL population within the city and the region. The broad scope of work is to develop a 500 bedded hospital at a site identified by LDA. The Hospital may be upgraded to have super specialty courses along with training courses for nursing and paramedical staff. Lucknow Development Authority has identified and earmarked total 15 acres of plot situated in between Sultanpur road and Gomti River on Amar Shaheed Path in Lucknow. The site can also be approached through a service road next to Amar Shaheed path. The site shall be given on lease for a concession period of 90 years and the lease is renewable twice during the concession period at every 30 years. The successful bidders shall Design, Build, Finance, Own and Operate Manyavar Shri Kashiramji Super Specialty Hospital on the 15 acre of plot earmarked for the purpose over the concession period of 90 years, after which the facility will be transferred to the Concessioning Authority. The maximum FAR allowable is 2.5 as per the prevailing Development Control Regulations of LDA. Awas Bandhu, UP, through this RFP invites the Pre-Qualified bidders to participate in the bid to Design, Build, Finance, Own and Operate Manyavar Shri Kashiramji Super-Specialty Hospital in Lucknow. The successful bidder shall construct following facilities and get all the approvals for commercial operations within 36 months from the effective date: Minimum Development Obligations (Essential Facilities):

• To build and operate 500-bedded Super-specialty hospital as per the Indian Public Health Standard (IPHS).

However, the developer is allowed to construct 250 bed capacity in initial three years and remaining 250 bed capacity in next two years.

• Atleast four specialties from the following specialties shall be developed in the Hospital.

Departments / Specialties Trauma Care Cardio Thoracic care unit (ICCU- Intensive Cardiac Care Unit) Intervention specialty and Cerebral Intervention Kidney Transplant (Hemodialysis) Neurology unit Obs & Gynecology Pediatric unit (with NICU – Neonetal Intensive Care unit) Dental unit for surgery Ophthalmology and ENT Cancer unit

• The hospital shall also have a round the clock emergency unit.



Optional Facilities Service Apartments can be provided within the hospital complex to cater to the needs of the patients and

their relatives. Institute offering Laboratory Technician courses, nursing courses can also be developed within the hospital

complex. Restaurants, ATMs, Pharmacy for the convenience of the patients can be provided within the hospital

complex. Research Institutes can also be setup in the hospital complex. Helipad for picking up patients may be provided.

All the facilities are to be developed as per the minimum quality standards set out for the purpose in the technical schedule appended as Annexure B with this document. While undertaking development of the Project, the Successful Bidder shall adhere to latest amended National Building Code of India, other relevant IS Codes and practices, Development Control Rules, FAR Limits, statutory requirements, guidelines and approvals of the Health Department of the Government of Uttar Pradesh, laws of land, the principles of good industry practices and any other norms as applicable from time to time. The Successful Bidder shall also take into account the guidelines issued by the State Health Department and obtain the necessary approvals. The successful bidder shall be responsible for all the clearances as may be required for the development and operations of the project. Government, through UP Awas Bandhu will facilitate for single window clearance for all the necessary approvals for the project from various authorities. The project shall be ready for operation after taking all the clearance(s) within 36 months of the effective date. For the purpose of providing subsidized health services to poor, the Concessionaire shall provide 1% of the revenues of the hospital every year to the State Health Department throughout the concession period. Revenue of the Hospital shall mean Registration Fees, Hospital Bed Revenue, Diagnostics – Laboratory tests, Consultation Charges, Operation Charges and lease rental from the commercial facilities like Bank, Restaurant etc. Revenue of the Hospital shall not include revenue from Pharmacy, Service Apartments, Training Institutes and Consumables cost directly reimbursed by the patients.

5.4 Cost of the Project The project is estimated to cost Rs. 2,40,00,00,000/-( Rupees Two hundred and forty Crores only)

5.5 Commercial Consideration

In consideration of the designated plot of land given on lease for a period of 90 years, the Successful bidder shall quote the percentage revenue that will be shared with the Concessioning Authority beginning from the eleventh year of signing of the agreement. The Concessionaire shall pay to the Concessioning Authority an annual lease rental equivalent to 2% of the land cost (considered as present circle rate) per acre of land on the 15 acre land earmarked for Super Specialty Hospital for the entire concession period of 90 years.



Bidders may please note that in case of failure of the bidder in completion of the project, as mentioned in the scope of work and as per the minimum standards and specifications as per the technical schedule appended with this document as Annexure B, within 36 months, the performance security furnished on the execution of the Agreement shall be forfeited by LDA and blacklisted, as per the Provision of the draft Concession agreement. Additional measures as the Govt. may deem fit would be applicable on such a bidder. However, bidders may note that in case the work is being executed as per the minimum technical specifications in Annexure B but delayed due to Force Majeure Event as defined in the Draft Concession Agreement, the remedies pertaining to such Force Majeure Event shall be applicable as per the provisions in the Draft Concession Agreement.

5.6 Project Implementation Mechanism The successful bidder in case of a consortium shall form a Special Purpose Vehicle (SPV) in the form of limited company under Companies Act, 1956, registered in UP for the purpose of implementation of the project. The Concession Agreement shall be signed between the SPV and LDA. In case, the successful bidder is a single entity, the Concession Agreement shall be signed between the Single Entity and LDA. No SPV shall be formed in case Single Entity is the Successful Bidder.



6 INFORMATION AND INSTRUCTION TO BIDDERS

6.1 Scope of Application

6.1.1 ABUP wishes to receive Applications from experienced and capable Bidders for proposal in respect of the Project(s).

6.2 Eligible Bidders

6.2.1 The Bidder may be a single company or a group of maximum 4 companies (hereinafter referred to as Consortium), coming together to implement the Project. The term Bidder used hereinafter would therefore apply to both a single entity and/or a Consortium.

6.2.2 The Bidder should submit a Power of Attorney as per the format enclosed at Appendix 1A, authorizing

the signatory of the Application to commit the Bidder. 6.2.3 Applications submitted by a Consortium should comply with the following additional requirements:

a. Number of members in a consortium would be limited to maximum of 4;

b. The Application should contain the information required for each member of the Consortium

c. The purchaser of the RFQ CUM RFP document must be the Bidder itself or member of the consortium submitting the application.

d. An individual Bidder cannot at the same time be member of a Consortium applying for this Project. Further,

a member of a particular Consortium cannot be member of any other Consortium applying for this Project; an undertaking towards this end needs to be submitted by all members.

e. Members of the Consortium shall nominate one member as the Lead Member. The nomination shall be

supported by a Power of Attorney as per the format enclosed at Appendix 1B

f. Members of the Consortium shall enter into a Memorandum of Understanding (MOU) as per the format enclosed at Appendix 10 and duly notarized for the purpose of making the Application and submitting a Proposal. The MOU shall, inter alia:

i. Convey the intent to form a Special Purpose Vehicle with shareholding commitment(s) as stipulated in this

document, which would enter into the Concession Agreement and subsequently carry out all the responsibilities as Concessionaire in terms of the Concession Agreement, in case the Concession to undertake the Project is awarded to the Bidder.

ii. Clearly outline the proposed roles and responsibilities of each member in case of Consortium at each

stage,

iii. Commit the minimum equity stake as stipulated, and iv. include a statement to the effect that all members of the Consortium shall be liable jointly severally for the

execution of the Project in accordance with the terms of the Concession Agreement



g. In case of consortium, the Lead Member shall hold at least 51% share in the shareholding. h. The other members of the consortium shall hold a minimum of 11% share each in the shareholding.

6.2.4 Notwithstanding anything stated elsewhere in this document, ABUP shall have the right to seek updated

information from the Bidders to ensure their continued eligibility. Bidders shall provide evidence of their continued eligibility in a manner that is satisfactory to ABUP. Bidder may be disqualified if it is determined by the ABUP, at any stage of the process, that the Bidder will be unable to fulfil the requirements of the Project or fails to continue to satisfy the Eligibility Criteria. Supplementary information or documentations may be sought from Bidders at any time and must so be provided within a reasonable time frame as stipulated by ABUP.

6.2.5 Any entity which has been barred or disqualified either by GOI or GOUP or their Departments or agencies

from participating in projects (BOT or otherwise) and such disqualification subsists as on the Application date, would not be eligible to submit an Application, either individually or as member of a Consortium. Bidder to submit an affidavit to this effect.

6.3 Changes in Consortium Composition 6.3.1 No change in Consortium Members shall be allowed till the completion of the project or a minimum of 3

years (whichever is later). However, the Lead Consortium Member shall not be allowed to be changed over the entire Concession Period and shall continue to hold 51% stake in the Consortium till the start of Commercial Operations. The Lead Consortium Member shall be allowed to dilute the stake after the commercial operations date with the approval of the Concessioning Authority such that the stake of the Lead Consortium Member in the consortium shall not fall below 26% at any time till the end of Concession Period.

6.4 Number of Applications Each Bidder shall submit only one (1) Application in response to this RFQ cum RFP. Any Bidder, which submits or participates in more than one Application will be disqualified and will also cause the disqualification of the Consortiums / Bidder of which it is a member as the case may be.

6.5 Application Preparation Cost The Bidder shall be responsible for all of the costs associated with the preparation of its Application and its participation in the Selection process. ABUP will not be responsible or in any way liable for such costs, regardless of the conduct or outcome of the qualification process.

6.6 Project Inspection and Site Visit

6.6.1 It is desirable that each Bidder submits its Application after inspecting the sites; and ascertaining for itself the location, surroundings, access, transport, right of way or any other matter considered relevant by it.



6.6.2 Site visit may be facilitated by ABUP. A prospective Bidder may notify ABUP in writing 3 days prior to planned visit. ABUP would endeavor to facilitate the site visit depending upon the availability of the concerned officials.

6.6.3 It would be deemed that by submitting the Application, Bidder has:

(a) Made a complete and careful examination of the RFQ CUM RFP and (b) Received all relevant information requested from ABUP.

6.6.4 ABUP shall not be liable for any mistake or error on the part of the Bidder in respect of the above.

6.7 Right to Accept or Reject any or all Applications

6.7.1 Notwithstanding anything contained in this RFQ cum RFP, ABUP reserves the right to accept or reject any Application and to annul the bidding process and reject all Applications / Proposals, at any time without any liability or any obligation for such acceptance, rejection or annulment, without assigning any reasons.

6.7.2 ABUP reserves the right to reject any Application if:

(a) At any time, a material misrepresentation is made or uncovered, or (b) The bidder does not respond promptly and thoroughly to requests for supplemental information required for the evaluation of the Application. Such misrepresentation / improper response would lead to the disqualification of the Bidder. If the Bidder is a Consortium, then the entire Consortium would be disqualified / rejected.

6.8 Contents of RFQ cum RFP Document The RFQ cum RFP Document comprises the contents as given in the Table of Contents and would additionally include any Addenda issued in accordance with the provisions of this Document.

6.9 Clarifications Interested parties may address their queries relating to the RFQ cum RFP Document by email only at [email protected] with a mandatory copy to consultants at [email protected]. The queries should reach the above latest by 1000 hrs on 25.06.09

ABUP would endeavor to respond to the queries by the date mentioned in the Schedule of Bidding Process. The responses will be sent by fax/ email.

6.10 Amendment of RFQ cum RFP



6.10.1 At any time prior to the deadline for submission of Application, ABUP may, for any reason, whether at its own initiative or in response to clarifications requested by any Bidder, modify the RFQ cum RFP Document by the issuance of an Addendum.

6.10.2 Any Addendum thus issued will be sent in writing to all those who have purchased the RFQ cum

RFP Document and shall also be uploaded on www.awas.up.nic.in

6.11 Language The Application and all related correspondence and documents should be written in the English language. Supporting documents and printed literature furnished by Bidder with the Application may be in any other language provided that they are accompanied by appropriate translations of the pertinent passages in the English language duly certified appropriately. Supporting materials, which are not translated into English, may not be considered. For the purpose of interpretation and evaluation of the Application, the English language translation shall prevail.

6.12 Currency The currency for the purpose of the Application shall be the Indian Rupee (INR). The conversion to Indian Rupees shall be clearly indicated in the Appendix 4. In all such cases, the original figures in the relevant foreign currency and the INR equivalent thereof must be given. The exchange rate(s) applied shall be clearly stated. The conversion to Indian Rupees shall be based on the closing exchange rate published by the Reserve Bank of India as on 31st December 2008. ABUP reserves the right to use any other suitable exchange rate for the purposes of uniform evaluation for all Bidders.

6.13 Validity of Application Applications shall remain valid for a period not less than 180 days from the Application Due Date. ABUP reserves the right to reject any Application, which does not meet this requirement.

6.14 Format and Signing of Application

6.14.1 The Bidder would provide all the information as per this RFQ cum RFP Document. ABUP would evaluate only those Applications that are received in the required format and are complete in all respects.

6.14.2 The Bidder shall prepare one original of the documents comprising the Application and clearly

marked "ORIGINAL". In addition, the Bidder shall make two copies of the Application, clearly marked "COPY". In the event of any discrepancy between the original and the copies, the original shall prevail.

6.14.3 The Application and its copies shall be typed or written in indelible ink and each page shall be initialed and stamped by the Bidder. All the alterations, omissions, additions, or any other amendments made to the Application shall be initialed by the person(s) signing the Application.



6.15 Sealing and Marking of Applications

6.15.1The First Envelope should be marked as Envelope A (original and copy) and shall contain:

a) Power of Attorney for the signing authority as per the format enclosed at Appendix 1A,

b) Power of Attorney for the Lead member of the consortium as per the format enclosed at Appendix 1B, in case of Consortium;

c) Bidder details (Appendix 2)

d) Application in the prescribed format (Appendix 3) along with supporting documents;

e) Completed Format for Experience as in Appendix 4 (BRS 1 to 2), along with supporting

documents. f) Completed Format for Financial Capability Evaluation as in Appendix 5 (BRS3 &4) and Appendix

7, along with supporting documents.

g) Format of Anti collusion certificate as in Appendix 8. h) Format of Project Undertaking as in Appendix 9A.

i) In case of a Consortium, an undertaking from each member of Consortium certifying that it is an

exclusive member of that particular consortium alone and not a member of any other consortium nor an independent Bidder, bidding for this project and has submitted only one (1) Application in response to this RFQ CUM RFP. (Appendix 9B)

j) MOU in case of a Consortium (Appendix 10);

k) Earnest Money Deposit l) Letter of Undertaking for the success fee of 1% of the Project Cost net of taxes, and Consultancy

Fees as per Appendix-12 m) Letter of Acceptance as per Appendix-13 n) Letter of Commitment as per Appendix-14

o) Documentary evidence, if applicable, relating to experience of group companies/associates as per

clause 8.1.2.

6.15.2 The second Envelope should be marked as Envelop B and shall include: • Financial Proposal as per Appendix-15.

Please note that Awas Bandhu, UP retains the right to ask for any further information/ clarification during the Bid Process.

6.15.3The Bidder shall also enclose in a separate envelope, enclosed in the outer envelope, a demand draft for Rs

25,000/- (Rupees Twenty Five Thousand Only), through account payee Demand Draft in favour of Awas Bandhu payable at Lucknow on any scheduled bank towards non refundable Document Fee. Application unaccompanied by this demand draft will not be considered for evaluation and short-listing.



6.16 Submission of Bid Both the Envelopes A and B shall be put together in one envelope and be sealed properly. The Bidder shall seal the original and copy duly marking the envelopes as "ORIGINAL" and "COPY" the envelopes shall then be sealed in an outer envelope superscribing “RFQ cum RFP for DEVELOPMENT OF MANYAVAR SHRI KANSHIRAMJI SUPER SPECIALTY HOSPITAL IN LUCKNOW, UTTAR PRADESH” and also the name(s) of bidder/consortium

The envelope shall be addressed to: The Executive Director, Awas Bandhu, Uttar Pradesh, Housing & Urban Planning Department, Government of Uttar Pradesh Ist Floor, Janpath Market, Lucknow-226001 India Tel: 0522-2237161 Fax:0522-2612098, E-Mail: [email protected], Web: awas.up.nic.in If the envelope is not sealed and marked as instructed above, ABUP assumes no responsibility for the misplacement or premature opening of the contents of the Application submitted.

6.17 Application Due Date Applications should be submitted before 1300 hours IST on the Application Due Date mentioned in the Schedule of Bidding Process, at the address provided above in the manner and form as detailed in this RFQ cum RFP. Applications submitted by either facsimile transmission, telex or e-mail will not be considered for evaluation and short listing. However ABUP reserves the right to extend the Application Due Date and Time, at any time prior to opening of RFQ cum RFP Applications; in such cases the applications received prior to such extension shall not be opened. Further if the RFQ cum RFP document is materially modified along/during such extended period, the RFQ cum RFP application received prior to extension shall be returned to the applicants and appropriate time shall be allowed for resubmission of the Applications.

6.18 Late Applications Applications received after the Application Due Date shall not be considered.

6.19 Modifications/ Substitution/ Withdrawal of Proposals The Bidder may modify, substitute or withdraw its Proposal after submission, provided that written notice of the modification, substitution or withdrawal is received by ABUP before the Proposal Due Date and time. No Proposal shall be modified or substituted or withdrawn by the Bidder after the Proposal Due Date and time

6.20 Evaluation of Application - Due Date



ABUP would open the Applications after 1400 hours IST on the Application Due Date mentioned in the Schedule of Bidding Process, for the purpose of evaluation.

6.21 Evaluation of Application - Criteria ABUP would subsequently examine and evaluate Applications in Accordance with the criteria set out in Section 8.

6.22 Evaluation of Application - Supporting Documents ABUP reserves the right to call for supporting documentation to verify the data provided by Bidders, at any time during the bidding process. The Bidder in such cases would need to provide the requested clarification / documents promptly and within the stipulated time failing which the Bidder is liable to be disqualified at any stage of the bidding process.

6.23 Evaluation of Application - Right to Reject ABUP reserves the right to reject any Application if: (a) At any time, a material misrepresentation is made or uncovered; or (b) The Bidder does not respond promptly and thoroughly to requests for supplemental information required for the evaluation of the Application.

6.24 Confidentiality Information relating to the examination, clarification, evaluation, and recommendation for the short-listed Bidders shall not be disclosed to any person not officially concerned with the process. ABUP will treat all information submitted as part of Application in confidence and would require all those who have access to such material to treat the same in confidence. ABUP will not divulge any such information unless it is ordered to do so by any authority that has the power under law to require its disclosure.

6.25 Tests of responsiveness

6.25.1 Prior to evaluation of Applications, ABUP will determine whether each Application is responsive to the requirements of the RFQ cum RFP. An Application shall be considered responsive if the Application:

a) is received by the Application Due Date (Clause 6.17) including any extension thereof pursuant to

Clause 6.17 b) is accompanied by MOU in case of a Consortium ( Appendix 10), if applicable, duly supported by

Board resolution and charter documents c) contains information required as per Appendix 3, 4(BRS 1 to2), 5(BRS 3 to 4) and 7. d) It is accompanied by Bid Document Fee of Rs. 25,000/- e) It is accompanied by a valid Earnest Money Deposit ; f) Letter of Undertaking for the Success fee of 1% of project cost (net of taxes) to the consultants

and Consultancy Fees as per Appendix - 12. g) Letter of Acceptance as per Appendix-13 h) Letter of Commitment as per Appendix-14 i) Contains all the documents which were to be submitted as per the provisions of Section 6.15 of this

Document.



ABUP reserves the right to reject any Application which is non-responsive and no request for alteration, modification, substitution or withdrawal shall be entertained by ABUP in respect of such Applications.

6.26 Clarifications To facilitate evaluation of Applications, ABUP may at its sole discretion, seek clarifications in writing from any Bidder regarding its Application.

6.27 Qualification and Notification After the evaluation of Applications, ABUP would announce a list of successful Bidders (Bidders) who meet the Qualification Criteria. At the same time, ABUP would notify the other Bidders that their Applications have been unsuccessful.

6.28 RFQ cum RFP Document

RFP Documents contain the following: Volume I - Instruction to Bidders Volume II - Draft Concession Agreement, Technical Schedule

TEFR is available with the above documents for the reference of the bidder. However the bidder has to conduct his own feasibility before submitting the bids.

6.29 Fees of the Consultants Darashaw & Company Private Limited has been appointed as a Consultant to assist Awas Bandhu, UP in handling the bid process management for the selection of the Successful bidder. The Success Fee of 1% of the project cost exclusive of taxes at applicable rates has been agreed by Awas Bandhu UP, to be paid to Darashaw & Company Private Limited for providing the above mentioned advisory services. The Success Fee shall be net of all taxes (1% of Project Cost is net of all taxes). Every bidder shall therefore submit along with the Proposal, an undertaking as per Appendix-12 for the Success Fees of the Consultants (calculated at the rate of 1% of the project cost as mentioned in Section 5.4 of this RFQ cum RFP document, plus taxes as applicable) and the Consultancy fees of Rs. 1, 00,000/- (Rupees One Lakh only) to be reimbursed to Awas Bandhu, UP. This success fee shall be paid in the form of a Demand Draft issued by a Bank in favour of Darashaw & Company Private Limited. Such a Demand Draft shall be extendable for a further period of 6 months by replacing it with a fresh Demand Draft after 5 months of its issue if required and asked by Awas Bandhu, UP due to delay in signing of Concession Agreement or otherwise beyond a period of 5 months from the date of issue of the said Demand Draft. The Success Fee in the form of Demand Draft shall be handed over to Awas Bandhu, UP by the Successful Bidder before the signing of the Concession Agreement. The successful bidder shall pay and deposit the amount of withholding or other taxes to the credit of the relevant tax authorities and issue a certificate of deduction and payment to Darashaw & Company Private Limited.



The Consultancy Fee of Rs. 1,00,000/- (Rupees One Lakh only) paid by Awas Bandhu,UP to the Consultants will be reimbursed by the bidder to Awas Bandhu, UP within 2 weeks of signing the concession agreement between LDA and Bidder, on receipt of invoice from Awas Bandhu, UP.



7 Other Instructions

7.1 General Provisions

7.1.1 Non-Discriminatory and Transparent Bidding Proceedings Awas Bandhu, UP shall ensure that the rules for the Bid Process for the Project are applied in a non-discriminatory, transparent and objective manner. Awas Bandhu, UP shall not provide to any Bidder, information with regard to the Project or the Bidding Process, which may have the effect of restricting competition.

7.1.2 Prohibition against Collusion with other Bidder Each Bidder shall warrant by its Bid that the contents of its Bid have been arrived at independently. Any Bid which has been arrived at through consultation, collusion, or understanding with any other prospective Bidder for the purpose of restricting competition shall be deemed to be invalid and the Bidder shall lose its Earnest Money Deposit. The anti-collusion certificate submitted at the time of submission of RFQ CUM RFP shall be applicable.

7.1.3 Inducements Any effort by a Bidder to influence processing of Bids or award decision by Awas Bandhu, UP or any officer, agent or Advisor thereof may result in the rejection of such Bidder’s Bid. In such a rejection of Bid, the Bidder shall lose its Earnest Money Deposit.

7.2 Confidentiality 7.2.1 Awas Bandhu, UP shall treat all Bids and other documents, information and solutions submitted by Bidders as confidential, and shall take all reasonable precautions that all those who have access to such material, treat this in confidence. Awas Bandhu, UP will not divulge any such information unless it is ordered to do so by any authority, which has the power to require its release. 7.2.2 Each Bidder shall, whether or not it submits a Bid, treat the RFP Documents and other documents, information and solutions provided by Awas Bandhu, UP in connection with the Project or the bidding proceedings as confidential for a period of five (5) years from the issuance of the RFP Documents. During this period, the Bidder shall not disclose or utilize any such documents, information without the written approval of Awas Bandhu, UP or as required by law or any governmental authority. 7.2.3 Awas Bandhu, UP shall have the right to release the Bid information provided by the Bidders to its Advisors for the purpose of Bid evaluation and negotiations. Each Bidder shall have the right to release these RFP Documents and other Documents to its advisors and to financial institutions for the purpose of Bid preparation, negotiations and financing. Both Awas Bandhu, UP and the Bidder shall ensure that their Advisors and/ or financial institutions treat this information in confidence. 7.2.4 Any information relating to examination, clarification, evaluation and comparison of bids and recommendations for the award of a contract shall not be disclosed to Bidders or any other person not officially concerned with the Bid Process until the award to the Successful Bidder has been communicated, except of reasons of public transparency.

7.3 Communication between Bidders and Awas Bandhu, UP



All communication, unless specified otherwise, on these RFP Documents to Awas Bandhu, UP shall be addressed to:

The Executive Director, Awas Bandhu, Uttar Pradesh, Housing & Urban Planning Department, Government of Uttar Pradesh Ist Floor, Janpath Market, Lucknow-226001 Tel: 0522-2237161 Fax:0522-2612098, E-Mail: [email protected] Web: http://awas.up.nic.in

All communication to the Bidder shall be sent to the Authorised Representative & Signatory at the addresses mentioned in the covering letters to this RFP, unless Awas Bandhu, UP is advised otherwise.

7.4 Interpretation of Documents Awas Bandhu, UP will have the sole discretion in relation to:

• The interpretation of this RFP, the Proposals and any documentation provided in support of the Proposals; and

• All decisions in relation to the evaluation and ranking of Proposals, whether or not to request for any clarifications or additional information from Bidder in relation to its Proposal and the selection of the Successful Bidder.

• Awas Bandhu, UP will have no obligation to explain its interpretation of this RFP, the Proposals or their supporting documentation and information or to explain the evaluation process, ranking process or the selection of the Successful Bidder.

7.5 Enquiries concerning the RFQ cumRFP / Draft Concession Agreement 7.5.1 Awas Bandhu, UP encourages a careful review of these RFP Documents and preparation of the

observations/ comments by the Bidder. The Bidder should send their comments in writing at least by 10.0 am 25th June 2009. Inquiries/ comments received after the set time limit may not be addressed by Awas Bandhu, UP.

7.5.2 Awas Bandhu, UP at its discretion, may respond to inquiries submitted by any Bidder after the date of the Pre-Bid Conference. Such a response will be sent in writing to all the Bidders and will qualify as an “Addendum”.

7.5.3 All inquiries should be submitted to the Awas Bandhu, UP in writing by e-mail to [email protected] with a copy marked to [email protected]

7.5.4 No interpretation, revision or other communication regarding this solicitation is valid unless in writing and is signed by an officer so designated by the Executive Director of Awas Bandhu, UP. Written copies of Awas Bandhu, UP responses, including a description of the inquiry but without identifying its source, will be sent to all the Bidder(s) and will qualify as an “Addendum”

7.6 Amendment of RFQ cum RFP 7.6.1 On its own initiative or any further discussions with any/ all Bidder(s), Awas Bandhu, UP may at its own

discretion make changes in the technical/commercial parameters for the Project, which would be



common for all the Bidders. Such changes in the technical / commercial parameters of the Project will qualify as an “Addendum”.

7.6.2 The Addendum will be posted on the website of Awas Bandhu, UP http://awas.up.nic.in and will be binding on the bidders. Each such Addendum shall become part of the RFP Documents.

7.6.3 In order to offer prospective Bidders a reasonable time to take into account an Addendum while preparing their Proposals, or for any other reason, Awas Bandhu, UP may, at its discretion, extend the Proposal Due Date.

7.7 Submission of Bids

7.7.1 Document Fee • The Bidder shall submit Document Fee of Rs. 25,000/- (Rupees Twenty Five Thousand only) along with the

Proposal. • The Bid Document Fee shall be in the form of a Demand Draft in favour of Awas Bandhu, UP, payable at

Lucknow. • The Bid Document Fee is non-refundable. • Bids not accompanied by Bid Document Fee shall be rejected.

7.8 Bid Opening • All Bids received by Awas Bandhu, UP will remain sealed and unopened in Awas Bandhu, UP’s possession

until the Proposal Due Date. Awas Bandhu, UP shall open all Bids, received on or prior to the Proposal Due Date mentioned under Schedule of Selection Process or on any date as extended by Awas Bandhu, UP and communicated to the bidders. The Bids shall be opened in the presence of Bidders’ representatives, who choose to attend. Bidders’ representatives attending the Bid Opening shall register to evidence their presence.

• The following information will be announced at the Bid Opening and recorded: Bidder’s names Names of Consortium Members

• After the Bid Opening, information relating to the examination, clarification and evaluation of Bids and

recommendations concerning the Bid Award shall not be disclosed.

7.9 Earnest Money Deposit

• The Bidder shall submit an Earnest Money Deposit (EMD) for an amount of Rs.2,40,00,000/- (Rs. Two Crores forty lakhs only) along with its Proposal.

• The Earnest Money Deposit shall be in the form of Bank Guarantee from SBI or any Nationalised Bank or Indian Scheduled Commercial Bank whose networth is not less than Rs. 300 crores as on 31st March 2008.

• The EMD shall be valid for a minimum period of 90 days more than Bid Validity Period. Upon any extension of the Bid Validity Period, the validity of the EMD shall be extended by the corresponding period.



• Awas Bandhu, UP shall have the right to reject the Proposal, which does not include the Earnest Money Deposit as non-responsive.

• The EMD of Unsuccessful Bidders, except the second successful bidder will be returned within a period of ten (10) days from the date of acceptance of Letter of Intent by the Successful Bidder. However, the EMD of second successful bidder shall be returned on signing of the concession agreement by the successful bidder.

• The EMD of the Successful Bidder shall be returned on submission of Performance Security by the Successful Bidder to the Concessioning Authority

• In addition to the above, Awas Bandhu, UP will promptly release EMD of all the Bidders in the event Awas Bandhu, UP decides to terminate the Bidding Process.

• The EMD shall be forfeited by Awas Bandhu, UP, in any of the following case: The Bidder withdraws his bid after the Proposal Due Date Successful Bidder fails to accept Letter of Intent Successful Bidder fails to submit the Performance Security or As per the provisions of Draft Concession Agreement

7.10 Performance Security The Successful Bidder shall for due and faithful performance of its obligations during the Project completion, provide to LDA a performance security of Rs. 12,00,00,000/- (Rupees Twelve crores only) in the form of Bank Guarantee (in the format prescribed in the RFP) from SBI or any Nationalised Bank or Indian Scheduled Commercial Bank whose networth is not less than Rs. 300 crores as on 31st March 2008.

The performance security shall be provided within 15 days of issue of Letter of Award by LDA. The Performance Security shall be released to the Successful Bidder as per provisions of the Draft Concession Agreement as follow: 25% of the Performance Security in the form of bank guarantee shall be released to the Concessionaire on the issuance of Construction Completion Certificate by the Concessioning Authority. The next 25% of the Performance Security in the form of bank guarantee shall be released to the Concessionaire on the start of Commercial Operation. The balance 50% of the Performance Security in the form of bank guarantee shall remain in force and effect beyond the period of six months from the date of the expiry of the Concession Period It shall be duly discharged and released to the Concessionaire beyond the period of six months from the date of the expiry of Concession Period and transfer of the Manyavar Shri Kanshiramji Super Specialty Hospital to LDA. If the Agreement is terminated due to any event other than a Concessionaire Event of Default, the Performance Security shall, subject to the Concessioning Authority’s right to receive or recover amounts, if any, due from the Concessionaire under this Agreement, be duly discharged and released to the Concessionaire. Upon occurrence of a Concessionaire Default, the Concessioning Authority shall, without prejudice to its other rights and remedies hereunder or in law, be entitled to invoke and appropriate the relevant amounts from the Performance Security as Damages for such Concessionaire Default. Upon such invocation and appropriation from the Performance Security, the Concessionaire shall, within 15 (fifteen) days thereof, replenish, in case of partial appropriation, the Performance Security to its original level, and in case of appropriation of the entire Performance Security provide a fresh Performance Security, as the case may be, and the Concessionaire shall, within the time so granted, replenish or furnish fresh Performance Security as aforesaid failing which the Concessioning Authority shall be entitled to terminate this Agreement in accordance with Article 13 of the Concession Agreement.



In case the successful bidder fails to furnish the Performance Security within the stipulated time as mentioned herein, the LOA shall stand void and LOI may be issued to the second successful bidder.

7.11 Sources of Funds

The responsibility to raise funds for the Project would rest with the Successful Bidder.



8 DESCRIPTION OF THE SELECTION PROCESS

8.1 CRITERIA FOR EVALUATION 8.1.1 Evaluation Parameters The Bidder's competence and capability is proposed to be established by the following parameters: (a) Technical Experience (b) Financial capability factor, in terms of: i. Turn over

ii. Net worth iii. Operating Profit

On each of these parameters, the Bidder would be required to meet the evaluation criteria as detailed in this Section Bidders meeting all the criteria only will be qualified for further evaluation of the Proposal. 8.1.2 Eligible Experience Technical Experience

For the purpose of this RFQ cum RFP, the applicant which could be single entity or the consortium shall be evaluated on the following:

(i) Development or construction of core infrastructure projects (either individually or as a consortium

member) each having a minimum project cost of Rs 30 croress (ii) Development or construction of similar Infrastructure projects ( either individually or as a

consortium member) each having a minimum project cost of Rs 25 crores

Eligible project: a) Projects awarded/awarded and under execution/completed during the last seven financial years, not

before 31st March 2001, shall only be considered. b) Only eligible projects should be considered for category (i) above for estimation of the technical

experience. An eligible project would have minimum project cost of at least Rupees 30 crores. For such category (i) evaluation, core infrastructure projects would mean national highways and expressway, airports, refineries and pipelines thereof, railways, ports, power, telecom, industrial parks, SEZs, Group Housing and Integrated/Hi-tech Township.

c) More weightage will be given to experience of similar kind of infrastructure projects or category (ii) above than to experience of infrastructure projects. Similar kind of Infrastructure: Hospitals and medical institutions of 100 or more beds.

d) Experience as a consortium member will be considered in proportion to the equity holding in the project at the time of execution /construction of the Project.

Documentary evidence in the form of a CA certificate (Appendix 4) must be submitted along with the proposal:

a) a certificate from the appropriate authorities of respective clients should be submitted in support of the above in case of completed projects.



b) Relevant pages of the Contract Agreement in projects which are awarded and under execution as per clause 8.1.2(a). Relevant pages shall mean the Preamble of this CA detailing the Parties and the last pages detailing the signatories.

c) A copy of the Work Order/Letter of Award in cases where the work has been awarded within three months before the RFQ CUM RFP application due date.

8.1.3 Details of Experience The Bidder should furnish details of technical experience as on the date of submission of RFQ cum RFP as per Appendix 4, Bid Response Sheet No. 1. The Bidder must provide the necessary project specific information as per Appendix 4, Bid Response Sheet No. 2. 8.1.4 Financial Capability The financial capability of the bidder / consortium will be evaluated on the basis of

(a) Turnover (b) Net Worth and (c) Operating Profit

The Bidders should provide information regarding the above based on audited annual accounts. The Application must be accompanied by the audited Balance Sheet and Profit and Loss Account of the Bidder (of each member in case of a consortium) as per Appendix 5 for the last three (3) Financial Years not prior to 2004-05. 8.1.5 Evaluation Criteria for Financial Capability

For the purpose of Qualification, the applicant – a single entity or a consortium should demonstrate the Threshold Financial Capability measured on the following criteria:

1. Minimum Turnover of Rs. 80 crores in each of the last three financial years not earlier than 2004-05 2. Minimum Net worth of Rs. 50 Crores as on 31st March 2008 as certified by Chartered Accountant. 3. Annual Operating Profit for 3 out of last 5 years not prior to 2002-03 should be positive. 4. Single entity bidder and all members of the consortium, if applicable, should be profit-making concerns for

the last 3 yrs not prior to 2004-05.

8.1.6 Special Conditions for a Consortium

In case the Bidder is a Consortium, turnover, net worth and operating profit would be taken as an arithmetic sum of net worth, turnover and operating profit of each member of the Consortium, calculated in the ratio of their stake in the consortium/JV. The Consortium would be required to meet the threshold criteria on the basis of aggregate figures subject to provisions of this Clause. 8.1.7 Evaluation methodology The technical and financial capacity of the bidder will be evaluated as per following:

Sr. No. Criteria Marks Marking System 1. Technical criteria 65%



Number of eligible projects – 15 marks

3 marks for initial project and 1.5 marks for every addl project.

1a. Core infrastructure 30 marks

Cumulative cost- 15 marks

1.5 marks for initial Rs 30 crores and 0.75 marks for every addl. comleted Rs. 30 crs. or 0.50 marks for every other addl. Rs. 30 crs.

Number of eligible projects – 20 marks

4 marks for initial project and 2 marks for every addl project.

1b. Similar infrastructure 35 marks

Cumulative cost- 15 marks

3 marks for initial Rs 25 crores and 2 marks for every completed addl Rs. 25 crs or 1.5 marks for every other addl. Rs. 25 crs.

2 Financial criteria 35% 2a. Networth 15 marks 10 marks for the

initial Rs 50 crores and 5 marks for addl Rs. 50 crs

2b. Turnover 10 marks 7 marks for the initial Rs 80 crores and 3 marks for addl Rs 80 crs

2c. Average Operating Profit

10 marks 10 marks if it is positive for 3 out of last 5 years not prior to 2002-03

8.1.8 For evaluation of technical experience as per clause 8.1.2 and of financial capability as per clause 8.1.5, the

financial and technical capabilities of the group companies/associates shall also be considered (for Projects costing Rs.200.00 cr or more). For these purposes group companies/associates shall mean the following “For the purposes hereof, associate means, in relation to the applicant/consortium member a person who controls and is controlled by or is under the common control with such applicant/consortium member. As used in this definition, the expression ‘control’ means, with respect to a person, which is company or corporation, the ownership, directly or indirectly of more than 50% of the voting shares of such person, and



with respect to a person which is not a company or corporation, the power to direct the management and policies of such a person, whether by operation of law or by contract or otherwise”.

In case the RFQ CUM RFP applicant claims the technical and/or financial capacity of its group

companies/associates, the applicant shall necessarily submit documentary evidence in proof of such claims. Such documentary evidence shall consist of CA certificates to support such capacity and also to establish requisite “Control” relationship as defined in 8.1.8 above.

8.1.9 The scores for the technical and financial capacity evaluated as per clause 8.1.7 shall be added to arrive at

combined score of each applicant against maximum total marks of 100. Applicants scoring 50% or more in the combined scores shall be eligible for opening of Financial Proposal.

8.2 Evaluation of Financial Proposal (Assessment of Envelope B)

Financial Proposal of the Bidders only who have secured 50 % or more marks (Clause 8.1.7) on the evaluation of envelop A would be evaluated. The evaluation criteria for assessment of the Financial Proposals are described in Section 10 of this RFQ cum RFP. In case of ambiguity between the amount in words and figures the former shall prevail.



9 RULES REGULATING THE CONSORTIUM

The objective of this stage is to outline the Rules regarding the Consortium. The Envelope A shall contain the information in respect of the Bidder/Consortium as per Clause 6.15 of this RFP document. Following are the rules which shall guide the operation of the Consortium:

9.1 Consortium of Bidders

9.1.1 Rules Regulating the Participation of a Consortium of Companies Awas Bandhu, UP may also consider a bid submitted by a consortium of companies subject to the following conditions:

1. The Consortium Members should not exceed four. 2. The foreign construction company / Developer may apply directly for the project or in association

with Indian Partner subject to the prevailing GoI, FDI and Indian Laws. 3. The members of the Consortium must form a Special Purpose Vehicle (SPV) and submit an MoU

to that extent as per Clause 9.1.3 below. 4. The commercial arrangements and roles and responsibilities between the consortium partners

should be specified in Memorandum of Understanding and duly executed copy of MOU should be submitted along with the proposal. The MOU to be entered into between the Consortium Members as per Appendix 10 of this RFQ cum RFP Document shall reflect the above.

5. The members of the consortium shall designate among themselves one member as “Lead Consortium Member”.

6. Lead Consortium Member shall hold a minimum of 51% equity in the SPV and each of the other Consortium Member shall hold a minimum of 11% in the SPV.

7. The Members of the Consortium shall execute Power of Attorney as per the format enclosed in Appendix 1B of RFQ cum RFP Document.

8. A bidder who has applied for a project in its individual capacity or as a part of a consortium cannot participate as a Member of any other Consortium applying for this Project.

9.1.2 Change in Composition of Consortium No change in Consortium Members shall be allowed till the completion of the project or a minimum of 3 years (whichever is later). The Lead Consortium Member shall not be allowed to be changed over the entire Concession Period and shall continue to hold 51% stake in the Consortium till the start of Commercial Operations. However, the Lead Consortium Member shall be allowed to dilute the stake after the commercial operations date with the approval of the Concessioning Authority such that the stake of the Lead Consortium Member in the consortium shall not fall below 26% at any time till the end of Concession Period.

9.1.3 Other Conditions in Respect of Consortium Each Consortium Member shall have a minimum of 11% stake in the SPV formed. None of the Consortium Member shall be allowed to dilute its stake till the completion of the project or a minimum of 3 years (whichever is later).



Lead Consortium Member shall invest minimum 51% of the equity towards the project. Lead Consortium Member shall not be allowed to dilute its stake to a level below 51% till the start of Commercial Operations. The Lead Consortium Member shall be allowed to dilute the stake after the commercial operations date with the approval of the Concessioning Authority such that the stake of the Lead Consortium Member in the consortium shall not fall below 26% at any time till the end of Concession Period. Any change in Consortium members may be allowed only if equal or better replacement is there. However, any change in consortium shall be at the discretion of the Concessioning Authority.



10 METHODOLOGY & CRITERIA FOR EVALUATION OF FINANCIAL BID (ENVELOP B)

10.1 Financial Proposal Evaluation

• This part of the RFQ cum RFP provides information on the methodology that will be used to evaluate the Financial Proposals received.

• The Project will be awarded to such Eligible Bidder, which submits a responsive Bid and offers to enter into a Draft Concession Agreement on the best financial terms with LDA.

• These RFP Documents stipulate the minimum qualification for the Project. These RFP Documents may be amended or technical and financial parameters of the Project may be changed by Awas Bandhu, UP by issue of an Addendum. Such an Addendum will form part of these RFP Documents and would be common for all the Bidders. Bid Evaluation Committee reserves the right to reject the Proposals, which do not conform to the provisions stipulated in the RFP Documents.

• Financial Proposal of only the Bidders who have achieved on 50% or more marks after evaluation of Envelope A, would be opened and evaluated. The Financial Proposals of the non-responsive Bidders would be returned to the respective Bidders unopened.

• Bid Evaluation Committee shall evaluate and submit its recommendations to the competent authority.

10.1.1 Responsiveness of Financial Proposal

• BEC through Awas Bandhu, UP will open Envelope ‘B’ of only who have achieved on 50% or more marks after evaluation of Envelope A as per Section 8.1.7 of this document. Any bid containing caveats/ deviations from RFQ cum RFP Documents is liable to be rejected by BEC/ Awas Bandhu, UP.

• Bidders shall be ranked as per the percentage revenue quoted that will be shared with the Concessioning Authority beginning from the eleventh year of signing of the agreement. The proposal of the bidder quoting the highest percentage revenue sharing shall be considered as the proposal having highest financial score. The proposal with highest financial score would be ranked first.

10.1.2 Determination of Preferred Bidder

• Awas Bandhu, UP shall issue a Letter of Intent to the Successful Bidder after obtaining approval from the Competent Authority which needs to be accepted within 7 days of issuance of Letter of Intent.

• LDA shall issue a Letter of Award (LOA) after getting the approval of the Board to the successful bidder within 7 days of issuance of LOI by Awas Bandhu, UP.

• The Successful Bidder shall enter into Concession Agreement with LDA for the implementation of the project within 30 days of issuance of LOA.

• The successful Bidder shall be required to give performance security before signing of the Concession Agreement within 30 days of issue of Letter of Award. If the Successful Bidder fails in entering into contract (Concession Agreement) as required without giving the required clarifications to the satisfaction of Awas



Bandhu UP, Awas Bandhu UP reserves the right to begin negotiations with the next highest ranked Bidder and so on.

• Awas Bandhu, UP also reserves the right to reject any Proposal if: - At any time, a material misrepresentation is made or uncovered, or - The Bidder does not respond promptly and thoroughly to the requests for supplementary

information required for evaluation of the Proposal. - The Proposal deviates from the commercial parameters of these RFP Documents.



APPENDICES APPENDIX 1A FORMAT FOR POWER OF ATTORNEY FOR SIGNING PROPOSAL

(On a Stamp Paper of appropriate value)

POWER OF ATTORNEY Know all men by these presents, we ____________ (name and address of the registered office) do hereby constitute, appoint and authorize Mr./Ms. _____________________ (name and address of residence) who is presently employed with us and holding the position of __________________ as our attorney, to do in our name and on our behalf, all such acts, deeds and things necessary in connection with or incidental to our proposal for the Manyavar Shri Kanshiramji Super Specialty Hospital in Lucknow on Design, Build, Finance, Own and Operate (DBFOO) basis in the state of Uttar Pradesh, including signing and submission of all documents and providing information/ responses to Awas Bandhu, Uttar Pradesh, Housing & Urban Planning Department, Government Of Uttar Pradesh, (ABUP), representing us in all matters before GOUP, and generally dealing with ABUP in all matters in connection with our proposal for the said Project.

We hereby agree to ratify all such acts, deeds and things lawfully done by our said attorney pursuant to this Power of Attorney and that all such acts, deeds and things lawfully done by our aforesaid attorney shall and shall always be deemed to have been done by us.

For ------------------------

(Signature) (Name, Title and Address)

Accepted

________________ (Signature) (Name, Title and Address of the Attorney) Company seal & stamp Notes: 1. To be executed by the sole Bidder or the Lead Member in case of a Consortium duly supported .by a Board Resolution 2. The mode of execution of the Power of Attorney should be in accordance with the procedure, if any, laid down by the applicable law and

the charter documents of the executant(s) and when it is so required the same should be under common seal affixed in accordance with the required procedure.

3. Also, where required, the executants(s) should submit for verification the extract of the charter documents and documents such as a

resolution / power of attorney in favour of the Person executing this Power of Attorney for the delegation of power hereunder on behalf of the Bidder.

APPENDIX 1B FORMAT FOR POWER OF ATTORNEY FOR LEAD MEMBER OF CONSORTIUM (On a Stamp Paper of appropriate value)



POWER OF ATTORNEY

Whereas Awas Bandhu, Uttar Pradesh, Housing & Urban Planning Department, Government Of Uttar Pradesh., (ABUP) has invited Proposals from interested parties for Manyavar Shri Kanshiramji Super Specialty Hospital in Lucknow on Design, Build, Finance, Own and Operate (DBFOO) basis ("the Project"). Whereas, the members of the Consortium are interested in bidding for the Project and implementing the Project in accordance with the terms and conditions of the Bid Document and other connected documents in respect of the Project, and Whereas, it is necessary under the Bid Document for the members of the Consortium to nominate one of them as the Lead Member with all necessary power and authority to do for and on behalf of the Consortium, all such acts, deeds and things as may be necessary in connection with or incidental to the Consortium’s proposal for the Project. NOW THIS POWER OF ATTORNEY WITNESSETH THAT: We, M/s. _________________, and M/s. ________________ (the respective names and addresses of the registered office) do hereby constitute, appoint and authorize M/s. __________________________ as the Lead Member of the Consortium and as our attorney, to do on behalf of the Consortium, all or any of such acts, deeds or things as may be necessary in connection with or incidental to the Consortium’s proposal for the Project, including submission of application/ proposal, participating in conferences, responding to queries, submission of information/ documents and generally to represent the Consortium in all its dealings with Awas Bandhu, Uttar Pradesh, Housing & Urban Planning Department, Government Of Uttar Pradesh., (ABUP), or any other Government Agency or any person, in connection with the Project until culmination of the process of bidding and thereafter till the Concession Agreement is entered into with Awas Bandhu, Uttar Pradesh, Housing & Urban Planning Department, Government Of Uttar Pradesh., (ABUP). We hereby agree to ratify all such acts, deeds and things lawfully done by Lead Member as our said attorney pursuant to this Power of Attorney and that all acts deeds and things lawfully done by our aforesaid attorney shall and shall always be deemed to have been done by us/Consortium. Dated this _______ Day of ________ 200_.

(Executants) (To be executed by all the members of the Consortium) Company seal & stamp Note:

1. The mode of execution of the Power of Attorney should be in accordance with the procedure, if any, laid down by the applicable law and the charter documents of the executant(s) and when it is so required the same should be under common seal affixed in accordance with the required procedure.

2. The executant(s) should submit for verification the extract of the charter documents and documents such as Board Resolution and

Power of Attorney in favour of the person executing this Power of Attorney in favour of the Lead Member.



APPENDIX 2 DETAILS OF BIDDER 1. (a) Name

(b) Country of Incorporation (c) Address of the corporate headquarters and its branch office (s), if any, in India (d) Date of incorporation and / or commencement of business

2 Brief description of the Company including details of its main lines of business and proposed roles

and responsibilities in this Project. 3 Name, Designation, Address and Phone Nos. of Authorized Signatory of the Bidder

(a) Name: (b) Designation: (c) Company: (d) Address: (e) Telephone No: (f) E-mail Address: (g) Fax No:

4 Details of individual (s) who will serve as the point of contact / communication for ABUP, within the

Company (a) Name: (b) Designation: (c) Address: (d) Telephone No. (e) E-mail address: (f) Fax No.

5 In case of Consortium: (a) The information above (1-4) should be provided for all the Members of the Consortium (b) Information regarding role of each Member should be provided as per table below:

Sl. No. Name of Member Role of the Member* 1 2

Specify whether Lead Member, Associate Member (Signature of Authorised Signatory) Company seal & stamp



APPENDIX 3 FORMAT FOR LETTER OF APPLICATION [On the Letter Head of the Bidder (in case of Single Bidder) or Lead Member (in case of a Consortium)]

Date: ------------ The Executive Director, Awas Bandhu, Uttar Pradesh, Housing & Urban Planning Department, Government Of Uttar Pradesh Ist Floor, Janpath Market, Lucknow-226001 India Manyavar Shri Kanshiramji Super Specialty Hospital in Lucknow on Design, Build, Finance, Own and Operate (DBFOO) basis Sir, Being duly authorized to represent and act on behalf of _________________ (hereinafter referred to as "the Bidder"), and having reviewed and fully understood all of the qualification requirements and information provided, the undersigned hereby expresses it’s interest and apply for qualification for Manyavar Shri Kanshiramji Super Specialty Hospital in Lucknow. We are enclosing our Technical Proposal in one Original and two Copies, and Financial Proposal in One Original only with the details as per the requirements of the Bid Document, for your evaluation. The undersigned hereby also declares that the statements made and the information provided in the Proposal are complete, true and correct in every detail. We confirm that the application is valid for a period of 180 days from the due date of submission of application and unconditional. We hereby also confirm the following:

1. The Proposal is being submitted by (name of the biding Company/Lead Consortium member) who is the Bidding Company/the Lead Consortium Member of the Bidding Consortium Comprising (mention the names of the entities who are the Consortium Members), in accordance with the conditions stipulated in the RFP.

2. As the Bidding Company/Lead Consortium Member (in case of a Bidding Consortium), we hereby confirm to abide by the roles and responsibilities assigned to us as per the MoU between the Consortium Members and as outlined in this RFP.

3. We have examined in detail and have understood the terms and conditions stipulated in the RFP Document issued by Awas Bandhu, UP and in any subsequent communication sent by Awas Bandhu, UP. We agree and undertake to abide by all these terms and conditions. Our Proposal is consistent with all the requirements of submission as stated in the RFP or in any of the subsequent communications from Awas Bandhu, UP.

4. We confirm that there are no conditions in “Envelope B: Financial Proposal”. 5. The information submitted in our Proposal is complete, is strictly as per the requirements stipulated in the

RFQ cum RFP, and is correct to the best of our knowledge and understanding. We would be solely responsible for any errors or omissions in our Proposal.

6. We confirm that we have studied the provisions of the relevant Indian laws and regulations required to enable us to prepare this Technical and Financial Proposal and as required to Design, Build, Finance, Own



and Operate Manyavar Shri Kanshiramji Super Specialty Hospital in Lucknow, in the event that we are finally selected.

7. We confirm that all the terms and conditions of the Proposal are firm and valid for acceptance for a period of 180 days from the Proposal due date.

Our PAN number is ----------------- Our TAN number is -----------------

Thanking You, Yours Sincerely, For and on behalf of : (name of the Bidding Company / Lead Consortium Member and the Company Seal) Signature : (Authorised Representative & Signatory) Name of the Person : Designation :



APPENDIX 4 INFORMATION RELATED TO EXPERIENCE

GUIDELINES

1. Member Code : NA= Not Applicable in case of a single entity Bidder, LM =Lead member, AM= Associate Member

2. The Chartered Accountant issuing the certification for Experience of the Bidder must hold a valid Certificate

of Practice. 3. Any Bidder consisting of a Single Entity should fill in details as per the row titled Single Entity Bidder and

ignore the other rows mentioned below. In case of a Consortium, the details need to be provided as per the lower rows and the row titled Single Entity Bidder may be ignored.



FORMAT FOR ESTABLISHING EXPERIENCE OF BIDDER

BID RESPONSE SHEET 1

Project

Date of

S.No

Na

me of

the P

rojec

t

Type

: Sim

ilar

or c

ore

infra

struc

ture

Loca

tion

Cost

Rs. c

rore

s

Awar

d

Comm

ence

-me

nt Co

mplet

ion

Autho

rity

for

whom

ca

rried

out

Equit

y ho

lding

at t

he

time

of ex

ecuti

on/

cons

tructi

on

Estim

ated M

arks

Total

Note:

1. Only the eligible projects that satisfy technical criteria shall be included. 2. All the Financial numbers are to be given in INR 3. The format shall be filled up for each member of the consortium and as a cumulative experience for the consortium

(Signature of Authorised Signatory) Company seal & stamp Signature , Name, Address and Membership No. of Chartered Accountant



Bid Response Sheet 2

Member Code: Name of Bidder:

Category: Name of Contract 1. Country

2. Name of Employer 3. Employer’s address, telephone and fax no.) 4. Role (strike out whichever is not applicable)

Developer/Prime contractor/ Subcontractor

5. Value of the Total Contract (in specified currencies and INR) 6. Value of the Bidder’s Contract (in specified currencies and INR) 7. Certified Billings till date (in specified currencies and INR and exchange rate) 8. Date of Award 9 Date of Commencement of Project/ Contract 10. Date of Completion/ Commissioning (Signature of Authorised Signatory) Company seal & stamp Instructions

1. Information provided in this section is intended to serve as a back up for information provided in accordance with Appendix 4, Bid Response Sheet 1.

2. The Projects cited must comply with the eligibility criteria specified in Clause 8.1. 3. A separate sheet should be filled for each of the Eligible Projects.



APPENDIX 5 FORMAT FOR ESTABLISHING FINANCIAL CAPABILITY OF THE BIDDER

Bid Response Sheet 3 Format for Financial Capability of Single Entity Bidder

Turnover, Net Worth and Operating Profit

Net Worth (Rs. Crores )

Operating Profit (Rs. Crores)

Turnover ( Rs. Crores)

As on 31.3.08 Year Year Year Year Year Year




BID RESPONSE SHEET 4

Format for Financial Capability of Consortium

Turnover, Net Worth and Operating Profit

Turnover

( Rs Crores)

Net Worth (Rs.

Crores)

Operating Profit (Rs. crores)

Bidder Type Equity share (%) Year Year year As on

31st March 2008

Year Year Year Total CA

Consortium Member 1

Consortium Member 2

Consortium Member ….

Total

Aggregate Turnover = Rs ---------------- crores Aggregate Net worth = Rs ________ crores Average Operating Profit = Positive / Negative (Signature of Authorised Signatory) Company seal & stamp Signature , Name, Address and Membership No. of Chartered Accountant



APPENDIX – 6 (INTENTIONALLY LEFT BLANK)



APPENDIX 7 GUIDELINES FOR PROVIDING INFORMATION RELATED TO FINANCIAL CAPABILITY 1. The Bidder should provide the Financial Capability based on its own audited financial statements. Financial

capability of the Bidder's parent company or its subsidiary or any associate company (who are not Members of the Consortium) will not be considered for computation of the Financial Capability of the Bidder.

2. Member Code LM = Lead member, AM = Associate Member 3. Instructions for calculation of Financial Capability:

(a) Operating Profit = (Profit After Tax + Interest + Tax) (b) Net Worth = Subscribed and Paid-up Equity (including Share Premium, if any) + Reserves - Revaluation

Reserves - Miscellaneous expenditure not written off-Deferred Revenue Expenditure-Deficit in Profit & Loss Account

(c) The financial year would be the same as followed by the Bidder for its annual report. Year 1 will be the last

Financial Year. Year 2 shall be the year immediately preceding Year 1.

(d) The Bidder shall provide audited Annual Reports as required under this Bid Document. For a Consortium, audited Annual Reports of all Members shall be provided.

(e) In case of a Consortium comprising of members with holdings in each other, the cross holdings between the

group companies comprising part of the Consortium will be deducted for the purpose of Net Worth calculations.

4. Financial details of the Bidder. If the Bidder is a consortium the Financial Details of all the members. The

Financial Details should be provided in the following manner. Name of Member: Role of Member:



Sr. No. Particulars as per the Audited Balance Sheet

Year 3 Year 2 Year 1 TOTAL

1 Profit After Tax (PAT)

2 Depreciation 3 Other non-cash expenditure 4 Subscribed and Paid up Equity 5 Reserves 6 Revaluation reserves 7 Miscellaneous expenditure not

written off

8 Deferred Revenue Expenditure 9 Deficit in Profit & Loss Account 10 Interest Expense 11 Tax 12 Operating Profit = (1+10+11) 13 Net Worth = (4+5-6-7-8-9)




APPENDIX 8 FORMAT FOR ANTI-COLLUSION CERTIFICATE [To be submitted on the letter heads of the bidders separately]

Anti-Collusion Certificate Date: ------------ The Executive Director, Awas Bandhu, Uttar Pradesh, Housing & Urban Planning Department, Government Of Uttar Pradesh Ist Floor, Janpath Market, Lucknow-226001 India Manyavar Shri Kanshiramji Super Specialty Hospital in Lucknow on Design, Build, Finance, Own and Operate (DBFOO) basis Sir,

We hereby certify and confirm that in the preparation and submission of this Bid, we have not acted in concert or in collusion with any other Bidder or other person(s) and also not done any act, deed or thing which is or could be regarded as anti-competitive, restrictive or monopolistic trade practice.

We further confirm that we have not offered nor will offer any illegal gratification in cash or kind to any person or agency in connection with the instant Bid.

Dated this ______________ Day of ________________, 200_

Name of the Bidder Signature of the Authorised Person Note: To be submitted by each Member in case of Consortium.



APPENDIX 9A FORMAT FOR PROJECT UNDERTAKING [To be submitted on the letter heads of the bidders separately]

The Executive Director, Awas Bandhu, Uttar Pradesh, Housing & Urban Planning Department, Government Of Uttar Pradesh Ist Floor, Janpath Market, Lucknow-226001 India Manyavar Shri Kanshiramji Super Specialty Hospital in Lucknow on Design, Build, Finance, Own and Operate (DBFOO) basis

Sir, We have read and understood the Bid Document in respect of the captioned project provided to us by the Executive Director, Awas Bandhu, Uttar Pradesh, Housing & Urban Planning Department, Government Of Uttar Pradesh

We hereby agree and undertake as under:

(a) Notwithstanding any qualifications or conditions, whether implied or otherwise, contained in our Bid we hereby represent and confirm that our Bid is unqualified and unconditional in all respects.

(b) We are not barred by the Government of India or the Government of Uttar Pradesh or their Departments or Agencies from participating in any projects (DBFOO or otherwise).

Dated this ___________________ Day of _______________, . Name of the Bidder _________________________________ Signature of the Authorised Person Company seal & stamp



APPENDIX 9B FORMAT FOR PROJECT UNDERTAKING [In case of Consortium] [To be submitted on the letter heads of the bidders separately]

The Executive Director, Awas Bandhu, Uttar Pradesh, Housing & Urban Planning Department, Government Of Uttar Pradesh Ist Floor, Janpath Market, Lucknow-226001 India Manyavar Shri Kanshiramji Super Specialty Hospital in Lucknow on Design,Build, Finance, Own and Operate (DBFOO) basis

Sir, We have read and understood the Bid Document in respect of the captioned project provided to us by the Executive Director, Awas Bandhu, Uttar Pradesh, Housing & Urban Planning Department, Government Of Uttar Pradesh

We hereby agree and undertake to be an exclusive member of the consortium and not a member of any other consortium nor an independent Bidder, bidding for this project and has submitted only one (1) Application in response to this RFQ CUM RFP

Dated this ___________________ Day of _______________, . Name of the Bidder _________________________________ Signature of the Authorised Person

Company seal & stamp



APPENDIX 10 FORMAT FOR MEMORANDUM OF UNDERSTANDING (MOU)

(On Non – judicial stamp paper of Rs 100/- or such appropriate document duly attested by notary public)

This Memorandum of Understanding (MOU) entered into this _____day of _______ 2009 at ______ Between _______________(hereinafter referred as”________”) and having office at _______, India Party of the First Part And ________(hereinafter referred as”__________”) and having office at ____________, India Party of the Second Part The parties are individually referred to as Party and collectively as Parties. WHEREAS Awas Bandhu, Uttar Pradesh, Housing & Urban Planning Department, Government of Uttar Pradesh, (ABUP) has invited RFQ cum RFP from entities interested in Manyavar Shri Kanshiramji Super Specialty Hospital in Lucknow Project. AND WHEREAS the Parties have had discussions for formation of a Consortium for bidding for the said Project and have reached an understanding on the following points with respect to the Parties’ rights and obligations towards each other and their working relationship. IT IS HEREBY AS MUTUAL UNDERSTANDING OF THE PARTIES AGREED AND DECLARED AS FOLLOWS:

1. That the Parties will form a Special Purpose Vehicle (SPV) with the shareholding commitments expressly stated. The said SPV shall not undertake any other business during the Concession Period, to domicile the Project prior to the start of implementation of the Project.

2. That the equity share holding of the Parties in the issued and paid up capital of the SPV shall not be less

than as Specified Under Evaluation Criteria Mentioned in RFQ CUM RFP Document during the Concession Period.

3. That M/s____________, and M/s____________, who are Members of the Consortium commit to hold the

following equity stake in the SPV which are in line with the requirements of Clause 3 of Evaluation criteria of the RFQ Document at all times during the Lease Period

Name of Member Type of Member % of shareholding

1. M/s.

2. M/s.

4. that any dilution in the equity holding by the Parties in the SPV shall be as per the provisions of the

Concession Agreement that will be executed on award of the Project to us. 5. However the parties undertake that there shall be no change in respect of the lead member in case of a

consortium till the execution of the concession agreement. 6. That the Parties shall carry out all responsibilities as Concessionaire in terms of the Concession Agreement.



7. That the roles and the responsibilities of each Party at each stage of the Bidding shall be as follows:

Name of Member Type of Member Role & Responsibility

1. M/s.

2. M/s.

8. That the Parties shall be jointly and severally liable for the execution of the Project in accordance with the

terms of the Concession agreement to be executed on award of the Project. 9. That the Parties affirm that they shall implement the Project in good faith and shall take all necessary steps to

see the Project through expeditiously. They shall not negotiate with any other party for this Project. 10. That this MOU shall be governed in accordance with the laws of India and courts in Lucknow shall have

exclusive jurisdiction to adjudicate disputes arising from the terms herein.

In witness whereof the Parties affirm that the information provided is accurate and true and have caused this MOU to be duly executed on the date and year above mentioned. Witness:

1. First Party 2. Second Party

Company seal & stamp



APPENDIX-11 (INTENTIONALLY LEFT BLANK)



APPENDIX-12 CONSULTANCY AND SUCCESS FEE COMMITMENT TO DARASHAW & COMPANY PRIVATE LIMITED The Executive Director, Awas Bandhu, Uttar Pradesh, Housing & Urban Planning Department, Government of Uttar Pradesh Ist Floor, Janpath Market, Lucknow-226001 Uttar Pradesh Sub: Commitment to pay the Success Fee and Consultancy Fee to Darashaw & Company Private Limited Sir, We ___________( the “Member”), /[ our consortium consisting of the following members ( the “Member”)]

1 [Lead party] 2 [ ] 3 [ ]

Have /[Has] submitted our/ [its] Bid for the development of Manyavar Shri Kanshiramji Super Specialty Hospital on Design Build Finance Own and Operate basis in Lucknow. We hereby write to inform you that if the Single Entity / Consortium is selected as the successful bidder for implementing the project, the Concessionaire shall pay Darashaw & Company Private Limited, a Success fee at the rate of 1% of the cost of the project (clause 5.4). The Demand Draft in favour of Darashaw & Company Private Limited for the said fee shall be handed over to Awas Bandhu UP before the signing of the Concession Agreement. The Consultancy Fee of Rs. 1,00,000/- (Rupees One Lakh only) paid by Awas Bandhu to the Consultants will be reimbursed to Awas Bandhu, UP within 2 weeks of receipt of invoice from Awas Bandhu, UP.

SIGNATURE _____________ NAME _____________ DESIGNATION _____________

COMPANY SEAL COMPANY ______________ DATE _______________



APPENDIX-13 FORMAT OF LETTER OF ACCEPTANCE

(The Letter of Acceptance is to be submitted by EACH Consortium Member of the Bidding Consortium)

Date: Place:

The Executive Director, Awas Bandhu, Uttar Pradesh, Housing & Urban Planning Department, Government of Uttar Pradesh Ist Floor, Janpath Market, Lucknow-226001 Uttar Pradesh Sub: Proposal for selection of Successful Bidder to Design, Build, Finance, Own and Operate Manyavar Shri Kanshiramji Super Specialty Hospital in Lucknow Dear Sir, This has reference to the Proposal being submitted by (name of the Lead Consortium Member of the Bidding Consortium), as Lead Consortium Member of the Bidding Consortium comprising (mention name(s) of the Consortium Members) in respect of selection of Successful Bidder to Design, Build, Finance, Own and Operate Manyavar Shri Kanshiramji Super Specialty Hospital in Lucknow in response to the RFQ cum RFP Document issued by Awas Bandhu, UP dated…. We hereby confirm the following:

(a) We (name of the Consortium Members furnishing the Letter of Acceptance), have examined in detail and have understood and satisfied ourselves regarding the contents including in respect of the following: a. The RFQ cum RFP Document issued by Awas Bandhu, UP; b. All subsequent communication between Awas Bandhu, UP and the Bidder, represented by

(Mention name of the Lead Consortium Member) c. The Proposal being submitted by (name of the Lead Consortium Member)

(b) We agree to abide by the terms and conditions of the RFQ cum RFP Document and the Proposal being

submitted by the Lead Consortium Member in respect of the Project. (c) We also reaffirm that (name of the Lead Consortium Member) continues to be the Lead Consortium

Member and that (please give name, designation and address of authorized representative and signatory here) designated as the authorized representative and signatory of the Lead Consortium Member of the Bidding Consortium is the authorized representative and signatory in respect of all matters concerning our Proposal for this Project and contractual commitments thereof.

Thanking You, Yours Sincerely, For and on behalf of : (name of the Bidding Company / Lead Consortium Member and the Company Seal)



Signature : (Authorised Representative & Signatory) Name of the Person : Designation :



APPENDIX-14 FORMAT OF LETTER OF COMMITMENT (The Letter of Commitment is to be submitted by EACH Promoter(s) and/or Associate(s) and/or Subsidiary (ies) of the Bidding Company / Consortium Members of the Bidding Consortium whose strength have to be credited for)

Date: Place:

The Executive Director, Awas Bandhu, Uttar Pradesh, Housing & Urban Planning Department, Government of Uttar Pradesh Ist Floor, Janpath Market, Lucknow-226001 Uttar Pradesh Sub: Proposal for selection of Successful Bidder to Design, Build, Finance, Own and Operate Manyavar Shri Kanshiramji Super Specialty Hospital in Lucknow Dear Sir, This has reference to the Proposal being submitted by (name of the Lead Consortium Member of the Bidding Consortium), as Lead Consortium Member of the Bidding Consortium comprising (mention name(s) of the Consortium Members) in respect of selection of Successful Bidder to Design, Build, Finance, Own and Operate Manyavar Shri Kanshiramji Super Specialty Hospital in Lucknow in response to the Request for Qualification cum Request For Proposal (“RFQ cum RFP”) Document issued by Awas Bandhu, UP dated…. We hereby confirm the following:

1. We (name of the Promoter/Affiliate/Subsidiary), have examined in detail and have understood and satisfied ourselves regarding the contents including in respect of the following: a. The RFQ cum RFP Document issued by Awas Bandhu, UP; b. All subsequent communication between Awas Bandhu, UP and the Bidder, represented by (name

of the Bidding Company or of the Lead Consortium Member in case of a Bidding Consortium); c. The Financial Proposal being submitted by (name of the Bidding Company or of the Lead

Consortium Member in case of a Bidding Consortium) 2. We agree to abide by the terms and conditions of the RFQ cum RFP Document and the Proposal being

submitted by the Bidding Company / Lead Consortium Member in respect of the Project. 3. We also reaffirm that (please give name, designation and address of authorized representative and

signatory here) designated as the authorized representative and signatory of the Bidding Company / Lead Consortium Member of the Bidding Consortium is the authorized representative and signatory in respect of all matters concerning our Proposal for this Project and contractual commitments thereof.

Thanking You, Yours Sincerely, For and on behalf of : (name of the Bidding Company / Lead Consortium Member and the Company Seal)



Signature : (Authorised Representative & Signatory) Name of the Person : Designation :



APPENDIX-15 FINANCIAL PROPOSAL (Format for Information Submission)

(To be provided on the letterhead of the Bidder)

Date: Place:

The Executive Director, Awas Bandhu, Uttar Pradesh, Housing & Urban Planning Department, Government of Uttar Pradesh Ist Floor, Janpath Market, Lucknow-226001 Uttar Pradesh Dear Sir, Sub: Proposal for selection of Successful Bidder to Design, Build, Finance, Own and Operate Manyavar Shri Kanshiramji Super Specialty Hospital in Lucknow 1. We the undersigned Bidder, submit the following as our Financial Proposal in response to the RFQ cum

RFP issued by Awas Bandhu, UP.

……………% ( percentage only) of the annual Revenue of the Hospital to be given to LDA every year, beginning from 11th year from the date of signing the agreement till the end of concession period.

2. We confirm that the Financial Proposal conforms to all the terms and conditions stipulated in the Request for Proposal Document.

3. We confirm that our Financial Proposal is FINAL in all respects and contains NO conditions. 4. We confirm that in the event of more than one Responsive Bidders quoting the same percentage revenue

sharing value, Awas Bandhu, UP shall break the tie by way of draw between such Bidders. 5. We confirm that, the information submitted in our Financial Proposal is complete and is correct to the best of

our knowledge and understanding. We would be solely responsible for any errors or omissions in our Proposal.

6. We confirm that we have studied the provisions of relevant Indian laws and regulations required to enable us to prepare this Financial Proposal and as required to design, build, Finance, Own and Operate the Project, in the event that we are finally selected.

Thanking You, Yours Sincerely, For and on behalf of : (name of the Bidding Company / Lead Consortium Member and the Company Seal) Signature : (Authorised Representative & Signatory) Name of the Person : Designation :



APPENDIX-16 PROFORMA FOR BANK GUARANTEE FOR PERFORMANCE SECURITY TO LUCKNOW DEVELOPMENT AUTHORITY

[To be issued by SBI or any Nationalised Bank or Indian Scheduled Commercial Bank whose Net Worth is not less than INR 300 crores as on 31st March 2008]

From: …………………………………………………………………………… [Name and Address of Bank/ Financial Institution] The Vice Chairman, Lucknow Development Authority, Lucknow Uttar Pradesh

1. In consideration of the Governor of Uttar Pradesh represented by ________________ (hereinafter called “ the Government”) having agreed to exempt __________________ (hereinafter called “ the said Bidder(s)“) from the demand, under the terms and condition of an Agreement, dated _________made between ____________________and Lucknow Development Authority for Design, Build, Own and Operate “Manyavar Shri Kanshiramji Super Specialty Hospital in Lucknow” (hereinafter called “ the said Agreement”), of performance security for the due fulfilment by the said Developer(s)of the terms and conditions contained in the said Agreement , on production of a bank guarantee for Rs. (Rupees only). We, _____________________ (hereinafter referred to as “the Bank”) at the request of ______________/ Bidder(s)/ do hereby undertake to pay to the Government an amount not exceeding Rs. /- against any loss or damage caused to or suffered or would be caused to or suffered by the Government by reason of any breach by the said Developer(s)of any of the terms or conditions contained in the said Agreement. 2. We __________________________ (indicate the name of bank) do hereby undertake to pay the amounts due and payable under this guarantee without any demur, merely on a demand from the Government stating that the amount claimed is due by way of loss or damage caused to or would be caused to or suffered by the Government by reason of breach by the said Bidder(s) of any of the terms or conditions contained in the said agreement or by reason of the Bidder(s) failure to perform the said Agreement. Any such demand made or the bank shall be conclusive as regards the amount due and payable by the Bank under this guarantee. However, our liability under this guarantee shall be restricted to an amount not exceeding Rs. /-. 3. We undertake to pay to the Government any money so demanded notwithstanding any dispute or disputes raised by the Bidder(s) in any suit or proceeding pending before any court or Tribunal relating to our liability under this present being absolute and unequivocal, unless otherwise directed by such Court or Tribunal.

The payment so made by us under this bond shall be a valid discharge of our liability for payment there under and the Bidder(s) supplier (s) shall have no claim against us for making such payment.



4. We __________________________________ (Indicate the name of bank) further agree that the guarantee herein contained shall remain in full force and effect during the period that would be taken for the performance of the said Agreement and that it shall continue to be enforceable till all the dues of the Government under or by virtue of the said Agreement have been fully paid and its claims satisfied or discharged or till Govt certifies that the terms and conditions of the said Agreement, have been fully and properly carried out by the said Bidder(s)and accordingly discharges this guarantee, however not exceeding six months beyond the date of expiry of the Concession Period. Unless a demand or claim under this guarantee is made on us in writing on or before the date of expiry of we shall be discharged from all liability under this guarantee thereafter.

5. We _____________________ (indicate the name of Bank) further agree with the Government that

the Government shall have the fullest liberty without our consent and without affecting in any manner our obligations hereunder to vary any of the terms and conditions of the said Agreement or to extend time of performance by the said Bidder(s)from time to time or to postpone for any time or from time to time any of the powers exercisable by the Government against the said Bidder(s) and to forbear or enforce any of the terms and conditions relating in the said agreement and we shall not be relieved from our liability by reason of any such variation or extension being granted to the said Bidder(s)or for any forbearance act or commission on the part of the Government or any indulgence by the Government to the said Bidder(s)or by any such matter or thing whatsoever which under the law relating to sureties would, but for this provision, have effect of so relieving us.

6. This guarantee will not be discharged due to the change in the constitution of the Bank or the

Bidder(s)/ Supplier(s). 7. We, __________________________ lastly undertake not to revoke this guarantee during (indicate

the name of bank) its currency except with the previous consent of the Government in writing. SEAL OF [BANK/FINANCIAL INSTITUTION] ……………………………….. NAME OF [BANK/FINANCIAL INSTITUTION] ……………………………….. SIGNATURE …………………………….. NAME …………………………….. TITLE …………………………….. DATE ……………………………..



EXHIBIT I PRINCIPLES OF THE MEMORANDUM OF UNDERSTANDING TO BE EXECUTED BETWEEN THE MEMBERS OF A CONSORTIUM

In case of a Bidding Consortium, the principles according to which the Memorandum of Understanding (MoU) shall be executed between/among the Consortium Members, are stated below: 1. The MoU should clearly specify the roles and responsibilities of each of the Consortium Members, along

with their proposed equity contribution. It is expected that the individual members have role definitions not conflicting with those of the other Consortium Members.

2. The MoU should clearly designate one of the Consortium Members as the Lead Consortium Member.

3. The Lead Consortium Member shall be responsible for:

a. Tying up finances for the Project b. Liasoning with the lending institutions and mobilizing debt resources for the Project. c. Ensuring the individual and collective commitment of each of the Consortium members in

honouring the Developer’s obligations towards LDA. The Lead Consortium Member would be responsible for the overall execution of the Project. All Consortium Members shall be jointly and severally responsible for the same.

4. The MoU shall be duly signed by each of the Consortium Members

5. The MoU should be executed an appropriate stamp paper

6. The MoU should be specific to this Project.

7. The MoU should be valid for a minimum period of twelve months from the Last Date for submission of

the Request for Proposal. The validity period of the MoU should be extendible on the original terms, if required by LDA.

MoU should clearly specify that in case of award of the project each consortium member will invest at least 11% equity for project.



CHECKLIST FOR PROPOSAL SUBMISSION Bidder(s) are requested to organize their Proposals as per the following checklist: ENVELOPE A (a) Original Power of Attorney authorizing Authorised Representative & Signatory to act on behalf of the

Bidding Company / Bidding Consortium on all matters relating to the Project as per the format specified in Appendix 1A

(b) Original Power of Attorney authorizing Lead Consortium Member to act on behalf of the Bidding Consortium on all matters relating to the Project as per the format specified in Appendix 1B

(c) Details of the Bidder in Appendix 2 (d) Letter of Application as per format in Appendix 3 (e) Information Related to Experience in Appendix 4 (BRS1& BRS2) (f) Establishing Financial Capability of the Bidder as per format in Appendix 5 (BRS 3 & BRS 4) (g) Guidelines for providing information related to Financial Capability in Appendix 7 (h) Anti-collusion certificate in Appendix 8 (i) Project Undertaking as per format in Appendix 9 A and 9B (j) Memorandum of Understanding executed between the Consortium Members on the principles as

stated in Exhibit I (k) MOU as per format as stated in Appendix 10 (l) Consultancy and Success Fee Commitment to Darashaw & Co Pvt. Limited as per format stated in

Appendix 12 (m) Letter of Acceptance as per format stated in Appendix 13 (n) Letter of Commitment as per format in Appendix 14 (o) Earnest Money Deposit in the form of Bank Guarantee ENVELOPE B (a) Financial Proposal as per format specified in Appendix 15



Annexure A - PROJECT SITE Details of Site :- The Project Site is located at Lucknow bypass, Amar Shaheed Peeth. The site has an area of 15 acres and it is situated in between Sultanpur road and Gomti river on Amar Shaheed Path. The site can also be approached through a service road next to Amar Shaheed. The topography is more or less even. At present there are no major developments adjoining the plot except some scattered residential structures in the vicinity. Shaheed Smarak is being developed on the opposite side of the site.

Site Photograph



Location Map



Annexure B - TECHNICAL SCHEDULES

The proposed Super specialty hospital at Lucknow shall have 500 beds. Atleast four specialties from the following disciplines shall be developed in the Hospital.

Sr. No. Departments / Specialties 1 Trauma Care 2 Cardio Thoracic care unit (ICCU- Intensive Cardiac Care Unit) 3 Intervention specialty and Cerebral Intervention 4 Kidney Transplant (Hemodialysis) 5 Neurology unit 6 Obs & Gynecology 7 Pediatric unit (with NICU – Neonetal Intensive Care unit) 8 Dental unit for surgery 9 Ophthalmology and ENT 10 Cancer unit

The Concessionaire may also develop additional specialties other than those mentioned above. The hospital shall also have a round the clock emergency unit. A. Planning

The Concessionaire shall plan the facilities, manpower and the service as per the Indian Public Health Standard (IPHS).

The hospital shall be developed with 500 bed capacity within 36 months from the Effective Date. However, the developer is allowed to construct 250 bed capacity in initial three years and remaining 250 bed capacity in next two years time.

The hospital shall be planned in accordance with the Development Control Regulations applicable to the region and norms if any prescribed by the Medical Council of India, Ministry of Health and Family Welfare and the State Health Department.

The developer shall obtain necessary clearances and approval for the plans from the relevant authority as per the requirements.

Service Apartments can be provided within the hospital complex to cater to the needs of the patients and their relatives.

Institute offering Laboratory Technician courses, Nursing courses can also be developed within the hospital complex.

Restaurants, ATMs, Pharmacy for the convenience of the patients can be provided within the hospital complex.

Research Institutes can also be setup in the hospital complex. Helipad for picking up patients may be provided.



B. Designing

Modular design to enable addition of new departments, least disturbance to existing facilities, quality, and added benefits of economy of scale shall be preferred.

Architectural design norms as per NBC (National Building Code – 2005) Structural Design norms as per NBC and BIS (Bureau of Indian Standards) Services design norms as per CPEEHO (Central Public Health and Environmental Engineering

Organisation), NBC and BIS In case of contradiction between IPHS norms and the Design Norms specified above, the former shall prevail. C. Construction

The construction shall be strictly as per the design norms specified above.

Draft Concession Agreement for Design, Build, Finance, Own and Operate Manyavar Shri Kanshiramji Super Specialty Hospital in Lucknow

Request for Proposal – Volume II 1

VOLUME II

Draft Concession Agreement

Between

Lucknow Development Authority

And

____________________________



Index Article 1. Definitions and Interpretation 6

1.1. Definitions 6

1.2. Interpretation 9

1.3. Measurements and Arithmetic Conventions 11

1.4. Priority of Agreements and Errors/Discrepancies 11

Article 2. Scope of the Project 13

2.1. Scope of the Project 13

Article 3. Consideration of the Contract 15

3.1. The Consideration 15

Article 4. Conditions Precedent to the Agreement 16

4.1. Conditions Precedent 16

4.2. Compliance Certificate 16

4.3. Non-Fulfillment of the Conditions Precedent 16

Article 5. Obligations of the Concessionaire 18

5.1. Obligations of the Concessionaire 18

5.2. Obligations relating to Other Agreements 19

5.3. Obligations relating to Change in Ownership 19

Article 6. Obligations of the Concessioning Authority 21

6.1. Obligations of the Concessioning Authority 21

Article 7. Representations and Warranties 22

7.1. Representations and Warranties of the Concessionaire 22

7.2. Representations and Warranties of the Concessioning Authority 23

7.3. Disclosure 24

Article 8. Disclaimer 25

8.1. Disclaimer 25

Article 9. Performance Security 26

9.1. Performance Security 26

9.2. Appropriation of Performance Security 26

9.3. Release of Performance Security 26

Article 10. Access on Project Site 27

10.1. Project Site 27

10.2. Others 27

Article 11. Construction on the Project Site 28

11.1. Obligations prior to the commencement of any work 28

11.2. Project Start and Completion date 28

11.3. Completion Certificate 28

Article 12. Force Majeure 29

12.1. Force Majeure 29

12.2. Force Majeure Events 29

12.3. Duty to Report Force Majeure Event 29

12.4. Effect of Force Majeure Event 29

12.5. Allocation of Costs Arising out of Force Majeure 30

12.6. Dispute Resolution 30

Article 13. Termination 31

13.1. Termination for Concessionaire Default 31

13.2. Procedure to issue Termination Notice 32

13.3. Effect of Termination 32



13.4. Other Rights and Obligations of the Concessioning Authority 32

Article 14. Liability and Indemnity 33

14.1. General indemnity 33

14.2. Liability of Concessioning Authority 33

14.3. Indemnity by the Concessionaire 33

14.4. No consequential claims 34

14.5. Survival on Termination 34

Article 15. Dispute Resolution 35

15.1. Dispute resolution 35

15.2. Conciliation 35

15.3. Arbitration 35

Article 16. Miscellaneous 37

16.1. Governing Law and Jurisdiction 37

16.2. Waiver of Immunity 37

16.3. Delayed Payments 37

16.4. Waiver 37

16.5. Liability for Inspection of Documents 38

16.6. Exclusion of Implied Warranties etc. 38

16.7. Survival 38

16.8. Entire Agreement 38

16.9. Severability 38

16.10. No partnership 39

16.11. Third Parties 39

16.12. Successors and Assigns 39

16.13. Notices 39

16.14. Language 40

16.15. Counterparts 40

16.16. Validity 40

Schedule 1. Project Site 41

Schedule 2. Technical Schedule 43



CONCESSION AGREEMENT This AGREEMENT is entered into on this the [ ] day of [ ] (Month), 2009 at Lucknow

BETWEEN

1. Lucknow Development Authority established under the Uttar Pradesh Urban Planning

and Development Act 1973, having its registered office at Pradhikaran Bhavan, Vipin Khand, Gomti Nagar, Lucknow, Uttar Pradesh (hereinafter referred to as ‘Concessioning Authority’ which expression shall unless repugnant to the subject or the context include its successors) of One Part;

AND

2. ______________, a company incorporated under the Companies Act, 1956, and having its registered office at _________________________ (hereinafter referred to as the ‘Concessionaire’ which expression shall unless repugnant to the subject or the context include its successors) of the Other Part.

WHEREAS:

A. The Government of Uttar Pradesh has established Lucknow Development Authority under the Uttar Pradesh Urban Planning and Development Act 1973(hereinafter called the “Act”), for the development and planning of Lucknow.

B. In order to develop the tertiary healthcare infrastructure in Lucknow, LDA intends to setup

a 500 Bed Super-Specialty Hospital and related facilities and has earmarked 15 acres of

land for the same.

C. Concessioning Authority through Awas Bandhu,UP had invited proposals for the selection

of a Concessionaire through the competitive route on the basis of Design, Build, Finance Owb and Operate the Project, from bidders, including the Consortium comprising of _____________ as the Lead Member/Company by issuing the Request for Qualification (“RFQ cum RFP”) document dated 22nd January 2009 containing inter-alia the minimum qualification for a bidder and the technical and commercial parameters of the Project and the terms and conditions for the implementation of the Project.

D. On evaluation of the submitted proposals, Awas Bandhu, UP accepted the proposal of the

Consortium/Company and issued Letter of Intent (“LOI”) dated __________ to the Consortium/Company specifying interalia the obligation of the Parties to create a Special Purpose Vehicle for implementing the Project [ Applicable in case of Consortium]

Pursuant to the issuance of LOI vide letter no. ___________ dated ________, the Consortium have incorporated and constituted ______________ as the Special Purpose Vehicle created for the sole purpose of implementation the Project which is Concessionaire.



E. The Concessionaire is desirous of developing the Project, in accordance with all approved plans and has the necessary capability for completion of the project and has offered his services and has made payment of 1% of the project cost and taxes as applicable to M/s Darashaw & Company Pvt. Ltd.

NOW THEREFORE IN CONSIDERATION OF THE FOREGOING AND THE RESPECTIVE COVENANTS AND AGREEMENTS SET FORTH IN THIS CONCESSION AGREEMENT, THE SUFFICIENCY AND ADEQUACY OF WHICH IS HEREBY ACKNOWLEDGED, AND INTENDING TO BE LEGALLY BOUND THE CONCESSIONING AUTHORITY AND THE CONCESSIONAIRE (HEREINAFTER REFERRED TO AS “PARTIES” AND INDIVIDUALLY AS “PARTY”) HEREBY AGREE AND THIS AGREEMENT WITNESSTH AS FOLLOWS:



Article 1.Article 1.Article 1.Article 1. Definitions and Interpretation

1.1. Definitions The words and expressions defined in this Agreement shall, unless repugnant to the context or meaning thereof, have the meaning ascribed thereto herein, and the words and expressions defined in the Schedules and used therein shall have the meaning ascribed thereto in the Schedules;

“Accounting Year” means the financial year commencing from the first day of April of any calendar year and ending on the thirty-first day of March of the next calendar year;

“Affected Party” shall have the meaning set forth in Clause 12.1;

“Agreement” or “Concession Agreement” means this Agreement, the Schedules hereto and any amendments thereto made in accordance with the provisions contained in this Agreement;

“Agreement Date” means the date of execution of this Agreement;

“Applicable Laws” means all laws, brought into force and effect by GOI or the State Government including rules, regulations and notifications made there under, and judgments, decrees, injunctions, writs and orders of any court of record, applicable to this Agreement and the exercise, performance and discharge of the respective rights and obligations of the Parties hereunder, as may be in force and effect during the subsistence of this Agreement;

“Applicable Permits” means all clearances, licenses, permits, authorisations, no objection certificates, consents, approvals and exemptions required to be obtained or maintained by the Concessionaire under Applicable Laws during the subsistence of this Agreement;

“Approvals” means all approvals, permissions, authorisations, consents and notifications from any Governmental Authority, regulatory or departmental authority including, but not limited to the approvals of the Lucknow Development Authority, Secretariat for Industrial Assistance, Reserve Bank of India and any other regulatory authority, as may be applicable.

“Arbitration Act” means the Arbitration and Conciliation Act, 1996 and shall include modifications to or any re-enactment thereof, as in force from time to time;

“Bank Guarantee” means an irrevocable and unconditional bank guarantee payable on demand issued by a bank in favour of Concessioning Authority and furnished by the Concessionaire to Concessioning Authority for guaranteeing the due performance of the obligations of the Concessionaire under this Agreement. Here Bank means any Indian Nationalized Bank or any Indian Scheduled Commercial Bank whose net worth is not less than Rs.3000 million as on 31st March 2008.

“Bid” means the documents in their entirety comprised in the bid submitted by the Concessionaire in response to the RFQ/RFP in accordance with the provisions thereof;



“Business Day” means a day on which banks are generally open for business in the city of Lucknow in India;

“Change in Ownership” means a transfer of the direct and/or indirect legal or beneficial ownership of any shares, or securities convertible into shares, that causes the change in management structure of the bidder company according to the opinion of the Concessioning Authority;

“Conditions Precedent” shall have the meaning set forth in Clause 4.1;

“Construction Period” means maximum period of 36 months from the Effective Date, after which commercial operations must start;

“Consortium” means the group of entities that have jointly submitted the proposal for the Project.

“Consortium Member” means each entity in the Consortium shall be referred to as a Consortium Member.

“Damages” shall have the meaning set forth in Sub-clause (t) of Clause 1.2;

“Developmental and Operations Standard(s)” means the minimum parameters and standards to be achieved by the Concessionaire in the construction, development and operations of the Project in accordance with internationally sound engineering practices, National Building Code and Applicable Law and / or as determined by the relevant Governmental Authority;

“Dispute” shall have the meaning set forth in Clause 15.1.1;

“Dispute Resolution Procedure” means the procedure for resolution of Disputes set forth in Article 15;

“Effective Date” means the date on which all the conditions Precedent are satisfied or waived as per Article 4 in writing by both the Parties.

“Financial Commitment” means the legally binding undertaking of the Concessionaire to mobilize the financial requirements of the project, for ensuring the completion of the project;

“Financial Year” shall mean the year commencing from the 1st April of any calendar year and ending on 31st March of the next calendar year.

“Force Majeure” or “Force Majeure Event” shall have the meaning set forth in as per Clause 12;

“GOI” means the Government of India;

“Good Industry Practice” means the practices, methods, techniques, designs, standards, skills, diligence, efficiency, reliability and prudence which are generally and reasonably expected from a reasonably skilled and experienced operator engaged in the same type of undertaking as envisaged under this Agreement and which would be expected to result in the performance of its obligations by the Concessionaire in accordance with this Agreement, Applicable Laws and Applicable Permits in reliable, safe, economical and efficient manner;

“Government Instrumentality” means any department, division or sub-division of the Government of India or the State Government and includes any commission, board, authority, agency or municipal and other local authority or statutory body including



Panchayat under the control of the Government of India or the State Government, as the case may be, and having jurisdiction over all or any part of Lucknow or the performance of all or any of the services or obligations of the Concessionaire under or pursuant to this Agreement;

“Hospital Revenue” shall mean registration fees, hospital bed revenue, diagnostics – laboratory tests, consultation charges, operation charges and lease rental from the commercial facilities like bank, restaurant etc. Hospital Revenue shall not include revenue from pharmacy,

service apartments, training institutes and consumables cost directly reimbursed by the patients;

“Indemnified Party” means the Party entitled to the benefit of an indemnity pursuant to Article 14;

“Indemnifying Party” means the Party obligated to indemnify the other Party pursuant to Article 14;

“Lenders” shall mean the banks, financial institutions, international credit agencies that extend or agree to extend a credit facility to the Concessionaire in relation to the Project;

“Parties” means the parties to this Agreement collectively and “Party” shall mean any of the parties to this Agreement individually;

“Performance Security” shall have the meaning set forth in Clause 9.1;

“Project” shall mean Design, Build, Finance, Operate and Transfer of 500 Bed Super

Specialty Hospital with at least four specialties from the selected specialties like Trauma

centre, Plastic surgery unit, Burn Unit, Neurology, Ophthalmology in the hospital as

mentioned in Annexure B of this document, round the clock emergency unit along with

15 acres Site earmarked for the purpose in accordance with the provisions of this

Agreement at the end of the concession period;(more specifically as mentioned in

Article 2 of this agreement). The Project shall be named as Manyavar Sri Kanshiramji

Super Specialty Hospital.

“Project Completion Date” shall mean the date on which the Concessioning Authority has issued the Project Completion Certificate after completion of the Project and shall have the meaning set forth in Clause 11.2;

“Project Completion Certificate” shall mean the Project Completion Certificate issued by the Concessioning Authority certifying completion of Project by the Concessionaire;

“Revenue of the Hospital” shall mean registration fees, hospital bed revenue, diagnostics –

laboratory tests, consultation charges, operation charges and lease rental from the commercial

facilities like bank, restaurant etc. of that Financial Year. Revenue of the Hospital shall not

include revenue from pharmacy, service apartments, training institutes and consumables cost

directly reimbursed by the patients.

“Rs.” or “Rupees” refers to the lawful currency of the Republic of India;

“Security Interest” means any existing or future mortgage, charge (whether fixed or floating), pledge, lien, hypothecation, assignment, security interest or other encumbrances of any kind securing or conferring any priority of payment in respect of



any obligation of any Person and includes without limitation any right granted by a transaction which, in legal terms, is not the granting of security but which has an economic or financial effect similar to the granting of security in each case under any Applicable Law.

“Site” means the Project site measuring 15 acres as given in Schedule 1 of this Agreement given on lease for a total lease period of 90 years. The lease is renewed every 30 years till the end of the total lease period of 90 years. The Project shall mean the same as defined in this Agreement.

“Standards of Reasonable and Prudent Concessionaire” means the standards, practices, methods and procedures expected from a person seeking in good faith to perform its contractual obligations and in so doing and in the general conduct of its undertaking exercising that degree of skill, diligence, prudence and foresight which would reasonably and ordinarily be expected from a skilled and experienced Person engaged in the same type of undertaking under the same or similar circumstances and conditions including the conditions as contemplated by the Basic Documents.

“Taxation” or “Tax” means all forms of taxation whether direct or indirect and whether levied by reference to income, profits, gains, net wealth, asset values, turnover, added value or other reference and statutory, governmental, state, provincial, local governmental or municipal impositions, duties, contributions, rates and levies (including without limitation social security contributions and any other payroll taxes), whenever and wherever imposed (whether imposed by way of withholding or deduction for or on account of tax or otherwise) and in respect of any person and all penalties, charges, costs and interest relating to it;

“Third Party Agreements” means all Agreements entered into between the Concessionaire and third Persons, including, but not limited to other Agreements with Concessionaire and vendors of any goods or services to the Concessionaire.

“Termination” means the expiry of the Concession period or termination of this Agreement;

“Termination Notice” means the communication issued in accordance with this Agreement by one Party to the other Party terminating this Agreement;

1.2. Interpretation

1.2.1. In this Agreement, unless the context otherwise requires,

(a) references to any legislation or any provision thereof shall include amendment or re-enactment or consolidation of such legislation or any provision thereof so far as such amendment or re-enactment or consolidation applies or is capable of applying to any transaction entered into hereunder;

(b) references to laws of India or Indian law or regulation having the force of law shall include the laws, acts, ordinances, rules, regulations, bye laws or notifications which have the force of law in the territory of India and as from time to time may be amended, modified, supplemented, extended or re-enacted;

(c) references to a “person” and words denoting a natural person shall be construed as a reference to any individual, firm, company, corporation, society, trust, government,



state or agency of a state or any association or partnership (whether or not having separate legal personality) of two or more of the above and shall include successors and assigns subject to the provisions of this Agreement;

(d) the table of contents, headings or sub-headings in this Agreement are for convenience of reference only and shall not be used in, and shall not affect, the construction or interpretation of this Agreement;

(e) the words “include” and “including” are to be construed without limitation and shall be deemed to be followed by “without limitation” or “but not limited to” whether or not they are followed by such phrases;

(f) references to “construction” include, unless the context otherwise requires, investigation, design, developing, engineering, procurement, delivery, transportation, installation, processing, fabrication, testing, commissioning and other activities that are to be completed on or before “Project Completion Date” as per the scope of work as defined under Article 2, and “construct” shall be construed accordingly;

(g) any reference to any period of time shall mean a reference to that according to Indian Standard Time;

(h) any reference to day shall mean a reference to a calendar day;

(i) any reference to month shall mean a reference to a calendar month as per the Gregorian calendar;

(j) references to any date, period or Milestone shall mean and include such date, period or Milestone as may be extended pursuant to this Agreement;

(k) any reference to any period commencing “from” a specified day or date and “till” or “until” a specified day or date shall include both such days or dates; provided that if the last day of any period computed under this Agreement is not a business day, then the period shall run until the end of the next business day;

(l) the words importing singular shall include plural and vice versa;

(m) references to any gender shall include the other and the neutral gender;

(n) “lakh or lac” means a hundred thousand (100,000) and “crore” means ten million (10,000,000);

(o) references to the “winding-up”, “merger”, amalgamation”, “takeover”, “dissolution”, “insolvency”, or “reorganization” of a company or corporation shall be construed so as to include any equivalent or analogous proceedings under the law of the jurisdiction in which such company or corporation is incorporated or any jurisdiction in which such company or corporation carries on business including the seeking of liquidation, winding-up, reorganization, dissolution, arrangement, protection, change in management or relief of debtors;

(p) any reference, at any time, to any Agreement, deed, instrument, license or document of any description shall be construed as reference to that Agreement, deed, instrument, license or other document as amended, varied, supplemented, modified or suspended at the time of such reference; provided that this Sub-clause shall not operate so as to increase liabilities or obligations of the Concessioning Authority hereunder or pursuant hereto in any manner whatsoever;



(q) any Agreement, consent, approval, authorization, notice, communication, information or report required under or pursuant to this Agreement from or by any Party shall be valid and effective only if it is in writing under the hand of a duly authorized representative of such Party, as the case may be, in this behalf and not otherwise;

(r) the Schedules and Recitals to this Agreement form an integral part of this Agreement and will be in full force and effect as though they were expressly set out in the body of this Agreement;

(s) references to Recitals, Articles, Clauses, Sub-clauses or Schedules in this Agreement shall, except where the context otherwise requires, mean references to Recitals, Articles, Clauses, Sub-clauses and Schedules of or to this Agreement, and references to a Paragraph shall, subject to any contrary indication, be construed as a reference to a Paragraph of this Agreement or of the Schedule in which such reference appears; and

(t) the damages payable by either Party to the other of them, as set forth in this Agreement, whether on per diem basis or otherwise, are mutually agreed genuine pre-estimated loss and damage likely to be suffered and incurred by the Party entitled to receive the same and are not by way of penalty (the “Damages”).

(u) any reference to Build shall mean Construct and vice-versa unless the context otherwise requires

(v) any reference to Operate/Operations shall mean Operate and Transfer/ Operations & Maintenance unless the context otherwise requires

1.2.2. Unless expressly provided otherwise in this Agreement, any documentation required to be

provided or furnished by the Concessionaire to the Concessioning Authority and/or the agency or

person appointed by the Concessioning Authority shall be provided free of cost and in two copies,

and if the Concessioning Authority and/or the person appointed by the Concessioning Authority is

required to return any such documentation with their comments and/or approval, they shall be

entitled to retain one copy thereof.

1.2.3. the rule of construction, if any, that a contract should be interpreted against the parties responsible

for the drafting and preparation thereof, shall not apply.

1.2.4. any word or expression used in this Agreement shall, unless otherwise defined or construed in this

Agreement, bear its ordinary English meaning.

1.3. Measurements and Arithmetic Conventions All measurements and calculations shall be in the metric system and calculations done to 2 (two) decimal places, with the third digit of 5 (five) or above being rounded up and below 5 (five) being rounded down.

1.4. Priority of Agreements and Errors/Discrepancies

1.4.1. This Agreement, and all other Agreements and documents forming part of this Agreement are to

be taken as mutually explanatory and, unless otherwise expressly provided elsewhere in this



Agreement, the priority of this Agreement and other documents and agreements forming part

hereof shall, in the event of any conflict between them, be in the following order:

(a) this Agreement;

(b) RFP Document

(c) all other agreements and documents forming part hereof;

i.e. the agreement at (a) above shall prevail over the agreements and documents at (b) and (c) above and (b) shall prevail over all documents in (c) above.

1.4.2. In case of ambiguities or discrepancies within this Agreement, the following shall apply:

(a) between two or more Clauses of this Agreement, the provisions of a specific Clause relevant to the issue under consideration shall prevail over those in other Clauses;

(b) between the Clauses of this agreement and the Schedules, the Clauses shall prevail and between Schedules and Annexes, the Schedules shall prevail;

(c) between the written description on the Drawings and the Specifications and Standards, the latter shall prevail;

(d) between the dimension scaled from the Drawing and its specific written dimension, the latter shall prevail; and

(e) between any value written in numerals and that in words, the latter shall prevail.

Draft Concession Agreement for Design, Build, Finance, Operation and Transfer Manyavar Shri Kanshiramji Super Specialty Hospital in Lucknow

Request for Proposal – Volume II Page 13

Article 2.Article 2.Article 2.Article 2. Scope of the Project

2.1. Scope of the Project

The Concessionaire shall Design, Build, Finance, Own and Operate a Super Specialty Hospital on the 15 acre plot earmarked for the purpose over the concession period of 90 years, after which the facility will be transferred to the Concessioning Authority. The site shall be given on lease for the concession period of 90 years and the lease is

renewable twice during the concession period at every 30 years. The Project shall be named as Manyavar Sri Kanshiramji Super Specialty Hospital. Concessionaire’s brand name as suffix shall be allowed in the name of

Hospital.The maximum allowable FAR is 2.5 as per the prevailing Development Control Regulations of LDA .The successful bidder shall construct following facilities and get all the approvals for commercial operations within 36 months from the effective date.

A. Minimum Development Obligations (Essential Facilities):

• To build and operate 500-bedded Super-specialty hospital as per the International standards / Indian Public

Health Standard (IPHS). However, the Concessionaire is allowed to construct 250 bed capacity in initial three

years and remaining 250 bed capacity in next two years.

• Atleast four specialties from the following disciplines shall be developed in the Hospital.

Departments / Specialties

Trauma Care

Cardio Thoracic care unit (ICCU- Intensive Cardiac Care Unit)

Intervention specialty and Cerebral Intervention

Kidney Transplant (Hemodialysis)

Neurology unit

Obs & Gynecology

Pediatric unit (with NICU – Neonetal Intensive Care unit)

Dental unit for surgery

Ophthalmology and ENT

Cancer unit

• The hospital shall also have a round the clock emergency unit.

All the facilities are to be developed as per the minimum quality standards set out for the purpose in the Technical Schedule appended as Schedule B with this document.

While undertaking development of the Project, the Successful Bidder shall adhere to latest amended National Building Code of India, other relevant IS Codes and practices, Development Control Rules, FAR Limits, statutory requirements, guidelines and approvals of the Health Department of the Government of Uttar Pradesh, laws of land, the principles of good industry practices and any other norms as applicable from time to time. The developer shall also take into account the guidelines issued by the State Health Department and obtain the necessary approvals.

The Concessionaire shall be responsible for all the clearances as may be required for the development and operations of the project. The project shall be ready for operation after taking all the clearance(s) within 36 months from the effective date.

For the purpose of providing subsidized health services to poor, the Concessionaire shall provide 1% of the Revenue of the Hospital every year to the Uttar Pradesh Government Health Department for the entire



concession period. revenue of the hospital shall mean registration fees, hospital bed revenue, diagnostics – laboratory tests, consultation charges, operation charges and lease rental from the commercial facilities like bank, restaurant etc. Revenue of the Hospital shall not include revenue from pharmacy, service apartments, training institutes and consumables cost directly reimbursed by the patients.



Article 3.Article 3.Article 3.Article 3. Consideration of the Contract

3.1. The Consideration

3.1.1. Subject to and in accordance with the provisions of this Agreement, the Applicable Laws, rules and

regulations and the Applicable Permits, the Concessionaire shall pay to the Concessioning Authority:

_____% of the Hospital Revenue every year from the 11th year of the signing of the Concession Agreement

for the Concession period of 90 years.

The Concessionaire shall also pay to the Concessioning Authority an annual lease rental equivalent to 2% of

the land cost (considered as present circle rate) per acre of land on the 15 acre land earmarked for Super

Specialty Hospital for the entire concession period of 90 years. The lease period is renewed every thirty years

during the concession period.

3.1.2. Subject to and in accordance with the provisions of this Agreement, the Consideration hereby given by

Concessionaire, the Concessionaire shall be entitled to Construct and operate the Project on the land area

given on Concession period of 90 year, subject to :

(a) performing and fulfilling all of the Concessionaire’s obligations under and in accordance with this

Agreement; and

(b) bear and pay all costs, expenses and charges in connection with or incidental to the performance of the

obligations of the Concessionaire under this Agreement; and

(c) At the end of the concession period, the entire construction made by the Concessionaire till that date on the Project site as part of the scope of work shall get transferred without any consideration to the

Concessioning Authority.

3.1.3. In consideration of the mutual covenants and other good and valuable consideration expressed herein, the

Concessionaire hereby accepts the Consideration to be given and agrees to construct and operate the

Project on land given for 90 year Concession period as per the scope of work given in Article 2 and minimum

specifications mentioned in the technical schedules and to perform/discharge all of its obligations in

accordance with the provisions hereof.



Article 4.Article 4.Article 4.Article 4. Conditions Precedent to the Agreement

4.1. Conditions Precedent

4.1.1. The respective rights and obligations of the Parties under this Agreement shall be subject to the satisfaction

in full of the conditions precedent specified in this Clause 4.1 (the “Conditions Precedent”).

4.1.2. The Concessionaire may, upon providing the Performance Security to the Concessioning Authority in

accordance with Article 9, by notice require the Concessioning Authority to satisfy the Conditions Precedent

set forth in this Clause 4.1.2 within a period of 30 (thirty) days of the notice, and the obligations of the

Concessioning Authority hereunder shall be deemed to have been performed when the Concessioning

Authority shall have procured for the Concessionaire the peaceful possession of the Site as demarcated

under Schedule 1;

4.1.3. Concessionaire shall satisfy the Conditions Precedent at any time within 30 (thirty) days from the date the

Concessioning Authority has given the Letter of Intent for the appointment of the Concessionaire and all the

Conditions Precedent shall be deemed to have been fulfilled when the Concessionaire shall have

(a) provided Performance Security to the Concessioning Authority; and

(b) Delivered to the Concessioning Authority a legal opinion from the legal counsel of the Concessionaire with respect to the authority of the Concessionaire to enter into this Agreement and the enforceability of the provisions thereof

(c) The members of the Consortium must form a Special Purpose Vehicle (SPV) and submit an MoU for the purpose of Special Purpose Vehicle.

4.2. Compliance Certificate Upon compliance with the Conditions Precedent, each Party shall forthwith issue a Compliance Certificate pursuant to which the obligations of the Parties under this Agreement shall commence.

4.3. Non-Fulfillment of the Conditions Precedent

4.3.1. In the event of failure by any Party to procure compliance with any of the Conditions Precedent as per the

provisions of this Article 4 and the other Party have not waived any of the conditions (partially or absolutely),

the Agreement shall cease to have any effect as of that date.

4.3.2. In the event of the Agreement not coming into effect on account of the Concessionaire not fulfilling the

Conditions Precedent then the Concessionaire shall forfeit the Earnest Money Deposit and the Performance

Security.



4.3.3. In the event of the Agreement not coming into effect on account of the Concessioning Authority not fulfilling

any of the Conditions Precedent then the Earnest Money Deposit and the Performance Security shall be

returned to the Concessionaire.

4.3.4. Notwithstanding anything contained in this clause, the Parties may mutually decide to extend the time period

for the fulfillment of the Conditions Precedent.



Article 5.Article 5.Article 5.Article 5. Obligations of the Concessionaire

5.1. Obligations of the Concessionaire

5.1.1. Subject to and on the terms and conditions of this Agreement, the Concessionaire shall at its cost and

expense procure finance for and undertake the Project scope of work as mentioned in Article 2 and observe,

fulfill, comply with and perform all its obligations set out in this Agreement or arising hereunder.

5.1.2. The Concessionaire shall comply with all Applicable Laws in the performance of its obligations under this

Agreement.

5.1.3. Without prejudice to Clauses 5.1.1 and 5.1.2 above, the Concessionaire shall discharge its obligations as per

the National Building Code, Development Control Rules, the principles of good industry practice and as a

reasonable and prudent person, statutory requirements, laws of the land and any other norms, which are

applicable from time to time.

5.1.4. The Concessionaire shall get prior approval of the Concessioning Authority in case of there is any change in

the facilities defined under the Project during the Concession Period.

5.1.5. Without prejudice to Clauses 5.1.1 and 5.1.2 above the Concessionaire shall, at its own cost and expense

observe, undertake, comply with and perform, in addition to and not in derogation of, its obligations

elsewhere set out in this Agreement, the following:

(a) make, or cause to be made, necessary applications to the relevant Governmental Agencies with such particulars and details, as may be required for obtaining all Applicable Permits and obtain such Applicable Permits in conformity with the Applicable Laws;

(b) procure, as required, the appropriate proprietary rights, licences, agreements and permissions for materials, methods, processes and systems used or incorporated into development and operations of the Project;

(c) not to damage any other infrastructure or any other utility developed by the Concessioning Authority or any other utilities developed and maintained by any other authority or person and in case of any such damage to undertake the repair and also to pay for any losses that is incurred by the Concessioning Authority or any authority or any other person, as the case may be.

(d) ensure and procure that the Concessionaire shall comply with all Applicable Permits and Applicable Laws in the performance by them of any of the Concessionaire’s obligations under this Agreement;

(e) not to do or omit to do any act, deed or thing which may in any manner be violative of any of the provisions of this Agreement;

(f) not to create any third party rights, except for the purpose of borrowing from banks, on the land given on Concession for 90 years. But also to ensure that Government of UP/Concessioning Authority are not adversely affected in any way;



(g) shall make payment towards the Concessioning Authority as per provisions of this Agreement;

(h) Procure at its own costs, expenses and risk all services necessary for the construction and operations of the Project including without limitation electricity, water, materials and labour;

(i) shall ensure reservation in matters of employment as per applicable Government of UP policies

(j) shall complete construction of the Project and get necessary approvals for commercial operations within a period of 36 months from the Effective Date; and

(k) transfer the Project site on the date of termination of Concession to the Concessioning Authority.

5.2. Obligations relating to Other Agreements

5.2.1. It is expressly agreed that the Concessionaire shall, at all times, be responsible and liable for all its

obligations under this Agreement notwithstanding anything contained in any other agreement, and no default

under any agreement shall excuse the Concessionaire from its obligations or liability hereunder.

5.2.2. The Concessionaire may undertake development of Project by itself or through one or more contractors possessing requisite technical, financial and managerial expertise/capability; but in either case, the Concessionaire shall remain solely responsible to meet the scope of work as mentioned under Article 2.1.

5.3. Obligations relating to Change in Ownership

The Concessionaire shall not undertake or permit any Change in Ownership, except with the prior written approval of the Concessioning Authority as per the provisions of this Article 5.3.

5.3.1. No change in Consortium Members shall be allowed till the completion of the project or a minimum of 3 years

(whichever is later). However, the Lead Consortium Member shall not be allowed to be changed over the

entire Concession Period and shall continue to hold 51% stake in the Consortium till the start of Commercial

Operations. The Lead Consortium Member shall be allowed to dilute the stake after the commercial

operations date with the approval of the Concessioning Authority such that the stake of the Lead Consortium

Member in the consortium shall not fall below 26% at any time till the end of Concession Period.

5.3.2. Each Consortium Member shall invest minimum 11% stake in SPV. None of the Consortium Member shall be allowed to dilute its stake till the completion of the Project or a minimum of 3 years from the date of signing of the Concession Agreement (whichever is later).

5.3.3. Lead Consortium Member shall invest minimum 51% stake in the SPV. Lead Consortium Member shall not be allowed to dilute its stake to a level below 51% till the start of commercial operations. The Lead Consortium Member shall be allowed to dilute the stake after the commercial operations

date with the approval of the Concessioning Authority such that the stake of the Lead Consortium Member in the consortium shall not fall below 26% at any time till the end of Concession Period.



This holds for the single entity bidder also and hence no bidder who has 100% equity in the Project can dilute it to a level below 51% till the start of commercial operations. Remaining stake can be diluted as per the provisions of Clause 5.3.3.

5.4. Novation

The Concessionaire may be allowed to novate the agreement after completion of three consecutive years of commercial operations. The Concessionaire shall submit the details of the proposed novatee along with its other qualifications (financial and technical capabilities) to the Concessioning Authority for its due approval. Such novation shall be subject to execution of proper documents by the proposed novatee. Concessioning Authority shall reserve the right to reject any novation at any time.



Article 6.Article 6.Article 6.Article 6. Obligations of the Concessioning Authority

6.1. Obligations of the Concessioning Authority

6.1.1. The Concessioning Authority shall, at its own cost and expense, undertake, comply with and perform all its

obligations set out in this Agreement or arising hereunder.

6.1.2. The Concessioning Authority agrees to provide support to the Concessionaire and undertakes to observe,

comply with and perform, subject to and in accordance with the provisions of this Agreement and the

Applicable Laws, the following:

(a) upon written request from the Concessionaire, and subject to the Concessionaire complying with Applicable Laws, provide all reasonable support and assistance to the Concessionaire in procuring Applicable Permits required from any Government Instrumentality for implementation and operation of the Project;

(b) upon written request from the Concessionaire, assist the Concessionaire in obtaining access to all necessary infrastructure facilities and utilities, including water at rates and on terms no less favourable to the Concessionaire than those generally available to commercial customers receiving substantially equivalent services;

(c) extend the assistance of its good offices on a reasonable effort basis to assist the Concessionaire in the provision of electricity;

(d) procure that no barriers are erected or placed on the Project site or the way towards the Project site by the Concessioning Authority, by any Government Instrumentality or persons claiming through or under it, except for reasons of Emergency or national security, law;

(e) assist the Concessionaire in procuring Police assistance for regulation of movement of any person on the Project site, removal of trespassers and for security of the material, labour and machinery;

(f) not to do or omit to do any act, deed or thing which may in any manner be violative of any of the provisions of this Agreement; and

(g) support, cooperate with and facilitate the Concessionaire in the implementation of the Project.



Article 7.Article 7.Article 7.Article 7. Representations and Warranties

7.1. Representations and Warranties of the Concessionaire The Concessionaire represents and warrants to the Concessioning Authority that:

(a) it is duly organized and validly existing under the laws of India, and has full power and authority to execute and perform its obligations under this Agreement and to carry out the transactions contemplated hereby;

(b) it has taken all necessary corporate and other actions under Applicable Laws to authorize the execution and delivery of this Agreement and to validly exercise its rights and perform its obligations under this Agreement;

(c) it has the financial standing and capacity to undertake the Project in accordance with the terms of this Agreement;

(d) this Agreement constitutes its legal, valid and binding obligation, enforceable against it in accordance with the terms hereof, and its obligations under this Agreement will be legally valid, binding and enforceable obligations against it in accordance with the terms hereof;

(e) it is subject to the laws of India, and hereby expressly and irrevocably waives any immunity in any jurisdiction in respect of this Agreement or matters arising there under including any obligation, liability or responsibility hereunder;

(f) the information furnished in the Bid and as updated on or before the date of this Agreement is true and accurate in all respects as on the date of this Agreement;

(g) the execution, delivery and performance of this Agreement will not conflict with, result in the breach of, constitute a default under, or accelerate performance required by any of the terms of its Memorandum and Articles of Association or any Applicable Laws or any covenant, contract, agreement, arrangement, understanding, decree or order to which it is a party or by which it or any of its properties or assets is bound or affected;

(h) there are no actions, suits, proceedings, or investigations pending or, to its knowledge, threatened against it at law or in equity before any court or before any other judicial, quasi-judicial or other authority, the outcome of which may result in the breach of this Agreement or which individually or in the aggregate may result in any material impairment of its ability to perform any of its obligations under this Agreement;

(i) it has no knowledge of any violation or default with respect to any order, writ, injunction or decree of any court or any legally binding order of any Government Instrumentality which may result in any material adverse effect on its ability to perform its obligations under this Agreement and no fact or circumstance exists which may give rise to such proceedings that would adversely affect the performance of its obligations under this Agreement;

(j) it has complied with Applicable Laws in all material respects and has not been subject to any fines, penalties, injunctive relief or any other civil or criminal liabilities which in the aggregate have or may have a material adverse effect on its ability to perform its obligations under this Agreement;

(k) the existing Lead Consortium Members hold not less than 51% (fifty – one percent) of it’s issued and paid up Equity and together with the existing consortium member hold not less than 100% as on the date of this Agreement and the respective holding of each Consortium Member conforms to the representation made by the Consortium and accepted by the



Concessioning Authority as part of the Bid and that no member of the Consortium shall hold less than 11% (eleven per cent) of such as per the provisions of Article 5.3;

(l) no order has been made and no resolution has been passed for the winding up of the Concessionaire or for a provisional liquidator to be appointed in respect of the Concessionaire and no petition has been presented and no meeting has been convened for the purpose of winding up the Concessionaire. No receiver has been appointed in respect of the Concessionaire or all or any of its assets. The Concessionaire is not insolvent or unable to pay its debts as they fall due.

(m) no representation or warranty by it contained herein or in any other document furnished by it to the Concessioning Authority or to any Government Instrumentality in relation to Applicable Permits contains or will contain any untrue statement of material fact or omits or will omit to state a material fact necessary to make such representation or warranty not misleading; and

(n) no sums, in cash or kind, have been paid or will be paid, by it or on its behalf, to any person by way of fees, commission or otherwise for securing the grant of land or entering into this Agreement or for influencing or attempting to influence any officer or employee of the Concessioning Authority in connection therewith.

(o) It shall not novate the Concession Agreement and any rights and obligation arising therefrom to any party without any written approval from the Concessioning Authority

7.2. Representations and Warranties of the Concessioning Authority The Concessioning Authority represents and warrants to the Concessionaire that:

(a) it has full power and authority to execute, deliver and perform its obligations under this Agreement and to carry out the transactions contemplated herein and that it has taken all actions necessary to execute this Agreement, exercise its rights and perform its obligations, under this Agreement;

(b) it has taken all necessary action under the Applicable Laws to authorise the execution, delivery and performance of this Agreement;

(c) it has the financial standing and capacity to perform its obligations under the Agreement;

(d) this Agreement constitutes a legal, valid and binding obligation enforceable against it in accordance with the terms hereof;

(e) there are no actions, suits or proceedings pending or, to its knowledge, threatened against it at law or in equity before any court or before any other judicial, quasi-judicial or other authority, the outcome of which may result in the default or breach of this Agreement or which individually or in the aggregate may result in any material impairment of its ability to perform its obligations under this Agreement;

(f) it has no knowledge of any violation or default with respect to any order, writ, injunction or any decree of any court or any legally binding order of any Government Instrumentality which may result in any material adverse effect on the Concessionaire’s ability to perform its obligations under this Agreement;

(g) it has complied with Applicable Laws in all material respects;

(h) it has not entered into any other Agreement, contract, transaction, arrangement or understanding in relation to the same Project or part of the Project with any third party, or the sale, Concession assignment, or other disposition in whole or in part in respect of the said land other than the disclosed in this Agreement;



(i) all information provided by it in the Tender Notice and invitation to bid in connection with the Project is, to the best of its knowledge and belief, true and accurate in all material respects;

(j) it has good and valid right for construction of the Project, and has power and authority to give land on 90 years Concession to the Concessionaire; and

(k) upon the Concessionaire completing the Project as per this Agreement, and performing the covenants herein, it shall not at any time during the 90 years Concession, interfere with peaceful enjoyment of the land by the Concessionaire, except in accordance with the provisions of this Agreement.

7.3. Disclosure In the event that any occurrence or circumstance comes to the attention of either Party that renders any of its aforesaid representations or warranties untrue or incorrect, such Party shall immediately notify the other Party of the same. Such notification shall not have the effect of remedying any breach of the representation or warranty that has been found to be untrue or incorrect nor shall it adversely affect or waive any obligation of either Party under this Agreement.



Article 8.Article 8.Article 8.Article 8. Disclaimer

8.1. Disclaimer

8.1.1. The Concessionaire acknowledges that prior to the execution of this Agreement, the Concessionaire has,

after a complete and careful examination, made an independent evaluation of the Tender Notice, Scope of

the services to be provided, Project site, Specifications and Standards set for providing quality of services,

local conditions, possible demand and all information provided by the Concessioning Authority, and has

determined to its satisfaction the accuracy or otherwise thereof and the nature and extent of difficulties, risks

and hazards as are likely to arise or may be faced by it in the course of performance of its obligations

hereunder. Save as provided in Clause 7.2, the Concessioning Authority makes no representation

whatsoever, express, implicit or otherwise, regarding the accuracy and/or completeness of the information

provided by it and the Concessionaire confirms that it shall have no claim whatsoever against the

Concessioning Authority in this regard.

8.1.2. The Concessionaire acknowledges and hereby accepts the risk of inadequacy, mistake or error in or relating

to any of the matters set forth in Clause 8.1.1 above and hereby acknowledges and agrees that the

Concessioning Authority shall not be liable for the same in any manner whatsoever to the Concessionaire or

any person claiming through or under this Agreement.



Article 9.Article 9.Article 9.Article 9. Performance Security

9.1. Performance Security The Concessionaire has submitted to the Concessioning Authority Performance Guarantee of Rs. 12,00,00,000 (Rupees Twelve Crores Only) in the form of a Bank Guarantee in favor of Lucknow Development Authority, payable at Lucknow; the details of which are given below:

The Performance Security shall be valid for a period of twelve months and shall be renewed every year, at least 30 days prior to the last date. All charges, fees, costs and expenses related to the Bank Guarantee shall be borne and paid by the Concessionaire. 25% of the Performance Security in the form of bank guarantee shall be released to the Concessionaire on the issuance of Construction Completion Certificate by the Concessioning Authority. The next 25% of the Performance Security in the form of bank guarantee shall be released to the Concessionaire on the start of Commercial Operation. The Concessionaire undertakes and warrants to Concessioning Authority that the balance 50% of bank guarantee furnished as above shall be irrevocable and shall continue to be effective and enforceable six months beyond the period of six months from the date of the expiry of the Concession Period.

9.2. Appropriation of Performance Security Upon occurrence of a Concessionaire Default, the Concessioning Authority shall, without prejudice to its other rights and remedies hereunder or in law, be entitled to invoke and appropriate the relevant amounts from the Performance Security as Damages for such Concessionaire Default. Upon such invocation and appropriation from the Performance Security, the Concessionaire shall, within 15 (fifteen) days thereof, replenish, in case of partial appropriation, the Performance Security to its original level, and in case of appropriation of the entire Performance Security provide a fresh Performance Security, as the case may be, and the Concessionaire shall, within the time so granted, replenish or furnish fresh Performance Security as aforesaid failing which the Concessioning Authority shall be entitled to terminate this Agreement in accordance with Article 13.

9.3. Release of Performance Security

25% of the Performance Security in the form of bank guarantee shall be released to the Concessionaire on the issuance of Construction Completion Certificate by the Concessioning Authority. The next 25% of the Performance Security in the form of bank guarantee shall be released to the Concessionaire on the start of Commercial Operation. The balance 50% of the Performance Security in the form of bank guarantee shall remain in force and effect beyond the period of six months from the date of the expiry of the Concession Period. It shall be duly discharged and released to the Concessionaire beyond the period of six months from the date of expiry of the Concession Period and transfer of the Project along with the land to LDA.

The performance security in the form of bank guarantee shall be renewed every year till the end of the Concession Period and transfer of the Project along with the land to LDA. If the Agreement is terminated due to any event other than a Concessionaire Event of Default, the Performance Security shall, subject to the Concessioning Authority’s right to receive or recover amounts, if any, due from the Concessionaire under this Agreement, be duly discharged and released to the Concessionaire.



Article 10.Article 10.Article 10.Article 10. Access on Project Site

10.1. Project Site The Project site shall comprise of the land as described in Schedule- 1 and which shall be given on Concession by the Concessioning Authority to the Concessionaire for 90 years.

10.1.1. The Concessioning Authority on providing the performance security and signing this Agreement, shall

within 15 days, give on Concession to the Concessionaire, the Project site for 90 years for the Scope of the

Project as mentioned in Article 2.

10.1.2. It is being expressly agreed and understood that the Concessioning Authority shall have no liability

whatsoever in respect of survey and investigations carried out or work undertaken by the Concessionaire

pursuant hereto in the event of Termination or otherwise.

10.1.3. It is expressly agreed that the rights granted hereunder shall terminate automatically and forthwith, without

the need for any action to be taken by the Concessioning Authority to terminate the rights, upon the

Termination of this Agreement for any reason whatsoever.

10.1.4. It is expressly agreed that mining rights do not form part of the rights granted to the Concessionaire under

this Agreement and the Concessionaire hereby acknowledges that it shall not have any mining rights or

any interest in the underlying minerals on or under the area where cable have been laid. For the avoidance

of doubt, mining rights mean the right to mine any and all minerals or interest therein.

10.2. Others

10.2.1. Access to the Concessioning Authority and any person appointed as the Engineers / consultants appointed

by Concessioning Authority

The right of way granted for construction on the Project site shall always be subject to the right of access of

the person appointed by the Concessioning Authority for inspection, viewing and exercise of their rights

and performance of their obligations under this Agreement.

10.2.2. Special/temporary right of way

The Concessionaire shall bear all costs and charges for any special or temporary right of way required by it in connection with access to the Project Site. The Concessionaire shall obtain at its cost such facilities on or outside the Site as may be required by it for the purposes of the Construction and the performance of its obligations under this Agreement.



Article 11.Article 11.Article 11.Article 11. Construction on the Project Site

11.1. Obligations prior to the commencement of any work Prior to commencement of any work, the Concessionaire shall:

(a) submit to the Concessioning Authority time schedule for completion;

(b) appoint its representative duly authorised to deal with the Concessioning Authority in respect of all matters under or arising out of or relating to this Agreement;

(c) Undertake, do and perform all such acts, deeds and things as may be necessary or required before commencement of any work under and in accordance with this Agreement, the Applicable Laws and Applicable Permits; and

(d) Procure all such approvals/consents/permits as necessary as per applicable laws

11.2. Project Start and Completion date

11.2.1. On or after the Effective Date, the Concessionaire shall undertake construction of Project. The 36th month

from the Effective Date shall be the Scheduled Completion Date for completion of the Project and the

Concessionaire agrees and undertakes that atleast 250 beds of the Hospital shall be completed on or

before the Scheduled Completion Date. The remaining 250 beds shall be completed within 2 years from

the Scheduled Completion Date.

11.2.2. In the event that Project is not completed by the Scheduled Completion Date, unless the delay is on

account of reasons solely attributable to the Concessioning Authority or due to Force Majeure, the

Concessioning Authority shall encash 10% of the Performance Security amount per month, for a maximum

period of six months after which Concessioning Authority shall be entitled to terminate this Agreement. .

The Performance Security shall be replenished by the Concessionaire as soon the Performance Security is

encashed by the Concessioning Authority.

11.3. Completion Certificate The Concessionaire after completion of the Project shall inform in writing to the Concessioning Authority that it has completed the construction as per Project scope. The Concessioning Authority shall issue the Completion Certificate, after which the Concessionaire can start the commercial operations.



Article 12.Article 12.Article 12.Article 12. Force Majeure

12.1. Force Majeure As used in this Agreement, the expression “Force Majeure” or “Force Majeure Event” shall mean occurrence in India of any or all of events, as defined in Clause 12.2, if it affects the performance by the Party claiming the benefit of Force Majeure (the “Affected Party”) of its obligations under this Agreement and which act or event (i) is beyond the reasonable control of the Affected Party, and (ii) the Affected Party could not have prevented or overcome by exercise of due diligence and following Good Industry Practice, and (iii) has Material Adverse Effect on the Affected Party.

12.2. Force Majeure Events A Force Majeure Event shall mean one or more of the following acts or events:

(a) act of God, plague, lightning, earthquake, landslide, cyclone, flood, volcanic eruption, radioactive contamination;

(b) an act of war (whether declared or undeclared), invasion, armed conflict or act of foreign enemy)

(c) any failure of another service provider to the extent caused by any of the Force Majeure Event mentioned above affecting the performance of the Agreement;

(d) any event or circumstances of a nature analogous to any of the foregoing;

12.3. Duty to Report Force Majeure Event Upon occurrence of a Force Majeure Event, the Affected Party shall by notice report such occurrence to the other Party forthwith. Any notice pursuant hereto shall include full particulars of:

(a) the nature and extent of each Force Majeure Event with evidence in support thereof;

(b) the estimated duration and the effect or probable effect which such Force Majeure Event is having or will have on the Affected Party’s performance of its obligations under this Agreement;

(c) the measures which the Affected Party is taking or proposes to take for alleviating the impact of such Force Majeure Event; and

(d) any other information relevant to the Affected Party’s claim.

The Affected Party shall not be entitled to any relief under the Agreement for or in respect of a Force Majeure Event unless it shall have notified the other Party of the occurrence of the Force Majeure Event as soon as reasonably practicable, and in any event not later than 24 (twenty four) hours after the Affected Party knew, or ought reasonably to have known, of its occurrence, and shall have given particulars of the probable material effect that the Force Majeure Event is likely to have on the performance of its obligations under this Agreement.

12.4. Effect of Force Majeure Event Upon the occurrence of any Force Majeure Event the period set forth for the Project Completion Date shall be extended by a period equal in length to the duration of the Force Majeure Event.



12.5. Allocation of Costs Arising out of Force Majeure Upon occurrence of any Force Majeure Event, the Parties shall bear their respective costs and no Party shall be required to pay to the other Party any costs thereof. Neither Party shall be liable in any manner whatsoever to the other Party in respect of any loss, damage, cost, expense, claims, demands and proceedings relating to or arising out of occurrence or existence of any Force Majeure Event or exercise of any right pursuant hereto.

12.6. Dispute Resolution In the event that the Parties are unable to agree in good faith about the occurrence or existence of a Force Majeure Event, such Dispute shall be finally settled in accordance with the Dispute Resolution Procedure as mentioned in Article 15; provided that the burden of proof as to the occurrence or existence of such Force Majeure Event shall be upon the Party claiming relief and/or excuse on account of such Force Majeure Event.



Article 13.Article 13.Article 13.Article 13. Termination

13.1. Termination for Concessionaire Default Save as otherwise provided in this Agreement, in the event that any of the defaults specified below shall have occurred, and the Concessionaire fails to cure the default within the Cure Period set forth below, or where no Cure Period is specified, then within a Cure Period of 15 (fifteen) days, the Concessionaire shall be deemed to be in default of this Agreement (a “Concessionaire Default”), unless the default has occurred solely as a result of any breach of this Agreement by the Concessioning Authority or due to Force Majeure event. The defaults referred to herein shall include:

(a) the Performance Security has been partially or fully invoked and appropriated by the Concessioning Authority as per the Concession Agreement and the Concessionaire fails to replenish or provide fresh Performance Security within a Cure Period of 15 (fifteen) days;

(b) the Concessionaire does not make payment to the Concessioning Authority and remains in default for a period of more than 15 days from the due date of payment;

(c) the Concessionaire does not complete the Project as per the date mentioned in the Agreement and continues to be in default for 180 (One Hundred and Eighty) days;

(d) the Concessionaire does not construct and operate any of the items mentioned in the scope of work;

(e) the Concessionaire abandons or manifests intention to abandon the Project without prior written consent of the Concessioning Authority;

(f) the Concessionaire has failed to make any payment towards damages to any user or any utility within the period specified in this Agreement;

(g) the Concessionaire repudiates this Agreement or otherwise takes any action or evidences or conveys an intention not to be bound by the Agreement;

(h) Change in management control of the Concessionaire Company which according to the Concessioning Authority may have material adverse effect towards the completion of the Project.

(i) the Concessionaire is adjudged bankrupt or insolvent, or if a trustee or receiver is appointed for the Concessionaire or for the whole or material part of its assets at any time before the Scheduled Project Completion Date;

(j) the Concessionaire has been, or is in the process of being liquidated, dissolved, wound-up, amalgamated or reconstituted in a manner that would cause, in the reasonable opinion of the Concessioning Authority, a Material Adverse Effect;

(k) a resolution for winding up of the Concessionaire is passed, or any petition for winding up of the Concessionaire is admitted by a court of competent jurisdiction and a provisional liquidator or receiver is appointed and such order has not been set aside within 90 (ninety) days of the date thereof or the Concessionaire is ordered to be wound up by Court;

(l) the Concessionaire has failed to fulfill any obligation, for which failure Termination has been specified in this Agreement; or

(m) the Concessionaire commits a material default in complying with any other provision of this Agreement.



(n) The Concessionaire novates and /or assigns the agreement to any third party without any prior approval from the Concessioning Authority

13.2. Procedure to issue Termination Notice Without prejudice to any other rights or remedies which the Concessioning Authority may have under this Agreement, upon occurrence of a Concessionaire Default, the Concessioning Authority shall be entitled to terminate this Agreement by issuing a Termination Notice to the Concessionaire; provided that before issuing the Termination Notice, the Concessioning Authority shall by a notice inform the Concessionaire of its intention to issue such Termination Notice and grant 15 (fifteen) days to the Concessionaire to make a representation, and may after the expiry of such 15 (fifteen) days, whether or not it is in receipt of such representation, issue the Termination Notice.

13.3. Effect of Termination Upon Termination as per article 13.1, the Concessionaire hereby acknowledges that no Termination Payment shall be due or payable by the Concessioning Authority. Concessionaire acknowledges that within 10 days of termination, the Concessionaire vacates the Project site. Concessionaire acknowledges that once the agreement is terminated the land allocated shall be returned back to the Concessioning Authority. In such case, the lease deed will stand cancelled ipso facto and land is returned back to the Concessioning Authority automatically. The entire construction made by the Concessionaire till that date on the Project site as part of the scope of work shall get transferred without any consideration to the Concessioning Authority. Concessioning Authority at its own discretion may repay the consideration already paid by the Concessionaire after adjusting for any direct or indirect losses that Concessioning Authority might have incurred due to delay in completion of the Project. No liability with respect to the land or assets shall devolve on Concessioning Authority.

13.4. Other Rights and Obligations of the Concessioning Authority Upon Termination for any reason whatsoever, the Concessioning Authority shall:

(a) be deemed to have taken possession and control of the Project site and any construction made on such site till the date of termination;

(b) take possession and control of all materials, stores, implements and construction on or about the Project;

(c) be entitled to restrain the Concessionaire and any person claiming through or under the Concessionaire from entering upon the Project Site or any part of the Project; and

(d) Invoke the Performance Security as part Damages.

In case termination is done by the Concessioning Authority not because of the default of the Concessionaire, then in such condition the Concessioning Authority will pay for all the financial loses incurred by the Concessionaire and the quantum of the financial losses will be decided by the Arbitrator as per Clause 15.3.

13.5. The Concessioning Authority shall have at all times right to reject any third party which has been

proposed in relation to the novation of this agreement



Article 14.Article 14.Article 14.Article 14. Liability and Indemnity

14.1. General indemnity

The Concessionaire will indemnify, defend, save and hold harmless the Concessioning Authority and its officers, employees, agents and consultants against any and all suits, proceedings, actions, demands and third party claims for any loss, damage, cost and expense of whatever kind and nature arising out of any breach by the Concessionaire of any of its obligations under this Agreement or any related Agreement, except to the extent that any such suits, proceedings, actions, demands and claims have arisen due to any negligent act or omission, or breach of this Agreement on the part of the Concessioning Authority indemnified persons.

14.2. Liability of Concessioning Authority

The Concessioning Authority will indemnify, defend, save and hold harmless the Concessionaire against any and all suits, proceedings, actions, demands and third party claims for any loss, damage, cost and expense of whatever kind and nature arising out of

(a) defect in title and/or the rights of the Concessioning Authority in the land given on Concession to the Concessionaire

(b) breach by the Concessioning Authority of any of its obligations under this Agreement or any related Agreement, which materially and adversely affect the performance by the Concessionaire of its obligations under this Agreement, save and except that where any such claim, suit, proceeding, action, and/or demand has arisen due to a negligent act or omission, or breach of any of its obligations under any provision of this Agreement or any related Agreement and/or breach of its statutory duty on the part of the Concessionaire, its subsidiaries, affiliates, contractors, employees or agents and the same shall be the liability of the Concessionaire.

14.3. Indemnity by the Concessionaire

Without limiting the generality of Clause 14.1, the Concessionaire shall fully indemnify, hold harmless and defend the Concessioning Authority from and against any and all loss and/or damages arising out of or with respect to:

(a) failure of the Concessionaire to comply with Applicable Laws and Applicable Permits; (b) payment of taxes required to be made by the Concessionaire in respect of the income or

other taxes of the Concessionaire’s contractors, suppliers and representatives; or (c) non-payment of amounts due as a result of materials or services furnished to the

Concessionaire or any of its contractors which are payable by the Concessionaire or any of its contractors.

(d) Breach by the Concessionaire of any of the obligations under this Agreement.



14.4. No consequential claims

Notwithstanding anything to the contrary contained in this Article 14, the indemnities herein provided shall not include any claim or recovery in respect of any cost, expense, loss or damage of an indirect, incidental or consequential nature, including loss of profit, except as expressly provided in this Agreement.

14.5. Survival on Termination

The provisions of this Article 14 shall survive Termination.



Article 15.Article 15.Article 15.Article 15. Dispute Resolution

15.1. Dispute resolution

15.1.1. Any dispute, difference or controversy of whatever nature howsoever arising under or out of or in relation to

this Agreement (including its interpretation) between the Parties, and so notified in writing by either Party to

the other Party (the “Dispute”) shall, in the first instance, be attempted to be resolved amicably in

accordance with the conciliation procedure set forth in Clause 15.2.

15.1.2. The Parties agree to use their best efforts for resolving all Disputes arising under or in respect of this

Agreement promptly, equitably and in good faith, and further agree to provide each other with reasonable

access during normal business hours to all non-privileged records, information and data pertaining to any

Dispute.

15.2. Conciliation In the event of any Dispute between the Parties, either Party may call upon the Vice Chairman of the Concessioning Authority to mediate and assist the Parties in arriving at an amicable settlement thereof. Failing mediation by the Vice Chairman of the Concessioning Authority within 7 (seven) days from the date of reference to discuss and attempt to amicably resolve the Dispute , either Party may require such Dispute to be referred to the Principle Secretary, Housing for amicable settlement. If the Dispute is not resolved as evidenced by the signing of written terms of settlement within 30 (thirty) days of the notice in writing referred to in Clause 15.1.1 or such longer period as may be mutually agreed by the Parties, either Party may refer the Dispute to arbitration in accordance with the provisions of Clause 15.3.

15.3. Arbitration

15.3.1. Any Dispute which is not resolved amicably by conciliation, as provided in Clause 15.2, shall be decided by

reference to Arbitral Tribunal appointed in accordance with Clause 15.3.2. Arbitration shall be held in

accordance with the provisions of Arbitration and Conciliation Act, 1996 .The venue of arbitration shall be

Lucknow, and the language of arbitration proceedings shall be English.

15.3.2. The Arbitral Tribunal shall consist of three arbitrators. Each Party shall appoint one arbitrator, and the third

arbitrator shall be appointed by the two arbitrators so appointed, and in the event of disagreement between

the two arbitrators, the appointment shall be made in accordance with the Arbitration and Conciliation Act,

1996.

15.3.3. The arbitrators shall make a reasoned award (the “Award”). Any Award made in any arbitration held

pursuant to this Article 15 shall be final and binding on the Parties as from the date it is made, and the

Concessionaire and the Concessioning Authority agree and undertake to carry out such Award without

delay.



15.3.4. The Concessionaire and the Concessioning Authority agree that an Award may be enforced against the

Concessionaire and/or the Concessioning Authority, as the case may be, and their respective assets

wherever situated.

15.3.5. This Agreement and the rights and obligations of the Parties shall remain in full force and effect, pending

the Award in any arbitration proceedings hereunder.



Article 16.Article 16.Article 16.Article 16. Miscellaneous

16.1. Governing Law and Jurisdiction This Agreement shall be construed and interpreted in accordance with and governed by the laws of

India, and the courts at Lucknow shall have jurisdiction over matters arising out of or relating to this Agreement.

16.2. Waiver of Immunity Each Party unconditionally and irrevocably:

(a) agrees that the execution, delivery and performance by it of this Agreement constitute commercial acts done and performed for commercial purpose;

(b) agrees that, should any proceedings be brought against it or its assets, property or revenues in any jurisdiction in relation to this Agreement or any transaction contemplated by this Agreement, no immunity from such proceedings shall be claimed by or on behalf of the Party with respect to its assets;

(c) waives any right of immunity which it or its assets, property or revenues now has, may acquire in the future or which may be attributed to it in any jurisdiction; and

16.3. Delayed Payments The Parties hereto agree that payments due from one Party to the other Party under the provisions

of this Agreement shall be made within the period set forth therein, and if no such period is specified, within 15 (fifteen) days of receiving a demand along with the necessary particulars. In the event of delay beyond such period, the defaulting Party shall pay penalty for the period of delay calculated at a rate equal to 12% per annum, and recovery thereof shall be without prejudice to the rights of the Parties under this Agreement including Termination thereof.

16.4. Waiver

16.4.1. Waiver, including partial or conditional waiver, by either Party of any default by the other Party in the

observance and performance of any provision of or obligations under this Agreement:-

(a) shall not operate or be construed as a waiver of any other or subsequent default hereof or of other provisions or obligations under this Agreement;

(b) shall not be effective unless it is in writing and executed by a duly authorised representative of the Party; and

(c) shall not affect the validity or enforceability of this Agreement in any manner.



16.4.2. Neither the failure by either Party to insist on any occasion upon the performance of the terms,

conditions and provisions of this Agreement or any obligation thereunder nor time or other indulgence

granted by a Party to the other Party shall be treated or deemed as waiver of such breach or acceptance of

any variation or the relinquishment of any such right hereunder.

16.5. Liability for Inspection of Documents Except to the extent expressly provided in this Agreement:

(a) no review, comment or inspection by the Concessioning Authority of any document submitted by the Concessionaire nor any observation or inspection of any document or operations conducted at the Project Site hereunder shall relieve or absolve the Concessionaire from its obligations, duties and liabilities under this Agreement, the Applicable Laws and Applicable Permits; and

(b) the Concessioning Authority shall not be liable to the Concessionaire by reason of any review, comment, approval, observation or inspection referred to in Sub clause (a) above.

16.6. Exclusion of Implied Warranties etc. This Agreement expressly excludes any warranty, condition or other undertaking implied at law or

by custom or otherwise arising out of any other Agreement between the Parties or any representation by either Party not contained in a binding legal Agreement executed by both Parties.

16.7. Survival

16.7.1. Termination shall:

(a) not relieve the Concessionaire or the Concessioning Authority, as the case may be, of any obligations hereunder which expressly or by implication survive Termination hereof; and

(b) except as otherwise provided in any provision of this Agreement expressly limiting the liability of either Party, not relieve either Party of any obligations or liabilities for loss or damage to the other Party arising out of or caused by acts or omissions of such Party prior to the effectiveness of such Termination or arising out of such Termination.

16.7.2. All obligations surviving Termination shall only survive for a period of 5 (five) years following the date of

such Termination.

16.8. Entire Agreement This Agreement and the Schedules together constitute a complete and exclusive statement of the

terms of the Agreement between the Parties on the subject hereof, and no amendment or modification hereto shall be valid and effective unless such modification or amendment is agreed to in writing by the Parties and duly executed by persons especially empowered in this behalf by the respective Parties. All prior written or oral understandings, offers or other communications of every kind pertaining to this Agreement are abrogated and withdrawn.

16.9. Severability If for any reason whatever, any provision of this Agreement is or becomes invalid, illegal or

unenforceable or is declared by any court of competent jurisdiction or any other instrumentality to be invalid, illegal or unenforceable, the validity, legality or enforceability of the remaining provisions shall not be affected in any manner, and the Parties will negotiate in good faith with a view to



agreeing to one or more provisions which may be substituted for such invalid, unenforceable or illegal provisions, as nearly as is practicable to such invalid, illegal or unenforceable provision. Failure to agree upon any such provisions shall not be subject to the Dispute Resolution Procedure set forth under this Agreement or otherwise.

16.10. No partnership This Agreement shall not be interpreted or construed to create an association, joint venture or

partnership between the Parties, or to impose any partnership obligation or liability upon either Party, and neither Party shall have any right, power or authority to enter into any Agreement or undertaking for, or act on behalf of, or to act as or be an agent or representative of, or to otherwise bind, the other Party.

16.11. Third Parties This Agreement is intended solely for the benefit of the Parties, and nothing in this Agreement shall

be construed to create any duty to, standard of care with reference to, or any liability to, any person not a Party to this Agreement, unless expressly provided in this Agreement.

16.12. Successors and Assigns This Agreement shall be binding upon, and inure to the benefit of the Parties and their lawful

successors, as per the provisions of this Agreement.

16.13. Notices Unless otherwise stated, all notices, approvals, instructions and other communications for the

purposes of this Agreement shall be given in writing and may be given by facsimile, by personal delivery or by sending the same by prepaid registered mail addressed to the Party concerned at its address stated in the title of this Agreement or the fax numbers set out below and/or any other address subsequently notified to the other Parties for the purposes of this clause 16.14 and shall be deemed to be effective (in the case of registered mail) 10 calendar days after posting, (in the case of facsimile) two Business Days after receipt of a transmission report confirming dispatch or (in the case of personal delivery) at the time of delivery.

If to Concessioning Authority:

Address : Lucknow Development authority Pradhikaran Bhavan, Vipin Khand,

Gomti Nagar, Lucknow, Uttar Pradesh Tel: No. 0091-522-2302578

Fax No. 0091-522-2398386

Attention : Vice Chairman

If to the Concessionaire:

Address : Telephone : Fax :



Attention :

16.14. Language All notices required to be given by one Party to the other Party and all other communications, Documentation and proceedings which are in any way relevant to this Agreement shall be in writing and in English or Hindi language.

16.15. Counterparts This Agreement may be executed in two counterparts, each of which, when executed and delivered, shall constitute an original of this Agreement.

16.16. Validity This Agreement shall be valid for the entire concession period

IN WITNESS WHEREOF THE PARTIES HAVE EXECUTED AND DELIVERED

THIS AGREEMENT AS OF THE DAY, MONTH AND YEAR FIRST ABOVE

WRITTEN.

SIGNED, SEALED AND SIGNED, SEALED AND

DELIVERED DELIVERED

For and on behalf of For and on behalf of

Concessioning Authority (Lucknow Development CONCESSIONAIRE by: Authority) by:

(Signature) (Signature)

(Name) (Name)

(Designation) (Designation)

In the presence of:

1.

2.


Request for Proposal – Volume II

Page 41

Schedule 1.Schedule 1.Schedule 1.Schedule 1. Project Site

Details of Site :-

Site Photograph


Request for Proposal – Volume II

Page 42

Location Map

43

Schedule 2.Schedule 2.Schedule 2.Schedule 2. Technical Schedule

The proposed Super specialty hospital at Lucknow shall have 500 beds. Atleast four specialties from the

following disciplines shall be developed in the Hospital.

Sr. No. Departments / Specialties

1 Trauma Care

2 Cardio Thoracic care unit (ICCU- Intensive Cardiac Care Unit)

3 Intervention specialty and Cerebral Intervention

4 Kidney Transplant (Hemodialysis)

5 Neurology unit

6 Obs & Gynecology

7 Pediatric unit (with NICU – Neonetal Intensive Care unit)

8 Dental unit for surgery

9 Ophthalmology and ENT

10 Cancer unit

The Concessionaire may also develop additional specialties other than those mentioned above. The hospital

shall also have a round the clock emergency unit.

A. Planning

The Concessionaire shall plan the facilities, manpower and the service as per the Indian Public Health Standard

(IPHS).

� The hospital shall be developed with 500 bed capacity within 36 months from the Effective Date.

However, the Concessionaire is allowed to construct 250 bed capacity within 36 months from the

Effective Date and remaining 250 bed capacity within 60 months from the Effective Date.

� The hospital shall be planned in accordance with the Development Control Regulations applicable to the

region and norms if any prescribed by the Medical Council of India, Ministry of Health and Family

Welfare and the State Health Department.

� The developer shall obtain necessary clearances and approval for the plans from the relevant authority

as per the requirements.

� Service Apartments can be provided within the hospital complex to cater to the needs of the patients

and their relatives.

� Institute offering Laboratory Technician courses, Nursing courses can also be developed within the

hospital complex.

� Restaurants, ATMs, Pharmacy for the convenience of the patients can be provided within the hospital

complex.

� Research Institutes can also be setup in the hospital complex.

� Helipad for picking up patients may be provided.

B. Designing

� Modular design to enable addition of new departments, least disturbance to existing facilities, quality,

and added benefits of economy of scale shall be preferred.

� Architectural design norms as per NBC (National Building Code – 2005)

� Structural Design norms as per NBC and BIS (Bureau of Indian Standards)

� Services design norms as per CPEEHO (Central Public Health and Environmental Engineering

Organisation), NBC and BIS

44

In case of contradiction between the IPHS norms and the Design Norms specified above, the former shall prevail.

C. Construction

The construction shall be strictly as per the design norms specified above.

Pre Feasibility Report-Manyavar Shri Kanshiramji Super

Specialty Hospital, Lucknow

i

Disclaimer:

Neither Awas Bandhu, UP nor their employees or consultants make any

representation or warranty as to the accuracy, reliability or completeness of

the information in this Pre Feasibility report . Awas Bandhu, UP nor their

employees or consultants take any responsibility for any kind of investment

done on the basis of this report. This report is only for reference of the

bidders.



ii

Table of Content

1 Background ........................................................................................... 4

1.1 About Awas Bandhu UP & Lucknow Development Authority 4

1.2 Lucknow City Profile 6

2 Benchmarking Study ...................................................................... 10

2.1 Indian Healthcare Scenario 10

2.2 Key Healthcare Statistics 12

2.3 Demand Drivers for Healthcare 13

2.4 Benchmarking of Hospitals 21

2.5 Key Observations 36

3 Healthcare Scenario in Uttar Pradesh................................... 42

3.1 Healthcare Facilities in Lucknow 49

3.2 Partial List of Hospitals 49

3.3 Partial List of Diagnostic Clinics 50

4 Project costing and Phasing....................................................... 52

4.1 Site Details 52

4.2 Departments proposed in the Hospital 53

4.3 Hospital Configuration 53

4.4 Area Statement 54

4.5 Capital Expenditure 55

4.6 Project Costing and Phasing 57

4.7 Project Funding 57

5 Feasibility Study ............................................................................... 58

5.1 Revenue Assumptions 58

5.2 Operating Expenses 61

5.3 Summary of Operating Expenses 64

5.4 Debt and Interest Repayment 64

5.5 Financial Viability 65

5.6 Projected Profit and Loss Statement 65

5.7 Projected Balance Sheet 66

5.8 Projected Cash Flow Statement 66

6 Conclusion ............................................................................................ 67



iii

Abbreviations

FSI Floor Space Index

GoUP Government of Uttar Pradesh

IURP Integrated Urban Rejuvenation Plan

JCAHO Joint Commission on the Accreditation of Healthcare Organisation

JCI Joint Commission International

LDA Lucknow Development Authority

WHO World Health Organisation



4

1 Background

1.1 About Awas Bandhu UP & Lucknow Development

Authority

The Government of Uttar Pradesh intends to develop the infrastructure of

major cities in the Uttar Pradesh namely Ghaziabad, Meerut, Agra, Aligarh,

Allahabad, Varanasi, Lucknow and Kanpur in the areas of Healthcare,

Education, Transportation and Recreation through PPP and is in the process of

preparation of Integrated Urban Rejuvenation Plan (IURP). The UP

Government has set up a nodal agency namely Awas Bandhu, UP for

implementation of the projects in these cities.

Lucknow Development Authority was established in 1974 under the Uttar

Pradesh Urban Planning & Development Act 1973. LDA has progressed from

small beginnings to embrace an overreaching authority in the development

scenario of Lucknow. In consonance with the aspirations of modern India, LDA

aims at coordinated and planned development of a historical city: to enable

Lucknow to achieve pride of place as the worthy capital of the largest State of

the country which has played a very important role in the Freedom Struggle,

to extend urban infrastructure to absorb the pressures of a rapidly changing

society, and to provide an environment which would enable the utmost

satisfaction level of all sections of its inhabitants.

To fulfill its role, the Authority seeks to coordinate in accordance with a

comprehensive Master Plan along with the work of various other agencies

involved in the creation and extension of urban infrastructure.

It has initiated following development programmes:

� Development of Pollution free Planned Colonies healthy and Eco-friendly

Atmosphere and Environment.

� Development of Gomtinagar Scheme on Lucknow Faizabad Highway at

approx. 5 km. distance from Hazaratganj and Vidhan Sabha with



5

sectorwise development of Residential/ Commercial, Multiplex, Office

and School Plots

� Planned Sectorwise Development of Residential/ Commercial, Multiplex,

Office and School Plots at Hardoi Road Scheme, which is just 4 km. from

Medical College, 5 km. from Sitapur Road Highway and 3 km. from

Historical Places of Lucknow like "Bhool Bhulaiyan", "Chota Imambada",

"Ghantaghar"


Office and School Plots at Kanpur Road Scheme, which is just 5 km.

from Charbagh Railway Station, 3 km. from Amausi Airport.


Office and School Plots at Sitapur Road Scheme near Engineering

College and New Building of Lucknow University- Law Faculty.

� Beautification and Renovation work at various Public Places of Lucknow

� Development of a huge ground with the name of "Ambedkar Railly

Sthal" for the purpose of Political Meetings, Exhibitions and Mahotsav.

� Development of Kaiserbagh Heritage Zone in the heart of the city near

Kaiserbagh Baradari with beautification of Begum Hazratmahal Park,

Subhash Park, Laxman Park and Parivartan Chowk.

� Development of Kudiyaghat Picnic Spot on the banks of Gomti river at

Hussainabad Chowk.

� Renovation of the old Lohia Park in Chowk area. Also a huge Lohia Park

is being developed in Gomtinagar Scheme. The speciality of this park is

that 96 % of the total area is being developed as Green Space and

Herbal park.

� Keeping in View the demand in Gomtinagar Scheme, development of

Highway " Amar Shaheed Path" joining the Faizabad Road and Kanpur

Road and an ultra modern Scheme - Gomtinagar Extension has been

introduced.

Under the IURP, LDA intends to develop a 500 Bed Super-Specialty Hospital in

Lucknow through PPP. LDA has acquired 15 acres of land for this purpose.



6

1.2 Lucknow City Profile

Avadh counts among

the historical states

of India. At the end

of the twelfth

century, it was

conquered by the

Sultan of Ghazni,

and became a part

of the Delhi

Sultanate. Nawab

Asaf-ud-Daula,

moved the capital of

Avadh from

Faizabad to Lucknow

in 1775, and made

it, culturally and architecturally, one of the most splendid cities of India.

Architectural Zeal Nawab Asaf-ud-Duala was an inveterate builder of

monuments and a distinguish patron of the arts. He built Bara Imambara,

Rumi Darwaza and the Bibiapur Kothi. His Brother, Sadat Ali Khan after taking

over, added to the rich glory of Lucknow by building grand palaces including

Dilkusha, Hayat Baksh, Farhat Baksh as well as the famous Baradari.

The last of the Nawabs. Wajid Ali Shah, was imprisoned in 1856 in Calcutta.

One of his wives. Begum Hazrat Mahal remained in Lucknow and when the

mutiny broke out in 1857 she was the head of those fighting for freedom.

Every ruler of Lucknow, native or foreign has contributed in his own way to the

city’s architecture. There is much for the visitors to see in Lucknow. The city’s

landmark, which occupy a pride of place, include the Residency, Bara

Imambara, Rumi Darwaza, Husainabad Imambara, the Picture Gallery,



7

Sikandarabagh, (the grounds of which are now given to National Botanical

Research Institute) Dilkusha Palace Kaiserbagh Palace, the Hussainabad Clock

Tower etc.

Lucknow is the capital of India’s most populous state, Uttar Pradesh and is

situated about 500 km southeast of New Delhi in the heart of the state. The

City has a humid subtropical climate with a cool dry winter from December to

February and a hot summer from April to June. The temperature extremes

vary from about 45 degrees Celsius in the summer to 3 degrees Celsius in the

winter. The City receives about 100 cm of annual rainfall mostly from the

southwest monsoons between July and September. The city lies at an average

altitude of 110 meters above mean sea level and generally slopes to the east.

Lateral slopes are towards the River Gomti, which flows from north-west to

south-east through the heart of the city, dividing it into the Trans-Gomti and

Cis-Gomti regions. The more densely populated areas of the city are on the

southern bank of the River Gomti and several planned residential colonies have

been developed to the north of the River. Lucknow is known for its cultural

heritage.

Area of Lucknow is 79 Sq. Km. The population of Lucknow (including

Cantonment) as per 2001 census is 22,45,509 and is projected to touch

32,26,000 by 2011 as per the City Development Plan. Lucknow is well

connected by air and rail connectivity is also very good with all the major

stations in India.

1.2.1 Demographic and Social Profile

Lucknow Urban Agglomeration (LUA) became a million-plus city in 1981.

Besides the areas under jurisdiction of the Lucknow Municipal Corporation, the

agglomeration also includes the Lucknow Cantonment. Census 2001 estimated

the population of the Lucknow Urban Agglomeration at 22.46 lakhs. This

included an estimate of about 60,000 as population of the Lucknow

Cantonment and 21.85 lakh population of Lucknow City. The population of the

Lucknow Cantonment has remained constant in the last three decades.



8

Official records show that Lucknow’s population grew more than that of other

cities in the 1980s – mainly due to the extension of the jurisdiction of the

Lucknow Municipal Corporation – from 14,594 hectares in 1981 to 33,750

hectares in 1991. In the 1990s, average growth was cdomparable to that of

cities of similar size, more than Kanpur and Nagpur, but lower than Jaipur and

Surat.

The expansion in the 1980s meant the population density decreased from 69

persons per hectare to 49 persons per hectare, but has now increased to 67

persons per hectare due to population growth. The population growth

projected varies between 3.51 to 4.37 per cent per year over different 5-year

periods until 2021, somewhat higher than for the average growth rate of cities

of similar size in the country and the state. Migration into Lucknow accounts

for 36% increase in population over the last decade. Of the 5.76- lakh people

added to the LUA during 1991-2001, about 2 lakh were migrants. In

comparison, the natural growth was 3.68 lakh.

In the Lucknow Municipal Corporation, in 2002, there has been a steady

increase in the number of women per 1000 men – from 829 in 1971 to 849 in

1981, 862 in 1991 to 893 in 2001. Despite comparative economic prosperity

and better infrastructure and education facilities, literacy levels in the City vary

from those in other cities of similar size. The literacy rate in the Lucknow

Municipal Corporation area recorded in 2001 was 67.46%

1.2.2 Economy

The major industries in the Lucknow Urban Agglomeration include aeronautics,

machine tools, distillery chemicals, furniture and chikan embroidery. Lucknow

has traditionally been associated with chikan embroidery work on readymade

garments, sarees, etc. with most units being small scale and household based

and located in the old city area. Lucknow is also a major centre for research

and development (R&D) and an education centre. Lucknow, being a tehsil

headquarter, a divisional headquarter and the state capital, is a prominent

administrative and commercial centre of the state.



9



10

2 Benchmarking Study

2.1 Indian Healthcare Scenario

The global healthcare market has been one of the fastest growing markets in

the world over the last decade. Underlying this growth is a combination of

factors such as a) enhanced living standards, b) increase in aging population,

c) growing healthcare awareness and d) market-oriented industrial reforms in

many countries.

The healthcare industry is the world's largest industry with global revenues of

an estimated $2.8 trillion, or close to 9 per cent of global domestic product

(GDP). U.S. health care expenditures are $1.68 trillion in 2003. (Source : CII-

McKinsey Report).

The size of Indian healthcare industry is about US$ 20 billion (close to Rs

100,000 crore, or about 5% of GDP) and India could emerge as a major player

owing to its high population (1.05 bn- 2001census survey), which is the

second largest in the world.

India's healthcare sector has been growing rapidly and estimated to be worth

US$ 40 billion by 2012, according to Pricewaterhouse Coopers in its report,

'Healthcare in India: Emerging market report 2007'. Revenues from the

healthcare sector account for 5.2 per cent of the GDP, making it the third

largest growth segment in India.

The sector's growth will be driven by the country's growing middle class, which

can afford quality healthcare. Over 150 million Indians have annual incomes of

more than US$ 1,000, and many who work in the business services sector

earn as much as US$ 20,000 a year. Today at least 50 million Indians can

afford to buy Western medicines-a market only 20 per cent smaller than that

of the UK.



11

The growing purchasing power of Indian patients is revealed in the increased

business of air ambulance services. Around 365 airliftings worth several

millions of rupees happen in Delhi in a year on average.

If the economy continues to grow faster than the economies of the developed

world, and the literacy rate keeps rising, much of western and southern India

will be middle class by 2020.

To meet this demand, the country needs US$ 50 billion annually for the next

20 years, says a CII study. India needs to add 2 million beds to the existing

1.1 million by 2027, and requires immediate investments of US$ 82 billion.

Funds in the sector have been largely private. In fact, it is believed that the

private sector provides 60 per cent of all outpatient care in India and as much

as 40 per cent of all in-patient care. It is estimated that nearly 70 per cent of

all hospitals and 40 per cent of hospital beds in the country are in the private

sector, says PWC.

In India, 5% of the national annual expenditure is on healthcare. India’s

expenditure on health is relatively high when compared to other South Asian

countries

a) Pakistan – 3.2%

b) Sri Lanka – 3.7%

c) Bangladesh – 3.1%

(Source : UNDP 2005)

Of this, 81% of the outpatient care and 56% of inpatient care is being

provided by the private sector in the country while employers account for 9 %

and insurance cover, 5 per cent of the total healthcare expenses.

As per the study of CII and McKinsey the sector is growing at 13%, consumers

are likely to increase total healthcare spending from Rs 86,000 crore (2001) to

more than Rs 200,000 crore (2012)



12

2.2 Key Healthcare Statistics

India has 503,900 Doctors, 737,000 Nurses, 162 Medical Colleges, 143

Pharmacy Colleges and 350,000 Chemists. There are 43,322 hospitals and

dispensaries accounting for 870,161 hospital beds in India. There is an

extensive three-tiered government healthcare infrastructure comprising

23,000 Primary Health Centers and 137,000 sub-centers serving, the semi-

urban and rural areas and more than 3000 Community Health Centers.(Source :

NHP- 2002)

2.2.1 Quality

On the quality front the Indian Healthcare

Sector, lags behind. For instance, India has

1.5 beds per 1,000 people while China,

Brazil and Thailand have an average of 4.3

beds. The density of doctors is also low.

There are only 43 doctors for a population of

10,000.This is a result of the poor

performance of the health system in terms

of coverage, purchasing and delivery. The

country is below international standards on

basic healthcare infrastructure and facilities.

One of the main reasons underlying the poor state of healthcare facilities in

India happens to be the very low levels of public expenditure in health sector,

which happens to be among the lowest in the world. The healthcare spending

Per Capita is low in India as compared to other countries, which is as low as

$71.



13

2.3 Demand Drivers for Healthcare

2.3.1 Change in Demographics

The most important structural change affecting the Indian healthcare sector is

the changing demographic and socio-economic profile. As India has been

demographically late expanding, the proportion of the country's population in

the 15-54 and the 54 years and above age groups is increasing. The average

age of the Indian population for many years has been less than that of the

general population. However, successes at improving the health status of

Indian people have resulted in a rapid life span increase, with a corresponding

increase in our elder population. Those numbers are expected to increase

greatly in the coming years. Unfortunately, the prevalence of chronic disease

among Indian elders also continues to increase, contributing to a frail,

medically complicated elder population with increasing long-term care needs.

Projections of current levels of functional impairment and current population

growth rates into the next decade suggest a 51 per cent increase in the

number of elders with functional impairment by 2010. The increase in the

proportion of the working age group (15-54) is being accompanied by an

unprecedented rise in per capita income, which is ushering in lifestyle and

consumption patterns markedly different from that observed, five years ago.

And with lifestyle patterns changing, the country’s disease profile has been

changing too.

2.3.2 Change in Disease Profiles

� 61% spend –out patient care

� 39% spend- in patient care

� 57%- outpatients-spend on acute infections

� 85%- inpatients- spend on cardio, cancer, accidents, acute infections

and maternity

� Substantial share of spending for inpatient care comes from urban and

rich Indians

� Inpatient care to grow to 47% of total spends

� Increase in inpatient spends on lifestyle diseases (cancer and

cardiovascular diseases)



14

With the rise in lifestyle diseases such as cancer and cardiovascular, the

spending pattern will change dramatically by 2012 with inpatient spending

accounting for 47% of the private health care spending, up from the 39% at

present. The outpatient spending which accounts for 61% of the private

spending at present will decrease in terms of share but increase in absolute

terms to Rs 74,000 crores.

2.3.3 Emergence of Corporate Hospitals

The emergence of corporate hospitals on a large scale is another important

development. Corporate entry into healthcare is important for the bed-supply

deficit to be bridged, as well as for the professionalisation of hospital

management. Of late modern management systems have penetrated most

healthcare institutions However, most hospitals organize their resources and

manpower within structures that have evolved rather than been designed.

Healthcare establishments such as hospitals, nursing homes, diagnostic

centres and clinical research organisations have been experiencing an

unprecedented growth during the last five years in India.

The growth of healthcare establishments in India is actually propelled by a

spurt in the income levels of the people and the consequent tendency to spend

more on health. This is indeed a positive indicator of a growing economy.

Prominent examples are Wockhardt Medical Centre and Apollo Clinics.

2.3.4 Increasing use of Information Technology and Entry

of International Players

Healthcare is racing towards high-tech, automated technologies and health

agencies wanting to distinguish themselves from the pack will have to opt for

leading -edge technologies.

This means healthcare delivery through application of telecommunications

technology or rather tele-medicine. This will transfer electronically, medical

data, including high resolution images, sounds, live video and patient records

from one location to another through telephone lines, ISDN, modem, Internet,

satellites, video-conferencing, etc.



15

Prominent examples are Wipro-GE Medical Systems is India’ s largest medical

systems sales and service provider. Drager Medical AG, a joint venture

between Dragerwerk AG and Siemens AG has entered India. Proton Health

Care has also entered the market realizing the growth potential for digital

health monitoring devices. Philips has emerged as the number 2 player in the

medical equipment market.

2.3.5 Health Maintenance Clinics

Few Indian corporates are in the process of establishing a new operational

system of linking the primary care with secondary and tertiary care, all under

one management. Besides, the healthcare providers plan to concentrate on

setting up small clinics known as Health Maintenance Clinics that provide

simple treatments and laboratory facilities in major ‘catchments areas.’ The

idea of connecting these clinics to the same organization’s larger diagnostic

centers and hospitals makes sense if further medical intervention in the form

of testing or hospitalizations are available or needed by the patient. Prominent

example are Kovai Medical Centre at Ramnagar and Perundarai.

2.3.6 Accreditation

A disturbing trend in this sector is the lack of standards of these

establishments in terms of their operations and services. There are a few

hospitals, diagnostic centres and CROs maintaining high standards but a large

majority of them are operating without any norms and good practices. Most of

the state governments have also been lax in framing rules to control the

activities of healthcare establishments. Hence, there has been no check in the

growth of these establishments and their standards in most parts of the

country.

The plan by the Central government to establish a National Commission for

Excellence in Healthcare, in this context, is certainly a welcome move. The

body, proposed by the National Commission for Macroeconomics and Health, is

expected to lay standards for the entire healthcare sector.



16

NCMH has also mooted establishment of a National Commission for

Accreditation for all healthcare institutions on the basis of standards prescribed

by NCEH. Standards followed by most of the nursing homes and diagnostic

centres in the country are pathetic and they are getting away with it. The need

for enforcing stringent standards in healthcare institutions is extremely

important especially when India is being looked at as a major source of clinical

research services to the global pharmaceutical industry.

A dozen or more CROs are doing extremely well with orders from US and

European companies. Many more are expected to set shops soon. An

accreditation system for CROs, as proposed by NCMH, could check the entry of

ill equipped ones into this sector. The good clinical practices as per the

amended Schedule Y of the Drugs and Cosmetics Act could also help to

upgrade the clinical practices in the country. Syngene International, Lotus

Labs, Rallis India Ltd are the leading players in this industry.)

In recognition of the quality of healthcare delivery services in India, a number

of Indian hospitals have received accreditation from international agencies

worldwide.

• Five hospitals in India -- Indraprastha Apollo Hospital (New Delhi),

Apollo Hospital (Chennai), Apollo Hospital (Hyderabad), Wockhardt

Hospital (Mumbai) and Shroff Eye Hospital (Mumbai) -- have been

accredited to the leading healthcare accreditation agency in the United

States, Joint Commission International (JCI).

• NHS of the UK has indicated that India is a favoured destination for

surgeries.

• The British Standards Institute has now accredited the Delhi-based

Escorts Hospital.

• India's independent credit rating agency CRISIL has assigned a grade 'A'

rating to super specialty hospitals like Escorts and multi specialty

hospitals like Apollo.

• Wockhardt Hospital has an exclusive association with Harvard Medical

International, the global arm of Harvard Medical School, the world's

leading medical institution.

• Max Healthcare, in collaboration with Singapore General Hospital, is into

clinical practice, research and training.



17

2.3.7 Medical Equipment Financing

In India, both Banks and Non-Banking Financial Companies ( NBFC’s) finance

Medical Equipment.

Bank of Baroda, ICICI and the State Bank of India (S.B.I) are among the

Banks that have a Medical Equipment Financing Division. L & T Finance Ltd,

also has a Medical Equipment Finance arm. Loans are offered for purchase of

new equipments as well as takeover or existing loans. The features include

a) Competitive Interest Rates

b) Flexible Repayment Structure.

2.3.8 Infrastructure

The current situation in the healthcare sector in India reflects poor

performance of the sector in terms of coverage, purchasing and delivery in

comparison to other developing countries such as Brazil.

For example, India has only 1.5 beds per 1000 people in comparison to the

average of 4.3 beds per 1000 in Brazil. In order to meet the growing demand

of healthcare in the country, huge investments worth Rs 1,00,000 crore to Rs

1,40,000 crore need to be made in infrastructure for providing cost effective

facilities in the next 10 years.

a) United States, the corresponding figure is 6 beds per 1000 people

b) Australia – 3.7 beds

c) U.K. – 3.7 beds

( Source WHO Report ‘01)

The bulk of the investments made will need to come from the private sector

for India to increase the distribution of medical facilities amongst its

population.

2.3.9 Insurance Coverage

The proportion of Health Care Financing in India is very low. Upto 83% of

India’s health-care spending is done by the Private Sector. Only 17% of

spending is done by the Public Sector. ( Source: CII-Mskinsey Report ’03)

This has been recognized by the National Health Policy and corrective steps

have being initiated.



18

India with a population of 1.05 billion experiences a vast inequity that exists in

the healthcare industry with Insurance Penetration at 3% in 2003 and 1% in

2001. Compared to Healthcare Insurance Penetration in United States. – 85%

(Source : K.P.M.G. Report ’03 )

In India, presently the health insurance exists in the form of Mediclaim policy

offered to the individual or to any group, association or corporate bodies.

Penetration of Mediclaim is currently carried out by state-owned insurance

companies, covering only about 2.5 million people i.e., less than even 0.50 per

cent of the country’s population. (Source : I.R.D.A.)

Geographic spread in terms of healthcare facilities and financing awareness is

limited. Selection Criteria by suppliers often restricts the poor (and more likely

to be ill ) from affordable pre-payment schemes.

Social insurance schemes available in India, such as the Employee State

insurance Scheme (ESIS) and Central Government Health Scheme (CGHS)

have restricted coverage to a very small segment of the population, around 3

per cent which shows there is a vast scope for the insurance coverage to be

increased to provide better healthcare facilities. Voluntary health insurance

market is estimated at Rs 4 billion currently and growing fast.

2.3.10 Investments

The opportunities presented by the healthcare sector have made it a major

draw for potential investors. The healthcare sector attracted US$ 379 million in

2006 - 6.3 per cent of the total private equity (PE) investment of US$ 5.93

billion. The PE deals that the sector attracted in 2006 were as large as inputs

into the automotive sector.

• Medical care services provider Apollo Hospitals group will invest about

US$ 235.69 million in the next 18 months to set up 15 hospitals in tier-

II and tier-III cities in India.

• The Indian government plans to invest US$ 177.22 million across the

golden quadrilateral (GQ) project, to develop nearly 140 trauma care

centres on the 6,500 km long north-south and east-west corridors.

• Competitor Fortis Healthcare Ltd will add 28 hospitals to its 12-hospital

chain by 2012.



19

• George Soros's fund Quantum and BlueRidge bought 10 per cent in

Fortis Healthcare.

• Manipal Health Systems raised over US$ 20 million equity from IDFC

Private Equity Fund.

• Bangalore-based HealthCare Global Enterprises raised over US$ 10

million in equity from IDFC.

• Metropolis Health Services, a diagnostic chain, raised over US$ 8 million

in equity from ICICI Venture.

• Investment firms Apax Partners, IFC and Trinity Capital have invested

over US$ 200 million in hospital firms.

2.3.11 Private healthcare

With private healthcare driving a large chunk of healthcare in India, the stage

is set for private healthcare players to take wing.

• Global Hospitals in Hyderabad, which had a modest beginning as a 150-

bed facility dedicated to multi-organ transplantation in Hyderabad, is set

to invest close to US$ 178 million in a couple of years to set up hospitals

in other metropolitan cities.

• Mumbai-based healthcare firm Wockhardt Hospitals is planning to set up

14 super-speciality hospitals across the country over the next two years,

which could entail an investment of up to US$ 152 million.

• Apollo Hospitals, Asia's largest healthcare group, is planning to expand

its operations by setting up 50 hospitals across the country, including

many in tier-II cities. It will invest US$ 5-9 million in each of the

facilities.

2.3.12 Medical Tourism

The attraction of high quality healthcare facilities at competitive costs has been

instrumental in a large number of foreign arrivals to access healthcare services

in India. Going by the current pace with which this segment has been growing,

the CII-McKinsey study estimates that revenues from this segment could touch

US$ 2.2 billion by 2012 (from the current figure of US$ 333 million).

Indian hospitals are fast becoming the first choice for an increasing number of

foreign tourists. Over 150000 medical tourists travelled to India in 2002 alone,

bringing in earnings of US$ 300 million. India's growing reputation as a major



20

medical tourism destination is attracting more and more visitors from Gulf

countries with many travel agents now offering packages combining treatment

with a vacation.

Cost of Key HealthCare Procedures

Currency: USD US Thailand India India healthcare cost-%

of US

Cardiac surgery 50,000 14,250 4,000 12.5

Bone marrow

transplant

62,500 62,500 30,000 13.33

Liver transplant 500,000 75,000 45,000 11.11

Orthopaedic

surgery

16,000 6,900 4,500 3.56

Source: IBEF Research

However, the Indian healthcare story is not about cost advantage only. It has

a high success rate and a growing credibility.

• Indian specialists have performed over 500,000 major surgeries and

over a million other surgical procedures including cardio-thoracic,

neurological and cancer surgeries, with success rates at par with

international standards.

• The success rate of cardiac bypass in India is 98.7 per cent against 97.5

per cent in the U.S.

• India's success in 110 bone marrow transplants is 80 per cent.

• The success rate in 6,000 renal transplants is 95 per cent.

The Government has also been proactive in encouraging prospects in this

sector with a number of initiatives:

• A new category of visa "Medical Visa" ('M'-Visa) has been introduced

which can be given for a specific purpose to foreign tourists coming into

India.

• Guidelines have been formulated by Department of AYUSH prescribing

minimum requirements for Ayurveda and Panchkarma Centres.



21

Consequently, easy access to visa facilities coupled with the best emerging

medical infrastructure in large and tertiary towns will lead to an increase in

foreign exchange earning through medical tourism. Annual earnings from

medical tourism is estimated to rise from the current US$ 815.32 million to

US$ 1.87 billion by 2012.

2.4 Benchmarking of Hospitals

Darashaw has collected information by way of secondary research details of

facilities provided by hospitals across India, their financials, education

initiatives of these hospitals, tariffs for their various services etc. The hospitals

covered as part of the secondary research are:

� Kovai Medical Centre and Hospital

� Indraprastha Apollo Hospitals

� Malar Hospitals Ltd.

� K. G. Hospital

� Malabar Institute of Medical Sciences Ltd.

� Wockhardt Hospitals

� Breach Candy Hospital Trust

� Madras Institute of Orthopaedics and Traumatology (MIOT) Hospitals

� Apollo Gleneagles

� Escorts Hospital and Research Centre Ltd.

� Lakeshore Hospital and Research Centre

� Other Hospitals

Comparison of the financials, facilities provided, pricing of services of these

hospitals will help in arriving at –

� Pricing of different services

� Revenue projections

� Cost of different components of the hospital project

� Departments

The findings from the Benchmarking studies can be compared with the primary

research data. This will help in developing pricing strategy for the various

services of the proposed hospital.



22

2.4.1 Kovai Medical Centre and Hospital

� Located at Coimbatore, TamilNadu

� Established in 1986

� 350 bed Multi-disciplinary Super Specialty Hospital

� Equipped with most modern equipments like CT Scanner, Angiography

equipment with DSA, Operating Microscope, Mammography, C-arm,

Color Doppler etc.

� 11 Operation Theatres

� Nearly 500 Outpatients & Inpatients are treated everyday

� 25 major and minor surgeries are performed everyday

� Super-speciality procedures like Coronary Bypass surgeries, Coronary

Angioplasty, Stent Implantation, Laparoscopic & Vascular Surgeries, Hip

& Knee replacements, Kidney transplants, complex Neuro surgeries are

regularly done.

� Hospital has two satellite medical centers at Ramnagar,Coimbatore and

Perundurai.

� Hospital is recognised to carry out Renal transplants, Corneal

transplants and Heart transplants by TamilNadu Government. Cadaver

transplant programmes are also done regularly

� Hospital is recognised by National Board of Examinations for training

DNB candidates in General surgery, Orthopaedic surgery, Cardiothoracic

surgery, Cardiology, Anesthesiology, and Obstetrics & Gynaecology.

� Hospital is recognised by the Royal College of Surgeons, Edinburgh to

train AFRCS candidates.

� Market price for land and building estimated to be Rs. 350 Cr. as of 31st

March 2006. (Source: Hindu Business Line)

Departments

Medical Surgical Other

Internal Medicine General Surgery Anaesthesiology

Cardiology Cardio-Thoracic Surgery Radiology & Imaging

Sciences

Dermatology Dentistry Laboratory Sciences

Endocrinology ENT Physical Medicine &



23

Medical Surgical Other

Rehabilitation

� Physiotherapy

� Occupational Therapy

� Artificial Limb Center

Gastro Enterology Neuro Surgery

Haematology & Haemato

Oncology

Obstetrics &

Gynaecology

Nephrology Ophthalmology

Neurology Orthopaedics

Paediatrics Paediatrics Surgery

Psychological Medicine &

De-Addiction

Plastic Surgery

Pulmonology Urology

Rheumatology Vascular Surgery

Master Health Check Up

Diabetology

Financials

Sr. No. Particulars 2005 2004 2003 2002

1 Sales (Net of Consulting Doctor Fee) Rs.

Cr.

40.55 35.08 30.92 29.12

2 Consulting Doctor Fee Rs. Cr. 5.86 4.3 3.5 2.8

3 PBDIT Rs. Cr. 6.06 6.3 5.78 6.26

4 PAT Rs. Cr. 1.16 1.14 0.48 1.54

5 Gross Fixed Assets Rs. Cr. 51.7 49 46 40.3

6 Medical Equipments Rs. Cr. 27.4 26.2 24.6 21.6

7 Medical Equipments to GFA 0.53 0.53 0.53 0.54

8 Sales to Gross Fixed Assets 0.78 0.72 0.67 0.72

9 PBDIT to Sales (%) 15% 18% 18.7% 21.5%

10 Debt Equity ratio 1.2 1.14 1.14 0.88

Tariffs for Health Check-up Programs

S.No. Name of The Check Up Cost

1 Executive master health check up plus for men Rs.4,500/-



24

S.No. Name of The Check Up Cost

2 Executive master health check plus up for women Rs.4,500/-

3 Executive master health check up Rs.3,500/-

4 Master health check up Rs.2,500/-

5 Senior citizen's master health check up Rs.3,000/-

6 Master health check up for children Rs.750/-

7 Pre marriage check up for men Rs.1,500/-

8 Pre marriage check up for women Rs.1,500/-

9 Comprehensive heart check up Rs.1,750/-

10 Comprehensive diabetic check up Rs.1,750/-

11 Cancer screening for men Rs.1,500/-

12 Cancer screening for women Rs.3,000/-

13 Master health check up for alcohol abusers Rs.2,250/-

14 Sexual dysfunction check up (Males) Rs.1,250/-

15 Health check up for Haj Pilgrimage / Foreign travels Rs.2,000/-

16 Routine health check up Rs.1,000/-

17 Pre employment check up Rs.1,000/-

Education Initiatives

� B.Sc (Nursing) Programme at KMCH College of Nursing – Started in

1993

� B.P.T programme at KMCH College of Physiotherapy – Started in 1994

� B.O.T course at KMCH College of Occupational Therapy – Started in

1995.

� B.Pharmacy degree course at KMCH College of Pharmacy – Started in

1995

� M.Sc (Nursing) started at KMCH College of Nursing in the year 1998 in

four specialities viz.,

a. Medical - Surgical Nursing

b. Child Health Nursing

c. Maternity Nursing

d. Community Health Nursing

� M.P.T started at KMCH College of Physiotherapy in the year 1999 in

three specialities viz.,

a. Advanced PT in Orthopaedics



25

b. Advanced PT in Neurology

c. Advanced PT in Cardio - respiratory diseases

� Diploma Courses

a. PGDMLT (Medical Lab Technician) – 2 year course

b. DMIT (Medical Imaging Technology) - 2 years

� Certificate Courses

a. Cath Lab Technician

b. Dialysis Lab Technician

2.4.2 Indraprastha Apollo Hospitals

� Located in New Delhi


� Total beds 695 including 138 ICU beds with provision for expansion to

1000 beds in future.

� No. of patients treated annually – about 2,00,000

� Land Area is 12 acres and Built-up area is about 6,75,000 Sq. Ft

� Has 14 Operation Theatres

� Has Joint Commission International USA Accreditation - Gold Standard

Certification

� 9,500 International Patients mainly from USA, Australia, Malaysia,

Yemen, Brunei and Tanzania

� 181 Consulting Doctors – Fee ranging from Rs. 350 – 500; average Rs.

400; This explains the reason for consulting fee contributing to about

25% of the hospital’s total income.

� Over 40 Departments

Tariff for Health Checkup Programs

Sr. No.

Name of the Health

Checkup

Price for Local

patients

Price for

International

Patients

1 Apollo Health Cheq Rs. 2,250/- $65

2 Apollo Executive Cheq Rs. 2,750/- $80

3 Apollo Heart Cheq Rs. 3,500/- $100

4 Apollo Whole Body Cheq Rs. 5,250/- $150

5 Apollo Well Women Cheq Rs. 1,350/- $35

6 Apollo Breast Cheq Rs. 1,000/- $30



26

Sr. No.

Name of the Health

Checkup

Price for Local

patients

Price for

International

Patients

7 Apollo Child Cheq Rs. 950/- $25

8 Apollo Diabetic Cheq Rs. 2000/- NA

9 Apollo Cancer Cheq Rs. 2000/- NA

10 Apollo Master Cheq Rs. 2250/- NA

Financials

Sr. No. Particulars 2005 2004

1 Sales (Excluding Consulting Doctor Fee) Rs. Cr. 146.5 136.2

2 Consulting Doctor Fee Rs. Cr. 47.6 44.4

3 PBDIT Rs. Cr. 38.2 39.3

4 PAT Rs. Cr. 16.34 15.5

5 Gross Fixed Assets Rs. Cr. 234.55 227.12

6 Medical Equipments Rs. Cr. 111.45 108.75

7 Medical Equipments to Gross Fixed Assets 0.47 0.48

8 Sales to Gross Fixed Assets 0.62 0.6

9 PBDIT to Sales 26.1% 28.9%

10 Debt Equity ratio 0.21 0.15

Education Initiatives

– Fellowship in Emergency Medicine

– Nursing - Offer 3 year diploma course in gen. Nursing & midwifery

(recognized by Indian nursing council & Delhi nursing council)

with an annual intake of 50 students.

2.4.3 Malar Hospitals Ltd.

� Located in Chennai

� Total No. of Beds - 250

� Leading centre for Cardiac Care, Renal Transplants, Neurosurgery,

Oto-laryngocoloy, Limb Reconstruction Surgery and Maxillo Facial

Orthodontology.

� The Department of Orthopaedic Surgery of Malar Hospitals is a reputed

centre for trauma care in India.

� Attracts International Patients from Bangladesh, Mauritius and Middle

East

Financials



27


1 Sales Rs. Cr. 15.86 16.19

2 Consulting doctor Fee Rs. Cr. 2.31 2.32

3 PBDIT Rs. Cr. 3.65 2.93

4 PAT Rs. Cr. -0.58 -0.67



7 Medical Equipments to GFA 0.4 0.45

8 Sales to GFA 0.45 0.43

9 PBDIT to Sales 23% 18.1%


2.4.4 K.G. Hospital

� Located at Coimbatore, TamilNadu

� Founded in 1974

� No. of beds : 300 bed Multi-specialty Hospital

� Employs over 250 doctors, 800 nurses, and 200 Para-medical staff

including consultants.

� Hospital has 2 intensive care units, 2 coronary care units and 1 post

operative intensive care unit

� Run by K. Govindswamy Medical Trust

� KG Hospital has been active in Medical Tourism. It offers Pick-up

services, translator, accommodation for international patients

� The centers of excellence of K.G. Hospital include KG Brain and Spine

Center, KG Heart Center, Joint and Replacement Center, Kidney Center,

KG Eye Hospital, KG Advanced Laprascopy Center

� Education Initiatives

o Diploma in General Nursing and Midwifery

o B.Sc. Nursing

o Post Basic B.Sc. Nursing

o M.Sc. Nursing

o BPT and MPT

o Certificate in MLT and Diploma in MLT

o Total no. of students in various programmes - about 1000



28

2.4.5 Malabar Institute of Medical Sciences Ltd.

� Location: Calicut, Kerala

� No. of beds: 300 bed Multi-specialty hospital

� Department: Has over 40 disciplines

� Has over 1200 employees including 100 full time doctors

� 12 Operation Theatres

� Financials (2004)

o Sales – Rs. 27.63 Cr.

o PBDIT- Rs. 4.86 Cr.

o PBDIT to sales – 17.6%

o PAT – Rs. 0.88 Cr.

o Gross Fixed Assets – Rs. 63.38 Cr.

o Sales to Gross Fixed Assets – 0.44

o Debt Equity Ratio – 0.26

� Education Initiatives

Sr. No. Name of the course Duration No. of

seats

1 DNB - General Medicine 3 Years 2

2 DNB - General Surgery 3 Years 1

3 DNB - ENT 3 Years 1

4 DNB - Anaesthesia 3 Years 2

5 DNB - Paediatrics 3 Years 1

6 DNB - Family Medicine 3 Years 2

7 Post Doctoral Certificate course in Cardiac

Anaesthesiology (PDCC) 2 years 2

8 Certificate Course in Critical Care Medicine

(Recognized by Critical Care Education

Foundation) 1 years 4

9 Critical Care Nursing 1 year 20

10 Diploma in Cardiac OT Nursing 1 year 2

11 Diploma in Cardiac Surgical ICU Nursing 2 years 2

12 Diploma in Cardiac Rehabilitation Technology

(CRT) 1 year 2

13 Post Graduate Diploma Course in Cardio

Vascular Technology(PGDCVT)

2 Years 4

14 DMLT - Diploma in Medical Laboratory 2 years 10



29

Sr. No. Name of the course Duration No. of

seats

Technology

15 Diploma Course in Anesthesia Technology 2 years 8

16 Diploma Course in C.S.S.D (Sterilization

Technology) 2 years 10

17 Diploma Course in Medical Records

Management 1.5 year 4

18 Diploma Course in Dialysis Technology (DDT) 2 years 2

19 Diploma in Endoscopy Technology 2 years 2

20 Diploma in Cardiac Operation theatre

technology (COTT) 2 years 2

21 Diploma in Podiatry Technology 2 years 2

22 Nursing Assistants Course 2 years 40

23 Physician Assistant Course 3+1 years 1

24 BSc. Nursing 4 years 50

25 GNM - General Nursing & Midwifery 3 ½ years 20

� Some of the Corporate Clients with whom MIMS has tie-ups are -

Airport Authority of India, Association of Senior Citizens, BSNL, Canara

Bank, E-Serve International, HPCL, HUDCO, IOC, Malayala Manorama,

Punjab National Bank, Taj Hotels, TATA Motors, Mathrubhumi, UTI, AMP

Sanmar, ICICI Prudential Life Insurance, HDFC Standard Life Insurance,

Metlife India, ING Vysya, Vijaya Bank, Indian Airlines, Air India, Jet

Airways etc.

� It also has tie-ups with following Third Party Administrators - Family

Health Plan Medi Assist, Medicare TPA Pvt Ltd., Paramount, TTK

Healthcare Pvt Ltd., Universal Medi-aid Services Ltd.

2.4.6 Wockhardt Hospitals

� No. of Hospitals : 5; Location: Mumbai, Bangalore, Kolkatta, Hyderabad,

Nagpur

� No. of beds: 420

� Wockhardt, Mumbai – First Super specialty hospital to achieve JCI

accreditation

� Special division to look after international patients



30

� Wockhardt Heart Hospital, Brain and Spine Hospital, Eye Hospital, Bone

and Joint Hospital, Minimal Access Surgery Hospital, Hospital and Kidney

Institute, Kolkatta

� Financials (2004):

o Sales – Rs. 76. 87 Cr.



o PAT – Rs. –(8.65) Cr. due to depreciation of Rs. 8.22 Cr. and

interest charge Rs. 8.36 Cr.

o Gross Fixed Assets – 125.73 Rs. Cr.


o Debt Equity Ratio – Negative networth and debt Rs. 124.21 Cr.

Charges for various procedures

Sr.

No. Procedure / Treatment

Wockhardt

Hospitals, India USA UK

1 Total Knee Replacement $6,000 $32,000 $11,700

2 Birmingham Hip Resurfacing $7,000 Not Available $19,000

3 Coronary Artery by-pass

surgery $7,600 $35,000 $16,000

4 Liposuction / Tummy Tuck $1,200-2,000 $ 4,500-

10,000

$ 2,700-

8,500

5 Face lift $1,800-3,200 $9,000 $10,200

6 Obesity Surgery (Gastric

Bypass) $9,000 $35,000 $20,100

2.4.7 Breach Candy Hospital Trust

� Location: Mumbai

� No. of beds : 173

� Over 17 departments and 8 operation theatres





o PAT – Rs. 17.34 Cr.




31


o Their investments in Mutual Funds and other investments to the

tune of Rs. 46.49 Cr.

o Debt Equity Ratio – Negligible debt.

2.4.8 Madras Institute of Orthopaedics and Traumatology

(MIOT) Hospitals

� Located in Chennai

� No. of beds is 250

� The hospital is spread over a land area of 22 acres

� No. of departments: 32




o PBDIT to sales – 28.6 %

o PAT – Rs. 1.56 Cr.




� Medical Tourism Initiative - In 2004-05, 26,000 from abroad to MIOT for

treatment, of them 1300 being foreigners. Ordinarily foreigners account

for 5-7 per cent of the total patients at MIOT.

� Expansion Plans - MIOT’s expansion plans include Rs. 28 Cr. on

extending Medicare facilities including an additional 85 beds

� 2004-05 revenues is Rs. 37 crore, a growth of Rs 6 crore and generated

a profit of around Rs. 7 Cr. (before tax). The number of patients visiting

India is expected to increase by 15 per cent annually in the future.

2.4.9 Apollo Gleneagles

� Location: Kolkatta


� Land area: 9 acres

� Setup with an investment of Rs. 2.1 billion



32

� Departments: Cardiology & Cardiothoracic Surgery, Neurology and

Neurosurgery, Gastroenterology, Nephrology, Orthopaedics,

Dermatology, Emergency

� JV between Apollo and Parkway Group, Singapore.

� 72-bed Intensive Care Unit, 7 Super-specialty Operation Theatres, 1

Emergency Operation Theatre, 2 Digital Cath Labs, 12-bed Dialysis Unit

� Serves as a healthcare hub for East and North East India, Bangladesh,

Myanmar, Nepal and Bhutan.

� Well-equipped 'Renal Transplant Unit'. First in Eastern India to introduce

the concept of 'Full Time Consultants'.



o PBDIT- Rs. -(0.66)Cr.

o PBDIT to sales – NA

o PAT – Rs. – (2.15) Cr.

o Gross Fixed Assets – Rs. 166.3 Cr. – Capital work in progress

very high


o Debt Equity Ratio – 4

2.4.10 Escorts Hospital and Research Centre Ltd.

� Location: Haryana


� No. of patients treated per year : More than 1,00,000

� Departments – 22





o Loss – Rs.1.46 Cr.






33

2.4.11 Lake shore Hospital and Research Centre

� Located at Kochi, Kerala

� Established in 2002 – First Phase with 350 beds at a cost of Rs. 50 Cr.

(Source: Project Monitor Online Edition dated 1st June 2002); Became

Operational from January 2003.

� Has 31 departments; Eight clinics – Liver, Pancreas, Proctology, IBD,

Epilepsy, Spine, Asthma, Rheumatoid Arthritis

� 40 Beds in Critical Care Unit

� Health Check-up Programs

Sr. No. Program Fee Rs.

1 Comprehensive Executive

Health Checkup 3900

2 Special Executive Health

Checkup 7500

3 Diabetes Basic Checkup 2900

4 Diabetes Comprehensive

Checkup 6900

5 Healthy Women Checkup 2000

� Patients from USA, Australia, Britain, Canada, Sweden, Italy, France,

Finland, Malaysia, Mauritius, Netherlands, UAE, Oman, Bahrain, Saudi

Arabia, Qatar, Kuwait, Chile, Tanzania, Tunisia, Libya, Kenya,

Bangladesh, Maldives, Japan.

� Financials


1 Sales Rs. Cr. 20.42 2.68

2 PBDIT Rs. Cr. 3.07 -0.83

3 PAT Rs. Cr. -4.08 -4.26


5 Land and Building Rs. Cr. 20.2 18.8

6 Plant and Machinery Rs. Cr. 20.81 19.22

7 Others Rs. Cr. 14 14

8 Share Capital Rs. Cr. 23.65 20.27

9 Debt Rs. Cr. 31.02 29.29

10 Sales to Gross Fixed Assets 0.37 0.05

11 Plant and Machinery to

Gross Fixed Assets

0.38 0.37

12 PBDIT to Sales (%) 15.03% -(30.97)%



34


13 Debt Equity Ratio 1.31 1.45

2.4.12 Apollo Hospitals, Chennai


� Major Departments: Cardiology & Cardiothoracic Surgery, Cancer care,

Cosmetic Surgery, Neuro Science, Nephrology & Urology, Orthopaedics,

Critical Care Medicine, Obstetrics and Gynaecology and IVF, Radiology &

Imaging Sciences

� Established 1983.

� Departments

� Comprehensive wellness centre - Ayurveda, Aromatherapy, Pranic

Healing, Yoga, Meditation and Music Therapy.

� 27,000 heart surgeries - success rate of 99.6%. in Bone Marrow

Transplant - success rate of 70%.

� Specialised Clinics - BreatheEazy - the Asthma Clinic, Andropause, Pain

Clinic, Migraine, Epilepsy, Stroke, Adolescent Clinic.


1 Sales Rs. Cr. 595.6 499.8

2 PBDIT Rs. Cr. 121.6 104.1

3 PAT Rs. Cr. 49.2 37.1



6 Medical Equipments to Gross Fixed

Assets

50.81% 50.63%

7 Sales to GFA 1.38 1.27

8 PBDIT to Sales 20.42% 20.83%


2.4.13 Apollo Hospitals, Hyderabad

� No. of beds: 550; patients treated annually: 1,00,000

� Land area: 35 acres; Built-up area: 1,90,000 Sq.ft.

� 50 Medical and Surgical disciplines.

� Average staff to patient ratio 3:1 with a 1:1 ratio in priority areas like

the ICU and Cardiac Care Unit.



35

� International patients from Tanzania, the USA, the UAE, Kenya, Oman

and neighbouring Asian countries.

� Has treated over 3 million patients so far. Over 1,00,000 Preventive

Health Checks done.

� Performed over 80,000 major and 1,20,000 minor surgeries. Over

10,000 cardiac surgeries with a success rate of 98.8 %. Over 12,000

interventional cardiac procedures with a success rate of 98.9 %. Over

600 renal transplants with a success rate of 95 %. Pioneers in balloon

and LASER angioplasty techniques. Pioneers in Keyhole spinal surgery.

2.4.14 Apollo, Colombo

� No. of beds – 254; Built-up area: 3,00,000 Sq.ft.

� Established June 2002.

� Equipped for over 500 beds. Over 1200 Cardiac Surgeries performed

with a 98.5% success rate.

� Treated over half a million patients since its inception.

2.4.15 Apollo, Bilaspur, Chattisgarh

� No. of beds: 275; Land area: 17 acres

� Established October 2001.

� Has treated more than 100,000 patients so far.

� Over 500 Cardiothoracic surgeries and 2200 Cardiac interventional

procedures with a success rate of 98.5%. Over 5500 major and 2000

minor surgeries that include: Neuro and Spinal surgeries, 1250

Orthopaedic surgeries including 95 Knee, Hip & Elbow joint

replacements, Over 400 Paediatric and Laparoscopic surgeries, Over

2500 eye surgeries, Uro-surgeries, Over 250 Oncology surgeries, 255

Plastic surgeries, Over 25 Facio- Maxillary surgeries.

2.4.16 Noida Medicare Centre Ltd.

� Located in Noida, Uttar Pradesh


� 120 bed hospital



36

� There are 14 medical departments; 15 surgical departments; 5

departments in the diagnostics services and 4 departments in the

clinical services

� Medical Tourism initiatives – Regional Office at Dhaka, Bangladesh.

Services like pick-up facilities, Travel and Tourism assistance, Visa and

Foreign Exchange assistance etc.

� One of the first hospitals in India having tie-up arrangement with major

Insurance Companies for Mediclaim registered under IRDA

� Health Check-up rates

o Preliminary/Pre-employment Health Check – Rs. 500/-

o General Health Check Rs. 900/-

o Well Women Check Rs. 1500/-

o Executive Health Check – Rs. 3000/-





o PAT – Rs.(- 0.69) Cr. (Loss)

o Gross Fixed Assets – Rs. 47.58Cr.

o Medical Equipment – Rs. 15.81 Cr.

o Medical Equipment to Gross Fixed Assets – 0.33



2.4.17 Ruby Hospital, Kolkatta

� Founded in 1995

� Medical Tourism being thrust area

� Special rates

� Empanelled with BUPA, International – UK

� Empanelled with Vanbreda International – Belgium

2.5 Key Observations



37

Darashaw carried out secondary research on different hospitals in the country.

The research findings can be brought under the following heads –

� Financials

� Medical Tourism Initiatives

� Facilities and tariffs for services

2.5.1 Financials

� Apart from the 10 hospitals mentioned in this report, the financials of

smaller hospitals like Seahorse Hospitals Ltd., Devaki Hospital Ltd.,

Dhanvantri Jeevan Rekha Ltd., Dolphin Medical Services Ltd., Lakeshore

Hospital and Research Centre Ltd., CDR Healthcare Ltd., Secunderabad

Healthcare Ltd., Dolphin Medical Services Ltd. Peerless Hospitex Hospital

and Research Center Ltd. were studied.

� Many of these hospitals were making losses. One main reason is the

need for continuous investment in medical equipments. Medical

equipment constitute about 40-50% of Gross Fixed Assets.

� An ICU set-up, costs around Rs. 40-50 lakh per bed. (Source: Express

Healthcare Management Online issue dated 1st to 15th May 2005)

� Sales to Gross Fixed Assets on an average should be about 0.6 to

achieve a good operating profit margin of more than 15%. Super

Specialty Hospitals achieve this profit margin even with sales to gross

fixed assets of about 0.45.

� Lakeshore Hospital and Research Centre, Kochi, Kerala is a 350 bed

hospital constructed at a cost of Rs. 50 Cr. in 2002. It started

functioning from January 2003. The debt equity ratio was about 1.4. For

the year 2004, it achieved a profit margin of 15%.

� Consulting fee to doctors expenditure in most hospitals is about 10-15%

of the total income. However hospitals like Indraprastha Apollo which

has large number of consulting doctors (about 180) the consulting fee to

doctors’ account for 25% of the hospital’s total income. At Indraprastha

Apollo the Consulting fees charged by doctors is about Rs. 500/-.

� Depreciation on medical equipment has been increased from 25% to

40% as per the IT Act.



38

� Medical Equipment Financing – Banks like ICICI Bank, SBI, Union Bank

of India, Bank of Baroda offer Medical Equipment Loans. ICICI offers

medical equipment loan to the tune of 85% of the invoice amount. L&T

Finance Ltd. offers medical equipment lease financing to select

hospitals. They have tie-ups with medical equipment manufacturers.

� Average Revenue per Hospital bed

Particulars

Kovai

Medical

Center and

Hospital

Apollo

Indraprasth

a Hospital

Malar

Hospitals

Ltd.

Malabar

Institute of

Medical

Sciences

Ltd.

Wockhardt

Hospitals

No. of Beds 350 695 250 300 420

Sales Rs. Cr. 40.55 146.5 15.86 27.63 76.87

Gross Fixed

Assets Rs.

Cr.

51.7 234.55 34.97 63.38 125.73

Revenue per

bed in Rs.

lakhs

11.59 21.08 6.34 9.21 18.3

Gross Fixed

Assets per

bed Rs.

lakhs

14.77 33.75 14 21.13 29.94

Particulars

Breach

Candy

Hospital

Trust

MIOT

Lakeshore

Hospital

and

Research

Centre

Noida

Medicare

Centre

Ltd.

Escorts

Hospital

and

Research

Centre

No. of Beds 173 250 350 120 250

Sales Rs.

Cr. 61.62 31.3 20 10.25 18.94

Gross Fixed

Assets Rs.

Cr.

16.98 46.96 55.05 47.58 68.14



39

Particulars

Breach

Candy

Hospital

Trust

MIOT

Lakeshore

Hospital

and

Research

Centre

Noida

Medicare

Centre

Ltd.

Escorts

Hospital

and

Research

Centre

Revenue

per bed in

Rs. lakhs

35.62 12.52 5.71 8.54 7.58

Gross Fixed

Assets per

bed Rs.

lakhs

9.82 18.78 15.73 39.65 27.26

� Financials of other hospitals

Particulars

(Rs. In cr)

Seahorse

Hospitals

Ltd.

(2005)

Devaki

Hospital

Ltd.

(2005)

Jaipur

Hospital

(2005)

Peerless

Hospitex

Hospital

Ltd.

(2003)

Pulikkal

Medical

Foundatio

n (2004)

Sales

Excluding

Consulting

Fees

3.36 5.92 2.6 *26.32 *28.53

Consultatio

n fee to

doctors

0.34 0.28 0.7 NA NA

PBDIT -0.2 0.22 0.37 2.76 6.28

PAT -1.3 -1 0.06 -0.92 4.28

Gross Fixed

Assets 24.4 15.1 7.7 70.26 45.5

Medical

Equipments 9.7 6.2 4 *38.38 *15.18

Medical

Equipments

to Gross

Fixed

Assets

39.75% 41.06% 51.95% 54.63% 33.36%



40

Particulars

(Rs. In cr)

Seahorse

Hospitals

Ltd.

(2005)

Devaki

Hospital

Ltd.

(2005)

Jaipur

Hospital

(2005)

Peerless

Hospitex

Hospital

Ltd.

(2003)

Pulikkal

Medical

Foundatio

n (2004)

PBDIT to

Sales -5.95% 3.72% 14.23% 10.49% 22.01%

Sales to

Gross Fixed

Assets

0.14 0.39 0.34 0.37 0.63

Note:

� Sales figures of Peerless and Pulikkal include consulting fees to doctors.

� Medical Equipment figures given for Pulikkal and Peerless is that of Plant

and Machinery. Figures of Medical Equipment separately not available.

2.5.2 Medical Tourism Initiatives

� Hospitals both in cities and towns are taking initiative to attract

international patients. Common services offered include pick-up from

airport, accommodation facilities, assistance in visa, foreign exchange,

insurance transfer, sight-seeing trips etc.

Im p a c t o f A d d itio n a l B e d s

0

2 5

5 0

7 5

1 0 0

1 2 5

1 5 0

1 7 5

2 0 0

2 2 5

2 5 0

0 1 0 0 2 0 0 3 0 0 4 0 0 5 0 0 6 0 0 7 0 0 8 0 0

N o . o f B e d s

S a le s R s . C r . PB D IT Rs . C r . G r o s s F ix e d A s s e ts R s . Cr .



41

� Big hospitals like Apollo, Wockhardt attract international patients from

US, UK etc. Indraprastha Apollo has Joint Commission International

Accreditation, USA.

� Many of the hospitals receive patients from the neighbouring countries

like Sri Lanka, Bangladesh, Mauritius, Nepal and also from Middle East

Countries.

� Noida Medicare Center Ltd. has a Regional Office at Dhaka to attract

patients from Bangladesh.

� Ruby Hospital, Kolkatta as part of its Medical Tourism initiative has a

tie-up with BUPA International, world's largest provider of international

expatriate health insurance for attracting international patients.

2.5.3 Facilities and tariffs for services

� Room charges and charges for medical services vary across hospitals.

Many hospitals have tie-ups with corporates for offering their services.

� Malabar Institute of Medical Sciences has tie-ups with Third Party

Administrators like Family Health Plan Medi Assist, Medicare TPA Pvt. Ltd

Paramount, TTK Healthcare Pvt. Ltd., Universal Medi-aid Services Ltd.

Hospitals offer preventive health check-ups like Executive health check,

Senior citizen's master health check up, routine health checkup, pre-

employment health checkup, well women checkup etc.

� The tariffs for these services in some of the hospitals have been

included in the report. Executive Health Checkup offered in most

hospitals is priced at about Rs.3000/-.

42

3 Healthcare Scenario in Uttar

Pradesh

Uttar Pradesh, with a population of around 166 million (Census 2001), is the

most populous State of the Indian Union and accounts for approximately 16.17

percent of the country's population. Out of the total population of the State,

more than 79 percent (13.15 crores) live in the rural areas, while the

remaining 21 percent (3.45 crores) live in the urban areas. The population

density of the State is 689 persons per sq. km, as against the national average

of 324 persons per sq. km. The demographic indicators are summarized in the

table ahead.

Demographic Profile of Uttar Pradesh

Description Value

Population ( Census 2001)

Male 8.75 Crores

Female 7.85 Crores

Total 16.60 Crores

Population Density (Per Square Kilometre) 689

Annual Exponential Growth Rate (1991-2001) 2.30

Sex Ratio per Thousand Male (In 2001) 898

Female Literacy (2001) Percent 42.98

Out of the total population, 52.7 percent (8.75 crores) are males and 47.3

percent are females (7.85 crores). The sex ratio of the population is 898

females per 1000 males for the State, compared to 933 for all India (Census

2001). The population density is very high in the Eastern and Western regions

and very low in Bundelkhand region. The literacy rate among those aged seven

years and above is 70.23 percent among males and 42.98 percent among

females. The life expectancy in the State is 65.48 years for males and 67.10

years for females, as compared to the national average of 65.63 years for

males and 66.38 years for females.

For planning and development purposes, the State is divided into four distinct

regions on the basis of homogeneity, contiguity and economic criteria. These

43

regions are— Western, Central, Eastern and Bundelkhand. For administrative

purposes, these regions are further divided into 17 divisions and 70 districts.

These districts are further divided into tehsils (303) and developmental blocks

(813). Each block consists of a number of villages (97,134), which is the

smallest unit in the rural areas. There are approximately 700 urban local

bodies, 8135 Nayay Panchayats, 52028 Gram Sabhas. There are around 631

cities and urban agglomerations in the State.

Health Status

The mortality indicators of the State depict an alarming situation. As per SRS

2004, the infant mortality in the State stood at 72 deaths per 1,000 births as

compared to the all India average of 58. Past trends have demonstrated that

while both the neo-natal & post-neonatal components of infant mortality have

declined, the decline in neo-natal mortality has not kept pace with the decline

in post neonatal mortality. Deaths during the neo-natal period (within 28 days

of life) contribute to almost 64% of the infant mortality in the State. As per

NFHS-II, U.P. had the highest Under 5 Mortality Rate in the country (122.5

deaths per 1000 live births as compared to the all India average of 94.9).

The latest survey of NFHS-III (2005-06) shows that only 23 percent of children

(12-23 months) were found to be fully immunized against the six vaccine

preventable diseases. Findings of NFHS-III reveal that although the State's

total fertility rate is high (3.8), there is a dismally low prevalence of ante-natal

care and birth related counseling being provided to pregnant women in the

State. As per the survey, only 26 percent of the pregnant women in the State

received 3 or more ANCs. The share of institutional deliveries in the State

stands at only 22 percent. The nutritional status of women is also poor. Almost

50 percent of women in the State suffer from some form of anaemia. In 1997,

there were an estimated 707 maternal deaths per 100,000 live births (SRS

1997), almost 70 percent higher than the national average of 437, as per the

recent SRS (2001-03), the maternal mortality stands at 517 per 100,000 live

births.

Nutritional indicators of the State are also one of the poorest in the country

with large interregional imbalances. High levels of malnutrition particularly

among women and children have been directly and indirectly influencing

44

mortality rates in infants, children and women. Although the incidence of florid

nutritional deficiencies like pellagra, beriberi etc has significantly gone down,

undernutrition among children and micronutrient deficiencies across all

sections of the population continues to be widespread in the State. NFHS-III

data indicates that out of 10 children under 3 years, almost 5 are underweight

and 4 are stunted. High incidence of general undernutrition and micronutrient

deficiency is reflected in the high childhood mortality and infant mortality.

Awareness of AIDS and HIV among women is quite low. As per NFHS-III, only

40 percent of ever married women (15-49 years) reported having heard of

AIDS and only 27 percent of women reported to know that consistent condom

use can reduce the chances of getting HIV/AIDS.

The draft Uttar Pradesh Human Development Report mentions that combined

losses due to premature death and disability from non-fatal illnesses

(measured as Disability Adjusted Life Years – DALYs) are very high in Uttar

Pradesh. A World Bank Study of the year 2000 showed that the estimates of

DALYs lost in six States in India suggest that Uttar Pradesh at 273.2 DALYs,

has the highest loss rate among all the Indian States. A further analysis of

ailments by cause shows that the overwhelming cause of premature death and

disability can be attributed to ‘Group 1’ diseases, namely communicable

diseases, malnutrition and peri-natal conditions, a disease pattern common

among poor populations.

Distribution of Reported Ailments across Disease categories in U.P.

%age of cases to Total No. of Cases Reported

Short Ailments Ailments requiring

Hospitalization Disease Categories

Rural Urban Total Rural Urban Total

Infectious & parasitic

diseases 56.21 54.86 55.98 92.07 20.19 91.00

Neoplasm 0.33 0.60 0.37 0.17 6.29 0.26

Endocrine, nutritional &

metabolic disorders 0.73 1.02 0.78 0.07 1.04 0.09

Diseases of blood &

blood forming organs 0.21 0.28 0.22 0.06 0.91 0.07

45

%age of cases to Total No. of Cases Reported

Short Ailments Ailments requiring

Hospitalization Disease Categories

Rural Urban Total Rural Urban Total

Mental, psycho-neurotic

& personality disorders 0.67 0.26 0.60 0.07 0.79 0.08

Diseases of nervous

system & sense organs 2.89 3.31 2.96 0.34 6.06 0.43

Diseases of circulatory

system 1.35 6.19 2.16 0.16 9.25 0.30

Diseases of respiratory

system 10.58 8.97 10.31 0.11 2.97 0.15

Diseases of digestive

system 2.45 2.21 2.41 0.14 2.52 0.17

Diseases of genito-

urinary system 0.90 1.65 1.02 0.22 6.11 0.31

Diseases of pregnancy &

child birth 0.57 0.92 0.63 0.31 7.54 0.42

Diseases of skin &

musculoskeletal system 0.91 1.03 0.93 0.01 0.34 0.02

Accidents & injuries 1.63 2.22 1.73 0.32 11.12 0.48

Other Diseases 20.60 16.48 19.91 5.94 24.86 6.22

Total 100.00 100.00 100.00 100.00 100.00 100.0

0

Source: NSS 52nd Round

It is evident from the above Table that about 56% of short duration ailments

reported belonged to the category of infectious and parasitic diseases, more so

in rural than in urban areas. Short duration fevers constituted 38.6% of all

ailments reported followed by diarrhoea and gastroenteritis (7.88%). 92

percent of hospitalization cases in rural areas in Uttar Pradesh fell in the

infectious and parasitic diseases category, more specifically within diarrhoea

and gastroenteritis. This indicates the widespread problem of poor water

quality and lack of basic sanitation and hygiene.

46

Health Infrastructure

The present public health infrastructure in the State, both in the urban and

rural areas, is shown below :

Urban Areas No. of Facilities Rural Areas No. of

Facilities

Super Specialty Institute 5* CHCs 315

Medical Colleges

7 - Govt.

2 – Central

Govt.

3 –Private

BPHCs 823

District Male/Female

Hospitals 53 Additional PHCs 3640

Combined Hospitals 13 Rural PPCs 147

Urban FW Bureau 5 Sub Centres 20521

Urban FW Centres 61

Health Posts 136

District Level PPCs 63

* 1 super specialty institute, SGPGI, is functional at Lucknow, 3 institutes at

Lucknow and 1 at Saifai, Etawah are in the process of development

Although Uttar Pradesh has a fairly large public sector health infrastructure

comprising one Super Specialty Institution (SGPGI) - 4 more in the process of

establishment, 7 government medical colleges & hospitals, 53 District

Hospitals, 13 Combined Hospitals, 388 Community Health Centres, 823 block

PHCs, 2817 Additional PHCs apart from 20521 Sub Centres, yet only 9 percent

of the State’s population actually make use of this facility for treatment of

ordinary ailments and people mostly have to depend on private healthcare. In

the private sector, there are 3 medical colleges & hospitals and 4913

Male/Female hospitals/nursing homes at District level in the State. However,

there are a large number of registered and non-registered medical

practitioners in the State and they play an important role in providing medical

service to the rural population.

However, the physical health infrastructure in the State is still much below the

country average. For instance, the population covered by a Sub-centre in the

47

State is 7080 and the average distance is 3.4 km. while the country average is

5109 and 1.3 km. It is estimated that 11% of people in Uttar Pradesh are not

able to access medical care due to locational reasons. Further, even when

accessed, there is no guarantee of sustained care. Several other deterrents

such as bad roads, the unreliability of finding the health provider, costs for

transport and wages foregone, etc. make it cheaper for a villager to get some

treatment from the local quack.

Besides the inadequate number of facilities, there is a severe shortage of

manpower at all levels in the public health delivery system. Every health

functionary is under a lot of pressure on account of the large numbers that

s/he is expected to serve. This has a direct bearing on the quality of services

rendered and uptake of services.

Human Resources

The ratio of doctors per thousand population for U.P. is much below the

national figure of 1 and although the ratio of beds is almost the same as the all

India figure of 0.7, their geographical distribution is highly skewed in favour of

the urban areas, depriving the rural masses.

The current position of doctors and paramedical staff in the State is as under:

Human Resource Sanctioned* Filled*

Medical Officers

Male (General) 6468 4940

Male (Specialist) 4128 3694

Female (General + Specialist) 1740 1319

Paramedical Staff

Pharmacist 5078 4695

Staff Nurse 4528 3678

ANM 23656 21944

Optometrist 923 833

Lab. Technician 1915 1442

X-Ray Technician 514 452

Dark Room Assistant 163 102

Physiotherapist 19 16

48

It is evident that the situation is grave in terms of requirement of medical

personnel, specially doctors and specialists. Although the State also has a

large presence of private health providers, it is mostly concentrated in the

urban areas and is largely focusing on curative aspects, rather than maternal &

child health services.

A survey of hospitals in the private sector, commissioned by the Government

of UP, revealed that there are 2,592 private hospitals with total bed capacity of

47,269. There are 2,321 general hospitals that account for 92.4 percent of

beds in the private sector, 201 nursing homes with 2,506 beds that offer

maternal and child health services exclusively, and 70 hospitals with 1,010

beds that offer specialty services1.

Total number of doctors and hospital beds, both public and private sector

combined, are estimated as under—

Description Government

Sector

Private

Sector Total

Ratio

(Per 1000

Popn)

Allopathic

Doctors 9950 29000 38950 0.2

Total Beds

54193

(Urban-31646,

Rural-22547)

46269 100462 0.6

The magnitude of various private health providers in the State (2001-02) is as

under:

Hospitals

Physicians

&

Specialists

Nurses,

Physio-

therapists &

Paramedical

Ayurveda Unani Homeo.

Diag.

/Patho.

Labs.

4424 214,127 53,280 27,042 5192 19,861 5,957

Source: National Commission on Macroeconomics and Health

1 UPHSDP Project Implementation Plan, Vol. 1, 2000

49

3.1 Healthcare Facilities in Lucknow

As per the WHO norms, for every 1000 populations, 3 beds are required.

Hence based on the population projection-2011 for Lucknow, with a population

of approx 32 lakhs, the city would require approx 9600 beds compared to the

existing 2500 beds. Hence there is huge shortfall in the medical facilities

including number of beds making this project viable for the city. In addition to

that, the land is already acquired. The Site is well connected with other parts

of the city through Amar Shaheed path and Sultanpur road. The commercial

centre of Lucknow, Gomti Nagar is in close vicinity of the site which will

provide catchment population. The site is well accessible by different public

transportation modes. A township Project “Golf City” is being developed by

Ansal API’s on Amar Shaheed Path which is approx 2km from the project site.

Considering the above facts, in order to improve the tertiary healthcare

facilities in Lucknow, LDA intends to setup a world class 500 Bed Multi-

specialty Hospital at Lucknow and has earmarked 15 acres for the same.

3.2 Partial List of Hospitals

The city has a number of hospitals and diagnostic clinics but lacks world class

tertiary hospitals. Recently Sahara has constructed and commissioned a 350

bed hospital expandable to 554 beds in Lucknow. Presented below is a list of

some of the hospitals and diagnostic clinics in Lucknow.

Sr. No. Partial List of Hospitals Discipline

1

Dental Clinic,

Tribeni House, 1, Nawal Kishore

Road, Hazrat Ganj, Lucknow.

Dental Care & Dental X-

Ray.

2 Javitri Hospital

Talibagh, Lucknow.

Obst. & Gynae.

Treatment, USG & X-Ray.

3

Jagrani Hospital,

Ring Road, Kalyan pur,

Near Kuckrail Picnic Spot Crossing, Lucknow

General purpose

treatment.

4

K.K.Hospital,

87/88, Nabibullah Road,

River Bank Colony,

Near Suraj Kund Park, Lucknow.

General medicine and

General surgery.

50

Sr. No. Partial List of Hospitals Discipline

5

City Hospital & Trauma Center,

C-1, Cinder Dump Complex,

Opp. Krishna Cinema Hall,

Kanpur Road, Alambagh, Lucknow.

Echo & Orthopaedic

treatment.

6

Mother & Child Care Center

MCC Nursing Home,

Opp. Kalyan Giri Mandir,

Hardoi Road,P.O. chowk, Lucknow.

Obst. & Gynae. And

Paediatrics surgery.

7

Shekhar Hospital,

B-Block, Church Road,

Indira Nagar, Lucknow.

Nephrology, Urology &

Lithotripsy.

8

Mayo Medical Center,

Vikas Khand-II, Behind Central

School, Gomti Nagar, Lucknow.

General purpose

treatment, Neurology

& Neurosurgery.

9

Awadh Hospital & Heart Center,

9-D, Singar Nagar,

Kanpur Road, Lucknow.

Cardiology & General

Surgery.

10

Vivekanand Polyclinic,

Ramakrishna Mission Sevashram,

Vivekananda Puram, Nirala Nagar

Lucknow.

General treatment &

diagnostic procedures.

11 Life Line Hospital & Heart Center,

B-1/31, Sector-K, Aliganj, Lucknow. Cardiology only.

12

Saroj Hospital & Research Center,

1-B, Barabirwa, Kanpur Road,

Lucknow.

Obst. & Gynae. Only.

13 Sewa Hospital & Research Center,

Sewa Nagar, Sitapur Road, Lucknow.

General Surgery, Urology

& Nephrology.

3.3 Partial List of Diagnostic Clinics

Sr. No. Partial List of Diagnostic Centres Discipline

1

Diagnostic Medical Center Pvt.

Ltd., B-52, J-Park,

Mahanagar Extension,

Near Kapurthala Crossing,

Lucknow.

X-Ray, USG & Echo.

2

Nidan Diagnostic Center,

4/31 Vivek Khand,

Thana Chauraha,

Gomti Nagar, Lucknow.

Pathological Tests only.

51

Sr. No. Partial List of Diagnostic Centres Discipline

3

Lucknow Pathology, Blood Bank

X-Ray, Ultra Sound,

2, Patel Nagar, Tehri Pulia,

Alambagh, Lucknow.

USG & X-Ray.

4

Park Diagnostics Center,

Regency Plaza, 5-Park Road,

Opp. Civil Hospital,

Lucknow.

Echo only.

5

Indira Diagnostics Center &

Blood Bank Ltd.,

Faizabad Road,

Lucknow.

CT Scan only.

6

Sarkar Diagnostics,

C-1093, Sector-A, Mahanagar,

Lucknow.

Conventional Radiology,

CT Scan, MRI,

Mammography, USG and

Color Doppler

7

Raj Scanning Ltd.,

1, Manas Nagar, Jaimau,

Lucknow.

MRI, CT Scan, X-Ray &

Oncology.

8

Charakdhar Diagnostic Pvt. Ltd.

292/05, Tulsidas Marg,

Chowk, Lucknow.

X-Ray and Ultrasound.

52

4 Project costing and Phasing

The proposed 500 bed super-specialty hospital will be spread across 15

acres of land. The details of project cost and its phasing is presented in

this chapter.

4.1 Site Details

Site Photograph

The Project Site is located at Lucknow bypass, Amar Shaheed Peeth. The site

has an area of 15 acres and it is situated in between Sultanpur road and Gomti

river on Amar Shaheed Path. The site can also be approached through a

service road next to Amar Shaheed. The topography is more or less even. At

present there are no major developments adjoining the plot except some

scattered residential structures in the vicinity. Shaheed Smarak is being

developed on the opposite side of the site.

53

4.2 Departments proposed in the Hospital

The following are the departments that can be established in the proposed

500 bed hospital:

Sr.

No. Departments / Specialities

1 Trauma Care

a. Ortho unit

b. Maxillofacial surgery unit

c. Cosmetic surgery (plastic surgery)

d. Blood Bank

e. Burn Care Unit

f. Physiotherapy

g. MRI, CT scan

2 Cardio Thoracic care unit (ICCU- Intensive Cardiac Care Unit)

3 Intervention specialty and Cerebral Intervention

4 Nephro unit

5 Neurology unit

6 Obs & Gynecology (IVF center may be kept as

optional)

7 Pediatric unit (with NICU – Neonetal Intensive Care

unit)

8 Dental unit for surgery etc

9 Ophthalmology and ENT

10 Cancer unit (for Lucknow only)

11 Fitness center (that can include diet counseling etc. for additional source of revenue)

12 OPD

13 General Surgery - will include laproscopy, hernia, biopsy, cyst excison, thyroidrectomy, haemorrhoids

etc.

4.3 Hospital Configuration

The proposed 500 bed shall have the following configuration. The configuration

presented below is based on the standard practices adopted in major private

hospitals in the country.

Hospital Configuration Nos. Unit

Total in-patient beds 500

Intensive care unit 100 beds

Emergency wards 25 beds

Single bed suites (with two rooms) 25 beds

Delux room 25 beds

Single room 100 beds

Inpatient double bed rooms 125 beds

54

Hospital Configuration Nos. Unit

4 bedded wards 100 beds

Other facilities

OPD (Consulting rooms) 15 Rooms

Emergency rooms 3 Rooms

Surgical suite (OT) 15 OTs

Cardiac catheterisation labs 1 labs

Labour room 4 Rooms

Imaging rooms 5

Pathology department 5 Labs

4.4 Area Statement

For the above configuration of the hospital, approximately 5,00,000 Sq.Ft. of

built-up space need to be constructed. The area statement is presented below:

Area occupied by hospital

Area (sq

mt) No. of bed

Norm

(sq.m./u

nit)

Total inpatient services 15250

Intensive care unit 4000 100 40

Emergency wards 1000 25 40

In-patient single rooms

Single bed suites (with two rooms) 1000 25 40

Delux room 875 25 35

Single room 2500 100 25

Inpatient double bed rooms 4375 125 35

4 bedded wards 1500 100 15

Other facilities 6689

OPD (Consulting rooms) 750 15 50

Emergency rooms 174 3 58

Surgical suite (OT) 3000 15 200

Cardiac catheterisation labs 100 1 100

Labour room 620 4 155

Imaging rooms 550 5 110

Pathology department 700 5 140

Blood Bank 155 1 155

Mortuary 165 1 165

Dialysis Suite 175 1 175

Physiotherapy Section 300 1 300

Administration for 500 beds 5720 500 11.44

Engineering Services @10% carpet area 10% 2765.9

Subtotal 30424.9

Wall Area @ 8% 2433.992

Core Area (Lift, shaft, fire stair, Main stair well) @ 8% 2433.992

55

Corridor / Circulation Area @ 20% 6084.98

Toilets (Wet area) @ 10% 3042.49

Total 44420.35

The FSI applicable is 1.5. Hence in 15 acres of land, the following are the

facilities constructed:

Facilities Sq. Mt

Hospital Facilities 44420

Staff Quarters 19500

Guest House and Training Institute

for Diploma Courses 25000

Other Commercial 6000

The commercial includes the following:

� Banks and ATM

� Pharmacy

� Restaurant and Service Apartment

4.5 Capital Expenditure

4.5.1 Land Development Cost

The cost of land development is taken as Rs. 25 lakhs per acre. The total

land development cost will be Rs. 375 lakhs.

Land Development Value Units

Land area 15 acres

Land development cost per

acre 25

Rs.

Lakhs

Land development cost 375 Rs.

Lakhs

4.5.2 Cost of Civil works

Cost of finishes have been taken separately. The capital cost of civil works

is as follows:

Facilities Sq. Mt Cost per

Sq.Mt

Civil

Construction

Cost (Rs.

Lakhs)

Hospital Facilities 44420.354 10760 4779.63

Staff Quarters 19500 8608 1678.56

Guest House and Institutes 25000 8608 2152.00

Other Commercial 6000 8608 516.48

Subtotal 9126.67

56

4.5.3 Cost of Medical Equipment

Medical equipment accounts for 35%-40% of a hospital project cost. The

details of cost of medical equipment is presented below:

Medical Equipment Rs. Lakhs

Cardiac, Cardiothoracic and Vascular 910

Oncology 1050

Radiology & imaging 1197

Nucleur medicine 337

Gastro 95

Gynecology & Obstetrics 24

Nephrology 19

Neurlogy 1027

Opthalmology 121

Orthpaedics 200

Pediatrics 46

Physiotherapy 20

Bed related equipment 654

Urology 450

Blood bank 57

OT 384

Laboratory 30

Anesthesia 2

Total 6625

4.5.4 Other Capital Costs

Plant and Machinery

Plant and Equipment Rs. Lakhs

Lifts / Elevators 144

Plumbing / Sanitation / Boiler/

Firefighting (High side) 0

Medical gases 175

Kitchen Equipment & fridges 80

IT and Telecommunication 180

Laundry Equipment 70

Incinerator 25

Mortuary 5

Vehicles 45

Total 724

57

Atleast 3 ambulances are envisaged for the 500 bed hospital.

Services

Services Rs. Lakhs

HVAC 635

Electrical 1073

Plumbing / Sanitation /

Boiler/ Firefighting 399

Wood work and Furnishing

Wood work and furnishing including office furniture costs Rs. 325 lakhs and

civil finishing cost is Rs.673 lakhs.

4.6 Project Costing and Phasing

Initially, 250 beds will be constructed in a period of three years.

Remaining 250 beds will be added such that within the next two years.

Cost escalation factors have been suitably assumed and included in the

project cost. The project cost is as follows:

Capital Expenditure Rs. Lakhs

Land development Cost 375

Civil works and finishing 9799

Wood work and furnishing 325

Services - HVAC, Electrical,

Plumbing, Boiler, Fire fighting 1730

Plant and Machinery 724

Medical Equipment 6625

Sub total 19578

Design and Architect's fee (1.5%)

294

Project Management Consultant

fee (1.5%) 294

Contingency (5%) 779

Cost Escalation (5%) 2334.38

Interest during Construction 727

Total Project Cost 24005

The cost of the 500 bed hospital is Rs. 240.05 Crores.

4.7 Project Funding

The project will be funded by a mix of debt and Equity. The debt equity

ratio assumed is 1.5 and the interest rate of debt is assumed as 13%

which is inline with the prevailing interest rate scenario.

58

5 Feasibility Study

5.1 Revenue Assumptions

5.1.1 In patient Revenue Assumptions

Inpatient Revenue Assumptions

Inpatient Volume Spread

Dental Unit 3%

Cardiac,Thoracic & Vascular 30%

E.N.T 4%

G.I Surgery 2%

Gastroenterology 3%

General Surgery 5%

Medicine 3%

Nephrology 5%

Neuro Surgery 3%

Neurology 5%

Obst & Gynaecology 4%

Oncology 5%

Opthalmology 6%

Orthopaedics 6%

Paediatric Surgery 3%

Paediatrics 3%

Plastic Surgery 5%

Urology 5%

Total 100%

5.1.2 Out patient Revenue Assumptions

OPD Revenue Assumptions

% of New Patients 35%

Average Consultation charges Rs. 400

% of Repeat patients 65%

Consultation charges - Repeat Patients Rs. 300

% of patients undergoing lab tests 50%

Average lab test revenue per patient Rs. 300

% of patients undergoing imaging 15%

Average imaging revenue per patient Rs. 1500

% of people buying medicines from hospital

pharmacy 75%

59

OPD Revenue Assumptions

Average pharmacy revenue per patient Rs. 200

5.1.3 Revenue for the first four years of operation

Year 1

Year 2

60

Year 3

Year 4

Other revenues include revenue from parking, patient registration and

ambulance charges.

5.1.4 Revenue from Lease Rentals

The commercial space can be constructed in phases over a four year period as

the occupancy levels improve in the hospital. The lease rental is taken as Rs.

10 per Sq. Ft initially with an escalation of 4% y-o-y.

61

5.2 Operating Expenses

5.2.1 Employee Costs

Employee cost is one of the major operatign expense in a hospital. Planning

and efficient utilisation of manpower is key to successful operation of a

hospital. For a 500 bed hospital the total no. of doctors is estimated to be 110-

125. The total no. of patients after commissioning of 500 beds is expected to

be about 475 per day. For the 500 bed hospital the doctor patient ratio will be

about 1:4. The nurse to bed ratio is 1:5 and for ICU and Emergency Unit it is

1:1. Further provision needs to be provided for nurses working in shifts.

Accordingly the Nurses required for 500 bed hospital is 248.

The employee costs for the first 4 years have been taken at 40%, 60%, 80%

and 100% of the total employee costs for a 500 bed hospital.

Presented below is the manpower and salary levels of staff for a 500 bed

hospital.

TOTAL STAFFING PATTERN

Department Nos. Salary (Rs. lacs)

Doctors 122 1873

Nurses 248 386

Specialty related other staff 92 81

Diagnostics 50 114

Other medical deptts. 33 133

Medical support facilities 69 79

Non-medical staff 75 167

Corporate 42 127

Finance & Commercial 26 94

Directors' office 3 40

Doctors HOD Level-1 Level-2 Level-3 Residents

Salary Levels (Rs. Lacs) 75 24 20 15 6

Cardiac 1 2 2 3 3

E.N.T 1 1 3

G.I Surgery 2 2 3

62

Gastroenterology 2 2 3

General Surgery 1 1 2 3

Medicine 1 1 3

Nephrology 1 1 1 2 3

Neuro Surgery 1 1 2 3

Neurology 1 1 2 3

Obst & Gynae. 1 1 3 3

Oncology 1 2 1 2 3

Opthalmology 1 1 3

Orthopaedics 1 1 3

Paediatric Surgery 1 1 3

Paediatrics 1 2 3

Cosmetic surgery 1 2 2 2

Plastic Surgery 1 1 1 1 3

Urology 1 1 3

Medical Suprintendent 1

Sub Total 5 15 17 32 53

NURSES

Norms for nurses Nurses Beds

Surgical Wards 1 3

Other Wards 1 3

ICU 1 1

CCU 1 1

OT 1 1

ICU 100 100

Other 133 133

OTs 15 15

Total number of Nurses

required 248

DIAGNOSTICS STAFFING

Imaging

Type of staff Number Salary/ person

Salary (pm)

Head - Radiology 1 100000 100000

Senior resident 1 50000 50000

Supervisors 1 12500 12500

Technicians 1 20833 20833

Radiographer 5 10000 50000

Steno 2 6000 12000

Dark room asst. 2 6000 12000

Assistant 2 6000 12000

Attendant 1 4500 4500

273833

Radiotherapy

Type of staff No. Salary/ person

Salary (pm)

Senior Resident 1 50000 50000

63

DIAGNOSTICS STAFFING


Receptionist 1 10000 10000

Asst. Technician 2 8000 16000

138500

Nuclear medicine

Type of staff No. Salary/ person

Salary (pm)

Senior Resident 1 50000 50000


Receptionist 1 10000 10000

Asst. Technician 1 8000 8000

109667

Laboratory

No. Salary/ person

Salary (pm)

Chief - Microbiology 1 100000 100000

Resident Biochemist 1 50000 50000

Resident Pathologist 1 50000 50000

Senior res 2 50000 100000

Suprintendent 1 12500 12500

Sr. Lab tech 1 20833 20833

Lab. Technician 5 8000 40000

Asst. 3 6000 18000


Lab trainees 5 5000 25000

50 425333

Total salary for diagnostics 114

OTHER MEDICAL/ PARAMEDICAL DEPARTMENTS STAFFING

Deptt. Type of staff Number

Salary/

person

Salary

(Rs.)

Head - Other medical deptts 0 100000 0

Anaesthesiology

Consultant 2 125000 250000

Residents 6 50000 300000

Technician 4 20833 83333

Attemdent 2 4500 9000

Steno 1 6000 6000

648333

Physiotherapy


Physiotherapists 5 7500 37500

Tech. Physio. 1 7500 7500

49500

64

Internal Medicine

Consultant 1 125000 125000

Chief Resident 0 50000 0

Residents 5 50000 250000

Clinical Offr 1 10000 10000

Compounder 1 6500 6500

Steno 1 6000 6000


33 406500

Total salary for other medical deptts.

(Rs. Lakhs) 133

5.3 Summary of Operating Expenses

The Summary of Operating Expenses for the first 4 years have been estimated. The staff will be 40% of the total in the first year, 60% in 2nd, 80% in the 3rd and 100% in the fourth year when the hospital has 500 beds. 30% Revenue sharing with doctors have been considered in the revenue stream itself and net revenues have been considered in the revenues.

Operating Expenses Yr-1 Yr-2 Yr-3 Yr-4

Surgical, Pharmacy & bloodbank consumables ( drugs and disposables)

834 2105 3680 6512

Lab & Imaging consumables 187 294 368 488

Uniforms 12 18 24 30

Linen cost 45 45 45 52

Laundry 35 35 35 40

Kitchen (F&B) / Pantry 75 75 75 86

Electricity & fuel charges 370 555 740 925

Water charges 5 5 5 6

Personnel costs 1238 1856 2475 3094

Advertising and Publicity 300 300 300 250

Books and periodicals 100 100 100 100

Training 200 220 242 266

Internal audit fees (icldg. OPEs for auditor) 10 10 10 10

Legal fees 17 29 39 54

Printing and stationery 29 49 64 91

Communication expenses 27 27 27 27

Referral costs 58 98 128 182

Bad Debts 29 49 64 91

Miscellaneous 174 294 385 545

Total Operating costs 3745 6164 8807 12849

5.4 Debt and Interest Repayment

The interest rate assumed for long term debt is 12%. The debt is assumed to

be repaid in 8 years period.

65

5.5 Financial Viability

Though the operating margins of hospitals vary widely between 10% and 25%

depending on the specialty services offered, due to the high capital cost and

periodic capital investment in medical equipments reduces the viability of a

hospital.

For the 90 year concession period the project yields and Internal Rate of

Return of 20% and the Cash Equity IRR is 24%.

5.5.1 Debt Service Coverage Ratio (DSCR)

The average Debt Service Coverage Ratio for the seven year repayment period

is 1.76 and the minimum DSCR is 1.34

5.6 Projected Profit and Loss Statement

The construction period is 2 years and the operations of the hospital will

commence from the third year. The Projected P&L statement for 10 year

period is presented below:

Projected P&L Statement (Rs. Lakhs)

66

5.7 Projected Balance Sheet

Projected Balance Sheet (Rs. Lakhs)

5.8 Projected Cash Flow Statement

Projected Cash Flow Statement (Rs. Lakhs)

67

6 Conclusion Hospital projects have a long gestation period owing to the huge initial capital

expenditure and recurring capital expenditure on medical equipments. Hence

to make the project viable commercial exploitation within the hospital complex

area shall be allowed. However, the commercial activity shall be related to

Hospital services catering to the needs of the patients. The Project IRR for 90

year concession period is 20% and the Cash Equity IRR is 24%.