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 NATIONAL SAFETY COUNCIL OF INDIA (NSCI) SAFETY AWARDS – 2015 APPLICATION FORM (Manufactu!n" S#ct$) %ENERAL INSTRUCTIONS 1. Provide specific information related to the question/ item and avoid unnecessary details or philosophical explanation. 2. Clarity of language a nd presentation are essential, and care shou ld be taken to avoid unnecessary technical terminology . . !efine all abbreviations. ". #upporting evidence, including annexures, shall include only data and documentation $hich most meaningfully and directly provide supporting evidence for statements made in the application. Photographs, if included, should have captions, clearly stating the specific features of the attached photograph $hich is relevant to the item of the application. %. &issing or irrelevant information and statements made $ ithout supporting evide nce may negatively affect quality and scoring. '. (he application preferably should not contain more than &50 'a"# )including annexures*.  +ll the pages should be seria lly numbered. . -ne hard copy (duly signed and stamped) and one electronic copy (in the form of CD/DVD) of the +pplication form should be submitted in #C office along $ith applicable entry fee before the last date of submission. (he hard copy should be $ell bound and the electronic copy should be in P! form. 0. Please read the ules and egula tions3 enclosed as +nnexure45 and 6uidelines for filling the +pplication orm3 enclosed as +nnexure455. 7. ill 4 in the Checklist enclosed as +ppendix and attach it $ith the +pplication. 8 8 8

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NATIONAL SAFETY COUNCIL OF INDIA (NSCI) SAFETY AWARDS 2015

APPLICATION FORM(Manufacturing Sector)

GENERAL INSTRUCTIONS

1. Provide specific information related to the question/ item and avoid unnecessary details or philosophical explanation.

2. Clarity of language and presentation are essential, and care should be taken to avoid unnecessary technical terminology.

3. Define all abbreviations.

4. Supporting evidence, including annexures, shall include only data and documentation which most meaningfully and directly provide supporting evidence for statements made in the application. Photographs, if included, should have captions, clearly stating the specific features of the attached photograph which is relevant to the item of the application.

5. Missing or irrelevant information and statements made without supporting evidence may negatively affect quality and scoring.

6. The application preferably should not contain more than 350 pages (including annexures).All the pages should be serially numbered.

7. One hard copy (duly signed and stamped) and one electronic copy (in the form of CD/DVD) of the Application form should be submitted in NSC office along with applicable entry fee before the last date of submission. The hard copy should be well bound and the electronic copy should be in PDF form.

8. Please read the Rules and Regulations enclosed as Annexure-I and Guidelines for filling the Application Form enclosed as Annexure-II.

9. Fill - in the Checklist enclosed as Appendix and attach it with the Application.

* * *APPLICATION FORMNATIONAL SAFETY COUNCIL OF INDIA (NSCI) SAFETY AWARDS 2015(Manufacturing Sector)(Last date for receiving filled in Applications in NSC Office is 31st May, 2015)

Application No.:(To be filled by NSC)

Notes: a) Before filling up the Application Form, please read the (i) Rules and Regulations for Participation in the NSCI Safety Awards 2015 (Manufacturing Sector) enclosed as Annexure-I and (ii) Guidelines for filling Application Form of the NSCI Safety Awards 2015 (Manufacturing) enclosed as Annexure-II.b) Fill - in the Checklist enclosed as Appendix and attach it with the Application.

GENERAL INFORMATION

1. Information about the Factory1.1 Name of the Factory: in English : ..

In Hindi (Devnagiri) : ..

1.2 Full Postal Address with PIN Code : .

..

.

1.3 Registration No. and date of Registration underthe Factories Act, 1948. Attach copy of certificate : .

1.4 Telephone No. & Fax No. with STD Code : ..

1.5 Email Id : ..

1.6 Name, Designation, Contact Phone No. andAddress (Email & Postal) of the 1.6.1 Occupier under the Factories Act, 1948 : ..

1.6.2 Chief Executive Officer / Unit Head, if he is notthe Occupier : ..

1.6.3 Chairman of the (Apex) Safety Committee : ..

1.6.4 Person who will provide further information orclarification, if needed in respect of the Application : ..

1.7 Was the Factory under shut down during theassessment period? If yes, state period and reason : .

2. Process Description and Industrial Classification

2.1 Brief description of process / operation (Notexceeding 10-15 lines, please attach as Annexure 2.1) :

2.2 Type of industry as per National IndustrialClassification (NIC) (See Annexure-III) :

2.3 Applicable Award Group: A B C D E (please put () mark, in the appropriate box)

(Note: * Refer point 4 of Annexure-II on Guidelines for filling the form)

Page 1 of 8

3. Work force and Man-hours worked

3.1 *Average number of workers in the factory

Types of workersAssessment Period(Three Preceding calendar years)201420132012a)Regularb)Contractor and Badli Workersc)TotalNote: * Refer point 5 of Annexure-II on Guidelines for filling the form

3.2 *Man-hours worked by all workers including overtime worked:

Types of workersAssessment Period(Three Preceding calendar years)201420132012a)Regularb)Contractor and Badli Workersc)TotalNote: * Refer point 5 of Annexure-II on Guidelines for filling the form4. Particulars of Membership Subscription and Payment of Entry Fee:

4.1 Is your factory a Corporate Member of NSC? Yes: No: (Please put () mark, in the appropriate box)

4.2 If yes, give NSC Membership Number :

4.3 Latest receipt No. & date of payment of Membership Subscription :

4.4 Entry fee: Rs.17,000/- (For Member Factory) D.D/Cheque No: Dated .

Rs.20,000/-(For Non-Member Factory) Drawn on ... (Name of the Bank)(Please write down the name & address of the factory on the back of DD/ Cheque)

PART A: SAFETY PERFORMANCE

5. Reportable Accidents and Frequency Rate

NSCI Safety Awards 2015 (Manufacturing Sector)

Assessment Period2014201320125.1Fatal5.2Total Permanent Disability5.3Non-Fatal (excluding item # 5.2)5.4Weighted Accident Frequency Rate (WAFR) [ {10(Items # 5.1 + 5.2) + Item # 5.3} ] X 10 6=Number of total man-hours worked (as in Item # 3.2 c)Number of Accidents Reportable under the Factories Act, 1948 (including accidents to workers employed by Contractors, Vendors, Transporters and Visitors)

Page 3 of 8

6. Man-Days Lost6.1Equivalent man-days lost for fatal accidents and total permanent disability cases = 6000 {Items # (5.1 + 5.2)}

6.2Man-days lost due to other non-fatal accidents

6.3Total No. of man-days lost due to accidents[Items # (6.1+6.2)]

7. Number of Dangerous Occurrences as defined under the Factories Rules Give a brief description of each occurrence particularly covering cause, damage, loss and impact outside the factory, if any.

8. The Longest Accident - Free Period (Continuous) covering the Three - Year Assessment Period as well as the period immediately preceding the Assessment Period.

a) During the Assessment Period only (1.1.2012 to 31.12.2014)

PeriodNo. of DaysAccident-Free Million Man-Hours

FromTo

b) Immediately Preceding the Assessment Period (before and upto 31.12.2011)

PeriodNo. of DaysAccident-Free Million Man-Hours

FromTo

9. Prosecutions and Convictions with regard to Safety, Health and Environment Provisions

9.1 Has there been any Prosecution (launched for accident occurred during the assessment period) / Conviction for contravention with regard to any Safety & Health provisions under the Factories Act and Rules framed there-under?

AssessmentPeriodProsecution, if any, under the FactoriesAct & Rules framed there-underConviction, if any, for contravention with regard to Safety and Health provisions

2014

2013

2012

If yes, please give brief description/particulars in each case.

9.2 Has there been any prosecution/conviction for breach of any provision under the Environment (Protection) Act,1986 and Rules framed there under or Water (Prevention & Control of Pollution) Act, 1974 or Air (Prevention andControl of Pollution) Act, 1981?

AssessmentPeriodProsecution, if any, under the Environment (Protection) Act, 1986, Water Act 1974 and Air Act 1981 and Rules framed there-underConviction, if any, for contravention with regard to Environment (Protection) Act, 1986,Water Act, 1974 and Air Act, 1981 and Rules framed there-under

2014

2013

2012

If yes, please give brief description/particulars in each case.

PART B : SAFETY MANAGEMENT10. Policy on Health, Safety & Environment (HSE)10.1 Does the factory have a written HSE policy? If yes, attach a copy of it and explain since when it has been reviewed or adopted.

10.2 Level at which the policy has been approved (please put () mark, in the appropriate box)

Board of the Company Chief Executive Officer of the Company Occupier of the factory Manager of the factory

10.3 Briefly describe how the objectives of the HSE Policy are achieved (Companys HSE Goals and the HSEtargets set and achieved at each level / function/department.

10.4 Explain how the policy is made known to the employees of your factory.

11. Review of HSE Performance by Top Management11.1 Does the top management receive periodic reports from factory on HSE performance? If yes, at what periodicity: Attach a copy of the last report submitted during the assessment period.

11.2 Explain the action taken by the top management on these reports and its implementation by the factory.

11.3 Is a resume of HSE performance of the factory published in the Annual Report and Sustainability Report of the Company? If yes, attach a copy of the relevant extract (highlighted) from the last Report published.

11.4 Is your factory certified for OHSMS under the Indian Standard IS: 18001 OR OHSAS 18001? If yes, attach a copy of the certificate.

11.5 Elucidate, if you have adopted any innovative approach/measure in HSE management practices beyond the scope of statutory requirements. If so, explain the benefits achieved by virtue of its implementation.

12. HSE Organisation (including Line Managers involvement)Multi-unit Companies with different factory registration numbers and separated by common boundary and having certain facilities / service departments (such as HSE, Fire, Utilities depts., etc.) in common should not add the manpower in these common facilities / service departments fully to each unit, instead they should apportion it toeach unit in proportion to the total number of workers (excluding the workers in the common facilities / servicedepartments) in the respective units.

12.1 Explain the organisational set-up, assignment of responsibilities at various levels and arrangements for implementation of the HSE policy. Attach a copy of the Organisation chart.

12.2 Explain the activities undertaken by Line Managers to achieve HSE objectives in theirDepartments/Sections.

12.3 Explain how the Safety & Health performance of individuals and their Departments taken into account while considering career advancement. Give brief details of the system and attach a copy of the Performance Appraisal Form, if any.

12.4 How many persons are working full-time in the HSE Department? State their professional qualification (as prescribed under the Factories Act) in the fields of Safety & Health and experience.

13. Workers Participation in HSE Management & Promotion13.1 Describe the structure and composition of Safety Committee(s) in your factory. Attach a copy of the order constituting the Safety Committee (s) during the Assessment Period.

13.2 Give a brief resume covering the following during the assessment:o number of meetings heldo important issues discussed (up to a maximum of 10)o Improvements suggested by the Committee and implemented.

13.3 Briefly explain any other activities designed to promote workers participation in HSE management. (i.e. suggestion scheme, contests, film/video screening, exhibitions, newsletter, poster display, etc.) Give a brief resume for the assessment period.

13.4 What special campaigns were undertaken in your factory (e.g. National Safety Day/Week, World Environment Day and Fire Service Week, World Health Day)? Give a brief resume for the assessment period.

13.5 Has your factory or employees participated in any Local /State /National level competition on HSE (i.e.Poster, Slogan, Quiz, Essay, Drama, etc.) or any other competition and won prizes? Give a resume for the assessment period.

Type ofCompetitionOrganised byLevel of EmployeesParticipatedPrize(s) Awarded / won

NSCI Safety Awards 2015 (Manufacturing Sector)Page 4 of 8

14. HSE Training14.1 Explain the procedure being followed for identifying Safety Training needs of employees.

14.2 Is Annual calendar for Safety Training prepared?If yes, enclose Annual HSE Training Calendar for the years 2012, 2013 and 2014 (giving number of programmes planned and their topics)

14.3 Do you have practice of imparting induction training on HSE to new employees?If yes, explain and enclose Induction training Module.

14.4 Details of In-house HSE programmes conducted during the Assessment period for the Regular employees.Give Year wise Statement as under:

Year

(1)

Total no. of regular employees

(2)No. of regular employees covered under HSE training

(3)Percentage of regularemployees coveredunder HSEtraining(%) (4)[(3) / (2) x 100]Total man- hours worked by Regular employees

(5)

HSE Training man- hours

(6)% of HSE Training man-hours over total man-hours worked by regularemployees(7)[(6) / (5) x 100]

2014

2013

2012

14.5 Details about employees deputed for External HSE Training Programmes / Seminars / workshops / Conferences during the Assessment Period (for regular employees)Give Year wise Statement as under:

Year

(1)No. of employees deputed

(2)Title of theProgramme

(3)Organized by

(4)Duration of the programme

(5)% of participation over total regular employees

(6)

2014

2013

2012

14.6 Details of HSE Training Programmes conducted for Contractor / Badli workers during the AssessmentPeriod.Give Year wise Statement as under:

Year

(1)

Total no. of Contractor/Badli workers

(2)

No. of Contractor / Badli workers coveredunder HSEtraining

(3)Percentage ofContractor/ Badliworkers coveredunder HSEtraining(%) (4)[(3) / (2) x 100]

Total man- hours worked by Contractor / Badli workers

(5)

HSE Training man- hours

(6)% of HSE Training man- hours over total man- hours worked byContractor/ Badli workers

(7)[(6) / (5) x 100]

2014

2013

2012

14.7Does the management have any policy regarding frequency of HSE training to each and every employee?If yes, state the desired frequency of providing training to each & every employee and explain how you ensure that each & every employee has undergone refresher HSE training at the desired frequency.

14.8 Whether training records in respect of each employee are maintained separately?If yes, attach sample copy.If no, explain other methods of maintaining training records.

NSCI Safety Awards 2015 (Manufacturing Sector)Page 5 of 8

15. Standard / Safe Operating Procedures

15.1 List developed and documented standard / safe operating & maintenance procedures in your factory and briefly explain them (e.g. Start-Up and Shut-Down Procedures, Work Permit System, Preventive Maintenance Procedures, etc.).

15.2 Explain how they are implemented.

15.3 Have you prepared Safety/HSE Manual? Is it available in the language spoken by a majority of workers?To whom its copies have been distributed? Has it been reviewed? If so, when? Attach latest copy of contents page(s) of English and local language safety manual.

15.4 Explain the Fire Prevention and Protection System in your factory.

16. Hazard Identification and Risk Analysis

16.1 Explain the procedures /techniques used for hazard identification in your factory.- Give specific examples of areas/operations/processes in which these techniques have been applied.- Give a brief resume of actions taken on recommendations and consequent improvements achieved.

16.2 Give brief details of the various procedures /techniques used for risk analysis.

17. Reporting/Investigating/Analysis of Accidents, etc.

17.1 Explain the procedure for Reporting, Investigating and Analyzing of Accidents, Dangerous Occurrences and Near-Miss Incidents. Attach a copy of the Reporting, Investigation and Analysis and Accident/Incidents during assessment period or format (if no accident / incidents reported).

17.2 How are the findings of Accident Investigations and Analysis utilized?

18. Safety of Contractor and Badli workers

Give a brief description of specific safety measures taken for safety of contractor or Badli workers in theAssessment Period covering the following points :-

18.1 Safety Clause in contractors work orders. Attach a copy of the document.

18.2 Supervision of worksite by contractors supervisor and departmental supervisor/engineer.

18.3 Inspection of worksite by factory safety officer.

18.4 Safety meetings with contractors.

18.5 Provision of Personal Protective Equipments to contract workers.

18.6 Any other, please specify.

19-A. Safety in the Use of Hazardous Chemicals

Does your factory produce/ handle/use any hazardous chemicals as defined under the Manufacture, Storage andImport of Hazardous Chemicals (MSIHC) Rules, 1989?

If yes, give a list of these chemicals, preferably in alphabetical order with their approximate maximum licensed quantities in tonnes.

19-A1 Are Material Safety Data Sheets (MSDS) on these Chemicals prepared /obtained in the prescribed format(Schedule 9 under MSIHC Rules/State Factories Rules)? If so, state their locations and availability.

19-A2 Give a summary of the process of disseminating information about these chemicals to the workers concerned.

19-A3 Explain the system of labelling of the containers for the chemicals.

19-A4 Does your factory come under the First Schedule to the Factories Act, 1948? (i.e. List of Industries Involving Hazardous Processes) Have you prepared On-Site Emergency Plan? Give a brief description of the latest on-site emergency plan? Attach copy of contents page(s) of On-Site Emergency Plan.

NSCI Safety Awards 2015 (Manufacturing Sector)19-A5 Explain the system for updating and testing of your On-Site Emergency Plan.

Page 6 of 8

19-B Safety in the Use of the radioactive material

Do you use any radioactive materials in the plant? Yes or No

19-B1 If yes, Give Name and Quantity of the radioactive material (inventory) and explain the measures taken to prevent exposure of employees during its handling & use.(Provide radiations characteristics of the material)

19-B2 Explain the procedure established for measuring radiation level and radiation dose.

19-B3 How many persons were subjected to over-exposure of radiations during the Assessment period?

AssessmentperiodRegular EmployeesContract Employees

No. of persons engaged in radiationworkover-exposure casesNo. of persons engaged in radiationworkover-exposure cases

2014

2013

2012

20. Occupational Health & Hygiene

20.1 Does your factory handle any chemicals listed under the Second Schedule to the Factories Act?If yes, name the chemicals and briefly describe the system of monitoring their concentration in the work environment (frequency, system of recording, follow-up action, etc).Enclose a copy of minimum one report prepared during each year of the Assessment period.

20.2 Do you have an Ambulance Room (First Aid Post) and/or Occupational Health Centre in your factory?If yes, briefly explain the services and facilities available in it.

20.3 Give the number of Factory Medical Officer(s) and Para-medical staff/First Aiders in your factory (full time &part time). Do they have prescribed qualifications as per the Factories Act and Rules?

20.4 What are the decontamination facilities available for the workers in case of any exposure to chemicals?

20.5 Is your factory involved in any hazardous process and/or dangerous manufacturing process or operation?How many workers are employed in these processes/operations? If yes, give a brief description of the system of medical examination of your employees (insurance coverage, periodicity, type, etc.)

21. Major Accident Hazard (MAH) Installations

Is your factory covered under the definition of Major Accident Hazard installation as per the MSIHC Rules-1989? If yes, please answer the following:-

21.1 Explain in brief, major accident hazards identified and the steps taken for their prevention.

21.2 Give a brief resume of your factorys involvement in preparation of Off-Site Emergency Plan.

21.3 Explain the steps taken by your factory to inform the persons outside the site who are likely to be in an area which may be affected by a major accident on your site.

21.4 Is your MAH Installation covered under Rule 10 of the MSIHC Rules, 1989? If yes, give a summary of theSafety Report as submitted to the Enforcing Authority highlighting the risk management measures taken.

22. Occupational Safety & Health Audit System

22.1 a) Give brief description of Internal OSH Audit System (i.e. Team, Frequency, Methodology, Submission ofReports, etc).

b) Give a brief description of action taken on the reports and consequent improvements achieved.

22.2 a) Have External OSH Audits been conducted during the Assessment Period?

Give details. (Organisation, Team, Frequency, Methodology etc)

b) Give a brief description of action taken on the reports and consequent improvements achieved.

Page 7 of 8

23. Safety Awareness Survey

23.1 Whether Safety Awareness Survey was carried out during the assessment period

23.2 If conducted, give the average awareness of the employees.

24. Environment Management

24.1 Is your factory required to obtain any or all of the following consents from Pollution Control Board: Water Consent Air Consent Authorisation for handling of hazardous wastesIf yes, attach a copy of the consents.If No, explain the reason

24.2 Briefly describe the measures taken to comply with the stipulated conditions in the Consent Orders orAuthorisation issued by the State Pollution Control BoardIf yes, provide details of measures taken under this charter.

24.3 Describe the frequency of ambient air and stack monitoring and the parameters monitored in your factory.

24.4 Describe the frequency of monitoring of treated effluent(s) and parameters monitored before final discharge.Also provide details of efforts taken for recycling of treated waste water within factory premises or outside premises.

24.5 Have you submitted Environmental Statement and Annual Returns for the Hazardous Wastes to thePollution Control Board?If yes, provide the copy of the latest Environment Statement and Annual Return for Hazardous Waste

24.6 Is your factory certified for EMS (Environment Management System) as per ISO 14001:2004? If yes, attach a copy of the Certificate.

25. Contribution to Promoting Exchange of HSE Information & Experience

25.1 Explain activities of your factory for promoting safe practices by your Suppliers, Transporters and Users.Give a brief resume of literature prepared & distributed; training programmes conducted, and checks carried out. Attach supporting documents.

25.2 Explain your factorys involvement in collaborative efforts with other industries in the neighborhood in respect of HSE activities. If your factory is a member of the Mutual - Aid Response Group (MARG), give a brief resume of the activities undertaken during the Assessment Period.

25.3 In addition to the above, what is your factorys involvement in playing Leadership Role and collaborative efforts on HSE? Give a brief resume of positions held and contribution made.

25.4 Give a brief resume of your factorys contribution (other than that given above) in sharing its experience and professional expertise with other Industries, Govt. Depts., Institutions and NGOs at the Local, State and National levels. Attach copies of supporting documents.

Certified that the above information has been verified and found correct

Workers Representative on the Safety Committee Chairman of the Apex Safety Committee

NSCI Safety Awards 2015 (Manufacturing Sector)

Page 8 of 8Signature : Name : Designation : ...

Signature : Name : Designation :

Seal of the Organisation

Appendix

CHECKLIST FOR ENSURING COMPLETENESS AND CORRECTNESS OF THE APPLICATION

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

Application No.:(To be filled by NSC)

ItemNo.DescriptionChecked By

ApplicantNSC

1.Complete information about the Factory (i.e. 1.1 to 1.7) provided.

1.3Copy of Certificate of Registration attached.

2.1Brief description of the process attached.

2.2Type of the Industry as per National Industrial classification (NIC)(as in the Annexure III to the Application Form) is mentioned.

4.Membership of NSC given.

4.2NSC Membership number mentioned.

4.3Reference to the latest payment of subscription provided.

4.4Demand draft details towards payment of fee provided.

10.1Copy of HSE Policy attached.

11.1Copy of last HSE performance report attached

11.3Copy of the relevant extract of Resume on HSE performance as published incompanys annual report attached

11.4Copy of Certificate for OHSMS IS 18001 or OHSAS 18001 attached

12.1Copy of the Organisation Chart attached

12.3Copy of the Performance Appraisal Form attached

13.1Copy of the order constituting the Safety Committee(s) attached

14.4In-House HSE Training details are filled as per the attached format and arecomplete in all respects

14.5External HSE Training details are filled as per the attached format and are complete in all respects

15.3Copy of the contents page(s) of the Safety Manual attached

17.1Copies of the accident reporting, investigating and analysis reports or formats (if no accidents) are attached

18.1Copy of Safety Clause in contractors work order attached

19 AList of Hazardous Chemicals used is attached in alphabetical order

24.6Copy of the ISO 14001:2004 Certificate attached

25.4Copies of documents, in support of Factorys contribution in sharing professionalexperience and expertise with other industries, are attached

Both Workers Representative and the Chairman of the Apex SafetyCommittee signed the Certificate.

Signature of the Chairman of the Apex Safety Committee

Name: Designation: . Seal of the Organisation:

Page 1 of 1

Annexure I

Rules and Regulations for Participation in the

NSCI Safety Awards-2015 (Manufacturing Sector)

1. OBJECTIVE

To recognize industrial undertakings (Manufacturing Sector) for their consistent and meritorious Occupational Safety and Health (OSH) performance and implementing effective OSH Management Systems, practices and procedures and to encourage their further commitment to OSH.

2. DEFINITIONS

The Rules may be called as the NSCI Safety Awards Rules

(a) Assessment Period means the three Consecutive Calendar Years 2012, 2013 and 2014

(b) Awards Committee means the Committee constituted by the Board for scrutinising and evaluating the

Applications for the Awards

(c) Award Year means the Calendar Year for which the Applications are invited i.e. Calendar Year 2015 (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

(a) The Scheme is open to the industries in the manufacturing sector registered as factories under the Factories Act, 1948 and have commenced the manufacturing activity before the assessment period. The Members of the Council who are in arrears of membership subscription will be eligible to participate in the Scheme only if the arrears are cleared before the last date for submission of Applications.

(b) An individual undertaking will be disqualified, if it has been convicted for any contravention with regard to any health and safety provision under the Factories Act or the Rules framed there under as well as the Environment (Protection) Act, the Water (Prevention & Control of Pollution) Act, 1974 and the Air (Prevention and Control of Pollution) Act, 1981 and the Rules framed there-under during the previous year of the Award Year.

(c) Any organisation in which an accident occurs, in which multiple fatalities / injuries or major damage to property or the environment either during the assessment period or subsequent period till the Awards Function is held, that organisation will be disqualified for getting any Safety Award.

NSCI Safety Awards 2015 (Manufacturing Sector)Page 1 of 2

NSCI Safety Awards 2015(Manufacturing Sector)

4. AWARDS GROUP

GroupNIC Code*Main ActivityA19Manufacturing Coke and Refined Petroleum products.B20,21Manufacturing Chemicals & Chemical Products, Manufacture ofpharmaceuticals, medicinal chemical and botanical productsC35Power Generation (Thermal/ Hydel/ Nuclear Power Plants)D23,24,25,27,28,29 and 30Engineering, Cement, Steel etc.E10,11,12,13,14,15,16,17,18,22,26,31,32,36 and 38Other industries not covered above e.g. Manufacture of food products and beverages, textiles, tobacco products, paper & paper products etc.The industrial undertakings (Manufacturing Sectors) are grouped in five groups for the Award purpose as follows:

(Refer Annexure-III for NIC Code)

Based on the NIC code of the Company, its application would be considered for the Awards in respective group as mentioned in above table.

5. LEVEL, NAME, NUMBER OF AWARDS & PRIZESThe Awards are categorised into four levels, viz.LevelName of AwardGr.AGr.BGr.CGr.DGr.ENo. ofAwardsMinimumScorePrize

1stAwardSARVA SHRESHTHA SURAKSHA PURASKAR(for Most Outstanding Performance)11111595%Golden Trophy and Certificate

2ndAwardSHRESHTHA SURAKSHA PURASKAR(for Outstanding Performance)222221085%Silver Trophy and Certificate

3rdAwardSURAKSHA PURASKAR(for Very Good Performance)333331580%Bronze Trophy and Certificate

4thAwardPRASHANSA PATRA (for Good Performance)At the discretion of Awards Committee75%Certificate

If no applicant comes within the minimum of 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 30.

6. ASSESSMENT PROCESS

(a) The information furnished in the Applications will be assessed and points awarded.(b) Based on the above assessment, Awards Committee would invite selected Organisations to make presentations by a team consisting of minimum three senior members of whom at least one each should be from the Production and Safety Departments.(c) Visit will be made to selected organisations for further assessment(d) Final list of Award wining organizations will be prepared on the basis of above three stages of assessment.

7.AWARDS COMMITTEE (a) ConstitutionThe Awards Committee will be constituted by the Board for the assessment.

(b) Decision of the Awards CommitteeThe decision of the Awards Committee shall be final.***

Page 2 of 2

NSCI Safety Awards 2015 (Manufacturing Sector)

Guidelines For Filling Application Form of the NSCI SAFETY AWARDS 2015 (Manufacturing Sector)

Annexure II

1.The duly filled in Application should be sent along with a Crossed Demand Draft for Rs. 17,000/- (Rupees Seventeen Thousand only) in case of NSC Corporate Members and Rs. 20,000/- (Rupees Twenty Thousand 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 - 2015 (Manufacturing Sector) to the Director General, National Safety Council, Plot No. 98-A, Sector 15, Institutional Area, CBD Belapur, Navi Mumbai - 400 614 by 31st May, 2015.

3. Each Application should be accompanied by the duly signed checklist attached along with the ApplicationForm as Appendix.

4.The industrial undertakings (Manufacturing Sectors) are grouped in five groups for the Award purpose as follows:

GroupNIC Code*Main Activity

A19Manufacturing Coke and Refined Petroleum products.

B20,21Manufacturing Chemicals & Chemical Products, Manufacture of pharmaceuticals, medicinal chemical and botanical products

C35Power Generation (Thermal/ Hydel/ Nuclear Power Plants)

D23,24,25,27,28,29 and 30Engineering, Cement, Steel etc.

E10,11,12,13,14,15,16,17,18,22,26,31,32,36 and 38Other industries not covered above e.g. Manufacture of foodproducts and beverages, textiles, tobacco products, paper &paper products etc.

(Refer Annexure-III for NIC Code)

Based on the NIC code of the Company, its application would be considered for the Awards in respective group as mentioned in above table.

5.Multi-unit Companies with different factory registration numbers and separated by common boundary and having certain facilities / service departments (such as HSE, Fire, Utilities depts., etc.) in common should not add the manpower in these common facilities / service departments fully to each unit, instead they should apportion it to each unit in proportion to the total number of workers (excluding the workers in the common facilities / service departments) in the respective units.

6. Attach separate sheets wherever required as Annexures with the same Item no.

7.The information given in the Application should be verified for their correctness and got approved by the Safety Committee set up as per the provisions under the Factories Act. If there is no Safety Committee, the verification should be done by any other joint Management - Workers Committee. The Application should be signed by both the Representatives of the Management and Workers after verification.

8.Applications incomplete in any respect or not accompanied by the Checklist in Appendix and necessary information are liable to be rejected.

***

Page 1 of 1NSCI Safety Awards 2015 (Manufacturing Sector)

NATIONAL INDUSTRIAL CLASSIFICATION(as per NIC-2008)

Annexure III

NIC CodeIndustry

10Manufacture of food products

11Manufacture of beverages

12Manufacture of tobacco products

13Manufacture of textiles

14Manufacture of wearing apparel

15Manufacture of Leather and related products

16Manufacture of wood and of products of wood and cork, except furniture;manufacture of articles of straw and plaiting materials

17Manufacture of paper and paper products

18Printing and reproduction of recorded media

19Manufacture of coke, refined petroleum products

20Manufacture of chemicals and chemical products

21Manufacture of pharmaceuticals, medicinal chemical and botanical products

22Manufacture of rubber and plastics products

23Manufacture of other non-metallic mineral products

24Manufacture of basic metals

25Manufacture of fabricated metal products, except machinery and equipment

26Manufacture of computer, electronic and optical products

27Manufacture of electrical equipment

28Manufacture of machinery and equipment n.e.c

29Manufacture of motor vehicles, trailers and semi-trailers

30Manufacture of other transport equipment

31Manufacture of furniture

32Other manufacturing

35Electricity, gas steam and air conditioning supply

36Water collection, treatment and supply

38Waste collection, treatment and disposal activities; materials recovery

*n.e.c = Not Elsewhere Classified

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