7. In terms of Rules 48 of Public Procurement Rules, 2004 Grievance Redressal Committee (GRC) is notified for the subject procurement and notification copy is available on the procuring agency’s website and also available on EPADS v2.0 as well as Authority’s website at (www.ppra.org.pk).
Hazara Electric Supply Company (Hazara Electric Supply Company (HAZECO)), Manager Supply Chain Management
HAZECO HQ, Gulistan Colony, College Road, Abbottabad., Abbottabad, Abbottabad (District), Hazara Division (Division), Khyber Pakhtunkhwa (KP) (Province).
+92-370-371-0055
manager.scm@hazeco.com.pk
The following specific data for the procurement of Non-Consultancy Services to be procured shall complement, supplement, or amend the provisions in the Instructions to Bidders (ITB). Whenever there is a conflict, the provisions herein shall prevail over those in ITB.
BDS Clause Number
ITB Number
Amendments of, and Supplements to, Clauses in the Instruction to Bidders
BDS Clause Number 1
Name of Procuring Agency: Hazara Electric Supply Company (Hazara Electric Supply Company (HAZECO))
The subject of procurement is: REQUEST FOR PROPOSAL FOR APPOINTMENT OF EXTERNAL / STATUTORY AUDITORS
Expected commencement date: Tuesday, October 6, 2026
BDS Clause Number 2
Financial year for the operations of the Procuring Agency: 2026-27
Name and identification number of the Contract: P99133
BDS Clause Number 3
JV/Consortium or Association Allowed: Yes
Number of JV/Consortium Members: 2
BDS Clause Number 4
The Bidders may seek clarifications through EPADS v2.0: Clarification Date: Friday, September 18, 2026
BDS Clause Number 5
Any addendum, in case issued, shall be published on Hazara Electric Supply Company (Hazara Electric Supply Company (HAZECO)) website and on EPADS v2.0.
BDS Clause Number 6
List of documents required along with the bid:
BDS Clause Number 7
The qualification criteria to establish the supply / production capability of the bidder.
see Eligibility Criteria
BDS Clause Number 8
Services and Their related documents:
See section Required Services and Scope of Work
BDS Clause Number 9
Price schedule will be provided according to the format defined and acquired.
see section price schedule.
BDS Clause Number 10
Specifications:
see section of specifications.
BDS Clause Number 11
The price shall be Fixed.
BDS Clause Number 12
Currency of the Bids shall be : PKR
BDS Clause Number 13
The Bids/Bid Validity period shall be: 90 Days
BDS Clause Number 14
The amount of Bid Security shall be as defined in Bid Security Section for items and lots given in BDS 6
The Bid Security shall be in the form of: Call at Deposit, Bank Guarantee
BDS Clause Number 15
The Bids security shall be valid for twenty-eight (28) days beyond the expiry of the Bids validity period specified in the bidding documents, for example the bid validity is 90 days so the bid security shall be valid for 90+28 = 118 days.
BDS Clause Number 16
Alternative Bids to the requirements of the bidding documents will not be permitted.
BDS Clause Number 17
Bid shall be submitted online on EPADS v2.0 whereas hard copy of the bid security should be submitted to the following;
HAZECO HQ, Gulistan Colony, College Road, Abbottabad., Abbottabad, Abbottabad (District), Hazara Division (Division), Khyber Pakhtunkhwa (KP) (Province).
Bids that are not submitted on EPADS v2.0 shall be disqualified.
The deadline for Bids submission is: Monday, September 21, 2026 10:30 AM
BDS Clause Number 18
The Bids opening shall take place on EPADS v2.0.
Day : Monday
Date: Monday, September 21, 2026
Time : 11:00 AM
BDS Clause Number 19
Selection technique adopted will be: Quality and Cost Based Selection (QCBS)
see Evaluation Criteria
BDS Clause Number 20
The Performance guarantee shall: 10.00%.
The Performance Guarantee shall be acceptable in the form of: Call at Deposit, Bank Guarantee
21.
51.1
Arbitrator shall be appointed by mutual consent of the both parties.
BDS Clause Number 22
Grievence against this procurement shall be submitted online on EPADS v2.0.
| Bidder's Type | Required Registration |
|---|---|
|
Any |
FBR (NTN) |
| Eligibility Criteria | Document |
|---|---|
| The bidder shall be a firm of Chartered Accountants in practice, duly registered with the Institute of Chartered Accountants of Pakistan (ICAP). A copy of the valid ICAP registration/current practising certificate shall be submitted. | Yes |
| The firm shall hold a satisfactory Quality Control Review (QCR) rating from ICAP, valid on the bid-submission date. A copy of the valid QCR rating certificate shall be submitted. | Yes |
| The firm shall be registered with the Audit Oversight Board (AOB) and authorised to audit public-interest companies. A copy of the valid AOB registration certificate shall be submitted. | Yes |
| The firm shall be placed in Category “A” of the current panel of auditors maintained by the State Bank of Pakistan. A copy of the relevant page of the current SBP panel shall be submitted. | Yes |
| The firm shall have at least ten (10) years’ experience in conducting statutory audits of companies in Pakistan. A firm profile showing the year of establishment and relevant client list shall be submitted. | Yes |
| The firm shall have audited at least two (02) power utility sector entities — generation, transmission or distribution companies, CPPA-G, or other NEPRA-licensed entities — during the preceding five (05) years. Relevant engagement letters, signed audit reports or client certificates, as specified in Annexure C-3, shall be submitted. | Yes |
| The firm shall have at least one (01) office in Pakistan and an office or established presence in Islamabad. Office addresses and contact details of the responsible partner shall be provided. | Yes |
| The firm shall not be blacklisted, debarred or suspended by any procuring agency, PPRA, ICAP, AOB, SECP, SBP or any other regulator. Furthermore, no litigation or dispute shall be pending with any government organisation that may impair the firm’s ability to perform the assignment. An affidavit on stamp paper of Rs. 100/-, as prescribed in Annexure, shall be submitted. | Yes |
| The firm, its partners, their spouses and minor children shall have no financial interest in, indebtedness to, or business relationship with HAZECO. The firm shall not provide any service to HAZECO that is prohibited for a statutory auditor. A declaration of independence, as prescribed in Annexure, along with confirmation of compliance with the ICAP Code of Ethics, shall be submitted. | Yes |
| No partner of the firm shall be, or shall have been during the preceding three (03) years, a director, officer or employee of HAZECO or any of its associated companies. A declaration on the firm’s letterhead shall be submitted. | Yes |
Quality and Cost Based Selection (QCBS)
Weightage
| Technical Evaluation % | Financial Evaluation % |
|---|---|
| 80 | 20 |
| Technical Marks | 100 | |
|---|---|---|
| Passing Marks | 70 | |
| Technical Evaluation Criteria | ||
| Standing of the firm — number of partners in Pakistan (minimum 4) (Quantitative)(Doc Required) 13 and above (11) 7 to 12 (8) 4 to 6 (3) | 11 | |
| Number of ICAP-qualified Chartered Accountants employed in Pakistan (minimum 10) (Quantitative)(Doc Required) 41 and above (11) 21 to 40 (8) 10 to 20 (4) | 11 | |
| Number of audit staff and trainees (minimum 50) (Quantitative)(Doc Required) 201 and above (6) 101 to 200 (4) 50 to 100 (3) | 6 | |
| Audit of power sector entities (generation, transmission, distribution, CPPA-G, NEPRA-licensed entities) in the last five years (Quantitative)(Doc Required) 5 and above (22) 3 to 4 (16) 2 (10) | 22 | |
| Audit of public sector companies, State-Owned Enterprises or autonomous bodies in the last five years (minimum 2) (Quantitative)(Doc Required) 6 and above (17) 3 to 5 (11) 2 (6) | 17 | |
| Audit of entities with annual revenue exceeding Rs. 20 billion in the last five years (Quantitative)(Doc Required) 4 and above (9) 2 to 3 (6) 1 (3) | 9 | |
| Engagement team: qualification and relevant experience of the engagement partner, EQCR, manager and supervisors named for this assignment. Assessed against CVs on Annexure C-4. (Quantitative)(Doc Required) | 14 | |
| Use of information technology in the audit, including data analytics and computer-assisted audit techniques on billing and financial systems. Assessed against evidence of methodology and prior application. (Quantitative)(Doc Required) | 6 | |
| Office network and presence — offices in Pakistan and in Islamabad (Quantitative)(Doc Required) 3 or more offices in Pakistan (4) Less than 3 (2) | 4 | |
Positions Without Lots :
| Position | Delivery Schedule | Quantity | Bid Security |
|---|---|---|---|
| APPOINTMENT OF EXTERNAL / STATUTORY AUDITORS | Address: HAZECO HQ, Gulistan Colony, College Road, Abbottabad., Abbottabad, Abbottabad (District), Hazara Division (Division), Khyber Pakhtunkhwa (KP) (Province). Schedule: 90 Days Quantity: 1/job |
1/job | 50000 PKR |
No
Positions Without Lots :
Position: APPOINTMENT OF EXTERNAL / STATUTORY AUDITORS
Specifications / Requirements:
As per TORSThe successful bidder shall perform the following services:
|
Deliverable |
Addressed to |
Timeline |
|
Audit planning memorandum, engagement team deployment plan and audit timetable |
Chief Financial Officer |
Within 15 days of signing of the Agreement |
|
Completion of interim / systems audit and issuance of interim observations |
Chief Financial Officer |
As per agreed timetable |
|
Completion of fieldwork on the annual financial statements |
Chief Financial Officer |
15 days from availability of the draft financial statements |
|
Draft audit report, draft management letter and list of audit adjustments |
Board Audit Committee through the CFO |
10 days from completion of fieldwork |
|
Signed audit report on the annual financial statements |
Members of the Company |
In time to permit approval and circulation within the statutory period |
|
Final management letter with management responses |
Board Audit Committee |
Within 15 days of issuance of the audit report |
|
Certificates and special purpose reports |
As required |
Within 10 working days of request |
The bidder shall deploy a dedicated engagement team headed by a designated engagement partner and an engagement quality control reviewer. Changes in the key team members named in the Technical Proposal shall require the prior written consent of the Company, and any substitute shall be of equivalent or better qualification and experience.
|
Term |
Provision |
|
Type of contract |
Lump sum contract at the fee quoted in the Financial Proposal. The fee is fixed and firm and shall not be subject to escalation. |
|
Duration |
The financial year ending 30 June 2027, extendable to the financial years 2027-28 and 2028-29 at the same fee, or on such revision as the Board may approve, subject to satisfactory performance and to appointment by the members in each Annual General Meeting. |
|
Performance guarantee |
The successful bidder shall furnish a performance guarantee equal to ten percent (10%) of the contract price, in the form of a bank guarantee or Pay Order valid until completion of the assignment, within fifteen (15) days of the letter of award. |
|
Fee and taxes |
The quoted fee shall be inclusive of all federal and provincial taxes, duties and levies. Payments shall be subject to withholding of tax and sales tax on services at the applicable rates. |
|
Out-of-pocket expenses |
Out-of-pocket expenses shall be quoted separately as a fixed amount and shall not exceed [10]% of the audit fee. No claim beyond the quoted amount shall be entertained. |
|
Payment schedule |
[50]% on completion of fieldwork and submission of the draft audit report; [50]% on issuance of the signed audit report and final management letter. Each valid invoice shall be paid within thirty (30) days of submission of the related deliverable. |
|
Confidentiality |
The firm and its personnel shall keep all information relating to HAZECO confidential, shall not disclose it to any third party without prior written consent except where required by law or a regulator, and shall return or destroy the Company’s records on completion of the assignment. |
|
Independence and non-audit services |
The firm shall maintain independence throughout the engagement in accordance with the ICAP Code of Ethics, shall promptly disclose any threat to independence, and shall not provide to HAZECO any non-audit service that is prohibited to a statutory auditor or that has not been approved in advance by the Board Audit Committee. |
|
Conflicting assignments |
Neither the firm, nor its personnel, nor any of its affiliates shall accept an assignment that by its nature conflicts with this engagement. |
|
Assignment and subcontracting |
The engagement shall not be assigned or subcontracted in whole or in part. Any change in the composition or control of the firm shall be notified to the Company forthwith. |
|
Termination |
The Company may terminate the Agreement on thirty (30) days’ written notice for failure to perform, loss of eligibility (including withdrawal of QCR rating or AOB registration), breach of confidentiality or independence, or on any ground on which the members may remove the auditor. Removal and resignation of the auditor shall be governed by the Companies Act, 2017. |
|
Liquidated damages |
Delay in submission of a deliverable beyond the agreed timeline, other than for reasons attributable to the Company, shall attract a deduction of [0.06]% of the audit fee per day of delay, subject to a maximum of [10]% of the audit fee. |
|
Governing law and disputes |
The Agreement shall be governed by the laws of Pakistan. Disputes shall first be referred to the Chief Executive Officer of HAZECO and the senior partner of the firm for amicable settlement, and failing settlement within thirty (30) days shall be referred to arbitration under the Arbitration Act, 1940, with the seat of arbitration at [Abbottabad / Islamabad]. |
For Individual Positions
| # | Position Title | Quantity | Unit Price (PKR) | Total Price (PKR) | Delivery Location | Delivery Period / Year | Country of Origin |
|---|---|---|---|---|---|---|---|
| 1 | |||||||
| 2 |
| # | Lot Title | Total Lot Price (PKR) | Country of Origin |
|---|---|---|---|
| 1 | [Lot 1 Title] |
The following Special Conditions of Contract shall supplement the General Conditions of Contract. Whenever there is a conflict, the provisions herein shall prevail over those in the Conditions of Contract. The corresponding clause number of the GCC is indicated in parentheses.
Number of GC Clause
Amendments of, and Supplements to, Clauses in the General Conditions of Contract
Definitions
The Procuring Agency is: Hazara Electric Supply Company (Hazara Electric Supply Company (HAZECO)), Manager Supply Chain Management HAZECO HQ, Gulistan Colony, College Road, Abbottabad., Abbottabad, Abbottabad (District), Hazara Division (Division), Khyber Pakhtunkhwa (KP) (Province).
The Supplier is:
The title of the subject procurement is:REQUEST FOR PROPOSAL FOR APPOINTMENT OF EXTERNAL / STATUTORY AUDITORS
Number of GC Clause 2
Applicable/Governing Law:
The Contract shall be interpreted in accordance with the laws of Islamic Republic of Pakistan
Number of GC Clause 3
Language:
The language of the Contract, all correspondence and communications to be given, and all other documentation to be prepared and supplied under the Contract shall be in English.
Number of GC Clause 4
Notices:
The addresses for the notices are:
Procuring Agency:
Hazara Electric Supply Company (Hazara Electric Supply Company (HAZECO)), Manager Supply Chain Management
HAZECO HQ, Gulistan Colony, College Road, Abbottabad., Abbottabad, Abbottabad (District), Hazara Division (Division), Khyber Pakhtunkhwa (KP) (Province).
+92-370-371-0055
manager.scm@hazeco.com.pk
Contractor/ Bidder:
[Name, address and telephone number].
The Contractor/ Bidder’s Representative(s)
[Name, address, telephone number and e-mail address]
Number of GC Clause 6.1
The Authorized Representatives are:
For the Procuring Agency:
Hazara Electric Supply Company (Hazara Electric Supply Company (HAZECO)), Manager Supply Chain Management
HAZECO HQ, Gulistan Colony, College Road, Abbottabad., Abbottabad, Abbottabad (District), Hazara Division (Division), Khyber Pakhtunkhwa (KP) (Province).
+92-370-371-0055
manager.scm@hazeco.com.pk
For the Bidder:
Name: ………………………
Designation: ……………..
Address: ……………………………..
Number of GC Clause 7
Effectiveness of the contract
The Contractor/Bidder shall be effective within ….. days from the date of signature of the Contract by both parties
Number of GC Clause 8
Commencement of Contract:
The Contractor/ Bidder shall provide Non-Consultancy Services from the effective date of contract.
Number of GC Clause 10.2
Expiration of Contract:
The time period shall be ………………….
Number of GC Clause 14
Termination
In the event of termination of the contract due to any reason as already defined in the General Conditions of Contract, the Bidder shall be responsible for providing to the Authority the Services till the time of alternate arrangements.
Number of GC Clause 16
Conflict of Interest:
The Procuring Agency reserves the right to determine on a case-by-case basis whether the Bidder should be disqualified from providing services due to a conflict of a nature described in Clause GCC C2.
Number of GC Clause 20
Liquidated Damages
If the Bidder fails to provide services as required under the contract or in case of any data loss/data breach or any incident compromising the data security or other such failures related to any services, the Bidder shall pay to the Procuring Agency as Liquidated Damages at a rate of 0.06% to 10.00% of the Contract value, in accordance with the extent of performance failure & the cost of investigating such incidents as judged by the Authority.
Number of GC Clause 21
Performance Guarantee:
The amount of performance guarantee shall be 10.00% of the contract price in acceptable form of Call at Deposit, Bank Guarantee
Number of GC Clause 27
Currency of Payment:
All the payment to be released to the contractor/Bidder shall be in Pakistani Rupees.
Number of GC Clause F
Payment terms:
Payment will be made to the Bidder against the procured Goods and services according to the actual invoice or running bills submitted by the Bidder against the services provided within the time given in the conditions of the contract.
Number of GC Clause F
Identifying Defects:
The Authority reserves the right at any time to inspect the premises of the provider to inspect the goods and monitor the goods being provided.
Number of GC Clause F 5 & 6
Following is the guidance for Dispute Resolution
Notwithstanding any reference to the arbitration herein, the parties shall continue to perform their respective obligations under the Contract unless they otherwise agree that the Authority shall pay the Bidder any monies due to the Bidder.
Arbitrator’s fee:
The fee shall be specified in Pak Rupees, as determined by the Arbitrator, which shall be shared equally by both parties.
Appointing Authority for Arbitrator:
By the Mutual Consent or in accordance with the provisions of Arbitration Act, 1940, in case the parties fail to reach a consensus on the name of sole arbitrator, any party may submit an application to the Chief Justice Islamabad High Court for appointment of sole arbitrator. The Chief Justice IHC may appoint a former judge of any High Court or Supreme Court as the sole arbitrator to resolve the dispute between the parties.
Rules of procedure for arbitration proceedings:
Any dispute between the Authority and a Bidder who is a national of the Islamic Republic of Pakistan arising in connection with the present Contract shall be referred to adjudication or arbitration in accordance with the laws of the Islamic Republic of Pakistan including Arbitration Act 1940, however above provision shall prevail in referring the case to the Arbitrator.
Place of Arbitration and Award:
The arbitration shall be conducted in English language and place of arbitration shall be at Islamabad. The award of the arbitrator shall be final and shall be binding on the parties.
Date: [insert date (as day, month and year)]
Bid No.:P99133
To: Hazara Electric Supply Company (Hazara Electric Supply Company (HAZECO)), Manager Supply Chain Management HAZECO HQ, Gulistan Colony, College Road, Abbottabad., Abbottabad, Abbottabad (District), Hazara Division (Division), Khyber Pakhtunkhwa (KP) (Province).
We, the undersigned, declare that:
We understand that, according to your conditions, Bids must be supported by a Bid Securing Declaration.
We accept that we will be blacklisted and henceforth cross debarred for participating in respective category of public procurement proceedings for a period of (not more than) six months, if fail to abide with a bid securing declaration, however without indulging in corrupt and fraudulent practices, if we are in breach of our obligation(s) under the Bid conditions, because we:
We understand this Bid Securing Declaration shall expire if we are not the successful
Bidder, upon the earlier of (i) our receipt of your notification to us of the name of the successful Bidder; or (ii) twenty-eight (28) days after the expiration of our Bid.
THIS AGREEMENT made the _____ day of __________ 20_____ between Hazara Electric Supply Company (Hazara Electric Supply Company (HAZECO)), Manager Supply Chain Management HAZECO HQ, Gulistan Colony, College Road, Abbottabad., Abbottabad, Abbottabad (District), Hazara Division (Division), Khyber Pakhtunkhwa (KP) (Province).
(hereinafter called “the Procuring Agency”) of the one part and [name of Bidder] of [city and country of Bidder] (hereinafter called “the Bidder”) of the other part:
WHEREAS the Procuring Agency invited Bids for provision of goods, viz., REQUEST FOR PROPOSAL FOR APPOINTMENT OF EXTERNAL / STATUTORY AUDITORS (P99133) and has accepted a Bids by the Bidder for the provision of Goods in the sum of [contract price in words and figures] (hereinafter called “the Contract Price”).
NOW THIS CONTRACT WITNESSETH AS FOLLOWS:
1. In this Contract words and expressions shall have the same meanings as are respectively assigned to them in the Conditions of Contract referred to.
2. The following documents shall be deemed to form and be read and construed as part of this Contract, In the event of any ambiguity or conflict between the Contract Documents listed below, the order of precedence shall be the order in which the Contract Documents are listed below:-
3. In consideration of the payments to be made by the Procuring Agency to the Bidder as hereinafter mentioned, the Bidder hereby covenants with the Procuring Agency to provide the Goods related services and to remedy defects therein in conformity in all respects with the provisions of the Contract.
4. The Procuring Agency hereby covenants to pay the Bidder in consideration of the provision of Goods and the remedying of defects therein, the Contract Price or such other sum as may become payable under the provisions of the contract at the times and in the manner prescribed by the contract.
IN WITNESS whereof the parties hereto have caused this Contract to be executed in accordance with their respective laws the day and year first above written.
Signed, sealed, delivered by __________________the ________________ (for the Procuring Agency)
Witness to the signatures of the Procuring Agency:
………………………………………………
Signed, sealed, delivered by __________________the ________________ (for the Procuring Agency)
Witness to the signatures of the Bidder: …………………………………………………
Contract Number: Contract Value: Contract Title:
Dated:
[Name of Supplier] hereby declares that it has not obtained or induced the procurement of any contract, right, interest, privilege or other obligation or benefit from Government of Pakistan or any administrative subdivision or agency thereof or any other entity owned or controlled by it (GoP) through any corrupt business practice.
Without limiting the generality of the foregoing [Name of Supplier] represents and warrants that it has fully declared the brokerage, commission, fee etc. paid or payable to anyone and not given or agreed to give and shall not give or agree to give to anyone within or outside Pakistan either directly or indirectly through any natural or juridical person, including its affiliate, agent, associate, broker, consultant, director, promoter, shareholder, sponsor or subsidiary, any commission, gratification, bribe, finder's fee or kickback, whether described as consultations fee or otherwise, with the object of obtaining or inducing the procurement of a contract, right, interest, privilege or other obligation or benefit in whatsoever form from GoP, except that which has been expressly declared pursuant hereto.
[Name of Supplier] certifies that it has made and will make full disclosure of all agreements and arrangements with all persons in respect of or related to the transaction with GoP and has not taken any action or will not take any action to circumvent the above declaration, representative or warranty.
[Name of Supplier] accepts full responsibility and strict liability for making and false declaration, not making full disclosure, misrepresenting fact or taking any action likely to defeat the purpose of this declaration, representation and warranty. It agrees that any contract, right interest, privilege or other obligation or benefit obtained or procured as aforesaid shall, without prejudice to any other right and remedies available to GoP under any law, contract or other instrument, be voidable at the option of GoP.
Notwithstanding any rights and remedies exercised by GoP in this regard, [Name of Supplier] agrees to indemnify GoP for any loss or damage incurred by it on account of its corrupt business practices and further pay compensation to GoP in an amount equivalent to ten time the sum of any commission, gratification, bribe, finder's fee or kickback given by [Name of Supplier] as aforesaid for the purpose of obtaining or inducing the procurement of any contract, right, interest, privilege or other obligation or benefit in whatsoever form from GoP.
To: Hazara Electric Supply Company (Hazara Electric Supply Company (HAZECO)), Manager Supply Chain Management HAZECO HQ, Gulistan Colony, College Road, Abbottabad., Abbottabad, Abbottabad (District), Hazara Division (Division), Khyber Pakhtunkhwa (KP) (Province).
WHEREAS [name of Bidder] (hereinafter called “the Bidder”) has undertaken, in pursuance of Contract No. [reference number of the contract] dated [insert date] for provision of Goods(hereinafter called “the Contract”).
AND WHEREAS it has been stipulated by you in the said Contract that the Bidder shall furnish you with a Bank Guarantee by a reputable bank for the sum specified therein as security for compliance with the Bidder’s performance obligations in accordance with the Contract.
AND WHEREAS we have agreed to give the Bidders guarantee:
THEREFORE, WE hereby affirm that we are Guarantors and responsible to you, on behalf of the Bidder, up to a total of [amount of the guarantee in words and figures], and we undertake to pay you, upon your first written demand declaring the Bidder to be in default under the Contract and without cavil or argument, any sum or sums within the limits of [amount of guarantee] as aforesaid, without your needing to prove or to show grounds or reasons for your demand or the sum specified therein.
This guarantee is valid until the: [insert date]
Signature and seal of the Guarantors
_____________________________________________________________________
[name of bank or financial institution]
_____________________________________________________________________
[address]
_____________________________________________________________________
[date}