RS/GPTP/PTB/MECH/55/19-20/00

Proficiency Testing Program

CIN NO. U74140DL2010PTC20147 Registration Form

1. Participant Lab Name:

2. Address (to which PT Item delivered):

Pin Code:

3. E-mail ID: GST No.:

4. Details of Contact Person:

Name Designation Mob. / Tel. No.

5. Accredited By (if any):

6. Willingness to publish your organisation name in the Final PT Report: Yes No

7. PT Program Details: [tick (√) the selected parameters]

PT Scheme Name PT Scheme Code PT Parameters Min Max Test Method

Range Range
1 MECHANICAL PROPERTIES OF PTB/MECH/55/19-20 Specific Gravity () 0.00 0.00 IS 2386 P-3
COARSE AGGREGATES
Water Absorption () 0.00 0.00 IS 2386 P-3
Flakiness Index () 0.00 0.00 IS 2386 P-1
Elongation Index () 0.00 0.00 IS 2386 P-1
Sieve Analysis () 0.00 0.00 IS 2386 P-1
* PT parameters & range may vary depending upon the stake holder's requirements or request.

Note: Various aspects of the proficiency testing scheme can be subcontracted to accredited laboratories and Global PT Provider is responsible for their work.

8. This PT Programme is not covered in NABL scope.

9. Payment Mode:

Cheque Cash DD RTGS

[please select the box by √, the DD/Cheque is to be made in favour of GLOBAL PT PROVIDER PVT LTD and payable at
KALKAJI, NEW DELHI [DL] ]

10. Details of Account (for Cash Deposit/NEFT/ECS/Fund Transfer):

Bank Name: Axis Bank Branch Name: KALKAJI, NEW DELHI [DL]

Issue No: 01 Revision No: --

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Issue Date: 28-06-2019 Revision Date: --
 RS/GPTP/PTB/MECH/55/19-20/00

CIN NO. U74140DL2010PTC20147

CIN No. U 7 4 1 4 0 D L 2 0 1 0 P T C 2 0 1 4 7 9
GST No. 0 7 A A O C S 1 4 5 9 G 1 Z 3
PAN No. A A O C S 1 4 5 9 G
A/c No. 9 1 2 0 2 0 0 6 2 0 1 9 3 3 0
IFS Code: U T I B 0 0 0 1 0 2 1
MICR Code: 1 1 0 2 1 1 0 7 7

11. Mode of Transport:

First Flight DTDC Courier DHL FedEx Express Blue Dart

12. Terms and Conditions

i. Payment
Payment in full is required from each Participants within 7 days after enrolling in the PT program.
ii. Laboratories outside India
Courier costs will be added and itemized separately on the invoice. Please ask for a quote.
Delivery of your order will be facilitated when you send us all relevant permits and import certificates prior to the shipping date.
Cheques and Bank Drafts
* Customers within India can pay by Company Cheque.
* Customers outside India can pay by Official Bank Draft on provision that all transaction fees are met by the customer.
Electronic Transfer
* All customers may pay by electronic funds transfer provided all fees are paid by the customer.
Credit Card
* GPTP accepts VISA card, Master Card. A surcharge of 2.5% will be added for use of this facility.
Cash
* GPTP accepts direct cash from the customer at company premises or can direct deposit in Bank Account.

iii. Return of results

Laboratories who are participate in proficiency testing programs on the understanding that they will be sharing their results and information anonymously
with other laboratories performing the same analysis. Non-return of results compromises the spirit of the programs, and reports will not be sent to
laboratories unless they return results. Payment in full is required from all laboratories enrolling whether they return results or not.

iv. Errors in Participant Proficiency Testing Results

Errors in Participant Proficiency Testing Results: Proficiency testing reports should reflect the level of accuracy that a regular testing client would receive.
If a participant finds an error in their proficiency testing results, they may notify us in writing and change their submission PRIOR to the due date for
return. Changes in result after submission of result will not be accepted. GPTP reports results as submitted by participants.

On occasion, it seems as though participants have mixed up the samples or not processed the samples according to the instructions. GPTP cannot make
assumptions of this nature and change results 'to suit'. We also cannot compromise the integrity of the programs by suggesting to some participants that
they should review their results prior to the due date. (This is unfair to other participants).

It is the responsibility of the participants to check all aspects of the program, including sample identification, preparation, testing instructions, calculations
and reporting of the results prior to results submission. If samples are not in good condition on arrival to the participant laboratory, GPTP must be
notified in writing IMMEDIATELY, as often samples can be replaced in good time. Claims about samples received in bad condition will not be accepted
after the report has been issued.

v. Late Enrolments and Late Results

Late enrolment requests cannot always be accommodated, as sample manufacture must be scheduled well in advance to the shipping date of the
program to allow all necessary quality assurance activities to be carried out.
Shipping of PTP materials and evaluating test results from PTPs out-of-cycle with the mainstream programs is considerably time consuming and
therefore costly.
In order not to disadvantage participants able to comply with time frames, GPTP will charge a late fee in the following circumstances:
* Requests for enrolment in PTPs after the advertised cut-off date
* Requests that GPTP staff enters results on behalf of participants
* Requests to record results after the due date
* Requests for PTP participation that is out-of-cycle with the scheduled dates

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CIN NO. U74140DL2010PTC20147

vi. Shipping fees and Customs clearance

Costs incurred for shipping samples and clearance of same through customs are the responsibility of the participating laboratory unless otherwise
indicated.

vii. Non-payment of fees

GPTP retains the right to withhold reports and/or PT materials and services when invoices are outstanding.

viii. Confidentiality of results

All data and information received by GPTP from its clients are considered confidential unless the client has given express permission to pass on
information.

ix. Use of reports

Proficiency Test Reports are the copyright of Global PT provider P ltd. They are issued under controlled conditions to participants and to organizations
with responsibility for the participation of laboratories in PT Schemes. Reports may not be passed to or used by other organizations without the express
authority of GPTP.

x. Acceptance of Orders
Orders for participation in GPTP proficiency testing programs and services may be accepted by receipt of a written request (i.e. by fax, letter, or official
company order form), sent to the company.
Once an order is placed, it can only be cancelled in writing. This MUST occur more than one week before the scheduled date of dispatch. Once samples
have been dispatched, an order cannot be cancelled.

xi. Participant Collusion and Falsification of Results

The dictionary definitions of “collusion” and “falsification” are as follows:

Collusion: A secret agreement or cooperation for a fraudulent or deceitful purpose.

Falsification: Deliberately changing something to be false.

In proficiency testing terms, collusion is comparing data (and perhaps changing data) to fit in with a believed “correct” result. This is contrary to the spirit
of proficiency testing programs, which are issued with the intention of providing an objective comparison of a laboratory’s performance with others.

GPTP tries to minimize the occurrence of collusion by being aware that laboratories should be objective when they report their results, and should
therefore not know the intended results at the time they are reporting to us. Answers are not provided to clients until results have been submitted.
We are also vigilant about checking the similarities in data which is submitted by more than one participant, particularly if the answers are incorrect.
However, it is seldom possible to substantiate suspicions of copied data from submitters and it would therefore be difficult to make accusations. It is
ultimately up to the participating laboratories to get the most benefits from a PT program. This is achieved through integrity, completing the tests without
foreknowledge of the intended or possible results and submitting the answers they actually generate.
To prevent collusion and falsification our advice to clients is:

DON'T confer with others about PT samples or results.

DO accept the fact that everyone makes errors.
DON'T average the results or opinions of every person in the laboratory before selecting the answer to be submitted.
DO have confidence in your own results.

Proficiency Testing (PT) is a compulsory part of laboratory accreditation, but it is also an important tool for giving you confidence in your results.
“Enhancing” your PT results with assistance from another participant cannot increase confidence in your laboratory’s performance.
Clients are always welcome to contact GPTP to seek advice or information about collusion or falsification of data.

xii. Policy for Participant Appeal of PTP Performance Assessment

If participants disagree with their performance assessment in a proficiency report, they should inform GPTP in writing to appealing officer or through our
website www.globalptprovider.com
Written submissions are assessed by GPTP staff, and a response should be expected within 7 days.
The response will include GPTP’s interpretation of the outcome of the re-assessment and an explanation of that outcome. (For example, explanation of
a calculation, or the rationale for the outcome of the evaluation.)
If a mistake has been made by GPTP, it will be dealt with via GPTP’s non-conformity (incident) system.
If the mistake is seen to be the customer's, it will be entered as customer feedback in GPTP's incident register for further review. The incident register is
used to improve programs and customer service, and will result in clearer documentation where deemed appropriate.

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CIN NO. U74140DL2010PTC20147

Signature:

Name:

Designation:

Company Sealed:

Contact Details:
Ms. Shivangi Sharma
TR. PT COORDINATOR

Global PT Provider Pvt. Ltd.

F 89/22 Okhla Industrial Area, Phase I, New Delhi - 110020
Mob.: 09873001545 / 09582999061 Ph: 011-40722200
Email: care@globalptprovider.com / info@globalptprovider.com

[Note: kindly fill up this form and original copy and DD/Cheque/Cash in our company account, send us by post to confirm your participation and must keep
duplicate copy.]

Issue No: 01 Revision No: --

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Issue Date: 28-06-2019 Revision Date: --