PROPOSAL FORMAT

GENERAL INSTRUCTIONS:

Proposal should be accompanied by a covering letter on the letterhead of the

Organisation along with the financial estimate. The letter must be signed by an
authorised signatory of the proposing Organisation.
Each page of the proposal and annexures should be stamped with
Organisation seal and countersigned by authorised signatory of the proposing
Organisation and its Designated CA of the Organisation.
All requisite permissions and approvals from appropriate authorities should
be obtained by the proposing Organisation and all statutory obligations and
compliances met.
For projects which require collaboration with a State Government/District
Administration, the proposal should preferably lead to a tripartite agreement
between the implementing Organisation, and the State Govt./District
Administration or any other implementing authorities.
Proposals with incomplete documentation are liable to be rejected.
As per GOI norms and regulations it reserves the right to accept/reject any
proposal
In case the proposal gets approved, the Organisation would need to open a
separate bank account for the CSR project
If the Organization proposes to undertake large scale projects they must
furnish proof of having undertaken similar projects (Example Rs.5 crore and
above), capability for executing it successfully as well share profile of the
team/staff.
Project proposals which mention capability in gathering real time data,
technological intervention, and project implementation support and impact
assessment shall be given preference.
Date: - DD/MM/YYYY

To: XXXXXXXXXX

Subject: Proposal for..................................................................

1.0 About the Organisation

(Organisational information- Historical overview/ past experience/ type of
projects executed/ reach and presence within country & abroad/ staff strength/
success stories/accolades/awards received if any. Also give website link if
available).

2.0 Background
(Give details of project background elaborating on the need of proposed project.
Kindly mention details of need assessment)

2.1 Thematic Area

(Mention the thrust areas under which the proposed project would be
categorised)

Education
Water Conservation
Health/Hygiene
Skill Development
Community Development
Others or More than one of the above (Please
Specify)

3.1 Methodology
Define the methodology for implementation of the program such as
implementation schedule, execution plan, and selection criteria for specific
beneficiaries etc.

3.2 Target Group

Mention Geographical area/location of the project and the profile of the
beneficiaries - details of Male/Female, minority group/others etc

3.3 Team for the project

Mention job profile & eligibility criteria for selection of staff/team members for
the project i.e. qualifications & experience, Roles & responsibilities,
Organization structure etc.

3.4 Monitoring Mechanism

Mention the monitoring mechanism such as frequency of visits, plan for
collection of data, monitoring of activity timeline & frequency of submission of
reports

4.1 Outcomes/Result expected –

(Mention the Quantitative & Qualitative outcomes expected from the project,
outcomes should be directly linked to proposed objectives; specific targets
should be benchmarked. It is recommended to use frameworks such as project
matrix, verifiable indicators, data analysis.)

4.2 Execution Plan

(Gantt chart with time line against activities may be given in tabular/other form)

4.3 Impact Assessment

(Mention the plan to measure the impact of planned interventions of this project
as defined in the scope of work)

5.1 Financial Implications

(Format given below is indicative. Based on the nature of the project, kindly use
appropriate format)
1. Breakup for each line item should be given. Separate annexure to be
provided if needed
2. Any procurement items have to be supported with documents proving
competitive rate in the market to be mentioned in the proposal.
3. List down items covered under Administrative expenses.

Sr. No Details Per unit cost Total Number Total Budget Budget for Remarks
(A) of Units for 1 ___Months/Yea (Justification of
(B) month/year rs cost element)
(C=AXB) (D=CX No. Of
Months/Years)
1
2
3
Sub Total (I)
1
2
3
Sub Total (II)
1
2
3
SUB TOTAL (III)
1
2
3
IV = TOTAL Of (I+II+III)
V = ADMINISTRATIVE
COST

GRAND TOTAL

COST PER
BENEFICIARY

5.2 Tentative vender payment schedule

Link payment schedule with project deliverables and timeline.
Sr. Description % of Total Amount in Rs Deliverables to
No. Project Budget be achieved
1 1st Payment 20%
2 2nd Payment 35%
3 3rd Payment 35%
4 4th payment after 10%
completion report of
project
Grand Total (In words ______________________________ Only)

6.0 Sustainability Plan: -

(Provide an action plan giving details of how the project will be sustainable
after exit of BPCL & the implementing partner. This must include maintenance
and ownership of assets where applicable)

7.0 Conclusion –

8.0 Enclosures –
1. Form A: - Attached (Yes/No)
2. Form B: - To be filled only for infrastructure project only. Attached (Yes/No)
3. Form C: - Attached (Yes/No)
4. Form D: - Attached (Yes/No)
5. Form E: - Attached (Yes/No)
6. Form F: - Attached (Yes/No)

Kindly ensure the Organisation Seal/Stamp & Sign on each page.

 Form A
CHECKLIST FOR SUBMISSION OF DOCUMENTS
Sr. No. Description of documents Attached (Yes / No) Remark
1* Trust deed /Society deed/ S
8 Company CA2013
2* Certificate of
incorporation/ Registration
certificate
3* Form 12 A / 12AA
4* Form 80 G
5 35 AC registration if any
6* Niti Aayog Registration
7* CSR –I Registration
8* PAN card Organisation &
Directors
9* Last 3 financial years
audited statements
10* Last 3 financial years ITR
11 Detailed proposal as per
format given
12 FCRA approval / If
Applicable
13 TDS exemption certificate
if applicable
14 GST Registration
certificate if applicable
15 2 Reference letters of past
or present supporters for
CSR project

*Sr. No. 1, 2, 3, 4,6,7,8,9,10 is mandatory documents

 Form B
CHECKLIST FOR INFRASTRUCTURE PROJECTS
Sr. Items Attached (Yes/No) Remarks
No.
A LAND RELATED
1 Land Ownership document
2 Property Card (Commercial/
Vastu/Wetland)
B ESTIMATES & APROVALS
1 Drawings- Site Plan, Building Plan,
Elevation, foundation / structural
details. All drawings need to be signed
& stamped by Licensed Engineer/
Architect & Client. License no. /
Registration no. of Architect/ Engineer
needs to be mentioned.
2 Drawings sanctioned by Govt.
Authorities
3 Basis of Estimate - For schedule items
- Preferably to be made from latest
CPWD/ DSR /State Govt published
rate along with GST if any. Brought
out items- Preferably to be made from
Quotations of supplier / rate charts of
Manufacturers. Estimated needs to be
vetted by Govt. Engineer/ Retd.
CPWD/ Retd State Govt. Engineer
Estimate also to be signed & stamped
by licensed Engineer & Client
4 Stability certificate needs to be
attached issued by licensed engineer in
case of expansion of existing building.
C EXECUTION WORKS
1 Execution Plan
 Form C
CHECKLIST FOR SUBMISSION OF PROPOSAL

S. N. Points Details
1 Address of registered office of the Organisation (in
India)
2 Any branches of the Organisation? Kindly mention
3 Registered as a trust/society/ section 8 or section 25
company or Other
4 How long has the Organisation been in existence in
years?
5 Which is the Organisation’s geographical area of
work?
6 What is/are your Organisation's expertise area/s? a.
Skill Development b. Health & Hygiene c. Education
d. Community Development e. Water f.
Other/Multiple (Kindly mention)
7 Names of Board Members/Trustees and CEO.
8 Are any of the trustees/board members affiliated to
any political / religious Organization?
9 What are the sources of funding for the remaining
60% of the project cost of the Organisation?
10 Has the Organisation received any
awards/recognition for its work? Kindly mention
11 Does it receive funds / implement programs for the
government? If yes-details

12 Has the Organisation been successful in handing

over projects/making projects sustainable? Give
example
13 Has the Organisation been blacklisted by
government/PSU or any corporate? If yes, reasons
for it
14 Is the Organisation empanelled by any reputed
institute or agency? If yes, give details
15 Is the Organisation associated with any other
corporate for implementing CSR projects? Mention
names
16 Total turnover in the last 3 financial years
17 Strength of staff (number of full time employees)
18 Any past projects with BPCL/other PSU’s If yes
then details thereof
19 Qualification/experience of staff/project team
20 Please provide two references of past funders of your
projects (Email id/ Contact Person with Designation/
Contact Number)
21 Have you filled all the information in the proposal?
 Form D
Summary Sheet for the Proposal
Title of the project
Project Description (Write a brief description of project)
Name of Executing Organisation
Address of Organisation (Registered address &
address of branch from which proposal is given)
Contact Person
Contact Number & email address
Experience of the Organisation (Mention no. of years of experience & short brief
about other projects executed)
Place of execution of project
Reason for choice of place
Tenure of the project
Cost of the project (enclose a detailed budget)
Funds requested from the Donor Company
Funds requested from any other sources if any
Objective of the project
Reason of Organisation preferring Donor to be (mention whether it is in line with Doror thrust
part of this project area & justify why Donor should consider the
proposal)
Benefits/Outcomes expected from the project
Quantitative (Mention as per parameter suitable, 1.
but make sure to mention number of beneficiaries 2.
) 3.
4.
5.

Qualitative (parameters which are difficult to 1.

capture in numbers) 2.
3.

Requirement of any approval from local Yes or No, If yes, give details in short
bodies/government/municipality or any statutory
body

Whether similar projects executed earlier? Yes or No, If yes, give details in short

In case the proposal is approved, the organisation

is okay to open separate bank account for BPCL?
(Yes/No)

Information given above is true and we can (seal of the Organisation & signature of an
provide the documentary proof of it in case of authorised person from the Organisation)
enquiry
 Form E
Track Record of Projects

Kindly mention projects undertaken in the last 3 years. If an organisation is

existing for 3 years, track record from inception till date is required.

Sr. No. Project Focus Area Location Period (To - Value in INR Number of Partner
Description From) Lakhs Beneficiaries Name
(Funding
Agency)
1 Skilling Skill Mumbai April XYZ 500 ABC
unemployed Developm 2015-2016 Lakhs
youth ent
2
3
4
5
6
7
 Form F
Declaration

I / We hereby declare and certify that all the information given in the
application form and in the documents submitted are true and correct to the best
of my knowledge.

I / We acknowledge that in case of misrepresentation of information or

furnishing of false information, my application is liable to be rejected and /or
approved project is be liable to be terminated by Donor at any stage

I / We further declare and certify that our firm / company / group of companies
has / have not been blacklisted or been put on the holiday list by any of the
Public Sector Undertakings in India or Statutory authority or any State and
Central Government .

Signature
…………………………….. Signature
Name……………………………… ……………………………..
…. Name………………………………
Designation……………………… ….
….. Designated CA of the Organisation
Seal of the Organisation Seal of the CA