1. Name of applicant manufacturer/company. 2. Authorized ...

ANNEXURE-I

APPLICATION FORM FOR REGISTRATION/RENEWAL OF REGISTRATION OF

MANUFACTURERS UNDER PMKSY.

1. Name of applicant manufacturer/company.

2. Authorized person/officer on the behalf of the company

A. Name

B. Designation

C. Specimen signature

Address Address District State Tel. No. Fax. No. E-mail

A Office

Head Office

Regional Office

B Factory

C Godown

3. Irrigation system for which registration is required:

4. Detail of BIS license

S.

No.

Component BIS Code CM/L

No.

Last date of

validity

Name of manufacturer

1 LLDPE Plain Laterals:12mm 2

to 32mm, 2.5 kg/cm

2 PE/PVC pipes : 25 to 32 mm,

10 kg/sqm.

3 Emitting Pipes:16mm, class-II-

NPC

4 Emitting Pipes:16mm, class-II-

PC

5 PE Micro tubes

6 Emitters (online)-PC

7 Emitters (online)-NPC

Mini sprinkler - double nozzle

& single nozzle

8 Ventury Injector (Fertilizer

and Chemical Injection

System)

9 Fertilizer Tank

10 Screen Filter

Media/Sand Filter

11 Hydrocyclone Separator

12 Disc Filter

13 Fittings and Accessories(with

NTH/CIPET Certificate)

5. Component wise price list in Annexure-II : Attached/Not attached

6. List of authorized dealers/distributers in Annexure-III

with TIN/RST/CST registration no. documents : Attached/Not attached

C:\Users\Ajmer\Desktop\Registration formats PMKSY 2015 16.doc

7. Detail of technical personnel in Annexure-IV. : Attached/Not attached

8. Performance in the State during last five years

in Annexure-V : Attached/Not attached

9. Affidavit w.r.t. terms and conditions in Format-A : Attached/Not attached

10. Authority letter of competent authority in support

of authorized signatory. : Attached/Not attached

11. RST/CST registration no. & date of company : Attached/Not attached

12. Whether GPS device available with the firm : Yes/No

13. Tentative campaigning schedule in Annexure-VI : Attached/Not attached

14. Last 3 years balance sheet of the company : Attached/Not attached

15. Agreement between company and dealer in Annexure-VII : Attached/Not attached

16. Detail of fees deposited

S. No. Particulars DD No. Date Validity Bank

1 Renewal fee- ₹ 50,000/-

2 Bank Guarantee/Extended Bank

Guarantee – ₹ 10.00 lacs, valid upto

31.03.2018.

(in favor of Director General Horticulture, Haryana, payable at Panchkula)

Certified that above said information are true to best of our knowledge.

Signature of competent authority

Place Name/ Designation

Date

Mention NA in column which is not applicable.


Annexure-II Prices of Micro Irrigation Systems Components: 2015-16 (Valid upto 31.3.2016)

Sr.

No.

Name of the System Components Raw material

used

ISI No Unit Price (Rs. -

inclusive of

taxes, levies &

freight

charges etc.)

1 PVC Pipes for Main and Submain Pipelines:

a 40 mm x 4 Kg/cm2 PVC 4985 Mtr

b 50 mm x 4 Kg/cm2 PVC 4985 Mtr

c 63 mm x 4 Kg/cm2 PVC 4985 Mtr

d 75 mm x 4 Kg/cm2 PVC 4985 Mtr

e 90 mm x 4 Kg/cm2 PVC 4985 Mtr

f 110 mm x 4 Kg/cm2 PVC 4985 Mtr

2 PE Pipes for Main and Submain Pipelines:

a 63 mm (4 Kg/cm2) PE 4151-PART-II Mtr

b 75 mm (4 Kg/cm2) PE 4151-PART-II Mtr

c 90 mm (4 Kg/cm2) PE 4151-PART-II Mtr

d 110 mm (4 Kg/cm2) PE 4151-PART-II Mtr

a 63 mm (2.5 Kg/cm2) PE 4151-PART-II Mtr

b 75 mm (2.5 Kg/cm2) PE 4151-PART-II Mtr

c 90 mm (2.5 Kg/cm2) PE 4151-PART-II Mtr

d 110 mm (2.5 Kg/cm2) PE 4151-PART-II Mtr

3 PE/PVC Pipes as riser pipe for Mini/Micro

Sprinkler:

a 25 mm (10 Kg/cm2) 4984/4985 Mtr

a 32 mm (10 Kg/cm2) 4984/4985 Mtr

4 LLDPE Plain Laterals

a 12 mm diameter, 2.5Kg/cm2 LLDPE 12786 Mtr

b 16 mm diameter, 2.5Kg/cm2 LLDPE 12786 Mtr

c 25 mm diameter, 2.5Kg/cm2 LLDPE 12786 Mtr

d 32 mm diameter, 2.5Kg/cm2 LLDPE 12786 Mtr

5 On line Dripper

a 4 LPH (Non-Pressure Compensating) PP 13487 No.

b 8 LPH (Non-Pressure Compensating) PP 13487 No.

c 4 LPH (Pressure compensating) PP 13487 No.

d 8 LPH (Pressure compensating) PP 13487 No.

6 Emmitting Pipe (Integral Drip Lateral)

Class II-NPC

a 16 mm, 1to4 LPH, 20cm LLDPE 13488 Mtr

b 16 mm, 1to4 LPH, 30cm LLDPE 13488 Mtr

c 16 mm, 1to4 LPH, 40cm LLDPE 13488 Mtr

d 16 mm, 1to4 LPH, 60cm LLDPE 13488 Mtr

7 Emitting Pipe (Integral Dripline - PC) Class

II-PC

a 16 mm, 1to4 LPH, 20cm LLDPE 13488 Mtr

b 16 mm, 1-4 LPH, 30 cms LLDPE 13488 Mtr

c 16 mm, 1-4 LPH, 40 cms LLDPE 13488 Mtr


d 16 mm, 1-4 LPH, 60 cms LLDPE 13488 Mtr

8 Filters

A Screen Filter with assembly

a 5 m3/hr x 1.5 " Metal 12785 No.

b 7 m3/hr x 1.5 " Metal 12785 No.

c 10 m3/hr x 1.5 " Metal 12785 No.

d 20 m3/hr x 2 " Metal 12785 No.

e 25 m3/hr x 2 " Metal 12785 No.

f 30 m3/hr x 2.5 " Metal 12785 No.

a 5 m3/hr x 1.5 " Plastic 12785 No.

b 7 m3/hr x 1.5 " Plastic 12785 No.

c 10 m3/hr x 1.5 " Plastic 12785 No.

d 20 m3/hr x 2 " Plastic 12785 No.

e 25 m3/hr x 2 " Plastic 12785 No.

f 30 m3/hr x 2.5 " Plastic 12785 No.

B Sand Filter with assembly

a 10 m3/hrx1.5" MS 14606 No.

b 25 m3/hr x 2 " MS 14606 No.

c 40 m3/hr x 2.5 "/3.0" MS 14606 No.

C Disc Filter with assembly

a 25m3/hr x 2" Metal 12785 No.

b 40 m3/hr x 2.5 "/3.0" Metal 12785 No.

a 25m3/hr x 2" Plastic 12785 No.

b 40 m3/hr x 2.5 "/3.0" Plastic 12785 No.

9 Fertigation Devices

A Ventury Injector with Assembly

a Ventury Injector Assembly 3/4 inch Plastic As Specified No.

b Ventury Injector Assembly 1.5 inch Plastic As Specified No.

c Ventury Injector Assembly 2.0 inch Plastic As Specified No.

c Ventury Injector Assembly 2.5 inch Plastic As Specified No.

B Fertilizer Tank with Assembly

a 30 Litres MS As Specified No.

b 60 Litres MS As Specified No.

c 90 Litres MS As Specified No.

d 120 Litres MS As Specified No.

10 By Pass Assembly

a 1.5 " MS As Specified No.

b 2 " MS As Specified No.

c 2.5" MS As Specified No.

a 1.5 " GM As Specified No.


b 2 " GM As Specified No.

c 2.5" GM As Specified No.

11 Valves

A Non Return Valve

a NRV, Low Friction 1 " GM 778 No.

b NRV, Low Friction 1.5 " GM 778 No.

c NRV, Low Friction 2 " GM 778 No.

d NRV, Low Friction 2.5 " GM 778 No.

B PVC Ball Valve / Control Valve

a 25 mm PVC As Specified No.

b 32 mm PVC As Specified No.

c 40 mm PVC As Specified No.

d 50 mm PVC As Specified No.

e 63 mm PVC As Specified No.

f 75 mm PVC As Specified No.

g 90 mm PVC As Specified No.

C PP Ball Valve / Control Valve

a 25 mm PP As Specified No.

b 32 mm PP As Specified No.

c 40 mm PP As Specified No.

d 50 mm PP As Specified No.

e 63 mm PP As Specified No.

f 75 mm PP As Specified No.

g 90 mm PP As Specified No.

D Throttle Valve

a Size .5" Gun Metal 1239 No.

b Size .75" Gun Metal 1239 No.

c Size 1.5" Gun Metal 1239 No.

d Size 2" Gun Metal 1239 No.

e Size 2.5" Gun Metal 1239 No.

f Size 3" Gun Metal 1239 No.

E Air Release Valve

a Air Release Valve 1 " Metal As Specified No.

b Air Release Valve 1.5 " Metal As Specified No.

c Air Release Valve 1 " Plastic As Specified No.

d Air Release Valve 1.5 " Plastic As Specified No.

F Flush Valve No.


a 40 mm PVC As Specified No.

b 50 mm PVC As Specified No.

c 63 mm PVC As Specified No.

d 75 mm PVC As Specified No.

12 Mini Sprinkler with Assembly

a Double Nozzle - full Circle Plastic

Engineering

IS 12232 (Part1):1996 &

(Part2): 1987

No.

b Single Nozzle - Adjustable Arc and full Circle Plastic

Engineering

IS 12232 (Part1):1996 & (Part

2): 1987

No.

13 Micro tube for DIS

a 6 mm LLDPE As Specified Mtr



Date


ANNEXURE-III

AUTHORIZED DEALER/DISTRIBUTERS NETWORK IN THE STATE OF HARYANA

(Valid upto 31.03.2016)

S.

No.

Name of

dealer/distributer

Address District Jurisdiction Tel. No. TIN/RST/CST No.

The dealer should have the TIN/RST/CST/No., for which attested copy of proof must be attached.



Date


ANNEXURE-IV

Detail of technical personnel with special emphasis on quality control

S.

No.

Name Post Qualification Experience Remark

A In Office

B In Industry

C In Field



Date


ANNEXURE-V

Performance of Firm in Haryana State.

Sr.

No.

Year/Component Beneficiaries

Covered (Nos.)

Area

Covered

(Nos.)

Total Sale

(Rs. in Lac)

Farmer

Share

Obtained

(Rs. in Lac)

Total

Subsidy

Obtained

(Rs. in Lac)

1 2006-07

Drip Irrigation System

Sprinkler Irrigation

System

Total

2 2007-08



System

Total

3 2008-09



System

4 2009-10



System

5 2010-11


Mini Sprinkler

Irrigation System

6 2011-12


Mini /Micro Sprinkler

Irrigation System

7. 2012-13


Mini/Micro Sprinkler

Irrigation System

Total

8. 2013-14



Irrigation System

Total

9. 2014-15



Irrigation System

Total

Note: Non performing registered firm have to give the reason for non-performance in Haryana state.



Date


ANNEXURE-VI

Tentative campaigning schedule

SN Name of district Dates



Date


FORMAT-A

Undertaking on Stamp Paper

We _________________ having our Head Office at

____________________ applying for the registration as a supplier of micro

irrigation system in Haryana State and declare as under:

- That we will supply micro irrigation system, component, products, devices

confirming to BIS standards/Specification laid by the authorities.

- That we will provide free „after sale service‟ for the next three years w.e.f. date of installation. The warranty of system will be for three years after installation.

- That we will supply user manual in local language known by the farmer for the

operation of micro irrigation system supplied by us.

- That we will design and supply effective and proper micro irrigation system in

accordance with the crop spacing and water requirement of the crop.

- That performance of the micro irrigation system shall meet the satisfaction of the

concerned farmers.

- That we will replace faulty parts free of cost during warranty period of three

years.

- That we will abide by the Government rules and regulations, terms & conditions

and instructions issued by department time to time.

Authorized signatory

Dated:


ANNEXURE-VII

AGREEMENT

This agreement is made and entered into at ___________ on this the ______ day of

_________ by and between ______________________________________, a

company incorporated under the Companies Act 1956 having its registered office at

_____________________________________________________________,

hereinafter referred to as “THE COMPANY”(which expression shall unless it be repugnant to the context or meaning thereof mean and include its successors and

assigns) of the One Part

AND

a Partnership Firm/Proprietorship Firm duly registered under the provisions of the

Indian Partnership Act, 1932 and carrying on business at _______, District

_____________, Haryana hereinafter referred to as “THE DEALER”(which expression shall unless it be repugnant to the context or meaning thereof be deemed

to include the Partners/Proprietor for the time being constituting the said firm, their

survivors or survivor and the heirs, executors and administrators of the last

surviving partner and their/his/her permitted assigns) of the Second Part.

WHEREAS the Company is inter-alia carrying on the business of manufacturing all

or some micro irrigation equipment (hereinafter referred to as “the Product”) used in micro irrigation system.

AND WHEREAS the Company desires to appoint party of the second part as one of

the Dealers on non-exclusive basis for selling and marketing of the Product in the

State of Haryana under micro irrigation programme of National Mission for

Sustainable Agriculture during the financial year _______.

AND WHEREAS the party of the second party has agreed to his appointment as the

Dealer of the Company for marketing of the said Product on the following terms and

conditions:

NOW WHEREAS PRESENTS WITNESS AND IT IS AGREED BY AND

BETWEEN THE PARTIES HERETO AS UNDER:

1) The company shall conduct site survey and make design of system and shall be

responsible for it.

2) Company shall provide „After Sales Services‟ and Spares for a period of 3 years to

farmers. Dealer shall not be held responsible in case of failure of company in these

services.

3) The Company reserves the right to change and allot, increase or decrease the area

allotted to the Dealer and to appoint other Dealer or operate directly in the area

assigned to the Dealer, depending on business needs and the performance of the

Dealer.


4) Dealer shall act as facilitator to company in visiting sites, supply material and local

arrangement.

5) Dealer shall coordinate company to install irrigation system as per specifications

under active supervision of the Company.

6) Dealer shall not collect documents from farmer and not collect payment from the

Farmer/ Government and/or other concerned authorities.

7) No any installation is within purview of the dealer and company, unless prior

approval/sanction is taken from the competent authority.

8) The Dealer shall provide a self-Photograph, Photo identification (Voter Card, Driving

Licence etc.), TIN/RST/CST to the company. In the event of a partnership firm or a

Private Limited company, Photographs and Photo Identification of all the

Partners/Directors shall be provided.

9) This agreement shall come into effect on the date mentioned hereinabove and shall be

valid up to 31.03.2016, unless terminated earlier.

10) The Dealer undertakes not to act as the Dealer/Agents of any other

person/firm/company/corporation for the sale of its products, which are similar to or

competing with the products of the Company, during the currency of this Agreement.

11) The Dealer shall keep adequate inventory to cater to immediate market needs. The

decision of the Company as to what constitutes adequate inventory shall be final and

binding on the Dealer.

12) In matter of supply of material, damage, payment terms, profit commission rate, and

any other business terms, dealer and company may enter into separate agreement,

wherein terms of this agreement be indicated.

13) The Dealer shall attend Training Programmes or send a competent member of his

team as and when organized and desired by the Company.

14) The Dealer has to furnish the following documents to the company on a monthly

basis-

a) Installation Reports duly signed by the client and authorised representative of

company.

b) Copy of invoice submitted to the department and authenticated by authorised

representative of company.

c) Statements of accounts.

15) Either Party may terminate this Agreement, by giving to the other person notice in

writing of not less than 60 (sixty) days of its intention to terminate this Agreement

and this Agreement shall stand terminated on the expiry of the period of such notice.

The company may, however, terminate this Agreement without any notice to the

Dealer in the following cases.

a) In case of breach, negligence, violation, unfair practice or failure on the part of the

Dealer to perform his duties/responsibilities as outlined.


__________________________

b) In case of non-payment by the Dealer of the Company‟s dues or the Dealer being adjudged insolvent.

16) All disputes and differences and questions what so ever which shall, either during the

said terms or otherwise, arise between the Parties touching these presents or things

herein contained or any account or assets, duties or liabilities to be made hereunder or

as to any act, deed or commission or omission of any part or as to any other matter in

any way relating to the matter herein contained or the rights, duties or liabilities of

any party to these presents shall be referred to the Arbitration in accordance with and

subject to the Arbitration and Conciliation Act, 1996 or the statutory modification or

substitution thereof, for the time being in force. Venue of such Arbitration shall

always be at New Delhi and only the Courts in New Delhi shall have jurisdiction to

entertain and try any suit or legal proceedings arising out of this Agreement.

17) This Agreement embodies the entire agreement or understanding between the parties

relating to the subject matter of this Agreement and no term or promise or condition

or obligation oral or in writing shall be pleaded as agreed between the parties, relating

to this Agreement.

IN WITNESS WHEREOF, the Parties hereto have entered into this Agreement the

day and year first herein above written.

SIGNED, SEALED AND DELIVERED

By_______________

By the within named COMPANY WITNESS

SIGNED, SEALED AND DELIVERED

By the within named DEALER WITNESS


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