CSR Proposal For Construction
CSR Proposal For Construction
CSR Proposal For Construction
GENERAL INSTRUCTIONS:
(Give details of project background elaborating on the need of proposed project. Kindly
mention details of need assessment/appraisal carried out)
(Mention the thrust area/s, Schedule VII item and Sustainable Development Goal (SDG)
under which the proposed project would be categorised)
(Mention the proposal objectives. Explain the activities planned in order to achieve the specific
objective/s along with the time frame)
(Define the methodology for implementation of the program such as implementation schedule,
execution plan, selection criteria for specific beneficiaries etc.)
(Mention Geographical area/location of the project and the profile of the beneficiaries - details
of Male/Female, minority or vulnerable group/others etc)
(Mention job profile & eligibility criteria for selection of staff/team members for the project
i.e. qualifications & experience, Roles & responsibilities, Organization structure etc.)
(Mention the monitoring mechanism such as frequency of visits, plan for collection of data,
monitoring of activity timeline & frequency of submission of reports)
(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.)
(Gantt chart with time line against activities may be given in tabular/other form)
4.3 Impact Assessment/ प्रभाि का आकलन
(Mention the plan to measure the impact of planned interventions of this project as defined in
the scope of work)
(Format given below is indicative. Based on the nature of the project, kindly use appropriate
format)
- Breakup for each line item should be given. Separate annexure to be provided if needed
- Any procurement items has to be supported with documents proving competitive rate
in the market.
- List down items covered under Administrative expenses.
Total Total
Per Number Budget for Budget for
unit of Units 1 ___Months/Years Remarks
Sr. cost (B) month/year (D=CX No. Of (Justification of
No Details (A) (C=AXB) Months/Years) cost element)
1
2
3
IV = TOTAL Of (I+II+III)
V = ADMINISTRATIVE
COST
GRAND TOTAL
(Link payment schedule with project deliverables and timeline. It will be reviewed by BPCL
and the final payment schedule might differ significantly as per nature of the project & BPCL
guidelines. For final payment, 10% of the total budget will be kept on hold until the submission
of the project completion report and audited fund utilisation certificate)
(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)
Sr. Attached
Description of documents Remark
No. (Yes / No)
1* Trust deed
Certificate of incorporation/
2*
Registration certificate
4* Form 12 A
5* Form 80 G
6 35 AC registration if any
7* PAN card
10 FCRA approval
2. Provide details of income, expenditure, assets and liabilities during the last 3 Financial
Years for which audited accounts are being submitted along with the application.
Total Income:
(in Rs.)
FY (……….) FY (……….) FY (……….) Major Reasons Major Reasons
for variation for variation
1 2 3 4 (1-2) 5 (2-3)
Total Expenditure:
(in Rs.)
FY (……….) FY (……….) FY (……….) Major Reasons Major Reasons
for variation for variation
1 2 3 4 (1-2) 5 (2-3)
Total Assets:
(in Rs.)
FY (……….) FY (……….) FY (……….) Major Reasons for Major Reasons
variation for variation
1 2 3 4 (1-2) 5 (2-3)
Total Liabilities:
(in Rs.)
FY (……….) FY (……….) FY (……….) Major Reasons Major Reasons
for variation for variation
1 2 3 4 (1-2) 5 (2-3)
3. Provide details of expenditures incurred during last 3 Financial Years other than
activities carried out by the NGO.
(in Rs.)
Form B
S.
Points Details
N.
Form D
Contact Person
1.
2.
Quantitative (Mention as per parameter suitable, 3.
but make sure to mention number of beneficiaries 4.
) 5.
1.
Qualitative (parameters which are difficult to 2.
capture in numbers) 3.
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)
Form E
(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. Project Focus Area Location Period (To Value Number of Partner
No. Description - From) in INR Beneficiaries Name
Lakhs (Funding
Agency)
1 Skilling Skill Mumbai April 2015- XYZ 500 ABC
unemployed Development 2016 Lakhs
youth
2
3
4
5
6
7
8
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.
Signature ……………………………..
Name………………………………….
Designation…………………………..