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									                                                                              NSCI Safety Awards – 2010 (MSME)

                                                                              Application No.:
                                                                              (To be filled by NSC)

Note: * Please put a (√ ) mark if “Yes” and ( x ) if “No” ;   put Remarks if No

Item                                                                                       Checked By
 No.                                                                                    Applicant NSC
  1  Complete information about the Enterprise (i.e. from 1.1 to 1.8) provided.
  1.3Copy of Memorandum of Understanding under MSMED Act, 2006 attached.
  1.4Copy of Certificate of Registration under Factories Act, 1948 attached.
  2.1Brief description of the process attached.
  2.2Type of the Industry as per National Industrial classification (NIC)
      (as in the Appendix III to the Application Form) is mentioned.
 3.2 Details of Total Man-hours worked mentioned
 4.1 Membership of NSC given.
 4.2 NSC Membership number mentioned.
 5   Details of reportable accidents, F.R & Man-days lost mentioned
 6   Details of Dangerous Occurrences mentioned
 7   Details of Longest Accident-free Period Man-hours mentioned
 9   Copy of HSE Policy attached.
10   Methods of conveying HSE Policy to employees, etc. described.
12   Copy of list of Safety Committee member with designation and copy of last
     meeting minutes attached
13   Description of Special HSE campaigns attached
15   Details of HSE training are filled as per the attached formats and are
     complete in all respects
16   Copies of the Work Permit System forms attached
17   Copies of the contents page(s) of Safety/ HSE Manual attached
23   Copies of accident reporting Form, and accident investigation report and
     latest accident analysis report are attached
25   List of Chemicals used is attached in alphabetical order
27   Enclosed copy of Emergency Plan, if prepared
30   Copy of the Consents from Pollution Control Board enclosed
     DD towards Application fee enclosed
     Name & Address of the enterprise written on the back of the
     Certificate signed.

                              Signature of the Occupier / Owner / Entrepreneur



                           Seal of the Enterprise

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                                                                              NSCI Safety Awards – 2010 (MSME)

                                                                                                 Appendix I

                             Rules & Regulations for Participation in the
              NSCI Safety Awards-2010 - Micro, Small & Medium Enterprises
                                 (Manufacturing / Producing Goods)

1.   Objective

The objective of the National Safety Council of India (NSCI) Safety Awards Scheme for Micro, Small &
Medium Enterprises (manufacturing) is to recognise performance & leadership, and encourage
commitment of the management & workers in the field of Occupational Safety & Health (OSH) in
micro, small & medium manufacturing enterprises. The Awards are given in recognition of the
attainment of consistent level of achievements in OSH performance and for implementing effective
OSH management systems & procedures by the enterprises.

2.   Definitions

The Rules may be called as the NSCI Safety Awards Rules for Micro, Small and Medium
Enterprises (Manufacturing).

     (a)      ‘Assessment Period’ means the three consecutive calendar years previous to the
              Awards Year i.e., for the Awards Year-2010, the assessment period is the three
              calendar years 2007, 2008 and 2009;

     (b)      ‘Awards Committee’ means the Committee constituted by the Board for scrutinising and
              evaluating the Applications for the Awards;

     (c)      ‘Awards Year’ means the calendar year for which the Applications are invited;

     (d)      ‘Board’ means the Board of Governors of the Council;

     (e)      ‘Chairman’ means the Chairman of the Council;

     (f)      ‘Council’ means the National Safety Council of India;

     (g)      ‘Director General’ means the Director General of the Council.

3.   Eligibility for Participation

     (a) The Scheme is open to manufacturing enterprises as defined under Section 2 (e) & classified
         under Section 7 (i) (a) of the Micro, Small and Medium Enterprises Development Act, 2006
         and filed Entrepreneurs Memorandum Part II with the authorities notified by respective State
         Government/UT Administration.

     (b) An enterprise will be disqualified from the contest, if it has been convicted for any
          contravention during the calendar year just preceding the Awards Year with regard to any
          safety and health provision under the:
           i.   the Factories Act, 1948 or the Rules framed there under; or
          ii.   the Environment (Protection) Act, 1986; or
         iii.   the Water (Prevention & Control of pollution) Act, 1974 or the Air (Prevention and
                Control of Pollution) Act, 1981 and the Rules framed there under.
         iv.    Any other Safety, Health and Environment Statutes.

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                                                                             NSCI Safety Awards – 2010 (MSME)

4.   Level, Name, Number of Awards and Prizes
The Awards are categorised into four levels, viz.

     Levels             Name of the Award                 No. of Award (s) Min. Score         Prize

 1st Award     Golden Safety Award                                                      Golden Trophy
                                                                 1            85%
               (Micro, Small and Medium Enterprise)                                     and Certificate

               Silver Safety Awards                                                      Silver Trophy
 2nd Award                                                       3            75%
               (Micro, Small and Medium Enterprise)                                      and Certificate
                                                                                        Bronze Trophy
 3rd Award     Bronze Safety Awards
                                                                 5            70%       and Certificate
               (Micro, Small and Medium Enterprise)
                                                         At the discretion
     th        Prashansa Patra
 4 Award                                                 of the Awards        65%          Certificates
               (Micro, Small and Medium Enterprise)

If no applicant comes within the minimum score of points prescribed against the respective four levels
of Awards (see Rule # 5), the Awards Committee may decide not to give the prescribed number of the
Awards in different levels as mentioned above. Further, the Committee may, if deemed necessary,
increase the number of Awards in the lower level, in case there are no eligible winners in the higher
level. However, the aggregate maximum number of Awards for the first three levels will not exceed

5.    Basis of Awards
The information furnished in the Applications will be assessed and points are awarded. Based on the
assessment, the Awards Committee may invite enterprise from the list of top ranking contesting
enterprises to make presentations before the Awards Committee and some of them may be visited for
further assessment.

6.    Assessment Period
The Awards will be given in a calendar year (Awards Year) based on the assessment of Safety
Performance and Safety Management during the Assessment Period i.e. preceding three Calendar
Years to the Awards Year.

7.        Awards Committee

(a) Functions
The Awards Committee will assess the Applications received and announce the Awards. For the
purpose of assessment of the Applications, it may call for additional information or ask the applicant to
depute representatives for making a presentation before it or send a technical team of experts to visit
the enterprise / factory.

(b) Decision of the Awards Committee
The decision of the Awards Committee for selection of Award winners shall be final and no
correspondence in this regard will be entertained by the Council.

                                                                                                   Page 2 of 2
                                                                        NSCI Safety Awards – 2010 (MSME)
                                                                                          Appendix II

                            THE NSCI Safety Awards – 2010
                             (Micro, Small and Medium Enterprises)

1.   The duly filled in Application should be sent along with a Crossed Demand Draft for
     Rs.3,000/- (Rupees Three Thousand only) in case of NSC Corporate Member and
     Rs.3,500/-(Rupees Three Thousand and Five Hundred only) in case of Non-Member
     drawn in favour of the "NATIONAL SAFETY COUNCIL", payable at Mumbai / Navi
     Mumbai. The Entry fee is NON-REFUNDABLE.

2.   The Application duly completed in all respects should be submitted in a sealed cover
     superscribed “NSCI Safety Awards - 2010” (MSME)” to the Director General, National
     Safety Council, Plot No. 98-A, Sector 15, Institutional Area, CBD Belapur, Navi Mumbai
     - 400 614 by 20th August 2010.

3.   Application should be accompanied by the duly signed check list attached
     along with the Application Form.

4.   Attach separate sheets wherever required as Annexure with the same
     Item no.
5.   The information given in the Application should be verified for their correctness and
     got approved by a Safety Committee. If there is no Safety Committee, the verification
     should be done by any other joint Management - Workers Committee. The Application
     should be signed by a Workers’ Representative and the Owner / Entrepreneur / Occupier
     after verification.
6.   Applications incomplete in any respect or not accompanied by the Checklist
     in Appendix and necessary information are liable to be rejected.
7.   Under item No. 6 in the form, report the following classes of dangerous occurrences,
     whether or not they are attended by personal injury or disablement:-

     (a)   Bursting of a vessel used for containing steam under pressure greater than
           atmospheric pressure.

     (b)   Collapse or failure of a crane, derrick, winch, lift, hoist or other appliances used in
           raising or lowering persons or goods, or any part thereof, or the overturning of a

     (c)   Explosion, fire, bursting out, leakage or escape of any molten metal, hot liquor, or
           gas causing bodily injury to any person or damage to any part or portion of the
           factory in which persons are employed or damage to any plant, machinery or

     (d)   Explosion of a receiver or container used in any process, or used for storage at a
           pressure greater than atmospheric pressure, of any gas or any (including air) or any
           liquid or any solid,

     (e)   Collapse or subsidence of any floor, gallery, roof, bridge, tunnel, chimney, wall or
           building forming part of a factory or within the compound or curtilage of factory.


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                                                                         NSCI Safety Awards – 2010 (MSME)

                                                                                           Appendix III

                                        ( as per NIC- 1998   )


 15          Manufacture of food products and beverages
 16          Manufacture of tobacco products
 17          Manufacture of textiles
 18          Manufacture of wearing apparel; dressing and dyeing of fur
 19          Tanning and dressing of leather; manufacture of luggage, handbags,
             saddlery, harness and footwear

 20          Manufacture of wood and of products of wood and cork, except furniture;
             manufacture of articles of straw and plaiting materials
 21          Manufacture of paper and paper products
 22          Publishing, printing and reproduction of recorded media
 23          Manufacture of coke, refined petroleum products and nuclear fuel
 24          Manufacture of chemicals and chemical products
 25          Manufacture of rubber and plastics products
 26          Manufacture of other non-metallic mineral products
 27          Manufacture of basic metals
 28          Manufacture of fabricated metal products, except machinery and equipment
 29          Manufacture of machinery and equipment NEC.*
 30          Manufacture of office, accounting and computing machinery
 31          Manufacture of electrical machinery and apparatus NEC*.
 32          Manufacture of radio, television and communication equipment and apparatus
 33          Manufacture of medical, precision and optical instruments, watches and clocks
 34          Manufacture of motor vehicles, trailers and semi-trailers
 35          Manufacture of other transport equipment
 36          Manufacture of furniture; manufacturing NEC*.
 37          Recycling

 40          Electricity, gas steam and hot water supply
 41          Collection, purification and distribution of water
*NEC = Not Elsewhere Classified

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