Request No. - CAR01676
Contractor Assessment Request Details
| Assessment Type | New |
| Vendor | |
| Contractor | MAMTA MEMORIAL HOSPITAL |
| Contractor Location | WALUJ, AURANGABAD |
| Contractor Email ID | MAMTA MEMORIAL HOSPITAL |
| Plant Code | 1130 |
Preliminary Details For Evaluation
| Contractor Type | Need Based Contractor |
| Name of Company / Contractor | Mamta Memorial Hospital |
| Contact Person Name | Mr. Dinesh Chavan |
| Contact Number | 8149803979 |
| Work Description | Health Service Provider |
| Previous ETL Contracts | Mr. Sandip Patil |
| Existing Clientele | Mr. Sandip Patil |
| Organizational Chart | 1676_OrganizationalChart_.pdf |
| Employees Head Count | 0 |
| Employees Deployed Count at ETL | 0 |
| Supervisors Count | 0 |
| Is Sub Contractor Nominated ? | No |
| Sub Contractor | |
| Contractors Financial Health & Capability (Turnover in INR) | 0 |
| C A Certificate | 1676_CACertificate_.pdf |
| Does your last two years balance sheet shows profit? | Yes |
| Balance Sheet | 1676_BalanceSheet_.pdf |
| Do you have at least 3 years of experience for carrying out similar activity? | Yes |
| Experience Certificate | 1676_ExperienceCertificate_.pdf |
Section 1 - Mandatory Requirement
| Sr.No | Requirement Text | Options | License / Registration No. / Policy No. | Attachment | Valid Till | Score |
|---|---|---|---|---|---|---|
| 1 | License under the Factory Act.1948 / Contract Labor Act / Shop Act | Complied | 114 | 1676_11__section1_.pdf | 31.03.2025 | 5 |
| 2 | Number of employees authorized to deploy as per license | Not Applicable | 1676_12__section1_.pdf | 5 | ||
| 3 | Is the organization registered for EPF? | Not Applicable | 1676_13__section1_.pdf | 5 | ||
| 4 | Is the organization registered for ESIC? | Not Applicable | 1676_14__section1_.pdf | 5 |
Total - 20
Section 2 - Safety Performance
| Sr.No | Requirement Text | Answer | Details | Attachment | Score |
|---|---|---|---|---|---|
| 1 | No. of Accidents (Medical Treatment) in last 2 years | 0 | 1676_21__section2_.pdf | 5 | |
| 2 | No. of Fatalities (Verify from Govt. data / reference check) | 0 | 1676_22__section2_.pdf | 5 | |
| 3 | No. of Lost time injuries as per Factories Act 1948 (Injured person not able to work more than 48 hours from time of accident) | 0 | 1676_23__section2_.pdf | 5 | |
| 4 | No. of Fire Incident in last 2 years | 0 | 1676_24__section2_.pdf | 5 | |
| 5 | Has the organisation been prosecuted for an HSE breach or injury to an employee? Specify nos. | 0 | 1676_25__section2_.pdf | 5 |
Total - 25
Section 3 - General EHS Systems
| Sr.No | Requirement Text | Answer | Details | Attachment | Score |
|---|---|---|---|---|---|
| 1 | HSE Policy (Provide evidence by supplying copies of relevant documents) | Not Applicable | We are running Health service provider organization so Not applicable. | 1676_26__section3_.pdf | 5 |
| 2 | Induction and Training (provide relevant documents) | Not Applicable | Not applicable | 1676_27__section3_.pdf | 5 |
| 3 | PPE’s maintained in Good Condition | Not Applicable | Not applicable | 1676_28__section3_.pdf | 5 |
| 4 | Health monitoring of Employees - Medical Check Up Done for employee’s as per Form 7 (date / Fitness Certificate from AFIH doctor) | Not Applicable | We are not running a factory so Not applicable. | 1676_29__section3_.pdf | 5 |
| 5 | Does the organization regularly inspect and maintain hand tools, machinery (cranes, vehicles, hoists/lifting tools, etc.) | Not Applicable | We are running Health service provider organization so not applicable. | 1676_30__section3_.pdf | 5 |
Total - 25
Section 4 - EHS Practices
| Sr.No | Requirement Text | Answer | Details | Attachment | Score |
|---|---|---|---|---|---|
| 1 | Is the contract employee aware of Work Permit System / Work Permit Adherence? | Not Applicable | We are not contractor/not providing manpower, we providing health service so Not applicable. | 1676_31__section4_.pdf | 5 |
| 2 | Is the organization aware of Method Statement/ Method Statement Adherence? | Not Applicable | Not applicable | 1676_32__section4_.pdf | 5 |
| 3 | Are the contract employees aware of Emergency Response Procedure? | Not Applicable | We are not contractor/not providing manpower, we providing health service so Not applicable. | 1676_33__section4_.pdf | 5 |
| 4 | Has the organization conducted a HIRA study in past / or as a part of current practice? | Not Applicable | We are not running a factory so Not applicable. | 1676_34__section4_.pdf | 5 |
| 5 | Does the organization have and follow safe work procedures, documents which define how risks relevant to the contracted activities are managed? | Not Applicable | Not applicable. | 1676_35__section4_.pdf | 5 |
Total - 25
Section 5 - Plant and Equipment
| Sr.No | Requirement Text | Answer | Details | Attachment | Score |
|---|---|---|---|---|---|
| 1 | Are the tools and equipment used in good working condition? | Not Applicable | We are not providing any tools and equipment to your company so Not applicable. | 1676_36__section5_.pdf | 5 |
| 2 | Do the tools and equipment comply with standards such as ISI Mark / Energy Efficient 5 star rating guidelines? | Not Applicable | We are not providing any tools and equipment to your company so Not applicable. | 1676_37__section5_.pdf | 5 |
| 3 | Is the holding handle of equipment in good condition? | Not Applicable | We are not providing any tools and equipment to your company so Not applicable. | 1676_38__section5_.pdf | 5 |
| 4 | Are all plants and equipment compliant with the safety requirements? (including not damaged cables, no loose connections, equipped with 3 pin top) | Not Applicable | We are not providing any tools and equipment to your company so Not applicable. | 1676_39__section5_.pdf | 5 |
| 5 | Do contract employees have correct licenses / certificates to operate the plants and equipment? | Not Applicable | We are not providing manpower or any tools and equipment to your company so Not applicable. | 1676_40__section5_.pdf | 5 |
Total - 25
Total Score
| Section | Score |
|---|---|
|
Section 1
Mandetory Requirement |
20
|
|
Section 2
Safety Performance & System Awareness |
25
|
|
Section 3
General EHS Systems |
25
|
|
Section 4
EHS Practices |
25
|
|
Section 5
Plant and Equipment |
25
|
|
Total Score
|
120
|
The overall ranking of pre-qualification is 80 % (Semi Professional)
Approval Process History
| Role | Employee | Request Status | Comments | Updated On |
|---|---|---|---|---|
| Department Head | 400665 - Umesh Ratanwar | Approved | ok | Jan 15 2024 5:21PM |
| EHS | 856015 - Pravin Mogal | Approved | Ok | Jan 24 2024 5:17PM |
| HR | 851649 - Mangesh Jambhorkar | Approved | Ok | Jan 29 2024 10:52AM |
| CorporateEHS | 400358 - Piyush Jaiswal | Approved | Approved | Jan 29 2024 4:02PM |
| HeadIR | 855987 - Kalyan Pawar | Approved | Approved | Jan 29 2024 5:25PM |