CSR Compliance Check List

EXECUTIVE SUMMARY
About Project
Title of the proposed project

Proposed project activities 1.

2.
3.
4.
Objectives of the proposed 1.
project 2.
3.
4.
Beneficiary Details Total Number of Beneficiary :
Community of Number of Amount
Beneficiary Beneficiary allocated

Schedule Caste
Schedule Tribe
Other Backward
Caste
Minority
General

Focused / Target Group

Target Group Number of Amount
Beneficiary allocated

Women
Children
Old Age / Senior
citizen
Disabled / Handicap
LGBTQ

Project location Pin Code: _________

State Name Amount
Name of the State
Name of the
District
Name of the Area
/ Taluka
 For Multiple location ( State / District ), information to be provided as
table above

Total project cost Break-up of Project cost :

Total OPEX amount :
Total CAPEX amount:
Support ( Amount in Rs. )
required from ONGC
Proposed project duration Tentative Start Date _______

Tentative End Date _______

About Organization/Agency
Name & registered address of
implementing agency:

Details Annexure
No
Legal status of agency (Trust /
Society / Section 8 company
must have been registered
minimum for the past three
years) with date of
Registration (Copy of Trust
Deed / Registration Certificate
/ Bylaws of
Society to be
enclosed)

CSR 1 Registration No.

(Copy to be enclosed )

Registration no of 80-G (Copy

to be enclosed )

Registration no of 12 A (Copy
to be enclosed )

Goals and objectives of the

agency as per Memorandum
of
Association/Bylaws/Articles
of
 Association

Contact details:
Name of the Contact
person of the NGO (office
no, mobile no. and e-
mail)
List of key officers including
Trustees, Directors,
Governing
Body members, President,
Vice
President, Secretary, etc.
with their work profile,
contact details, AADHAR
no. etc. (Copy to be
enclosed )
Financial Details Annexure
No
Affidavit (as per Annexure 1)

ECS Form (Format enclosed

at Annexure 2)
Copy of Cancelled Cheque

Copy of PAN Card

Copy of Audited Account

Statement of previous 3
financial years
Copy of Registration on NITI
Aayog Darpan Portal, if any
GST Number and GST
Registration
Certificate, if any (If GST
registration is not available
then certificate from Chartered
Accountant that, agency is not
required to be registered
under GST).

1. All the information sought is mandatory to be complied with. Failing which, proposal would be
considered as incomplete and liable to be rejected.
2. All documents submitted to this office should be in English/Hindi. In case the documents are in local
language, translation duly certified by the legal authority must be submitted.

SN All information/documents mentioned below are mandatory in order to Annexure

examine the proposal (To be submitted in the form of a Proposal) No.
1. Organization Details
1.1 Brief description of the organization/agency including Goals & Objectives

1.2 Details of similar projects ongoing/completed by the organization/agency in

previous three years

1.3 The impact assessment (Third party) of the previous projects executed by your
organization in the similar focus areas to that of current proposal, if any.

1.4 Details of previous support received from ONGC.

1.5 The details of largest project undertaken by the agency in recent past. Please
provide the financial implication involved in it.

2. Project Details Annexure

No
2.1 Details of the proposed CSR project to be undertaken by your organization

2.2 Brief about Goals and objectives of the project

2.3 Report of Need Assessment/Baseline Survey for the proposed project, if

any. Justification for taking up proposed CSR project

2.4 Brief about the targeted beneficiaries under proposed CSR project

2.5 Methodology of the selection of the beneficiaries and number of beneficiaries in

detail
2.6 Details about physical and social milestones/deliverables to be achieved through
the proposed CSR project

2.7 Detail timeline/duration of the proposed project

2.8 Budget estimate of the project with detailed budget break-up of each expenditure
head alongwith documents proving rate reasonability.

2.9 What is the monitoring mechanism for the project as far as project activities and
benefits to the beneficiaries are concern?

2.10 Documents depicting the funding sources for the total budget of project under
reference other than ONGC and details of the amount funded by each organization,
if any.
2.11 How sustainability of the project is planned to be ensured?

2.12 Under which sector of the Schedule VII of the Companies Act 2013 the project is
covered?

3. If Civil Construction is involved Annexure

No
3.1 The documents proving ownership of land, in case of own land or lease agreement
in case of rented premise where the civil construction is proposed. In case the
documents are in local language, please submit copy of its English/Hindi translation
duly certified by the legal authority.
3.2 Copy of approved construction map and estimate duly vetted and signed by the
certified Architect with NOC from the government authorities for construction,
along with a certified copy of relevant SOR from where the rates have been
adopted. In case of a construction project the total plinth area (floor wise) of the building
to be constructed, must be mentioned.
3.3 Detail budget estimates of the construction plan with drawings and bill of quantities
as per SOR/DSR and cost index of location where ever required,.
3.4 Documentary evidence of Land Use Conversion, in case of agriculture land.

4 If Procurement of Capital Items are Involved Annexure

No
4.1 What is the need of requirement of capital items with respect to benefits to the
beneficiaries?
4.2 What is the life of capital items and who will bear the maintenance cost of the capital
items and till what duration?

4.3 Three Quotations (inclusive of GST amount ) for each of the capital items
including installation cost, if any. Quotations shall have the GST number of the
Vendor . For purchase of any capital item, specification with number and other details if
any, should be mentioned..

Declaration:
I hereby declare that whatever has been stated above is true to the best of my knowledge,
correct and nothing has been concealed there from.

Place:
Date:
Signatory with Common Seal
 Annexure 1
[Format for Affidavit]

(Affidavit on Rs. 100 non-judiciary stamp paper duly notarized)

UNDERTAKING

1. We, (name of agency), PAN no. registered at (registered address) have not taken any support from any of the ONGC work
centres including Headquarters & corporate office during the current financial year.

2. There are no pending disputes or enquiries in connection with cheating, misappropriation of funds exploitation of beneficiary, etc.
on the name of (name of agency). The organization has never been “Black listed “or “Reprimanded” either by Govt./Govt.
Agencies/CPSEs/NCSR Hub or by reputed private organization.

3. The proposed project is neither covered under any existing scheme of Govt. of India / State Govt. nor is being funded by any
other organization to ensure that there no duplicity of the CSR activity under reference.

4. Any of Board of Directors/Trustees/Executive Committee members of (name of agency) or the organization itself doesnot
have any
material or pecuniary relationship of transactions with ONGC, its Promoter, its Directors, its Senior Management or its Holding
Company, its Subsidiary and Associates which may influence the process of administrative approval or financial concurrence or
fund disbursement for the proposed project.

5. We, (name of agency have not directly or indirectly supported/contributed by any political party or its affiliations and vice-versa.

6. We, (name of agency) assure that if ONGC approves any financial support towards proposed CSR project;

a. We will submit a Fund Utilization Certificate to ONGC, issued by a Chartered Accountant.

b. We will retain all relevant documents like Cash Book, Bank Book, Ledger, Journal, Relevant Bills, Vouchers and
Receipts etc. for a period of at least 03 years from the Project/Event.

c. That during this period of 3 years agency will allow authorized representative(s) of ONGC for audit (s) / inspection(s) of
above documents as and when asked by ONGC.

d. That during the period of 3 years as mentioned above, on ONGC's demand agency will provide the desired documents/
information pertaining to income
& expenditure detail of the project/ event including copies of relevant Bills, Vouchers and Receipts etc. for internal and/
or external purposes (for supplying to 3rd party) as per law.

Declaration:
I hereby declare that whatever has been stated above is true to the best of my knowledge, correct and nothing has been concealed
there from.

Date: Authorized signature

Place:
(Seal of the organization)
 Note: The affidavit shall remain valid till end of the project in case the project is approved by ONGC.
Annexure 2

Electronic Clearing Service (Credit Clearing) Form

(Investors/Customers/Vendors option to receive payments through Credit Clearing
Mechanism)

Particulars of Investor/Customer/Vendor
Name of Investor/Customer/Vendor
(As appears on Pass Book of bank)
Address of Investor/Customer/Vendor

Contact Details of
Investor/Customer/Vendor
(Office number, phone no. and e-mail)
PAN No. of Investor/Customer/Vendor

Particulars of Bank Account

Bank Name

Branch Name

Address of Bank

Telephone No. of Bank

Account Type
(S.B. Account / Current Account or any
other)
Account Number
(as appears on the Cheque Book)
MICR No.
(9 digits code number of the Bank and Branch
appears on the cheque issued by the bank)
IFS Code of Bank

I hereby declare that the particulars given above are correct and complete. If the transaction is delayed or not
effected at all for reasons of incomplete or incorrect information, I would not hold the user institution responsible. I
have read the option invitation letter and agree to discharge responsibility expected of me as a participant under the
scheme.

Certified that the particulars furnished above are correct as per our records.
Date Date

Signature of Investor/Customer/Vendor with Signature of Authorized bank official withcommon

common seal of the organization seal