E

DEALE RTP IGAIII

AND
AGREEMENT FORM

Dealer Code :

Name :

Address :

Pin Code
no.
Mobile :

GST No. : '

Date of Appointment:

N\A
AGRI TECH LIMITED
NOVA AGRI TECH LIMITED
(Formerly Known as Nova Agri Tech Private Limited)
Sy. No. 2511N1, Singannaguda (Village), Mulugu (Mandal), Siddipet (District), Telangana - 502279
E-mail : info@novaagritech.com, marketing@novaagritech.com, Tel : +91-8454-253446
For Queries / Complaints / Suggestions / Feedback
Consumer Gare Executive Contact No 040-27957081 I 82, E-mail : info@novaagritech.com

fSO 9001 2015 Gertified Company ...for better HARVEST

=
 NOVA AGRI TECH LIMITED
Sy. No. 2511N1, Singannaguda (Village), Mulugu (Mandal),
Siddipet (District), Telangana - 502279
AORI'I'IICH I,IMITF:D E-mail : info@novaagritech.com, marketing@novaagritech.com,
Tel : +91-8454-253446

l,Nlmr rnd Portal Address of the Organisation

Nrmr of thc Flrm :
(ln llook Lrtlrru)

I II L__l L--JL--]L- Affix PassDort Size

Photo Graoh of
Ooor No Proprietor / Managing
Partner / Managing
Vllhgr Director / President
Mrndrl / Trluq
Dlrlrlot
Pln Codo
Phonc STD
Frx STD
Mobllr

Emrll
2, Rrglrtratlon Details
A)Pcrtlclde Licence No. : Valid Up To
B) Fcrtlllzer Llcence Valid Up To
C)Sccd Llcence No. : Valid Up To
D) osttN No : E ilililililililt| E
E) moxln ruo : E
F) PAN No. EEEEE
f. Conrtltutlon : Tick 1/;in the relevant box and enclose support documents
( )Proprlctorshlp ( )Partnership ( ) Co-op/Assn ( ) P!'t. Ltd. Company
4, Prillculrrr Of Proprietor / Partners / Directors / President of Go-op/Assn / Power of Attorney

1,ilo. Name 'Age Address & Tel No. Aadhaar No. Pan No.
5. Permanent residential address of proprietor / Managlng Partner / Managlng Director / President

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Tel No. : STD Res : Fax :

Cell No. : Email :

6. Details Of Business
A) Year of Establishment
B) Present Lines of Business Agri / Non Agri / Both

C) No. of MajorAreas (Villages)Covered , f] E E

(Enclose the Villages List)
D) No. of Sub-dealers
E) Presently, dealing with Companies & T.O:
'[]EE Company T.O Company T.O
1 4
2 5
3 6.

F) Nature of Business : RETATL[l wHoLESALEI]

7. Sales Of Agri Inputs
( Pre ious Yearf-l EEE I (Rupees In Lakhs)
A) Pesticides
B) Fertilizers
: rt]EI
rrrr
C) Micro Nutrients : t]EET
D) Water Soluble Fertilizers :
EEET
E) Seeds ETET
F) Bio Products ETIE
G) lmplements TEEE
H) Others rTTT
8. Address of Branches / Sister Concerns if any: a.

b. G.

9. Godowns Address: a.
b.
c.
10. Facilities from Bank ( Rc. In Lakha)
S.No. Name of the Bank Type of Account Account No. Sanctioned Limit
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Nova Agri Tech Limited.

Fy Nrr /hl/A/1, Hltrgnnnnguda (Vlllage), Mulugu (Mandal),
!hhlllrrl (lllrhlrrl), Jqhillnrrrr 502279
F rrrrll lrrfrr@rrrrvmgrltor;h,com, marketing@novaagritech.com,
lrl rUl R4n4 2hll44lt
Vhll lr rl www troveagrltech.com

'l'h ro ugh : Regional 0ffice

| )nur Slls
l/Wn, iu'r, lrrtct'cstcd in buying your Micro Nurtients, Water Soluble Fertilizers, Pestisides, Fertilizers,
llkr Itrotlrrt'ts, Sccrls, lmplements and any other products being sold by you from time to time, accepting
llrn lrlrrrs & (lontlitions in agreement
'l'lrn lolrrrs & r'orrrlitions of Agreement in this connection have been read over and explained to me / us by your
in our own language nd I/ We understood the
Hrililt' irrrrl irg|ucrl to abide by such terms and conditions. I/We agree to pay
_(Rupees as Token Advance
ll r. (l{upees J as immediately after your
l;tpt'ovirl.
| / Wr, lirlrrlsh rlctails of my f
our organisation overleaf.l/We Authorise
Ml status to transact business
wlllr yorr (f n nry /our behalf and the same
wlll lrr, lrlrrtling on me/us. Changes if any in this regard will be made only after prior notice,

'l'ltuttklrrg yort,

Yorn'r lirltlrlirlly

Signatures Name of the Proprietor / Partners

( )
( )
t )
( )

Itrrwlnl to: Area Office:

Slgrrirturc of Sales 0fficer:

 From
FirmName
Address
Place
Tahsil
Dist
State
PinCodeNo.
To,

Nova Agri Tech Limited.

Sy. No. 251lA/1, Singannaguda (Village), Mulugu (Mandat),
Siddipet (District), Telangana - 502279
E-mail : info@novaagritech.com, marketing@novaagritech.com,
Tel : +91-8454-253446
Visit us at : www.novaagritech.com

Through: Regional Office

Dear Sirs
l/We, are interested in buying your Micro Nurtients, Water Soluble Fertilizers, Pestisides, Fertilizers,
Bio Products, Seeds, Implements and any other products being sold by you from time to time, accepting
the terms & Conditions in agreement
The terms & conditions of Agreement in this connection have been read over and explained to me us by your
/
Mr, in our own language andl/We understood the
same and agreed to abide by such terms and conditions. I/We agree to pay
Rs. fRupees as Token Advance
Rs. (Rupees as immediately after your
approval.
| /we furnish details of my f our organisation overleaf.l/weAuthorise
Mr status to transact business
with you on my /our behalf and the same
will be binding on me/us. Changes if any in this regard will be made only after prior notice,

Thanking you,

Yours faithfully

Signatures Name of the Proprietor Partners

/

7. ( )
2. ( )
3.
t )
4. ( )

Forward to: Area 0ffice:

Signature of Sales 0fficer:

 TERMS AND CONDITIONS OF AGREEMENT
L I/We (DealerJ shall purchase from the Company the products on principal to principal basis. Payment shall be made through a
Bank approved by the Company or through company's Area office or through representative specified or authorised by the
Company in writing. AII payments are to be made by RTGS/NEFT cheque, DD, UPI (BHMI-UPD, UPI QR CODE, (BHMI-UPI, QR
CODE), Debit Card powered by Rupay by the Company. No cash shall be paid to any of the company's representatives or agents and
any such payment made other than the modes mentioned above, shall not be account by the company and the company is no way
responsible for the same.

2. I/We (Dealer) note and understood thatthe goods orproducts soldbythe companywill notbetakenbackwithoutproperand prior
approval from the company.

3. I/We (Dealer) shall

be abide bythe rules and regulations ofthe state in respect ofpurchase, storing, resale s ofpesticides as notified
or amended by the State Government from time to time under CA, FCO and pesticides Act.

Goods once indented will notbe refused or shall not seekits diversion under anv circumstances atthe time of its arrival and dealer
shall be liable for its full payment.

5 I/We (Dealer) shall not carry out any activity which is likely to harm the reputation of the products purchased from Nova Agri Tech
Limited, itself,

6. I/We (Dealer) shall not refrain from selling substandard and expired stocks. -

7. I/We (Dealer) shall promptly intimate to the seller (companyJ as and when department officials draw samples oftheir products,

8. For products or goods supplied on credit basis we agreed to make the payment or on before the due date failing which shall pay on
overdue interest@ 24o/oper annum from the date ofsupply or as per the terms and conditions ofprice list.

9. I/We note and understood that for IPT (lnter Party Transferl there shall clear invoice at by the dealer who sent stock and the
receiver'sshouldacknowledgethatthe stockreceived or else IPTwill notbe done.

10. It is noted and understood that if at any time before delivery of the goods a new or increased rate of excise duty i.e., port duty or
taxation or Cesswhereverleviedbythe Governmentof India orbythe State Governmentorbyanylocal public authorityis imposed
upon such goods or any part ofthem or the existing levies ofany description applying to such goods is increased, then seller shall
have the right to recover retrospectively from buyers/dealers as an addition to the contract price, a sum equal to the amount which
has beenpaidbythe selleron accountofthe newdutyortaxation asthe case maybe and is bindingas bythebuyer/dealer,

L1.. The amount ofGST/CESS ifany, payable on the sale ofgoods shall be on the buyer's/Dealer's and the seller (Company) shall have
the rightto recoverforthwith fromthebuyerin additiontothe contractprice a sum equaltothe amountwhichhas been paidand or
which is or may become payable by the seller (Company) on account of such tax as may received by the respective Central/State
Government from time to time,

t2 All disputes, differences and or claims, arising out of in relation to this agreement shall be settled by way of an arbitration
proceedings in accordance with provisions of Arbitration and Conciliation Act,L996 or any statutory amendments there of an the
same shall be referred to the arbitration by or solo arbitrator to be nominated/appointed by NOVA. In the event of death, refusal,
neglect, inability or incapability ofthe persons so appointed to act as an arbitratol NOVA may appoint another person to act as an
arbitrator. The award including the interim awards of the arbitrator shall be final and binding on all parties concerned. The place
of arbitration proceedings shall be at Hyderabad. The jurisdiction of the courts of Hyderabad only is exclusive jurisdiction to
entertainthe matters between both the parties.

13. I/We (Dealer) submit security cheques which are operative and valid from time to time either sumoto or as requested by the
company.

L4. I/We (DealerJ herebyagreeto furnish securitybywayof depositingchequeswiththe NovaAgri Tech Limited, as securitywhichwill
be under the custody ofthe company.

15. I/We [DealerJ hereby authorise Nova Agri Tech Limited, in case of nonpayment of the due amounts, the cheques furnished for
security purpose shall be used for recovering the due amounts and the same are valid for presenting the same in the bank for the
purpose of recovering the due amounts.

L6. I/We (Dealer) hereby agree to pay a sum as agreed which will be treated as token advance is non refundable and will be treated as
advance amount for the first order placed.

COMPANY DEALER SIGNATURE

 NOVA AGRI TECH LIMITED
NU\A
AGRI TECH LIMITED
Hyderabad
CUSTOMER PROFILE
APPLICATION FOR DEALER / DISTRIBUTOR APPOINTMENT.

Signature Signature Signature Signature

District
Name of the firm
Customer Code No.
Proprietor / Partner Name
Address of the shop ,/ firm

City
Postal PIN Code

RESIDENCE / PERMANENT ADDRESS

Address ofthe Residence / Permanent

City
Postal PIN Code
District
State

CONTACT DETAILS
Telephone NO.s of Proprietor / Partner
Mobile NO.s
Shop Phone NO.s
Residence Phone NO.s fLandline)
Fax No. of Customer
E-mail Address

COMMERCIAL DETAILS
GST No.
Pesticides License No.
Fertilizers License No.
Firm PAN No.
Proprietor PAN No.
 BANK DETAILS
Name of the Bank in Operations
Address ofthe Bank

CurrentA/C or SB A/C
Dealer Token Amount
DD No. / Date / Amonnt,/ Bank
*MANDATORY
Advance Operative Cheques 5 No. S

Signed by the proprietor / Partners only

Cheque No.s / Bank

LEGAL INFORMATION DETAILS

Name of the Proprietor/ Partner / Director
Age of the Proprietor/ Partner / Director
Father's Name
Telephone No. / Mobile No.
Address of furisdictional Police Station ( for SHOpJ with plN Code
No.
Full Postal Address ofresidence with PIN Code

Full Permanent Native Address of Residence with plN Code

Address of Jurisdictional Police Station ( for SHOpJ with plN Code

No.
Name ofthe Zonal Manager
Contact No. ofthe Area Officer
Contact No. ofthe Zonal Manager
Personal Guarantee form in Rs. 60/- Stamp paper filled

PROPERTY DETAILS
Applicant Property
Property Address
Telephone No. (Preferable BSNL No. )
Mobile No.
Name of the Person on which the Property is held
Need to be Enclosed
Survey No. andAddress

I here by acknowledge that I have personally verified the

above details. Please create the new Dealer Code

Signature of the Marketing Officer Signature of the A. AM / A.M

Deputy General Manager / Zonal Manager

 To be filled in by the Nova Employee

A. Expected Turnover During the year:

B. Gredit Limit Recommendation (Rs. in Lakhs)
M.o.r/ M.o./s.M.o EIE AM EEE R.M./z.M.EEE
D.c.M/G.M. rIE c.E.o.ErI MD ETE
C. Token Advance Details:

D.D. /chq. /cash Receipt rrro. IETTTIEE oate EE @E EE

Amount : IEEII Bank& Location

D. Market Details
Total No. of Dealers in Market

Total No. of Nova Dealers in Market

Urban | | tRurat|--l rcemi Urban [-l

The information furnished by the party is verified and found correct.
[ ] The Party is recommended for appointment.

[ ] The Party is not recommended for appointment.

AM's/ Endorsement RM's/ Endorsement GM Endorsement

Recommendation: Recommendation: Recommendation:

Signature Date : Signature Signature Date :

Name: Name: Name:
Accounts Endorsement Marketing Director Endorsement M.D. Endorsement

Signature Date : Signature Date :

Name: Name:
Accounts:
a. Customer Code :

b. Created Date :

c. Narhe of the firm :

d. Village :

e. Application Date :

f. Received Date :

g. Agreement Date :

Remarks :

1. All documents received Yes / No :

2. TokenAdvanceAmount :

a. Received Date :

b. Bank :

c. Transaction ld :

d.DD :

Signature
This undertaking is executed at by
carrying on business at Hereinafter referred to as DEALER on this of
Whereas M/s. NOVAAGRI TECH LIMITED. Sy. No. 2511N1, Singannaguda (Village), Mulugu (Mandal),
Siddipet (District), Telangana - 502279, a manufacturing of Agri Inputs.

And Where as the DEALER has offered to Act as Pesticides, said the goods of the Manufacturer Marketers & pesticides
area in Telangana and in lndia subject to the stipulations, terms and conditions agreed to and conformed by the Dealer.

And Whereas the Dealer has offered to keep the Manufacturer indemnified against the value of the goods invoiced until and then
fulland final payment is made.

NOWTHEREFORE THE DEALER UNDERTAKEAS FOLLOWS :

The aforesaid Dealer through Shri being

the duly authorised representative in this behalf of do hereby execute the lndemnity Bond and undertake to Indemnify the
manufactureragainstthe cost of the goods invoiced and payment pending pursuanttothe letterof appointment.And the aforesaid
dealerfurtherhearby.agreesandconfirmsthat thereshallbeachargeuponthefollowingpropertyoftheDealer namely:

1.

2.

3.

4.

5.

Inwhich the Manufacturershallbe liberaltoenforceagainstthe DEALERand oranyperson holding aforesaid propertywhetheron

behalf of dealer or even otherwise.

And the aforesaid DEALER further hereby agrees and undertakes to keep the aforesaid property in act and free form of any
encumbrance of change otherthan the change agreed to be created byvirtue of this agreement.

And the aforesaid DEALER further hereby agrees that in the even of failure of the Dealerto payto manufacturerthe cost of goods
invoiced forwhich payment not made, the Manufacturershall be perfect liberalto take possession of the aforesaid property and to
haveitsoldforthepurposeofrealizationoftheamountpayablebyDealer totheManufacturer.

And the DEALER hereby agrees that the aforesaid rights of the Manufacturer shall always be enforced against the Dealer at will as
against his heirs, sucoessors and legal representatives irrespective of whether such failure is by reason of willful default, or be
reason enforcementof any process of lawo?by reason insolvency ordeath of ordissolution of the Dealer.

And the DEALER agrees and undertakes notto be obstruct in any mannerwhatsoever the enforcement of the manufacturerand or
its authorized representative of anyof the stipulations herein.

The executiants above name agreed that any claim arising of and by reason or of relating to this agreement always be subject to the
jurisdiction of SECUNDERABAD / HYDERABAD Courts.

Signed, Sealed and Delivery bythe

Within name Dealerof through

Its duly authorized representative

In Presence of
 -l
l.Value of Assets ( Rs. in Lakhs): stAssessment):
A) Land Survey No. :

B) Buldings Door No. :

C) Others

2.TaxAssessment ( Indicate the year of la st Assessment) :

A)lncomerax:IEEf] B) Sales Tax: tililil1

3. Transport (Priority Basls)
Name of The Transport Location
1.
2-
3.
4.

l/we hereby declare that the information provided by me/us in this application are true to the best of my/our
knowledge and belief and request you under the power vested in us by the articles of association of the
company rules and bye-law of the cooperative society/ association to appoint us one of yours,
Dealers At : Block / Mandal :

District: State :

Date Seal Of The Orqanisation Signature (s) With Name (s)

O We are attaching the Indemnity Bond duly executed.

O fnterest @ 24%will be attract over and above 9o days outstandings w.e.f : 01/06/2019
Enclosures (Tick 1/; in the Relevant Box)
I Application Form l_l Income Tax Coples for past two years
I DcalershlpR€qu€stLettorfrornthoDealcr(lnletterpad) ! Vnf CoCy/cSTtNCopy
l-l S-c:uJity-lc_lg:it of Rs. 100OO/- in from E notP€sticides-Licences (Underforce means
of DD of IFC Cheque an expired one)
!- Dcelcr Lcttcr Pads-3 (cmpty with sign and tcal) -
E "-p"t V Dctalls (Xerox coptes)
l_l Vittagc pten - lmportant and Potcntial Villagcr l_l ry" socurity cTs standard ch€ques of any
undcr coverag)c of tho Dcalcr Nation lizod or Commercial Banks
Uonttr wiao seL. plan . Doal.r l.ttor pad - Propcrty Oetalls (Xorox copie6)
I !
l_l partnersnip Deed if the firm is undcr Partn€r8hip, l_l plt'l Cad shop
MOAfor Pvt. Ltd. firm and RcAistratlon copy an'd'
- Rcsolution copy ror co tipe;it;;"d siffJi";. l_l plt't card pcraonel
E Indamnity Bond I nccotuilon copy In ces6 or Co operative
socisty
fl DearcrAorccmentform
- rcnarclrd/ccrde
powerofAttomoy(prescrlbedFormatwillbegiven) [
I
I Ocatcr P.$port Photos - 3

To be filled byAccounts :

Security cheque details :

Bank :

Branch :

Gheque No. :