SF C1: Request letter from PIA for changes in project parameters

(To be issued on the letter head of the organization)

To Letter No._________________

The COO Date:_____________________

MPDAY SRLM (DDU-GKY)(SRLM for APS/CTSA for YPS)
Beej Bhavan , Arera Hills, Bhopal , M.P.

Dear Sir/Madam

Sub: Submission of request for changes in project parameters- regarding Project

This has reference to MoRD/SRLM/SSM (concerned) order- No. 5852/MP-DAYSRLM/SKILL/36/2017,

dated 14/08/2017 sanctioning a project for imparting placement linked training to 386(no. of
candidates to be trained) and placement of 272 candidates (no. of candidates to be placed) in the
district of Alirajpur, Burhanpur,Dhar, Jhabua,Khandwa state Madhya Pradesh under DDU- GKY /
Roshni to our organization bearing PRN No. MP2016CR12873.

2. In this respect it is stated that due to the reasons indicated in the Annexure- 1, we seek approval
of the competent authority for allowing changes in the following parameters of the project:
1) District Covered for Mobilization.
2) ___________________
3) ___________________

3. It is requested that our proposal may be considered favorably and recommended to the
competent authority to approve the proposed changes.

Signature of Authorized person

Pithampur Auto Cluster

Enclosures:

Annexure 1: Request for change in project parameters

Annexure 2: All required documents.

Copy to:
1. Ministry of Rural Development for YP states only
2. Concerned State Rural Livelihood Mission for YP states only
3. Concerned Central Technical Support Agency for AP states only
Annexure-1:RequestforChangeinProjectParameters(RCP)Form

Name of PIA PITHAMPUR AUTO Date of Submission

CLUSTER
Sanction Order no./ 5852/MP-DAYSRLM/ State Madhya Pradesh
Date SKILL/36/2017 /
14/08/2017
<< Amendment order << Amendment order
to Sanction order/ to Sanction order/
Date, if any>> Date, ifany >>

Change Requested for

i. Project tenure Yes vi. Trade / Certifying Yes
Agency / Trade duration
ii. Total target No vii. One time travel cost No
iii. District No viii. Consortium partner No
iv. Residential Non- No ix. Total project cost No
Residential target
v. Location of Residential No
centers
All the documents marked with (*) are to be attached mandatorily for the relevant section.

i) Project Tenure

Sanctioned Duration of the Project end date Extension required for Reason for
project (dd/mm/yyyy) Extension
_yrs_months _yrs_months
Annexures Whether attached (Yes/No)

Revised PPWS* Yes

ii) TotalTrainingTarget

SanctionedTraining target Training already Proposed Target Reason for Change

completed
386 375 386 No Change
Required

iii) District
S.No. Name of the Whether Training Training Proposed Reason for Change
District district Target already Target
Already sanctioned completed
Sanctioned*
(Yes/No)
1 Alirajpur Yes 70 86 8
2 Burhanpur Yes 100 126 8
3 Dhar Yes 70 94 21
 4 Khandwa Yes 100 126 60
5 Jhabua Yes 86 19
Total 386 315
* If any district needs to be dropped, write the proposed target as "0"
iv) Trade duration & Residential/ Non-Residential
Duration 3 Month 9 Month 9 Month 12 Month Total
Residential Sanctioned
Completed
Proposed
Non- Sanctioned
Residential Completed
Proposed
Reasons for Change
Annexures Whether Attached (Yes/No)
1) Alignment letter from Certifying agency*
2) Employers tie-up for proposed trades

v) Location of Residential centers

State Headquarters (a) District Places Other than a) Total

Headquarters (b) and b)
Sanctioned
Completed training

Proposed
Reasons for Change

vi) CertifyingAgency/Trades
Already Sanctioned *
Name of the Sector
Name of Certifying

Course Duration in

Reason for Change

Training Already

Proposed Target
Whether Trade

Training Target
Trade/Course

Course Code
Name of the

(NCVT/SSC)

Completed
(Yes/No)
Agency

Hours
S. No.

1
2
3
4
5
Total

* If any trade needs to be dropped, write the proposed target as "0"

vii) One time Travel Cost

Amount in Rs.
Amount as per sanctioned Project Application
Amount already spent
Amount proposed
Reasons for Change

viii) Consortium Partner

Name and address of the PRN WhetherLead Partner Name and
Consortium Partner number (Yes/No) designation of
authorized person
Sanctioned
Proposed
Reasonsforchang
e
List of annexures for proposed Consortium partner Whether attached (Yes/ No)
i) Proof of PRN*
ii) MoU / Agreementbetweenproposedconsortium partner and
the PIA*

Total Project Cost

a. Post Placement Support
Within District Within Outside State of Total
domicile Stateofdomicile domicile

Sanctioned (total candidates)

Sanctioned (total amount in
Rs.)
Completedplacement(totalcan
didates)
Completedplacement
(totalamount in Rs.)
Proposed (total candidates)
Proposed (total amount in Rs.)
Reasons for Change

b. Incentives to PIAs
As per Approved Project Retention Career Overseas Live Distance
Application Support Progression Placement Learning
Support Support
Sanctioned (total
candidates)
Sanctioned (total amount
in Rs)
Completed (total
candidates achieved)
Completed (total amount
in Rs.)
Proposed (total
candidates)
Proposed (total amount in
Rs.)
Reasons for change

c. Project Cost
Sanctioned project Proposedproject cost Reason for Change
cost (in Rs.) (in Rs.)

Project cost(excluding Monitoring

fee to CTSA) (a)
Monitoring fee to CTSA (b)
Total Project cost (c=a+b)
Central Share of (c)
State Share of (c)

Undertaking:

I certify that I am the authorized person on behalf of the PIA, and also certify that the information
furnished in this form and all the corresponding documentary proof provided is complete and
correct in all respects to the best of my knowledge. In case any information provided in this formis
found to be false or incorrect, then the change request for project parameters may be deemed to be
cancelled without any opportunity of being heard by the Central/State Government (as the case may
be), and the PIA and myself shall be liable for any penal action for misrepresentation of facts to the
Government which tantamount to fraud.

Name of Authorized Legal Person Mr. Umesh Agrawal

Place of submission Indore
Date of submission

Signature: