Gujarat Chamber of Commerce & Industry. GCCI MSME Excellence Award

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Gujarat Chamber of Commerce & Industry GCCI MSME Excellence Award 2016-17 As an initiative to recognize outstanding performance by Micro, Small and Medium enterprises, Gujarat Chamber of Commerce & Industry has decided to confer MSME Excellence Award for outstanding performance by MSMEs in the year 2016-17. The awards would be conferred to the Best MSMEs in each of the below sectors: 1. Textiles (including Technical Textiles, Cotton Ginning & Pressing, Readymade Garments) 2. Chemicals, Dyes and Intermediaries (including Petrochemicals, Paints, Mineral based Products, and Lubricating Oils) 3. Ceramics and Glass 4. Pharmaceuticals (including Bulk Drug & Formulations) 5. Agro Products and Food Processing (including Cold Storage) 6. Engineering and Automobiles (including Foundries, Steel Fabrication and Textile Machineries) 7. Plastic and Rubber Industry 8. Electrical and Electronic Goods 9. IT and ITES (including IT Services, ITES, Hardware, Software, KPO, BPO) 10. Others (including Wooden, Leather, Handicrafts, and all the remaining sectors) Eligibility for applying for the awards It is not mandatory for the firm to be currently a member of GCCI to be eligible for applying for the awards. GCCI Executive Committee members are not eligible to apply for the awards. The firm should be in continuous production in Gujarat for the last 5 years to qualify for the awards. The award is open for registered MSME Organizations only. The product manufactured by the Organizations should not be socially undesirable or a health hazard. The firm/company should be complying with the statutory laws of the State and the Country. The awardees would receive a prestigious award along with a Citation from GCCI. Last Date for receiving the applications is 15 th February, 2018. For further details regarding the awards and for obtaining the application forms, you are requested to contact GCCI. The application form has been given below, which can be filled up and submitted at the GCCI Office.

Gujarat Chamber of Commerce & Industry GCCI MSME Excellence Awards 2016-17 Application Form 1) Enterprise Category Micro Enterprise (Original Investment in Plant & Machinery not exceeding 25 lakhs) Small Enterprise (Original Investment in Plant & Machinery between 25 lakhs and 5 crores) Medium Enterprise (Original Investment in Plant & Machinery between 5 crores and 10 crores) 2) Basic Information Name of the Company Name of the CEO/MD/Proprietor/Head/Partner of the Company Address of the Factory Unit Contact Details of the Company Address

Phone Fax Website Email Year of Establishment: Your company is: Private Ltd. Public Ltd. Partnership Proprietorship Number of Employees (2016-17) a. Permanent: b. Contractual: Industry Segment: Textiles (including Technical Textiles, Cotton Ginning & Pressing, Readymade Garments) Chemicals, Dyes and Intermediaries (including Petrochemicals, Paints, Mineral based Products, and Lubricating Oils) Ceramics and Glass Pharmaceuticals (including Bulk Drug & Formulations) Agro Products and Food Processing (including Cold Storage) Engineering and Automobiles (including Foundries, Steel Fabrication and Textile Machineries) Plastic and Rubber Industry Electrical and Electronic Goods

IT and ITES (including IT Services ITES, Hardware, Software, KPO, BPO) Others (including Wooden, Leather, Handicrafts, and all the remaining sectors) If Others, Please specify your segment: Number of years in operation: Less than 5 5 to 7 Is your company rated by any Rating Agency? 8 to 10 More than 10 If yes in the above Question, please specify a) Rating: b) Rating Agency: 3) CSR and Innovation Initiatives (As applicable) What is your spend on CSR Initiatives as a %age of turnover? 0 % 1% 2% More than 3% What is your spend on R&D Initiatives as a %age of turnover? 0 % 2% More than 3% Have you taken steps for Pollution Control? (If yes, please enclose 3% 1% 3%

Have you taken any measures for Energy Conservation? (If yes, please enclose Have you taken adequate Safety measures? (If yes, please enclose Have you taken any measures for Environment Conservation/ Waste Management/ Afforestation/ Greenhouse Mitigation? (If yes, please enclose 4) Standardization & Quality Control (As Applicable) Accreditations obtained for Standardization & Quality Control: (If yes, please enclose ISO-9000/ISO-14000/18000/22000 Certification/ HACCP/GMP/Equivalent Certificate BIS Mark/Equivalent Products conform to IS or any other National/International/User standards 5) Financial Performance Details of Investment (Rs. In Lakhs) 2012-13 2013-14 2014-15 2015-16 2016-17 Gross Block i. Land ii. Building iii. Plant & Machinery (original) iv. CSR and Innovation v. R&D Initiatives

vi. Pollution Control vii. Energy Conservation viii. Others Total Gross Block (i+ii+iii+iv+v+vi+vii+viii) Turnover (Rs. In Lakhs) Domestic Turnover (Rs. In Lakhs) Export Turnover (Rs. In Lakhs) Total Turnover (i+ii) (Rs. In Lakhs) Profit Before Tax Net Worth Total Production Quantity 6) Bankers Details Name of the Banker Address of the Banker 1) 2) 3) 4) 7) Any other important Achievement/ Award: (Please enclose

Declaration: I/We shall be abiding by the decision of the Committee for granting of Award. I/We undertake to refund the cash price, return the trophy and certificate, if awarded to me, in case it is ever found that the information furnished above was incorrect. Further, I/We may also be liable for any action under the law of land for any false declaration. I/We hereby affirm and declare that the information furnished in this form is authentic and correct. I/We hereby declare that the information, statement and other papers given herein are true and correct to the best of my knowledge and belief. I/We also declare that I/We am duly authorized to sign an application and also to submit details and documents. te: All Financial Statements to be submitted by the Enterprise must be signed by the Authorized Signatory of the Enterprise and certified by the Auditor/Charted Accountant. Date: Signature of the Applicant Or Authorized Signatory Place: With Name & Designation Seal of the Unit

Check list of Annexures Check list of documents/write-ups to be submitted along with prescribed Application Form with the documentary evidence for the awards to best MSMEs. Sr.. Particulars Please tick wherever applicable 1 Copy of EM Part- II. 2 Copy of Constitution of Enterprise. 3 4 5 CA Certified Details of Annual Production Capacity, Investment, Production, Sales, Export-Profit and Employment of Last five years. Copy of valid GPCB consent or copy of circular, if applicable. CA Certified Audited Annual Account Financial Statements (Balance Sheet & Profit & Loss Account) of Last five years. 6 Details of State/National Level Award received earlier. 7 Details of Important Achievements. 8 Details of Environment Conservation. 9 Details of Safety Measures. 10 Details of Energy Conservation. 11 Details of Quality Certifications: ISO/BIS etc. 12 Whether the Entrepreneur belongs to SC/ST, If attach certificate of Competent Authority. 13 Justification/ Write up - For why the Unit should be awarded. Signature of the Applicant Or Authorized Signatory With Name & Designation Seal of the Unit