4Th Smes Excellence Award - 2016
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4th SMEs Excellence Award - 2016 Felicitating Businesses for Sustainability & Growth
APPLICATION FORM Last date for submission of entries – 15th November, 2016
1. Basic Information a) Name of the Company
Constitution of the Company (Proprietorship/Partnership/Private Limited/ Limited/ LLP)
Address
Phone Fax Email ID
b) Details of the Chief Executive Officer/ Managing Director/ Proprietor of the Company:
Name Email ID Gender Landline No. Mobile No. Designation
c) Segment (Please tick as applicable)
Services Manufacturing Trading
d) Sector (Please tick as applicable)
Auto Ancillary & Engineering IT/ITes Agri & Food Processing Logistics & Transportation
Chemicals, Dyes & Plastics Metals
Education Pharma & Healthcare Export/Import Textiles
Infrastructure/EPC/Contractors Others (Please Specify______)
e) Number of years in operation <3 3-5 6-10 >10
f) Total Number of Employees (Permanent + Casual workers)
g) Is the Company a Member of ASSOCHAM? YES NO
h) Is the Company registered under any Act (Udyog Aadhar/SSI/EM-II) YES NO If Yes, please mention
i) Is the Company rated? YES NO. If yes, Please specify the Rating and the Rating Agency?
j) The number of product or process patents in the Company NIL 1-3 4-6 >6
2. Financial Performance
a) FY 2015 – 16 FY 2014 – 15 FY 2013-14
Turnover ( Crores)
PAT *( Crores )
Net Worth ( Crores )
Current Total Banking Limits (Working Capital + Term Loans)( as on 31st March 2016)
b) Are the above financial statements audited? YES NO
3. Award Category (Please tick as applicable)
SME of the Year Start-Up of the Year Innovation
Women Entrepreneur Most Promising Brand Green Business
Fair Business Practices CSR Activities Cost Competitiveness
Note:
1. Whomsoever wants to participate in “SME of the Year” category need to fill all the criteria below except ‘Women Entrepreneur’ & ‘Start-Up of the Year’. 2. For others, fill only Basic Information, Financial performance and their respective field
3. Please write “N/A” whichever question is not relevant CSR Activities Category
a) Does the company have a written CSR policy? YES NO (If Yes, Please submit) b) How are CSR objectives of the Company integrated with its vision & mission statement?
c) What was the budget for CSR during the financial years 2014-15 and 2015-16?
S.No. Budget 2015-16 2014-15
a. Budgeted amount
b. Actual Amount
c. Percentage of PAT* spent on CSR
d) Does the company have a written code of conduct or Ethics Policy? YES NO (If Yes, Please submit)
Innovation Category a) Has the company undertaken any projects to reduce dependence on non-renewable sources of energy? YES NO b) Please let us know the innovative story of your company (Not more than 50 words) c) Has the company filed patents? If yes how many?
Most Promising Brand Category a) What was the budget for Branding during the financial years 2014-15 and 2015-16?
S.No. Budget 2015-16 2014-15
a. Budgeted amount
b. Actual Amount
c. Percentage of PAT* spent on Branding b) Why do you consider yourself as the most promising brand? (Not more than 50 words)
Green Business Category a) How is your business adding value to our environment? (Please describe it within 50 words)
b) Technology used by the company for waste management? c) Has the company undertaken any projects to reduce dependence on non-renewable sources of energy? d) Does the company have Waste recycling facility? (If yes please describe within 50 words)
Cost Competitiveness Category a) How much amount company spends on R&D budget as % of turnover? <1% 1%–10% 11-20% >20% b) Technology used by the company for waste management? c) What is the productivity ratio of the company? (output / input)$ FY 2014 – 15 FY 2013 – 14 d) What is the Labour Productivity of the company? (the amount of goods and services produced / the number of labour hours used to produce those goods and services ) FY 2014 – 15 FY 2013 – 14 e) Average annual growth of net sales of the company (Sales of current financial year/ Sales of last financial year x 100) FY 2014 – 15 FY 2013 – 14 f) Profitability of your company (Net Profit/Sales x 100) <10% 10%–30% 31%-40% >40% g) What is the operating ratio of your company? (Operating expenses/Net sales x 100) <50% 50%–75% >75% h) What are the measures taken for quality enhancement of your products or services?
i)What are the innovative steps taken by your organization to become more cost competitive?
j) Is there any cost saving policy prevailing in your company? Do you review it periodically? Fair Business Practices Category a) What are the initiatives taken for economic value addition for the stake holders? (Please describe within 50 words)
b) Does the company have any Corruption and Bribery Prevention Cell? YES NO
c) Does the company have a written code of conduct or Ethics Policy? YES NO (If Yes, Please submit)
d) Does the company submit tax return file properly? YES NO
Women Entrepreneur
a) Did you face any challenges as woman entrepreneur during any phase of business and how did you overcome it? b) How are you returning back to the society? Describe in about 50 words
c) Have you availed any scheme/facility being offered by the Government to the Women Entrepreneurs? YES NO d) Do you give preference to the women candidate while offering employment YES NO
Start-Up of the Year
a) Please explain your business idea and revenue model and why it is sustainable b) How do you see your business growing in next five years
c) How extensively are you using Technology to sustain in the business d) Have you registered under Udyog Aadhar Memorandum YES NO (If yes please mention UAM No.
4. References of other SMEs (If Any)
Name of the Company Promoters Name Contact No. Email address
Declaration Company Seal with I hereby confirm that as per my best knowledge the above Authorized Signature information is true & accurate.
5. Terms & Conditions
All the information received will be kept confidential and shall be used only for the purpose of evaluation.
Shortlisted entries will be asked to provide additional information, if need be.
The entry fee for participation in the “ASSOCHAM SMEs Excellence Award – 2016” is 5,000/- per category. Cheque/Draft should be made in favor of ASSOCHAM, New Delhi. Payment can also be made through NEFT as per the Bank details provided at the end.
The forms should be duly filled and sent along with the necessary documents and its soft copy in a CD form to Mr. U.K. Joshi, Nodal Officer by 15th November, 2016 at The Associated Chambers of Commerce and Industry of India (ASSOCHAM), 5, Sardar Patel Marg, Chanakyapuri, New Delhi – 110 021, or e-mail to [email protected] or [email protected]. For further information, please call: 011-46550567 or visit: www.assocham.org/events
Receipt of the filled form shall be taken as a token of acceptance of the terms and conditions.
Entries are non-returnable. We recommend that you maintain a copy of the completed nomination form.
Short-listed nominations will be presented to an Independent Jury for determination of winners. Jury’s decision shall be final and binding on all participants. No feedback or correspondence will be entertained about the results, and the jury’s decisions shall be final.
If any information provided by any participant is found to be incorrect or incomplete in any manner, the same will not be considered.
Date ………………… Company Seal with Authorized Signature Place …………………
Online Payment Details (If Required) Bank Name–State Bank of Hyderabad, 36, Zamrudpur, Kailash Colony, New Delhi – 110 048 Beneficiary Name – The Associated Chambers of Commerce and Industry of India (ASSOCHAM) Bank Current Account No - 52050210412 IFSC Code - SBHY0020588 MICR Code - 110004007 Branch Code - 20588
You are requested to send the duly filled Application Form along with payment by Courier or E-mail to:
Mr. U.K. Joshi
Nodal Officer
The Associated Chambers of Commerce and Industry of India (ASSOCHAM)
5, Sardar Patel Marg, Chanakya Puri, New Delhi – 110 021
Phone: 011-4655-0583 Fax: 011- 46550567
E-mail: [email protected], Website: www.assocham.org