You are on page 1of 35

GOVERNMENT OF INDIA

MINISTRY OF MICRO, SMALL & MEDIUM ENTERPRISES
OFFICE OF THE DEVELOPMENT COMMISSIONER (MSME)

NATIONAL MSME AWARDS - 2015
MICRO, SMALL AND MEDIUM ENTERPRISES (MSME)
Applications to be submitted online

Last Date - 16th January, 2017

1. OBJECTIVES
The Micro, Small and Medium Enterprises (MSMEs) in India have undergone a vast development
in the last five decades. The MSMEs have registered tremendous growth as also progress in terms of
quality production, exports, innovation, product development and import substitution. Entrepreneurial
efforts have made it possible to produce a number of items, which hitherto were imported. In quite a
few cases new variants so produced are having additional attributes than their original versions and are
capable of solving a multitude of user problems.

The Indian entrepreneurs are very creative and innovate new products and process as well as
provide innovate services to remain competitive in domestic and global market. This has become
possible to encourage such innovative efforts and promote this spirit in larger interest of qualitative
development of MSME. The Ministry of MSME recognize these entrepreneurs for their outstanding
performance and by conferring awards motivate and encourage them.

2. CATEGORIES OF AWARDS

Categories of National MSME Awards for the year- 2015
S. Categories of Awards Application Numbers
No. Form No.
1 Product/ Process Innovation-6 numbers NMA-1

Innovation-Micro & Small (I,II and III Award) 3

Innovation-Medium (I,II and III Award) 3

2 Outstanding Entrepreneurship (Manufacturing)-14 NMA-2
numbers
Entrepreneurship- Micro (I,II, III Award and Special Award 4

1

to best Handicapped ( Divyang) entrepreneur)
Entrepreneurship- Small (I,II and III Award) 3
Special award to best SC/ST entrepreneur 1
Special award to best woman entrepreneur 1
Special award to best NER entrepreneur 1
Special award to best Handicapped ( Divyang) entrepreneur 1
Entrepreneurship - Medium (I,II and III Award) 3

3 Outstanding Entrepreneurship (Service)- 4 numbers NMA-3
Micro & Small (I,II, III Award and Special Award to best 4
Handicapped ( Divyang) entrepreneur)
4 Lean Manufacturing Techniques-3 numbers NMA-4
Micro -I Award 1
Small-I Award 1
Medium -I Award 1
5 Quality Products one each in following 10 selected NMA-5
products in Micro & Small Enterprises -10 numbers
Paints & Varnishes 1
Rubber Molded Products 1
Precision Machine Components 1
Auto Components 1
LED and LCD information Display System 1
Electronic Smoke Detectors/ Fire Alarms/ Pollution Detectors 1
and Monitors
Refractory 1
Confectionary Products 1
Leather Hand Bags 1
Readymade Garments 1
6 Export Awards -20 numbers NMA-6
Outstanding Export Performance in Micro Enterprises (Mfg) 2
I and II Award
Outstanding Export Performance in Small Enterprises(Mfg) 2
I and II Award
Best Exporter Woman Entrepreneur in Small 1
Enterprises(Mfg)
Best Exporter SC/ST Entrepreneur in Small Enterprises(Mfg) 1
Best Exporter NER Entrepreneur in Small Enterprises(Mfg) 1
Outstanding Export Performance in Medium 1
Enterprises(Mfg)
Outstanding Export Performance in Micro & Small 1
Enterprises (Service)
Outstanding Export Performance in Medium Enterprises 1
(Service)
Outstanding Export Performance one each in following
10 Selected Products in Micro, Small & Medium
Enterprises
Paints & Varnishes 1
Rubber Molded Products 1
Precision Machine Components 1

2

Auto Components 1
LED and LCD information Display System 1
Electronic Smoke Detectors/ Fire Alarms/ Pollution Detectors 1
and Monitors
Refractory 1
Confectionary Products 1
Leather Hand Bags 1
Readymade Garments 1
TOTAL 57

Prize: All awards will carry cash prize of Rs.1.00 lakh, a Certificate and a Trophy. No TA/ DA, Hotel
Charges etc. will be paid.

3. PERIODICITY & ELIGIBILITY
The MSMEs should have been in continuous manufacturing /services for last four years. The
awards will be given for each year to deserving Micro, Small & Medium Enterprises which have
Udyog Aadhaar Memorandum (UAM). MSMEs would also register in MSME Databank, web portal:
www.msmedatabank.in (click on register and then MSME) before submission of their application.
Registration at MSME Databank is mandatory for MSMEs even if they have earlier obtained UAM.

4. CRITERIA
The evaluation for Award will be done on the basis of various parameters mentioned in the
proforma .
5. COMPOSITION OF STATE LEVEL SELECTION COMMITTEE ( SLSC)
5.1 The State Level Selection Committee will consist of –

1. Secretary, Department of MSME/ Industries of State Govt. /U.T. Chairman

2. Director of MSME/Industries, State Govt. Member

3. One Representative each from two State level MSME Member
Associations to be nominated by Director, MSME-DI &
approved by the Chairman

4. Director, MSME-DI Member Convener
5.2 The Awardee shall not be nominated or considered for the same or lower category of award in the
subsequent 5 year (s). However, there will be no bar for an awardee to be nominated or considered for a
higher category of award in subsequent year.

5.3 MSME-DI of respective state will send applications recommended by State Level Selection
Committee along with evaluation of marks as per enclosed criteria format to the office of the
Development Commissioner (MSME), Ministry of MSME, Govt. of India, 7th Floor, A-Wing,
Nirman Bhawan, New Delhi-110108, latest by 31.1.2017.

6. COMPOSITION OF NATIONAL LEVEL SELECTION COMMITTEE (NLSC)

3

Govt. PRIVILEGE The winners of the awards shall have the privilege of allowing their employees to wear labels. Chairman 2 Two Secretaries. Member 5 President. (ii) The applications will further be scrutinized by the technical officers of concerned division in the office of the DC (MSME) for evaluating the mark as per the criteria before submitting to NLSC for selecting the awardees. ties. The amount of cash prize received by winners is exempted under section 10(17) of Income Tax Act 1961. (MSME). to be nominated by Govt.The National Level Selection Committee will consist of: 1 Additional Secretary & Development Commissioner. The last date for submission of application i. Member 8 Additional Development Commissioner O/o DC(MSME) Member Convener 7. METHODOLOGY For purposes of selecting MSME for consideration for awards. Federation of Associations of Small Industries of India (FASII). BIS or his nominee . Member 6 President. Member 7 3 industrialists to be nominated by Hon'ble Union Minister (MSME). The entrepreneurs can also use the symbol on their letterheads or any advertisement issued along with the year of the award. of India. logo or other distinctive badges with the symbol of the Awards indicating the year of Award inscribed on it. ❖❖❖ 4 . the following procedure will be observed:- (i) The applications will be scrutinized first by Director. PH & NER including Sikkim) for consideration by the SLSC / NLSC. Member 4 Director General. National Research Development Corporation (NRDC). pins. An enterprise can apply for more than one category of award . or his nominee. 8. 2017. of India. 16th January. Laghu Udyog Bharti.e. MSME-DI for State Level Selection Committee. HOW TO APPLY The eligible enterprises will submit online applications comprising of Part-I and Part-II of the relevant category of awards. The qualifying marks will be 60% (50% in case of SC/ST . Ministry of MSME. 9. Member 3 Managing Director. Department of Industries of State Govt.

Yes/No (Please attach certificate) D. Name and address of Enterprise (English) --------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------- District ------------------------------------------------. Whether the Entrepreneur belongs to SC/ST. (a) Udyog Aadhaar Memorandum: Tick Appropriately (Micro/ Small/ Medium) Number : Date: (b) Databank Registration of enterprise: Number : Date: 5 . Name of Entrepreneur (English) --------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------- B. (O) : --------------------------------------------------------------------------------------------------- Mobile No.State --------------------------------- Pin Code ------------------ STD Code & Telephone Numbers : Tel. PART-I Please affix one high resolution photo (size 8cmx5cm) A. -------------------------------------------------------------------------------------------------- E-mail: --------------------------------------------------------------------------------------------------- C. Physically Handicapped .

II or III Award) and year of Award.E. Yes/No if yes. Have you ever been awarded earlier by this Ministry. Front Attach Photo Rear Attach Photo G. 6 . Name of Products Attach Photo of products F. Pl Tick (I. Attach photo of Front /Rear View of Building of Enterprise showing name Board etc.

Items 2012-13 2013-14 2014-15 2015-16 No. 1 Original investment in Plant & Machinery/Equipment (Rs. in lakh) cumulative upto 31st March 2 Original investment in Plant & Machinery/ Equipment (Rs. in lakh) Please give write up of not more than 300 words about yourself.in lakh) 5 Net Profit (after taxes) (Rs. in lakh) 6 Export-Direct (Rs. your enterprise and the products(s) manufactured/service(s) rendered by indicating your achievements to justify as to why your application deserves to be considered for the award. in lakh) net addition during the year 3 No. 7 . of Employees as on 31st March 4 Value of Annual Turnover/ Sales (Rs.S.

No.5 Marks Please give details and attach/ upload evidences. full marks may be awarded) (i) Obtained .12 Marks Please give details and attach/ upload evidences.20 Marks 8 . Awarding Marks Marks allotted by suggested comments State Level by Selection Technical Committee group (1) (2) (3) (4) (5) (6) 1 Whether Innovative Development is 10 (i) Product development . Commercialized.house 10 R&D/Innovation facilities approved by DSIR (i) Yes. Parameters for Maximum Marks Marks Brief No.15 Marks (ii) Others -5 Marks 4 Whether Innovative Development is 12 i. Defense etc. S. 2 Whether enterprise has in. where obtaining patents not permissible. 9 ) (i) Recognized Incubation Centres .5 marks Please give details and attach/ upload evidences. NAM-1 Parameters & Proforma for Evaluation and Awarding Marks (Product/ Process Innovation) Part-I (Weight age-70%) S. 5 Patents/design/obtained or applied for 20 (Marks to be awarded for any one of (i)and(ii) as applicable (II) in case due to innovated specific product/supplies to strategic organizations (viz. Prototype Stage only-4 Marks ii.10 Marks (ii) Process/Design Development .10 marks (ii) others . Successfully Development -8 Marks iii. 3 Products/ Processes Developed through 15 (Ref.

Yes. No .10 Marks ii. Ag Mark etc) - 10 Marks (ii) Product equivalent to any other Specification-6 Marks Please give details and attach/ upload evidences.5 Marks iii.e. 7 Standardization 10 (i) Obtained BIS Mark/International/National Standard (RDSO. Yes. No. with supporting documents i. Certified Energy Audit Report.0 marks 9 .6 Marks i.1 Mark v.0 Mark Please give details and attach/ upload evidences. 6 Whether innovation (product/process) 10 is eco-friendly . 8 Energy conservation Measures 6 i. No initiative.3 Marks iii.6 Marks ii. Energy conservation measures adopted by enterprises . FSSAI.3 Marks iv. (ii) Applied for .0 Mark Please give details and attach/ upload evidences. less than 1 year . .7 Marks ii. with supporting documents . GMP. 3 years & above .10 Marks (iii) No initiative. 9 Obtaining ISO-9000 Series/14000/22000 7 /HACCP/ GMP/ equivalent certification i. less than 2 years &above 1 year . less than 3 years &above 2 years .BEE.0 Mark Please give details and attach/ upload evidences.

Please give details and attach/ upload evidences.25 Marks Please give details and attach/ upload evidences.500 lakh.1000 lakh .500 lakh & up to Rs.) (i) Yes.) 1 Pollution Control Measures 15 Note: (Full marks may be given if these measures are not applicable to this industry subject to presentation of relevant NOC from the Competent Authority/Enterprise exempted by State Govt.15 Marks (ii) No .10 Marks (iii) above Rs.5 Marks (ii) above Rs. 3 Growth rate of Average Annual Turnover/ Sales 15 of 3 years from 1st year.0 Mark Please give details and attach/ upload evidences.100 lakh & up to Rs.10 Marks (iv) growth rate above 30% -15 Marks (v) No growth .3 Marks (ii) growth rate above 10% & up to 20% .6 Marks (iii) growth rate above 20% & up to 30% .100 lakh . 4 Growth rate of Net Profit (after Taxes) of 3 years. (i) growth rate up to 10% .0 Marks 2 Value of Average Annual Turnover/ Sales of 3 25 years (i) up to Rs. 15 10 . Total 100 Part-II (Weight age: -30%.1000 lakh-15 Marks (iv) above Rs.

(i) Average growth rate up to 10%. (i) Average growth rate up to 10%.0 Mark Please give details and attach/ upload evidences.100.4 Marks (iii) Average growth rate above 20% to 30%.2 Marks (ii) Average growth rate above 10% to 20%.10 Marks (v) No growth . Part-II -30%. TOTAL 100 Weight age: Part-I .5 Marks (ii.6 Marks (iv) Average growth rate above 30%. 5 Value of Export Average of 3 years of 20 Innovated products/process. marks may be awarded on the basis of average growth rate of supply to strategic organizations.15 Marks (v) No growth .150.70%.50.6 Marks (iii) Average growth rate above 20% to 30%.00 lakh & up to Rs.00 lakh .00 lakh .150.00 lakh - 15 Marks (iv) above Rs. Signature Name and Designation of Marks Evaluation Officer of MSME-DI/ DC (MSME) 11 .) above Rs.50. where exports not permissible.00 lakh &up to Rs.100 lakh .0 mark Please give details and attach/ upload evidences.10 Marks (iii) above Rs. (i) up to Rs. 4 Exports (Direct) of Innovated products/process 10 during last three years Note: In case due to specific product/ supplies to strategic organizations (viz. Defense etc.20 Marks Please give details and attach/ upload evidences.10 Marks (iv) Average growth rate above 30%.3 Marks (ii) Average growth rate above 10% to 20%.

(i) growth rate up to 10% .500 lakh .100 lakh &up to Rs.2 Marks (ii.100 lakh .1 Marks 12 .8 Marks Please give details and attach/ upload evidences. (Application Form: NMA-2) Parameters & Proforma for Evaluation and Awarding Marks Outstanding Entrepreneurship (Manufacturing) Part-I (Weight age-70%) S. Awarding Marks Marks allotted by suggested comments State Level by Selection Technical Committee group (1) (2) (3) (4) (5) (6) 1 Value of Average Annual Turnover/Sales of 3 8 years (i) up to Rs.4 Marks (iii) above Rs.1000 lakh . 2 Growth rate of Average Annual Turnover/Sales 4 of 3 years from 1st year.) above Rs. Parameters for Maximum Marks Marks Brief No.6 Marks (iv) above Rs.1000 lakh .500 lakh & up to Rs.

4 Marks (iv) growth rate above 30% .5 Marks Please give details and attach/ upload evidences.) growth rate above 10% & up to 20% . where exports not permissible.1 Marks (ii. marks may be awarded on the basis of average growth rate of supply to strategic organizations.4 Marks (v) No growth . Average Growth rate of export value of 3 years from 1st year (i) Average growth rate up to 10% . marks may be awarded on the basis of value of products supplied to strategic organizations.4 Marks (iii) above Rs.2 Marks 13 . (ii. Value of Export Average of 3 years (i) up to Rs.) growth rate above 10% & up to 20% -2 Marks (iii) growth rate above 20% & up to 30% .0 Mark Please give details and attach/ upload evidences.3 Marks (iv) growth rate above 30% .) Average growth rate above 10% & up to 20% .200 lakh .) above Rs.0 Please give details and attach/ upload evidences.2 Marks (iii) growth rate above 20% & up to 30% .6 Marks (iv) above Rs.6 Marks (v) No growth .0 mark Please give details and attach/ upload evidences.100 lakh & up to Rs. where exports not permissible.100 lakh .2 Marks (ii.8 Marks (v) no export .200 lakh . Defense etc.1 Marks (ii.20 lakh &up to Rs. 4 Use of Technology 10 (i) Developed Technology . 3 Growth rate of Average Net Profit (after Taxes) of 6 3 years from 1st year (i) growth rate up to 10% . Defense etc. 6 Exports (Direct) during the period 4 Note: In case due to specific product/supplies to strategic organizations (viz. 5 Exports (Direct) during the period 8 Note: In case due to specific product/supplies to strategic organizations (viz.10 Marks (ii) Conventional .20 lakh .

1 Mark v. FSSAI. No initiative.6 Marks ii. Yes. 3 years & above .3 Marks iii. Energy conservation measures adopted by enterprises .6 Marks ii. 7 Obtaining ISO-9000 Series/14000/22000 10 /HACCP/ GMP certification - i. No .3 Marks (iv) Average growth rate above 30% -4 Marks (v) No growth . 11 Energy conservation Measures 6 i.0 Mark Please give details and attach/ upload evidences.e. No.BEE. No. 10 Safety Measure 6 i.6 Marks ii. Yes. less than 3 years &above 2 years .7 Marks iii. Certified Energy Audit Report. Govt.0 Marks Please give details and attach/ upload evidences. with supporting documents i. Ag Mark etc)- 12 Marks (ii) Product equivalent to any other Specification-6 Marks Please give details and attach/ upload evidences. GMP.3 Marks iii.0 mark Please give details and attach/ upload evidences. Measures adopted . less than 1 year . 8 Standardization 12 (i) Obtained BIS Mark/International/National Standard (RDSO.4 Marks iv. Yes . with Certificates from Appropriate Authority .0 marks Please give details and attach/ upload evidences. less than 2 years &above 1 year . (iii) Average growth rate above 20% & up to 30% . 9 Pollution Control Measures 6 Note: (Full marks may be given if these measures are not applicable to this industry subject to presentation of relevant NOC from the Competent Authority/ Enterprise exempted by State i. .10 Marks ii.0 Mark 14 .

2 Mark (ii) No. if not applicable. 14 Employees Welfare Measures. if not applicable. with supporting documents from external expert/ agency . 17 Employees Welfare Measures. Reward Scheme – 2 Marks (ii) No. (i) Yes.0 Mark Please give details and attach/ upload evidences. Bonus. CPF. full marks may be 2 given.2 Mark (ii) No. Reward Scheme – 0 Mark Please give details and attach/ upload evidences.3 Marks (iii) No. Yes. ESI . i. Bonus. Please give details and attach/ upload evidences. if not applicable. 12 Employees Welfare Measures. with supporting documents from internal expert. (i) Yes. full marks may be 2 given.0 Mark Please give details and attach/ upload evidences. with supporting documents . (i) Yes. 13 Whether any training provided to staff/officials to 6 upgrade their skill. 16 Customers satisfaction and feedback report 6 i. full marks may be 2 given. 15 Employees Welfare Measures. (i) Yes. (i) Yes. if not applicable. Total 100 Part-II (Weight age-30%) 15 . No.6 Marks ii (ii) Yes.0 Mark Please give details and attach/ upload evidences.2 Mark (ii) No.0 Mark Please give details and attach/ upload evidences. CPF. ESI . full marks may be 2 given.6 Marks ii.0 Mark Please give details and attach/ upload evidences.

18 Marks (v) No growth . 4 Whether First Generation Entrepreneur 18 (i) First Generation/Start-up .0 mark Please give details and attach/ upload evidences. 6 Basic Amenities / Facilities at Work Place 4 16 .8 Marks (iii) growth rate above 20% & up to 30% -12 Marks (iv) growth rate above 30% . 5 Basic Amenities / Facilities at Work Place 4 (i) Drinking Water.4 Marks (ii. Please give details and attach/ upload evidences.8 Marks (iii) growth rate above 20% & up to 30% .0 Marks Please give details and attach/ upload evidences.9 Marks Please give details and attach/ upload evidences.18 Marks (ii) Others .12 Marks (iv) growth rate above 30% .) growth rate above 10% & up to 20% . Yes.1 Average Growth rate upon cumulative 18 Investment in Plant & Machinery (i) growth rate up to 10% .4 Marks (ii) Drinking Water. 3 Average Growth rate upon Employment 18 (i) growth rate up to 10% .0 mark Please give details and attach/ upload evidences.4 Marks (ii.4 Marks Toilets.18 Marks (v) No growth . No. 2 Basic Amenities / Facilities at Work Place 4 (ii) Toilets.) growth rate above 10% & up to 20% .0 Marks Please give details and attach/ upload evidences. No. Yes.

Yes . 1 year .8 Marks (iii) 1 year export .12 Marks (ii) 2 years export . (i) Medical First aid . 3 years . 7 Export (Direct) 12 NB : In case due to specific products/supplies to Strategic organization viz. Defense etc. 9 Credit Rating of Enterprises 18 (i) Yes.0 Marks Please give details and attach/ upload evidences. No .4 Marks (ii) Canteen. Part-II -30%.12 Marks (iii) Yes. 2 years .4 Marks (iv) No export .0 Marks Please give details and attach/ upload evidences. 8 Basic Amenities / Facilities at Work Place 4 (i) Canteen. Yes .70%.6 Marks (iv) No. No .0 Marks Please give details and attach/ upload evidences.18 Marks (ii) Yes.4 Marks (ii) Medical First aid . TOTAL 100 Weight age: Part-I . where export were not permissible full marks may be awarded.0 Marks Please give details and attach/ upload evidences. (i) 3 years export . Signature Name and Designation of Marks Evaluation Officer of MSME-DI/ DC(MSME) 17 .

6 Marks (iv) Average growth rate above 30% .7 marks (ii) Good .8 Marks (v) No growth .2 Marks (iii) above Rs. Parameters for Maximum Marks Marks Brief No.6 Marks Please give details and attach/ upload evidences.50 lakh &up to Rs. Awarding Marks Marks allotted by suggested comments State Level by Selection Technical Committee Division (1) (2) (3) (4) (5) (6) 1 Use of Technology 14 (i) Advanced .150 lakh .3 Marks 18 .4 Marks (iv) above Rs.150 lakh . Application Form NAM-3 Parameters & Proforma for Evaluation and Awarding Marks Outstanding Entrepreneurship (Service) Part-I (Weight age-70%) S.100 lakh & up to Rs.4 Marks (iii) Average growth rate above 20% to 30% .100 lakh . 4 Growth rate of Average Annual Sales/services of 8 3 years from 1st year (i) Average growth rate up to 10% .0 mark Please give details and attach/ upload evidences.4 marks (iii) No such initiatives taken -0 marks Please give details and attach/ upload evidences.1 Mark (ii) above Rs. 2 Customers Satisfaction / feedback report 7 (i) Excellent with supporting documents .14 Marks (ii) Conventional -7 Marks Please give details and attach/ upload evidences.2 Marks (iii) Average growth rate above 20% & up to 30% .50 lakh .2 Marks (ii) Average growth rate above 10% & up to 20%.1 Mark (ii) Average growth rate above 10% & up to 20% . Value of Average Annual turnover/services of 3 3 years 6 (i) up to Rs. 5 Growth rate of Average profit of 3 years from 4 1st year (After Taxes) (i) Average growth rate up to 10% .

6 marks (ii) Measures .4 Marks (v) No growth . with supporting documents by external expert.9 marks (ii) Yes.6 Marks (ii) Services conforming to enterprise's Specification . (iv) Average growth rate above 30% .6 Marks No. 11 Whether any training provided to staff/ 9 officials to upgrade Skill (i) Yes.4 marks (iii) No such initiatives taken -0 marks Please give details and attach/ upload evidences. less than 3 years &above 2 years .8 Marks ii.0 marks 19 .4 Marks iv. 6 Obtaining ISO-9000 Series/14000/22000/ 8 HACCP/equivalent certification - i. less than 2 years &above 1 year .6 marks (iii) No .0 Mark 9 Pollution Control Measures 6 Note: (Full marks be given if these measures are not applicable to this enterprise subject to submission of relevant NOC/Notification from the Competent Authority) Yes .1 Mark v.0 marks Please give details and attach/ upload evidences. less than 1 year . No .6 Marks (ii) Good . 7 Standardization 6 (i) Services conforming to user's Specification .6 Marks iii.0 mark Please give details and attach/ upload evidences. with supporting documents/ certificate from appropriate Authority . 10 Safety Measures 6 (i) Yes. with supporting documents by internal expert. 3 years & above .3 marks (iii) No such initiatives taken .0 marks Please give details and attach/ upload evidences.3 Marks 8 Modernization efforts 6 (i) Excellent with supporting documents .

CPF.5 Marks (ii) Toilets. Please give details and attach/ upload evidences. or If not applicable. ESI -2 Mark (ii) No. Yes. 20 .2 Mark (ii) No. Reward Scheme -0 Mark Please give details and attach/ upload evidences. (i) Yes.0 Mark 16 Employees Welfare Measures (full marks may be 2 awarded on submission of documentary proof. or If not applicable. Bonus .0 mark Please give details and attach/ upload evidences.3 marks (iii) No such initiatives taken . 17 Employees Welfare Measures (full marks may be 2 awarded on submission of documentary proof. or If not applicable. (i) Yes. or If not applicable.6 marks (ii) Good .Bonus .2 Mark (ii) No.0 Mark Please give details and attach/ upload evidences. 15 Employees Welfare Measures (full marks may be 2 awarded on submission of documentary proof. 14 Employees Welfare Measures (full marks may 2 be awarded on submission of documentary proof. Total 100 Part-II (Weight age: 30%) 1 Basic Amenities / Facilities at Work Place 5 (i) Toilets.3.6 marks (ii) Others . Reward Scheme -2 Mark (ii) No. No.0 Marks Please give details and attach/ upload evidences. (i) Yes. CPF.4 marks Please give details and attach/ upload evidences. ESI -0 Mark Please give details and attach/ upload evidences. 12 Qualification of Entrepreneur as on 31.2016 6 (Mark any one) (i) Bachelor Degree and above . (i) Yes. 13 Energy Conservation Measures 6 (i) Excellent with supporting documents .

5 Whether First Generation Entrepreneur 30 (i) First Generation .15 Marks Please give details and attach/ upload evidences.0 Marks Please give details and attach/ upload evidences.20 Marks (v) No growth .30 Marks (v) No growth .5 Marks (ii) Drinking Water.0 mark Please give details and attach/ upload evidences. Total 100 Signature Name & Designation of Officers MSME-DI/ DC(MSME) 21 . 3 Basic Amenities / Facilities at Work Place 5 (i) Medical First aid .2 Basic Amenities / Facilities at Work Place 5 (i) Drinking Water. No . 4 Employment Growth of 3 years 30 (i) Average growth rate up to 10% .5 Marks (ii) Medical First aid . Yes. No .0 mark Please give details and attach/ upload evidences. Yes .5 Mark (ii) Average growth rate above 10% & up to 20% - 10 Marks (iii) Average growth rate above 20% & up to 30% - 20 Marks (iv) Average growth rate above 30% . 7 Average Growth rate of Cumulative Investment 20 in Plant & equipment (i) Average growth rate up to 10% .30 Marks (ii) Others . No.0 Marks Please give details and attach/ upload evidences.5 Mark (ii) Average growth rate above 10% &up to 20% - 10 Marks (iii) Average growth rate above 20% &up to 30% - 15 Marks (iv) Average growth rate above 30% . 6 Basic Amenities / Facilities at Work Place 5 (i) Canteen.0 Marks Please give details and attach/ upload evidences.5 Marks (ii) Canteen. Yes .

No initiative.8 Marks iii. No initiative .12Marks ii. For all processes through Internal Software . 4 Whether enterprise Implemented Energy 6 conservation Techniques i.12 Marks ii. 2 Whether Enterprise has implemented Standard Operating Procedures (SOPs) 12 i.4 Marks iii.6 Marks ii.12Marks ii Just introduced .10 Marks ii.0 Mark Please give details and attach/ upload evidences. For all processes . Good Techniques . Excellent Techniques with supporting documents . No initiative-0 Mark Please give details and attach/ upload evidences. No initiative .8 Marks iii.2 Marks iv.Yoke 12 instructions i. Partially for some processes .0 Mark Please give details and attach/ upload evidences.0 Mark 22 . Excellent Techniques. For all processes through recognized External Software . Awarding Marks Maximum Marks Marks Brief Marks allotted by suggested comments State Level by Selection Technical Committee Division 1 2 3 4 5 6 1 Whether Enterprise has adopted 5S system 12 i. Partially for some processes . up to 5S level .6 Marks iii No initiative . Yes. Up to 2S level . Parameters for No.6 Marks iii. supporting with Certified Energy Audit report .3 Marks iv. For most of production process . 5 Whether enterprise implemented Poka .0 Mark 3 Whether enterprise implemented Enterprise 10 Resource Planning (ERP) system i. Application form (NAM-4) Parameters & Proforma for Evaluation and Awarding Marks Lean Manufacturing Techniques Part-I (Weight age-70%) S.

6 Obtaining/Maintaining ISO -9001 7 i. No growth .10 Marks ii.0 marks Please give details and attach/ upload evidences.0 Mark Please give details and attach/ upload evidences. with supporting documents by external experts /agency .3 Marks iv. Yes . 3 years & above . No . with supporting documents . 23 . No .1 Mark v. less than 1 year .0 Mark Please give details and attach/ upload evidences.0 Marks Please give details and attach/ upload evidences. i. Average growth rate up to 10% .1 Mark v.8 Marks v. Average growth rate above 30% . less than 2 years &above 1 year . less than 1 year .6 Marks Please give details and attach/ upload evidences.12 Marks ii Self . Average growth rate above 20% up to 30% . Please give details and attach/ upload evidences. 7 Obtaining/Maintaining ISO -14001 7 i. 3 years & above .0 marks Please give details and attach/ upload evidences. Yes. 10 Technology/Strategy adopted for Lean 12 Manufacturing i By approved consultant/agency .5 Marks iii. Yes. less than 3 years &above 2 years . less than 3 years &above 2 years . 11 Growth rate of Average Turnover/ Sales of 8 3 years.6 Marks iv. with supporting documents by internal experts . 9 Whether Enterprise provides training to its staff 10 on lean manufacturing techniques i. less than 2 years &above 1 year . No .5 Marks iii. 8 Any reward scheme introduced for employees for 4 suggesting Lean manufacturing i. No . Average growth rate above 10% up to 20% - 4Marks iii.4 Marks ii.2 Marks ii.3 Marks iv.5 Marks iii.7 Marks ii.7 Marks ii.

ESI .4 Marks (ii) No. 8 Growth rate upon cumulative Investment in 20 Plant & Machinery (i) growth rate up to 10% .) growth rate above 10% & up to 20% . ESI . 2 Pollution Control Measures .500 lakh & up to Rs. 4 Basic Amenities at Work Place 2 (i) Canteen.10 Marks 24 .0 Mark Please give details and attach/ upload evidences. Govt.5 Marks (ii. No. Total 100 Part-II (Weight age-30%) 1 Value of Average Annual Turnover/ Sales of last 20 three years (i) up to Rs. Yes .20 Marks Please give details and attach/ upload evidences. 6 Employee Welfare Measures 4 (i) Yes.4 Mark (ii) No. CPF . 3 Employee Welfare Measures 4 (i) Yes. 7 Basic Amenities at Work Place 2 (ii) Toilets.) above Rs.2 Marks Toilets.2 Marks Canteen.0 Marks Please give details and attach/ upload evidences.1000 lakh .4 Marks (ii) No. CPF . Bonus.4 Marks (ii.1000 lakh-12 Marks (iv) above Rs. No. No .20 Marks ii.500 lakh-8 Marks (iii) above Rs. Yes .0 Marks Please give details and attach/ upload evidences.0 Marks Please give details and attach/ upload evidences. Bonus.0 Marks Please give details and attach/ upload evidences.20 Marks 20 Note:(Full marks may be given if these measures are not applicable to this industry subject to presentation of relevant NOC from the Competent Authority/ Enterprise exempted by State i.0 Marks Please give details and attach/ upload evidences. 5 Employee Welfare Measures 4 (i) Yes. 100 lakh .100 lakh &up to Rs. Yes.

No.20 Marks (v) No growth . Total 100 Weight age: Part-I . 11 Basic Amenities at Work Place 2 (iv) Medical First aid . Part-II -30%. No .0 Marks Please give details and attach/ upload evidences. Yes.15 Marks (iv) Average growth rate above 30%.20 Marks (v) No growth . 9 Growth rate of average Net Profit (after Taxes) of 20 3 years (i) Average growth rate up to 10%. Yes -2 Marks Medical First aid .10 Marks (iii) Average growth rate above 20% & upto 30%. 10 Basic Amenities at Work Place 2 (iii) Drinking Water.70%.5 Marks (ii) Average growth rate above 10% & upto 20%.0 Marks Please give details and attach/ upload evidences.2 Marks Drinking Water. Signature Name and Designation of Marks Evaluation Officer of MSME-DI/DC(MSME) 25 .0 mark Please give details and attach/ upload evidences. (iii) growth rate above 20% & up to 30% -15 Marks (iv) growth rate above 30% .0 mark Please give details and attach/ upload evidences.

6 Marks ii.0 Mark Please give details and attach/ upload evidences.6 Marks iii.3 Marks iii. No. 4 Obtaining ISO-9001 Series/14000/22000 / 9 HACCP/ GMP /equivalent certification - i. 3 Improvement in Quality 5 Assurance Techniques i. Ag Mark etc) . Awarding Marks Marks allotted by suggested comments State Level by Selection Technical Committee Division (1) (2) (3) (4) (5) (6) 1 Testing of Raw materials used / Components/sub 6 assemblies i. 3 years & above . less than 2 years &above 1 year . No .12 Marks 26 . No. 2 Testing equipment/ instrument available with 6 enterprise i.3 Marks iv.0 marks Please give details and attach/ upload evidences. (Application Form: NMA. Others.1 Mark v. No. GMP. less than 3 years &above 2 years .3 Marks iii. FSSAI.5) Parameters & Proforma for Evaluation and Awarding Marks Quality Products Part-I (Weight age-70%) S. Adequate .0 Mark Please give details and attach/ upload evidences.0 Mark Please give details and attach/ upload evidences.5 Marks ii.BEE. Adequate .3 Marks iii. Parameters for Maximum Marks Marks Brief No.9 Marks ii. less than 1 year . with supporting documents .6 Marks ii. Excellent. Good . 5 Standardization 12 (i) 14 Obtained BIS Mark/International/National Standard (RDSO. Others.

with supporting documents.1 Mark Please give details and attach/ upload evidences. Yes. ie Energy Audit Report .3 Marks iii. No . Excellent with supporting documents-5 Marks ii. 10 Energy conservation measures 4 i. Write up .3 Marks iii. . Poor .5 Marks ii. Yes. with supporting documents.0 Mark Please give details and attach/ upload evidences. (ii) Product equivalent to any other Specification . with supporting documents . Good . No . Excellent with supporting documents-4 Marks ii. 12 Inventory Control Method 5 i. ii. Yes.1 Mark Please give details and attach/ upload evidences.4 Marks ii. less than 3 years . write-up ..2 marks iii. Poor . Yes. 27 . 11 Standard of Packaging 4 i. Yes.2 marks iii.0 Mark 9 Whether Enterprise has Quality Audit Team 5 i.6 Marks 6 Getting instruments/Gauges/test rigs Calibrated 6 on regular intervals i.6 Marks ii. No . others .5 Marks ii. No initiative . with supporting documents. 8 Whether Enterprise has given skill knowledge to 5 the staff and workers for Quality Assurance i. with supporting documents. 3 years . No . 7 Any reward scheme introduced for employees for 5 suggesting Improvements Leading to Quality / Productively improvement i.0 Mark Please give details and attach/ upload evidences.3 Marks iii.5 Marks ii. with supporting documents.0 Mark Please give details and attach/ upload evidences. Good . Yes.2 Marks iii. Yes.0 Mark Please give details and attach/ upload evidences.

) above Rs.500 lakh & up to Rs.6 Mark (ii) No.1000 lakh .2 Marks (iii) growth rate above 20% & up to 30% .0 Mark Please give details and attach/ upload evidences.0 Mark 16 Growth rate of Average Net Profit (after Taxes) 6 of 3 years from 1st year (i) growth rate up to 10% .4 Marks (iii) above Rs. CPF. up to 10% .1 Marks (ii) growth rate above 10% & up to 20% -2 Marks (iii) growth rate above 20% & up to 30% -3 Marks (iv) growth rate above 30% .100 lakh . Bonus.10 Marks (ii) Conventional .5 Marks Please give details and attach/ upload evidences.4 Marks (iv) growth rate above 30% .3 Marks (ii) growth rate above 10% & up to 20% .6 Mark (ii) No.1 Marks (ii) growth rate above 10% & up to 20% .0 mark Please give details and attach/ upload evidences.4 Marks (v) No growth .13 Use of Technology 10 (i) Developed .6 Marks 28 . 15 Growth rate of Average Annual Turnover/Sales 4 of 3 years (i) from rate growth 1st year. 14 Value of Average Annual Turnover/Sales of last 8 3 years (i) up to Rs.100 lakh &up to Rs. 3 Growth rate upon cumulative Investment in 18 Plant & Machinery (i) growth rate up to 10% .6 Marks (iv) above Rs. 2 Employee Welfare Measures 6 (i) Yes.6 Marks (v) No growth .2 Marks (ii.0 Mark Please give details and attach/ upload evidences. Total 100 Part-II (Weight age-30%) 1 Employee Welfare Measures 6 (i) Yes. Bonus.8 Marks Please give details and attach/ upload evidences.1000 lakh .500 lakh . CPF.

20 lakh .12 Marks (iv) growth rate above 30% . 6 Value of Export Average of last 3 years 8 (i) up to Rs.0 Mark Please give details and attach/ upload evidences.2 Marks (iv) Average growth rate above 30% -4 Marks up to 30% .6 Marks (iii) 1 years export .12 Marks (iv) growth rate above 30% .20 lakh & up to Rs. 29 .0 mark Please give details and attach/ upload evidences.18 Marks (v) No growth .3 Marks (ii) growth rate above 10% & up to 20% .0 mark Please give details and attach/ upload evidences. No.2 Mark (ii)above Rs. Yes.200 lakh . marks may be awarded on the basis of average growth rate of supply to strategic organizations.0 Marks Please give details and attach/ upload evidences.0 mark Please give details and attach/ upload evidences.1 Marks (ii) Average growth rate above 10% & (iii) Average growth rate above 20% & up to 20% .0 mark Please give details and attach/ upload evidences. (iii) growth rate above 20% & up to 30% .3 Marks (v) No growth .3Marks (iv) No export . 8 Basic Amenities / Facilities at Work Place 4 (i) Toilets. 7 Growth rate of Average of export value 4 (i) Average growth rate up to 10% . 5 Exports (Direct) during the period Note: In case 9 due to specific product / supplies to strategic organizations (viz.100 lakh .4Marks (iii) above Rs. where exports not permissible.8 Marks (v) No Export .6 Marks (iv) above Rs.200 lakh .4 Marks (ii) Toilets. Defense etc. 4 Growth rate upon Employment 18 (i) growth rate up to 10% . (i) 3 years export .9 Marks (ii) 2 years export .18 Marks (v) No growth .6 Marks (iii) growth rate above 20% & up to 30% .100 lakh & up to Rs.

9 Basic Amenities / Facilities at Work Place 4 (i) Drinking Water. Yes . No . No . ESI.0 Mark Please give details and attach/ upload evidences. 10 Pollution Control Measures 9 Note:(Full marks may be given if these measures are not applicable to this industry subject to presentation of relevant NOC from the Competent Authority/ Enterprise exempted by State Govt. Yes. No . Yes.0 mark Please give details and attach/ upload evidences.9 marks ii.4 Marks Canteen.6 Mark (ii) No. ESI.0 Marks Please give details and attach/ upload evidences.0 Marks Please give details and attach/ upload evidences.4 Marks (ii) Drinking Water. Yes . i.4 Marks (ii) Medical First aid . 13 Basic Amenities / Facilities at Work Place 4 (i) Canteen. 12 Basic Amenities / Facilities at Work Place 4 (i) Medical First aid . Total 100 Signature Name and Designation of Marks Evaluation Officer of MSME-DI/ DC(MSME) 30 . No.0 Marks Please give details and attach/ upload evidences. 11 Employee Welfare Measures 6 (i) Yes.

3 Percentage of average export to average 35 Annual Turnover of last 3 years.0 mark Please give details and attach/ upload evidences.10 Marks (ii.5 Marks (ii. Application Form:NMA-6 Parameters & Proforma for Evaluation and Awarding Marks Export Awards S.50000 lakh .) above 10% & up to 20% -15 Marks (iii) above 20% & up to 30% .500 lakh & up to Rs. Parameters for Evaluation Marks Maximum Marks given Marks given Brief No. 31 .15 Marks (iv) Average growth rate above 30% -20 Marks (v) No growth .10 Marks (iii) Average growth rate above 20% & up to 30% .10 Marks (iii) above Rs.10000 lakh & up to Rs.35 Marks Please give details and attach/ upload evidences. 2 Exports (Direct) Average Growth rate of 20 export value of 3 years (i) Average growth rate up to 10% .25 Marks 14 (iv) above 30% .50000 lakh .) above Rs.5 Marks (ii. (i) up to 10% .10000 lakh .) Average growth rate above 10% & up to 20% .15 Marks (iv) above Rs. Marks by SLSC by comments DC(MSME) (1) (2) (3) (4) (5) (6) 1 Exports (Direct) Average export value of last 3 20 years (i) up to Rs.20 Marks Please give details and attach/ upload evidences.500 lakh .

TOTAL 100 Signature Name and Designation of Marks Evaluation Officer of MSME-DI/ DC(MSME) Example: 2012-13 2013-14 2014-15 2015-16 Value 20 25 18 30 (Rs.66% 20 25 18 Average Growth 25+(-28)+66.66/3=21.22% Rate of 3 Years 32 . 4 Status of Export House for the year 2014-15 25 One Star -5 Marks Two Star -10 Marks Three Star -15 Marks Four Star -20 Marks Five Star -25 Marks Please give details and attach/ upload evidences. in lakh) Growth Rate (25-20) x100 = 25% (18-25) x100 = -28% (30-18 )x100 = 66.

I certify that I have cleared income tax dues and I am not involved in any economic or other offence for which legal action/enquiry is pending and also the above information furnished by me is correct. in case it is ever found that the information furnished above was incorrect. Further I may also be liable for any action under the law of the land for any false declaration. Place: Date: SIGNATURE OF THE ENTERPRENEUR SEAL OF THE ENTERPRIS 33 . if awarded to me. return the trophy and certificate. I undertake to refund the cash prize.

Name & Address of the Designation Recommended Signature Members 34 .We have gone through the submissions made by the entrepreneur and after thorough scrutiny have found it to be a fit case for consideration by the National Level Selection Committee for National Award for (Please Tick) Micro/ Small / Medium Enterprise. RECOMMENDATIONS OF THE STATE/UT LEVEL SELECTION COMMITTEE (SLSC) Name of the enterprise: -------------------------------------------------------------------------------------- State: -------------------------------------------------------------------------------------------------------------- Out of 100 % Weight Marks age Marks Awarded (Part-I) 70 Marks Awarded (Part-II) 30 Total Recommendation :.

35 .