APPLICATION FORM
Service Cooperatives
under NCDC Scheme
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Regional Office, 5th
Floor, Co-Bank Towers , Palayam,
Trivandrum
Phone: (0471) 2318497 Fax: (0471)
2311673,Web site
: www.ncdc.in
Email - RO.TVM@ncdc.in
PART -A
Proforma Application for Service Cooperatives
General Information:
1.
Name of the
Society
(Address with Pin Code)
2.
No. with
date of Registration
3.
Area of
Operation
4.
Membership and own funds of society for the last two years
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Particulars
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Year -
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Year -
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No. of
Members
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Paid-up
Share capital
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No. of
members
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Paid-up
Share capital
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a)
Individual Members
(Total individual)
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i)
Scheduled Castes
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ii) Scheduled Tribes
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iii) Women
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iv) Others
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b)Cooperative Societies
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c )State Government
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d
) Others, if any
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e)
Total(a+b+c+d)
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5.Operational performance for the last
3 years & expected during next 2 years.
Type
of Business Last Coop. Previous
Year before Expected Expected
Year . Coop. previous during during
Year Year current ensuing
Year Year
1 11 111
______________ _______ _________
_____ ______ ______
a) Worth of service
rendered
/generated
b)
Service charges
received
c)
Service rendered to
1. members
2.Others(pl. specify)
Total
6.
Board of Directors Officials Non-officials
a
) Is the Board Elected?
b )
How many Directors are
there in the Board of the Society?
c ) When
was the last Election
held and tenure of the Body
d
)When the last General Body
Meeting
held?
e) Does the
Board of Society/General Body
approved the proposed investment?
f) When was
the last audit done and audit classification?
7.
Financial Performance
Error! Not a valid link.
: Attach copy of financial accounts
for above years
8.Agri Clinic/Showroom/Service Complex
details
Own Rented
a)
No. of Facilities
b)
Average ---
Agro-Clinic/Showroom/
Service Complex
i) Turnover/worth of services
rendered.
ii)Investment in the creation
of
facility.
iii)Floor area of the Facility(Sqft)
c)
Storage Capacity (area in Sqft)
(pl.
indicate the purpose)
9.
Any other information in support of the Proposal
Please enclose Balance Sheet , Trading Account,
P/L Account and copy of Bye-law of the
Society.
Please append separate note /project
report on the
Technical feasibility &economic
viability of the project.
I declare that the information
given are correct.
President/Secretary’s Signature
(Name-Address
with Rubber Stamp)
PART -B
Working Capital/Share Captial
/Margin Money assistance for Service Cooperatives
(Please submit Part A&Part B)
(Rs. In lakhs)
Amount No. of instalments &
Out standing Amount paid during
the year
------------------------ -----------------------------------------
1. Term Loan raised for
Investments in
Infrastructure/Fixed
Assets
a) State Govt.
b) Coop. Banks
c) Commercial Banks
d) Others, if any
------------------ -------------------------------
------------------ --------------------------------
2. Investment in Fixed Assets,
Securities & Shares etc
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Particulars
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Investment
made from out of borrowings as in (1) above
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Investment
made out of own funds
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Total
investment
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I
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II
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III
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1V
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a) fixed
assets of land buildings. Furniture/fixtures. Plant &machinery, transport
vehicles etc.
b ) Debentures,
Bonds Govt. Securities etc.
c)Share of
other
institutions
d) Any
other Investment of long term nature(please specify)
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e) Total
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3. Accumulated Losses/deficit, if any.
4. Net disposable resources(NDR)
5.Loans and advances taken for Working
Capital during the Year
(Rs.in
lakhs)
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Type of
Business
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Type of
credit sanctioned(Pledge hypothecation clean etc)
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Whether
the loans were guaranteed by S/govt
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Margin of
security prescribed
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Source of
credit(scheduled Bank)
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Credit
limit sanctioned
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Credit
limit utilized
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Rate of
interest
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a.
Name
of the bank/FI
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b.
Cash
credit limit sanctioned as on-
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c.
Cash
credit limit awarded as on-
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d.
Margin
provided by the society
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6. Programme
for the ensuing year
(Please
append a brief note &give the following information)
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Programme
I
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Value
II
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No.of
business/
Production
Turnovers
Expected
III
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Working
Capital required for production/sale
IV
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Margin
money needed for production
V
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a)
Worth of services rendered/generated
b)
Service generation inputs (pl. specify in quantitative terms)
c)
Others (pl specify)
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d) Total
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4.
Gap in
margin money
(V(d)
of Item 6-NDR
President/Secretary’s Signature with Seal
PART –C
Service Cooperatives
(Pl. submit Part A & Part C)
Creation of infrastructure including
installation of equipments/plants/apparatus; expansion/modernization/renovation
of existing service cooperative units.
_______________________________________________________________
(Rs. in lakhs)
1.Location & Site
a) Location of Facility
b) Whether the
site is acquired in the name of the
Society
c) Size of proposed Facility (length, breadth
& height)
(enclose Plan &Estimates)
d) Type
of equipments/plants/apparatus to be installed (enclosed quotations)
e) No. equipments/plants/apparatus to be
installed (enclosed quotations)
2. i
Size of existing Facility (enclose Plan)
ii) Details
of existing equipments/plants/apparatus
iii) Type of service presently undertaken
iv) Average worth of service per day:
Existing
Facility, if any Projected
on establishment of
new/Expn./modn./renovtn
of
existing
service facility, if any
(Pl. delete whichever not applicable
v) Average cost of service generation
(Rs.per unit of production)
3. Arrangements for inputs & Rendering
of
Service generated
4. Total
cost of Project :
a) Civil Construction
b) Purchase of Equipments/Plants/Apparatus
c) Modernization of equipments/plants/apparatus
others, if
any
5. Financial assistance required from
State Government.
a)
Share capital/subsidy
b)
Loan
Total
(Rs. In lakhs)
Y E
A R S
I II III IV
6. a)Projected turnover after
completion of the project
b) Projected Gross income
c) Projected Expenditure
d) Projected Net Income
e) Projected Profitability
---------------------------------------
7. Annual Instalment due to Principal Interest
Govt. on
account of loan
8. Is income indicated at 6 above
adequate to service the loan and
interest, if not how the deficit, if any,
will be met.
President
/Secretary’s Signature with seal
PART-
D
SERVICE COOPERATIVES
(Please subgmit Part-A & Part-D)
Construction of
Agri-clinic/Showrooms/godowns
Service Complex by Service
Cooperative Societies
(Rs. In
lakhs)
1. a)
Existing space/infrastructure
Created and its capacity
utilization
b)
No. of Agri-clinic/Showrooms/
Service Complex installed
(Pl. give details)
2.
Size of Agri-clinic/Showrooms/Service
Complex now proposed for
i) Construction
ii) Renovation
b) Location and reasons for selection
3. Estimated Cost
Cost of
Cost of Other Cost Total
Construction Renovation if any
------------------------------------------------------------------------
4. Assistance required Loan Share
capital
Y E A
R S
----------------------------------------------------
I II III IV V
5. a)
Project sales after completion
of Project
b) Projected gross income
c)
Projected Expenditure
d)
Projected Net income
e)
Projected Profit
--------------------------------------------------------------------(Pl.
enclose Drawings & Estimations. Also
pl. clearly indicate whether the proposal is for Opening/Renovation/Construction
of Agro-clinic/Showrooms/Service
Complex.)
President
/Secretary’s Signature with seal
Annexure
– III
GUIDELINES
FOR PREPARATION OF DETAILED PROJECT REPORT
FOR SERVICE COOPERATIVE PROJECTS
Creation of Common Infrastructure
Facilities with Installation of
Equipments/Plants/Apparatus; Expansion/Modernisation/
Renovation of Existing Service
Cooperative Units
AND
Construction of
Agro-clinic/Showroom/Service Complex etc.
I. Background :
a)
Name & Address of the Society, date of registration and its
promoters list.
b)
Board of Management (Elected/Nominated/Superseded) & tenure of
present Board.
c)
Audit status (completed upto –
state year), date of last General Body
Meeting held.
d)
Authorised shae capital-paid up
share capital-category-wise i.e.
individual members, cooperative
societies, State Govt. and others
(indicating number and amount).
e)
No. of SC/ST and women members enrololled .
f)
Members existing holding of production capacity in the same trade –
individual and cooperative basis.
g)
Project orientation – objective, target beneficiaries, reasoning to
consider the Project in Cooperative Sector.
h)
Economic and other policies of the State Government supporting the
project.
i)
Project background
II. Materials and inputs
a)
Status of similar project/capacity installed in the area,
State and Country
b)
Projects under installation with capacity
III. Installed Capacity
Details of existing similar units in
the area giving their location, sector,
Capacity & services/items
generated.
IV. Choice of location and site
1.
a) List out the possible
locations. Describe and show on maps of
appropriate scale.
b) Basis of choice of location, list out the
details taking into
consideration among
others -
-
Public policy; backward area notified by State
Govt./
Central
Govt. availability of incentives, subsidies etc.
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Service versus
market orientation
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Local conditions : Infrastructure &
Socio-economic Environment.
2.
a) List out the possible site
alternatives, describe & show them on
maps of appropriate
scale.
b) State reasons for selection
c) Describe the site (location, Taluk, Block,
District etc.)
d) List and describe the location, conditions
such as :
- Climate
- Site & Terrain
- Transport facilities
- Water Supply
- Power
supply
- Manpower
- Fiscal & Legal Regulations
- Construction, erection & maintenance
facilities
- Living conditions
- Effluent disposal arrangement, if need be
V. Demand
Study :
1) List and describe data needed for
demand study
2) List and describe possible alternative
methods of data
Evaluation &
determination of present & future demand
3) Select method for data evaluation and
state reasons for selection
4) Describe the size & composition of
present demand
5) Identity segments/end users
VI. Service Generation Programme
1.
Basis of selection of service-mix
2.
Arrangements of inputs to be made
3.
Supply Programme
- Quantitative
supply programme
- Source of supply
- Timely delivery (scheduled)
- Storage measures
4.
Estimated cost of inputs
5.
Transport & other charges
VII.
Project Engineering
1.
Civil Engineering
a) To be classified into site preparation and
development
main service buildings & ancillary
blocks.
b) List civil engineering works & possible
alternatives
c) Physical layout
d) Availability & quality of construction
material & manpower
e) Local conditions
f) Cost estimates:
* Site preparation & development
* Buildings (main building, ancillary blocks,
water tanks, Storage,
Air-conditioning system, Admn. & staff
welfare, residential
buildings etc.
·
Outdoor works
(cost estimates for buildings & civil works should be based on unit and/or
parameters such as square meters of build-up area or cubic meters of the
enclosed space of a building).
2.
Equipments/Plants/Apparatus
a) Explain the basis/criteria for selection
b) Complete list and evaluation of the
equipments/plants/apparatus
proposed to be acquired.
c) List out the indigenous/imported
equipments/plants/apparatus
to be acquired
alongwith their detailed
specifications
d) Give the number of Service Generation
Equipments/Plants/Apparatus proposed to be acquired with:
·
Basic cost
·
Duties &
taxes (CIF, landed costs, custom duty etc.)
·
Octroi
·
Erection &
installation cost
·
Transportation
costs
·
Insurance
a) Miscellaneous fixed assets to be acquired
* Electrical equipment
* Utility supply
* Workshop equipment
* Laboratory
* Fire fighting equipments
* Stand-by power generation equipment
* Office equipment
* Air-conditioning Plant & System
List out the cost of the above equipments,
giving the basic costs,
taxes, duties and other
expenses.
b)
Stores and spares :
Furnish details of the required spare parts
& tools with their
estimated costs. This will include parts to be obtained with
original
equipment and parts &
tools required for operational wear and tear.
VIII. Manpower
Prepare manning table defining
the staff requirement by functions and
categories. (Supervisory, skilled, semi-skilled and
un-skilled) (Staff :
technical, managerial, administrative
& sales). The manning table
based on standard work load may
be given department-wise. The
following factors may be
considered:
·
A general assessment of supply & demand of
manpower in the area
·
An evaluation of
manpower, occupational skills available
·
Wage levels,
fringe benefits
When estimating manpower requirements, the
qualifications & skills
required should be described by
categories in order to provide a fame-
work for recruitment and for
arranging suitable training programmes.
Further, when estimating the
technology selected, manpower
availability and changing levels
of productivity should be considered.
IX. Financial & Economic Evaluation
1. Calculate the
total investment cost of all investment
components
2. List out the
various assumptions made in working out the total service
generation costs.
3. Prepare cash
flow tables
4. Compute
commercial profitability criteria
* Net present value
* Break even
analysis
* Sensitivity analysis
* Debt-service
coverage ratio
X. Project
implementation
a) Give details
of the implementing agency, its present activity and past
experience in implementing project of
the kind envisaged.
b) Elaborate the
implementation programme and time schedules
considering.
·
Establishment of project implementation
management
·
Arrangement for supply of equipment/plant/apparatus
·
Detailed engineering of equipment,
tendering, evaluation of
tenders,
awards of contracts.
·
Detailed planning of civil works, tendering,
evaluation of
tenders , awards of contracts.
·
Arrangements for financing
c) Construction period :
Purchase of land, supervision and
coordination of civil
construction and supply/erection of
equipment/plant/apparatus,
build up of administration, recruitment
& training of staff etc.
d) Selection and describe
in detail the optimum implementation
programme and time
schedule. List activities and show
their
sequence.
NOTE : All
information should be supported by relevant documents
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