aw rd format

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DIRECTORATE OF MARKETINGKhadi and Village Industries Commission

3, Irla Road, Vile Parle (West), Mumbai -400056.

Ph: 022-26716680 Fax: [email protected]

No: MKT/ National Award-2012-13 /2013-14 Date:13-05.2013

To.The Dy. Chief Executive Officer (-------Zone)Zonal Office

Khadi & Village Industries Commission,New Delhi, Mumbai, Kolkata, Bangalore, Bhopal andGuwahati

SUB:- Furnishing the nominations for NationalAwards- 2012-13.

Sir,

National MSME Awards Function will be organized inassociation with the Annual Day of Ministry of MSME,encouraging artisans, institutions, PMEGP units, Banks andState KVI Boards etc. for their outstanding performance.

This year too the function will be organized at New Delhi asper the scheduled date.

2. You may kindly ensure sending nominations from all thestate/Div. offices under each category and forward 3 namesfor each category to this office only with the

recommendation of Zonal Committee. The details ofcategories of Awards are placed at enclosed annexure.

3. All the nominations for National Awards-2012-13 must besupported through valid details in the given format and allthe columns in the format have to be filled in. The formatprovided last year may be used with change of year for allthe categories of awards. In addition to the above, thecitation (1/2 to 1 page) of the concerned awardees will also

be required to be enclosed along with 2 passport size colored


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photograph, through e-mail, for correction/ modification andfor further course of action.

4. Every nomination must be certified by the concerned

State/Div. Director and declaring that individual/organizationhas not been convicted in any court of law nor has beeninvolved in any sort of financial irregularities whatsoever.

5. In view of the above, kindly attend it on priority to holdspecial Zonal Committee meeting urgently, if necessary andensure that in any case all such nominations reach toDirectorate of Marketing, KVIC, Mumbai on or before 15th

June 2013 positively.

This is issued with the approval of Chief ExecutiveOfficer.

Encl: As above

Yours faithfully

Sd/-

(G. Hussain)Director (Marketing)

Copy toState/Div. DirectorKhadi & V.I. Commission---------------------------


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ANNEXUREDirectorate of Marketing

Categories of National Awards -2012-13 underKVI Sector

SN Category ofAwardees

Type ofAward

No. ofAwards

proposed

1. Best Artisan award toKhadi Spinner

Zonal 6

2. Best Artisan award toKhadi weaver

Zonal 6

3. Best V.I. artisan

award

Zonal 6

4. Best Khadi Institution Zonal 6

5. Best PMEGP Unit Zonal 6

6. Best Bank for PMEGP Zonal 6Best Bank PMEGP National 1

7 Best SFURTI Cluster(Khadi)

National 1

8. Best SFURTI Cluster(V.I.)

National 1

9. Best KVI Board(Non NEZ)

National 1

10. Best KVI Board(NEZ)

National 1

11. Best Trading UnitDeptl.

National 1

12 Best Deptl. TrainingCentre

National 1

14.Best Institutional

Training CentreNational

1

15. Best export orientedunit (PMEGP)

National 1

16 Best Village Industriesinstitution

National 1

Total 46


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Directorate of MarketingDate-13-05-2013

Guidelines for criteria ofselection/recommendation the names for

National Awards-2012-13

1. For Artisans: (Spinners, weavers, V.I. Artisans)


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a. He/She should be Indian by birth.

b. He /She should not be involved in any un

constitutional work and should not been convictedby any court of law.

c. He /She should be regular Worker/artisan at leastfor last 5 years of the certified/bonafied KVIInstitution/ unit of KVIC or KVIB.

d. His/Her specialty of work must be reflected inconsideration for award and at least 50% target

(as per capacity of implement) of work, should becompleted during the year.

e. He /She should not be receiver of same Award forthe last 3 years, proceeding the current year.

f. He /She should not be below of 18 years old.

g. Any other point, in addition to the above as perrecommendation of the committee.

2. For Khadi/V.I. Institutions, REGP/PMEGP Units,SFURTI Clusters, Dept. Trading units.

a. Khadi Institution/REGP/PMEGP unit should havevalid registration certificate from competentauthorities, and in case of Khadi work it should

have a live Khadi certificate from KVIC, as ondate.

b. The institution/Unit should not be involved in anyunconstitutional work and should not be defaulterof KVIC or Bank or for other schemes of KVIC.

c. The institution/unit should be regular in the workand have been achieving a sustainable growth rate

for at least last 3 (three) years.


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d. The institution/ unit should not be run in losses atleast for last 2 years.

e. Specialties of work which includes the productdevelopment, licensing from ISO, BIS, Agmark,quality, packaging, higher wage component paidto workers, better management skill, welfaremeasures for artisans/ workers, creation of newdesigns, products etc should be reflected assustainable criteria for recommendation.

f. Special achievement/ action which includes

creation of new employment to rural artisans,coverage of SC/ST, hill boarder areas etc wouldalso be the criteria for selection.

3. Criteria forTraining Centers, PMEGP Banks, PRODIP& RISC project:-

a. It should be recommended mainly based on theirperformance during last year and over allperformance in the last three (3) years.

b. Creation of new product, designs and interventionand its coverage in case of PRODIP & RISCprojects.

c. Targets and achievements for arranging trainingcourses and getting the volume of IRG fortraining centers.

d. Volume of Sanction/Distribution of funds to

KVI/REGP/PMEGP units by the commercial Banksand utilizing the margin money under the schemein every zone and at National level.

2. Criteria for State KVI Board:-

a. The recommendation of the KVI Board should beconsidered on the basis of implementation of KVIprogramme, recoveries and payment of dues toKVIC, proper accounting system, account


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reconciliation with KVIC A/c and all other detailscalled in the format.

b. Timely reconstitution of the Board as well asproper supporting grant for establishment.

c. Running dept. programme, establishing trainingcenters, laboratories etc.

d. PMEGP implementation and coverage of thetargets in respect of all other schemes of theCommission.

e. Achievement during last year and progressthereupon.

FORMAT-1

FORMAT FOR RECOMMENDING THE NAME OF ARTISANFOR NATIONAL AWARD -2012-13

Type- Khadi Spinner / Khadi Weaver / V.I. Artisan

(Please tick)

SN GENERAL INFORMATION (FOR ALL)1. Name of Artisan:


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2. Age

3. Please tick Male/Female

4. Education

5. Full address of artisan

6. Tele/Mobile No. with codeNo.:-

7. Name and address of Institution/Unit where he/Sheis working with phone no andcode no.

Code No.Phone No.

8. Group (Please Tick) General OBC SC/ST

9. Period since working

10. Whether he/she is traditionalworker or new

(Please tick)

Traditional / New

11 If new, from where he/shehas get training.

12 Type of work doing

13 Whether any other memberof his/her family is engagedwith this work.

14 Whether earlier he/she hasget any Award fro KVIC orany other organization.

15 Whether he/she hasinnovated any new item, newequipment, new design etc. Ifyes please give details.

FOR SPINNER1. Name of Charkha using

2. Working at Home or at Shed.

3. No. of hours working in day

4. No. of count of yarn spinningand No. of hangs

5 Achievement during last 3years:

Count of yarn spun

2010-11 2011-12 2012-13


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Value of yarn(Rs.)

6 Specialization (if any) andother details for support.

FOR WEAVER1. Name of Loom using

2. Working at Home or at Shed.

3. No. of hours working in day

4. No. of assisting persons fromfamily

5 Achievement during last 3years:

Count of yarn weaving

Value of cloth (Rs.)

Wage earn (Rs.)

2010-11 2011-12 2012-13

6. Specialization (if any) andother details for support likecreation of designs, Muslinand Silk weaving etc.

VILLAGE INDUSTRIES/REGP/PMEGP ARTISAN7. Name of Machine using

8. Working at Home or at Shed.9. No. of hours working in day

10. No. of assisting persons fromfamily, if any

11. Name of items producedWith specification

12. Achievement during last 3years:

Production (Qty)

Value (Rs.)

2010-11 2011-12 2012-13


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13. Specialization (if any) andother details for support likecreation/invention of designs,quality etc

14. Recommendation of Secretary/ Manager of theInstitution/ Unit.

DECLARATION OF ARTISAN

I (_______________________________________________), is abonafied

(Name)Worker/Artisan of ________________________________________________

(Name of institution/Unit)I also declare that I am not involved in any un constitutional work andhas not been punished by any court of India.

(Signature/ Thumb of artisan)Photo

of Artisan Name______________________________

to be attested bySecretary/ Manager

of the Institution

Date:Place:

Certificate of Secretary/Manager of Institution/Unit

Certified thatShri/Smt./Km.______________________________________is a bonafied worker/ artisan of this institution/unit and his/herdeclaration stated as above is correct as per my best knowledge/records. I recommend his/her name for National Award -2012-13 of

KVIC.


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(Signature of Secretary/Manager)

Name_______________________

Date :Place:

Stamp

RECOMMENDATION OF STATE/DIV.OFFICE/KVI BOARD

Signature of State Div./ Director/CEO,KVI Board:

Name of Officer I/c

Countersign of State/Div. Director of KVIC in case of KVIB unit:______________

Name of Officer I/c __________________________________Designation __________________________________Name of Office __________________________________

RECOMMENDATION OF ZONAL OFFICE, KVIC

Signature of Dy.CEOName --------------------------------------

FORMAT-2

FORMAT FOR RECOMMENDING THE NAME OF KHADIINSTITUTION/SFURTI CLUSTER FOR NATIONAL

AWARD -2012-13

SN GENERAL INFORMATION

1. Name of the Institution


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2. Working under the fold of(Please tick)

KVIC KVIB

3. Full address with STD codeand Phone No.

4. Name of Chairman/SecretaryWith Phone/ Mobile No.

5. Activities under going

6. Khadi Certificate No. anddate of validity.

7. Category (A+,A,B,C,or D)

Period since working(Establishment year)

8. Name of founder of theinstitution

9. How many productioncenters are running?

10. No. of Sales centersestablished.

11 What types of equipments/implementsare available for work

12 Area of operation(Block,Dist, State,

Country)PERFORMANCE

13 Achievement during last 3years: (Rs. In lakhs)

a.Productionvalue(Yarn)

b.Production Value(cloth)

2010-11 2011-12 2012-13


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c. Sale value of cloth

14. Whether exporting anyitem

(Please tick)

Yes NO

15 If yes, details pleasea. Products name

b. Export value

c. Countries name

2010-11 2011-12 2012-13

16 Whether involved withGovt. Supply.

Yes NO

17 If yes, details of 3 yearsa. Products name

b. Value of supply

c. Name of Dept.

2010-11 2011-12 2012-13

18 Whether any product hasbeen brought underBIS,ISO , Ag Markcertification, if yes pleasegive details

19 Whether institutions hasinnovated any new item,new equipment, newdesign etc. If yes pleasegive details

20 Plan for creation of moreemployment, newproducts, new market orany new thing forpromotion of KVI


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activities.

21 Whether institution hasgot so far any award from

KVIC and or any otherorganization for KVIactivities.

Signature of Secretary/Chairman

Date-Name:______________________

Stamp

DECLARATION BY SECRETARY/CHAIRMAN OF INSTITUTION:-

I (______________________________), Secretary/ Chairman of_______________________________________________ who is abonafied

(Name of institution)Institution working under the fold of _________________________________

(Name of KVIC/KVIB)

declare that the institution is not involve in any un constitutional workand also it is not defaulter in any scheme of KVIC/KVIB.

(Signature of Secretary/ Chairman)Photo Name

________________________________of Secretary/Chairman

To be attested byRecommending

Authority

Date:Place: RECOMMENDATION OF STATE/DIV.OFFICE/KVI BOARD

It is certified that_______________________________________________.is a bonafied institution u8nder the fold of KVIC/KVIB and thedeclaration made by the Secretary/ Chairman of this institution

stated as above is correct as per my best knowledge and office


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records. I recommend the name of this institution for National Award-2012-13 of KVIC.

Signature of State Div./ Director of KVIC/CEO,KVI Board:

Name of Officer I/c

Stamp

Countersign of State/Div. Director of KVIC in case of KVIB Unit:__________________

Name of Officer I/c____________________________Designation _____________________________Name of Office _____________________________



FORMAT-3

FORMAT FOR RECOMMENDING THE NAME OF V.I.insti/ REGP/PMEGP UNIT FOR NATIONAL AWARD

-2012-13



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1. Name of the Unit/V.I.Institution

2 Full address with STD code

and Phone No.

3 Type of unit(Please tick)

V.I.Insti REGPPMEGP r

4 Working under the fold of(Please tick)

KVIC KVIB

5 Name of Bank branch fromwhere finance has beengot

6 Year of finance & amount

7 Name of entrepreneur/Contact personWith Phone/ Mobile No.

8 Age of entrepreneur

9 Education of entrepreneur

10 Group (Please Tick) General OBCSC/ST

11 Name of specializedproducts producing

12 Period since working(Establishment year)

13 What types of equipments/implementsare being used for work

14 Area of operation(Block,Dist, State,Country)

15 Whether any Award fromKVIC or any otherorganization has been


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received earlier? Givedetails and year of Award.

PERFORMANCE

1 Achievement during last 3

years: (Rs. In lakhs)a.Production in Qty

b.Production Value

c. Sale value

d. Employment (No.)

e. Wage earned (Rs.)

2010-11 2011-12 2012-13

2 Whether exporting anyitem

(Please tick)

Yes NO

3 If yes, details pleasea. Products name

b. Export value

c. Countries name

2010-11 2011-12 2012-13

4 Whether involved withGovt. Supply.

Yes NO

5 If yes, details of 3 yearsa. Products name

b. Value of supply

c. Name of Dept.

2010-11 2011-12 2012-13

6 Whether any product hasbeen brought underBIS,ISO , Ag Markcertification, if yes pleasegive details

7 Whether unit has


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innovated any new item,new equipment, newproduct etc. If yes pleasegive details

8 Plan for creation of moreemployment, newproducts, new market orany new thing forpromotion of KVIactivities.

9 Other details in support

Stamp Signature of Entrepreneur/ ManagerName:______________________

DECLARATION BY ENTREPRENEUR OF UNIT:-

I (______________________________________),entrepreneur/Manager of

_______________________________________________ who is abonafied

(Name of V.I./REGP/PMEGP Unit)

unit working under the fold of _________________________________

(Name of KVIC/KVIB)

declare that this unit is not involve in any un constitutional work andalso it is not defaulter in the scheme of KVIC/KVIB.

(Signature of Entrepreneur/Manager)Photo Name _________________________

of Entrepreneur/Managerto be attested by Recommending Authority

Date:Place:



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It is certified that_______________________________________________.is a bonafied institution under the fold of KVIC/KVIB and thedeclaration made by the Entrepreneur/Manager of this unit stated asabove is correct as per my best knowledge and office records. I

recommend the name of this unit for National Award -2012-13 ofKVIC.

Signature of State Div./ Director of KVIC/CEO,KVI Board:Name of Officer I/c

Stamp

Countersign of State/Div. Director of KVIC in case of KVIB unit:__________________




FORMAT-4

FORMAT FOR RECOMMENDING THE NAME OF DEPT.CENTRE OF KVIC/KVIB FOR NATIONAL AWARD

2012-13



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1. Name of the Dept Centre


KVIC KVIB


4. Name of Directorate/Deptunder which it is working

5. Name of Director/Manager/ In chargeWith Phone/ Mobile No.

6. Period of posting ,Since

8. Activities under taken inthe Centre

9. Period since working ofthe centre(Establishment year)

10. Name of branches of theCentre (if any)

11. What types of equipments/implementsare used in work

12. No. of employees/workersposted at Centre

13. Area of operation

(Block,Dist, State,Country)

PERFORMANCE

14. Achievement during last 3years:

a.

b.

2010-11 2011-12 2012-13


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c.

15. Profit /Loss during 3years

2010-11 2011-12 2012-13

16. Whether involved withGovt. Supply.

Yes NO

17. If yes, details of 3 years

a. Products name

b. Value of supply

c. Name of Dept.

2010-11 2011-12 2012-13

18. Whether the centre hasbeen brought underBIS,ISO , Ag Mark

certification, if yes pleasegive details

19. Whether the Centre hasinnovated any new item,new equipment, newdesign etc. If yes pleasegive details.

20. Further Plan for moreemployment, newproducts, new market orany new thing forpromotion of KVIactivities.

21. Whether the centre hasgot so far any award fromKVIC and or any otherorganization for KVI

activities.


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Date:- Signature of Director/Manager of the Centre

Name:____________________________

Stamp

Photo of AwardReceiving personTo be attested byHead of the Dept/Directorate

RECOMMENDATION OF STATE/DIV.OFFICE/KVIBOARD

It is certified that_______________________________________________.is a Dept. Centre of KVIC/KVIB working under theprogramme of _________________________ and thedetails given by the Director/Manager/I/c of this centre

stated as above is correct as per my best knowledge. Irecommend the name of this Centre for National Award-2012-13 of KVIC.


Date- Name of Officer /I/c ______________

Place- Stamp

Countersign of State/Div. Director of KVIC in case ofKVIB Unit:

Signature:Name of Officer I/c____________________________Designation _____________________________

Name of Office _____________________________


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Recommendation of Zonal Dy. CEO of KVIC

Signature of Zonal Dy.CEO /Officer I/cName of Zonal Dy.CEO /Officer I/c __________________Designation _____________________________Name of Zone Office _____________________________

Date-Place-

FORMAT-5

FORMAT FOR RECOMMENDING THE NAME OFINSTITUTIONAL TRAINING CENTRE/KG BHAVAN /CSPUNDER KVIC/KVIB FOR NATIONAL AWARD -2012-13



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1. Name of the Centre


KVIC KVIB


4. Name of Manager/ InchargeWith Phone/ Mobile No.

5. Period of posting ,Since

6. Name & address of theinstitution under which itis working.

7. Name of Secretary/Chairman of theInstitution withPhone/Mobile No.

8. Activities under taken inthe Centre

9. Period since working ofthe centre(Establishment year)

10. Name of branches of theCentre (if any)

11. What types of equipments/implements

are used in work

12. No. of employees/workersposted at Centre

13. Area of operation(Block,Dist, State,Country)

PERFORMANCE OF CENTRE

14. Achievement during last 3 2010-11 2011-12 2012-13


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years:a.

b.

c.

d.

e.

15. Profit /Loss during last3 years

2010-11 2011-12 2012-13

16. Whether involved withGovt. Supply.

Yes NO

17. If yes, details of 3 years

a. Products name

b. Value of supply

c. Name of Dept.

2010-11 2011-12 2012-13

18. Whether the centre hasbeen brought underBIS,ISO , Ag Markcertification, if yes pleasegive details

19. Whether the Centre hasinnovated any new item,new equipment, new

design etc. If yes pleasegive details.

20. Further Plan for moreemployment, newproducts, new market orany new thing forpromotion of KVIactivities.

21. Whether the centre has

got so far any award from


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KVIC and or any otherorganization for KVIactivities.

Place :- Signature of Manager /I/c of the centreDate:-Name:____________________________

Stamp

DECLARATION BY SECRETARY/CHAIRMAN OF INSTITUTION:-

I (________________________________________), Secretary/Chairman of_______________________________________________ declarethat this is a certified centre of___________________________________________and

(Name of Institution)Institution is working under the fold of_______________________________ .

(Name of KVIC/KVIB)I also declare that the institution is not involved in any Unconstitutional work and it is not defaulter in any scheme of KVIC/KVIB.

(Signature of Secretary/ Chairman)Photo of Name _________________________

Manager/Secretary/ChairmanTo be attested byrecommending

authority

Date:Place: RECOMMENDATION OF STATE/DIV.OFFICE/KVI BOARD

It is certified that_______________________________________________.is a bonafied institution under the fold of KVIC/KVIB and thedeclaration made by the Secretary/ Chairman of this institutionstated as above is correct as per my best knowledge and office

records. I recommend the name of this institution for National Award-2012-13 of KVIC.


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Stamp

Countersign of State/Div. Director of KVIC in case of KVIB Unit:

Signature:Name of Officer I/c____________________________Designation _____________________________Name of Office _____________________________


Signature of Zonal Dy.CEO /Officer I/cName of Zonal Dy.CEO /Officer c____________________________Designation _____________________________Name of Zone Office _____________________________

Date-

Place-

Format-6

Format for collecting the details from ExportOriented Units/Institutions for National Award

1. Name of the unit/institution:


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2. Category of unit ie Institution/REGP/PMEGP

3. Unit working under KVIC KVIB

4.Whether Unit has taken Membership of KVI-EPC

5. Address of the Unit:

6. Name of Secretary/Manager:

7. E.Mail:

8. Phone/Mobile No. along with STD Code

9. Establishing year of the unit:

10. Name of branches if any:

11. No. of staff and workers working at present :

12. Name of products which are being produced andexported :

13. Whether products has BIS/AG Mark etc:

14. Whether Institution/Unit has ISO2000/9000 Mark etc

15. Details of production and Export during last 3 years


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(Rs. in lakhs)

S.N. Details 2010-11 2011-12 2012-13

1. Production

2. Domestic Sales

3. Export

16. Details of Export during 2012-13

Name ofproducts

Qty. andvalue ofexport

Name oftheCountry

Whetherdirect orthroughMerchants

Capacityof exportin qty. andvaluewhich canbeincreased

17. Any other achievement if any:

18. Specialties to be added in Citation:-


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Place :- Signature of Secretary/Manager /I/cDate:-Name:____________________________

Stamp

DECLARATION BY SECRETARY/MANAGER OFINSTITUTION/UNIT:-

I (________________________________________), Secretary/Manager of

_______________________________________________ declarethat this is a certified centre of___________________________________________and

(Name of Institution/Unit)Institution is working under the fold of_______________________________ .

(Name of KVIC/KVIB)I also declare that the institution is not involved in any Unconstitutional work and it is not defaulter in any scheme of KVIC/KVIB.

(Signature of Secretary/Manager)Photo of Name _________________________

Manager/Secretary/ManagerTo be attested byrecommending

authority

Date:

Place:


It is certified that_______________________________________________.is a bonafied institution/Unit under the fold of KVIC/KVIB and thedeclaration made by the Secretary/ Manager of this institution/Unit

stated as above is correct as per my best knowledge and office


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records. I recommend the name of this institution/Unit for NationalAward -2012-13 of KVIC.


Stamp

Countersign of State/Div. Director of KVIC in case of KVIB Unit:

Signature:Name of Officer I/c____________________________Designation _____________________________

Name of Office _____________________________



Date-Place-

Format-7

Format for collecting the details from State

Khadi and Village Industries Board for NationalAward-2012-13

1. Name of the State/UT/Khadi & V.I. Board:


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2. Address with Pin Code:-

3. Phone/Fax No. along with STD Code:-

4. E.Mail of the Board:-

5. Date of constitution of the Board:

6. Date of reconstitution of the Board:-

7. Total Members of the Board

a) No. of Official Members:b) No. of Non Official Members:

8. Information in respect of PMEGP Scheme as on31-03-2013 (2012-13)

SN Particular No. of projects

forwardedto thebanks

No. ofprojects

sanctionedby thebanks

Totalamount of

loanreleasedby Banks

M.M.released

1. No. of Individual

2. No. of Institution

3. No. of Co.op.soc.

4. BF Linkages(Please specifybelow)

Total

9. Performance of the Board as on 31-03-2013 (2012-13)

Value Rs. in lakhs, Employment in numbers

SN Particulars Khadi V.I. Total

1. Production2. Sales


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3. Total Employment

a) Full Time

b) Part time

4. Share ofemployment

a) SC

b) ST

c) Women

5. Total Earning

a) Full Time

b) Part Time

Reason for slowdown in performance if any:-

10. Other special achievements of the Board regardingResearch & Development/Training/Equipments invention etcunder KVI programme in the State under their own resources(Please attach separately with the application)

Signature of Chief Executive Officer/ Chairman of the Board

Name:

Date:Place:

Recommendation of State Director of KVIC

Signature:Name of Officer I/c____________________________


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Designation _____________________________Name of Office _____________________________



Date-Place-

FORMAT-8FORMAT FOR RECOMMENDING THE NAME OF V.I.

/KHADI CLUSTER FOR NATIONAL AWARD -2012-13

SN GENERAL INFORMATION1. Name of implementing


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Unit/V.I./Khadi Institution

2 Full address with STD code andPhone No.

4. Name of Contact personWith Phone/ Mobile No.

5. Type of unit(Please tick)

V.I.Insti Khadi Insti.


KVIC KVIB

7. Name and Type of Cluster

8. Location of Cluster

9. Name of Cluster DevelopmentExecutive

10. Name of Technical Agency

11 Year of establishment of cluster

12. Establishment of CFC

13 Installation of CFC equipments

14. No. of Tool kits supplied to theartisans

15. Training imparted in details

16 Name of specialized productsproducing and their range

17 Total funds received(Rs. in lakhs)

18 Total funds utilized(Rs. in lakhs)

19 What types of equipments/implementsreceived and are being usedfor work

20 Whether any Award from KVIC


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or any other organization hasbeen received earlier? Givedetails and year of Award.

PERFORMANCE

21 Achievement during last 3years: (Rs. In lakhs)

a.Production in Qty

b.Production Value

c. Sale value

d. Employment (No.)

e. Wage earned (Rs.)

2010-11 2011-12 2012-13

22 Whether exporting any item(Please tick)

Yes NO

23 If yes, details pleased. Products name

e. Export value

f. Countries name

2010-11 2011-12 2012-13

24 Whether involved with Govt.Supply.

Yes NO

25 If yes, details of 3 yearsd. Products name

e. Value of supply

f. Name of Dept.

2010-11 2011-12 2012-13

26 Whether any product has beenbrought under BIS,ISO , AgMark certification, if yes pleasegive details

27 Whether unit has innovatedany new item, new equipment,new product etc. If yes please

give details


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28 Plan for creation of moreemployment, new products,new market or any new thingfor promotion of KVI activities.

29 Other details in support

30. No. of artisans covered as per DSR

SC ST Minority Others Total Women

31. No. of artisans newly covered, if any

SC ST Minority Others Total Women

32. Working Capital linkage/Outside fundgenerated:

33. Range increases in number of days ofwork/month

34.Savings (Rs. in lakhs)

35.Wages enhancement (in Rs.)

Earlier Wages Present wages % of increases

36.No. of SHG formed and their credit linkages

37.Social empowerment

i) Medi-claimii) Jan Shree Bima Yojna/ Pension schemeiii) Health Check-upiv) Social Security measuresv) Scholarship

38. Any other specialties/Remarks:-


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Stamp Signature of Secretary/ Manager

Name:______________________

DECLARATION BY SECRETARY/MANAGER OF CLUSTER:-

I (______________________________________),Secretary/Manager of_______________________________________________ who is abonafied

(Name of V.I./Khadi institution/ Cluster )

unit working under the fold of _________________________________

(Name of KVIC/KVIB)

declare that this unit is not involve in any un constitutional work andalso it is not defaulter in the scheme of KVIC/KVIB.

(Signature of Secretary /Manager)Photo Name _________________________of Secretary/Managerto be attested by Recommending Authority

Date:Place:


It is certified that_______________________________________________.is a bonafied institution implementing Khadi/V.I. Cluster under the

fold of KVIC/KVIB and the declaration made by the Secretary/Manager of this cluster stated as above is correct as per my best


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knowledge and office records. I recommend the name of this CLUSTERfor National Award -2012-13 of KVIC.


Name of Officer I/c

Stamp

Countersign of State/Div. Director of KVIC in case of KVIB unit:__________________




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