--MEMBERSHIP CONTRACT FORM--

1- DETAILS OF THE HEALTHCARE ESTABLISHMENT: ("THE GENERATOR")
NAME OF THE HEALTH CARE ESTABLISHMENT:
ADDRESS 1: ADDRESS 2: ADDRESS 3:
LANDMARK: PIN CODE:
CITY: STATE:
EMAIL TEL NO.
NAME OF THE PERSON IN-CHARGE:Dr.
MEDICAL COUNCIL REGISTRATION NO:
RESIDENTIAL ADDRESS:
MOBILE NO -
PERSON RESPONSIBLE TO HANDLE BIO-MEDICAL WASTE: MR./MS./DR.
MOB.NO 1 - 2 -
MEMBERSHIP STATUS:
SAP CODE NO:
NORMAL WORKING TIME:
2- TYPE/ CATEGORY OF THE HEALTHCARE DEVELOPMENT
CATEGORY SUB CATEGORY
ADDITIONAL CATEGORY -
TOTAL NO. OF BEDS BELOW 50
NO. OF BEDS
TOTAL NO. OF OPD
TOTAL NO. OF BLOOD BANK
TOTAL NO. OF LAB
TOTAL NO. OF DENTAL CHAIR
3- CHARGES: -
REGISTRATION CHARGES RS.
4- DOCUMENT ATTACHED-
*YOU CAN ATTACH UP TO 2MB JPG, DOC, XLS, PDF OR ZIP FILE
*ALL THE ABOVE DOCUMENT ARE MENDENTORY
PAN NO - GSTN NO-
Please upload GST File



"I/We hereby declare that I/We do not have GST Number currently, I/We shall submit GST
Number via registered/speed post at address bellow, alongwith GST Certificate. If obtain in future."

ADDRESS : Phase 20, RNM Dharsiwa Siltara, Khasara No 70/1, 70/2, 70/5 Raipur 493111

4- PERIOD MEMBERSHIP CONTRACT EFFECTIVE FROM
5.ANY ADDITIONAL INCREASE IN THE RATES APPROVED BY MCGM OR GOVT. AUTHORITY WILL BE PAYABLE WITH
IMMEDIATE EFFECT DURING THE ENFORCEMENT PERIOD OF THE CONTRACT.
Bank Name : Equitas Bank
BRANCH : Shankar Nagar Nagpur
ACCOUNT NUMBER : 200001171895
BANK BRANCH IFSC : ESFB0009031
UTR NO DATE OF TRANSACTION
YEARLY CHARGES (RS.): DEPOSIT AMOUNT (RS.):
TOTAL RECEIVED (RS.): CHEQUE NO.: DATED:
BANK:
* MEMBERSHIP WILL BE VALID SUBJECT TO THE REALIZATION OF CHEQUE.
Terms & Conditions of the Bio-Medical Waste Disposal Agreement

Bio-medical waste Disposal Contract between SMS Watergrace Enviroprotect Pvt. Ltd, registered (CIN No.:
U52100MH2011PTC214951) under Indian Companies Act, 1956, having Corporate office at 20, IT Park, Parsodi, Nagpur
– 440022 (hereinafter called “Operator”) approved by the Chhattisgarh Environment Conservation Board (CECB), as
a facility provider of common bio medical waste collection, transportation, storage, treatment and disposal
agency on one part and the party who is Generator of the Bio Medical Waste & who has mentioned and signed as a
Member (hereinafter called “Occupier”), which includes, its/his/hers successors and assignees of the other part.
Whereas the parties to the contract are desirous of entering into a contract, the terms of the contract agreed
between them are recorded as under:-

1. “Operator” and “Occupier” entered into the valid contract for the Collection, Transportation, Treatment &
Disposal of Bio-Medical waste against the consideration of charges for the period agreed by both the parties
mutually.

2. For the fulfillment of the contract a) “Occupier” should provide the necessary training to his staff as per
BMW Rules, involved in management of bio medical waste for appropriate handling and segregation of the same. If
required, “Operator” can provide such training to the staff of “Occupier” and will charge reasonably to
“Occupier” b) “Operator” will collect the Bio-Medical waste (which is duly segregated), from “Occupier”, through
its waste collecting system, transport it, treat and dispose off the same as per the rules laid down by the
Chhattisgarh Environment Conservation Board, Central Pollution Control Board, Ministry of Environment & Forest
and the Supreme Court’s orders in this regards.

3. “Operator” will undertake to make its best effort to carry out its obligation under the terms set in this
agreement but will not be responsible for any infectionary reaction arising directly or indirectly for any wrong
handling of Bio Medical Waste by the staff or by “Occupier.”

4. “Occupier” should undertake responsibility to appoint minimum one person, trained as a key person, in
segregation of bio medical waste and to keep the same in appropriate manner, ensuring its proper collection,
segregation, storage, weighing, Bar coding & data generation and hand over to the Operator’s logistic staff. The
waste storage bags & the sharp containers will be accepted only in sealed / self knotted form, as per BMW Rules
2016,

5. The “Operator” has right to reject a load of Bio-Medical waste, if 1) It is not segregated according to the
given instructions 2) it is not kept in the color coded bags 3) If the bags are not labeled with Operator’s Name
& Address as per BMW Rules 2016, the BMW storage place is predefined , under lock & Key .Storage of BMW at any
other place other than predefined storage place is illegal as per BMW Rules 2016, 4) It is not kept ready in
sealed / self knotted condition & delivered to the logistic vehicle, near the entrance of “Occupier” health care
unit. (HCU)

6. Food waste, Coconut shells, Fruits, Flowers, Biscuits, Wrappers, Dust, Paper, Packing of the drugs etc. should
not be included in the Bio-Medical waste. All these said wastes are part of Municipal Solid Waste and should be
sent to Municipal Waste bins if it’s found regularly mixed up with Biomedical Waste we will refuse to collect
Mixed waste & it will attract penalty.

7. The charges of the hospitals are fixed on the bed basis, (irrespective of the occupancy) and according to
availability of other facilities. In case of HCE other than hospitals, the charges are fixed depending on the
services / facilities( Non Bedded part will include HCEs like Path Lab/ AVR/ Dental chair/ OPD/Blood Bank/ MRI
centre/CT Scan centre / Hair Transplant centre / Cosmetic Surgical Centre/ OT/ Labor Room/ Histopathology centre
/ Clinics / Dialysis Center/ /Eye Bank/Semen Bank/ Occupational Health Center/ Educational Institutes, Hotels,
Airports, Railway Station, Medical Camps, Medical Stores, Warehouses, Industries, Individual Home & any other
places other than this where biomedical waste generated, etc.

8. The applicable charges for “Occupier” HCE are mentioned on Rate Sheet. The bill will be raised & delivered by
E-Mail after the end of the month. In case of advance payment supplementary invoice will be sent by email by 5th
of every month if any additional amount added due to any reason like extra waste receipt.

9. As the monthly charges are fixed, the payment of all the bills including supplementary bill, should be made
within 20th day of calendar month from the date of billing. Non-receipt of bill will not be considered as reason
for non-payment. For any delay in payment, interest @ 24% per month will be charged to “Occupier”. Bio Medical
Waste collection services may be stopped, if “Occupier” does not pay the charges for more than 3 months, after
sending the notice of the same to “Occupier”. Duplicate bills can be issued on request on additional charges.

10. All the health care units are required to maintain the record of category wise waste generated & handed over
for treatment and disposal, as specified under Bio- Medical Waste Management & Handling Rules 1998 & further
revised / modified on March 2018. Weighing balance should be available with HCE. “Occupier” should ensure the
weight & then sign on the collection list. If required, the logistic person of “Operator” will also sign on
“Occupier’s” record register. Any complaint regarding the weigh t of the waste can be sorted out, subject to the
availability of the records of weight at “Occupier” end, duly endorsed by “Operators” collection staff.

11. “Operator” will not be responsible for disposal of any illegal things, which may be stored in the bags /
containers (Especially Yellow bags), as the bags are supposed to be sealed / self knotted at “Occupier” end and
“Operator” is not suppose to open them. Dead Fetus to be packed in yellow Bag along with official MTP
certificate by Medical Superintendent only as per viability period as per BMW Rules. ETP Sludge/ Discarded
Linen/Mattresses to be packed separately. Disposal charges for it will be extra. Chemical Liquid waste &
Microbiology waste to be pretreated , sterilized with non chlorinated chemicals as per BMW Rules 2018.

12.A Certificate of membership may be issued annually to “Occupier” for the waste collected for treatment and
disposal. This will be issued only after receiving the full and complete payment of the charges, along with
outstanding, if any, from “Occupier”.

13. The “Occupier” shall promptly inform in writing the “Operator” any changes in the number of beds or
facilities provided in the HCE. The bed count or facilities will be considered as per the Authority records and
physical verification.

14. In Case if any “Occupier” is found operating with extra bed strength or with additional facilities from what
is given in the agreement, the “Operator” would charge for the extra bed strength, Facilities from the date of
joining along with 100% penalty & 24% per annum interest. The “Operator” reserves the right to stop providing
services to the concerned “Occupier” and suspend and revoke certificate/agreement issued, in the event the dues
for the increased bed strength are not paid in 30 days.

15. All the Terms, Conditions, Rules and regulations framed by CECB, CPCB, MOEF and the orders of Supreme Court
regarding the disposal of Bio-Medical waste are binding on both the parties of the contract.

16. “Occupier” may discontinue this contract by giving one month’s notice in advance, in writing. If such a
notice is not received and even if the contract also gets expired, still then it will be presumed that the
services of BMW collection are required by “Occupier”. For stoppage of the services, “Operator” should receive
intimation of stoppage of services, in writing, giving valid reason. The billing of “Occupier” & the collection
services may not be stopped, till “Operator” gets the intimation to stop the services in writing.

17. The “Occupier” should keep sufficient number of colour coded bags for storage of BMW. In case the “Occupier”
desires the “Operator”, the order can be placed with staff of the “Operator” and delivery can be received
against cash payment upto Rs.999/-. & inform to “Operator” by Email/Whats App/Letter However, the “Occupier” is
at liberty to purchase the bags from any other supplier as per his choice, taking care that the bags have been
made as per standard defined under BMW Rules 2016. The “Operator” shall not be bound to collect the bags which
do not qualify the required norms.

18. The “Occupier” shall make all payments by A/C payee, cross cheque, NEFT, RTGS, ECS or direct cheque deposit
in bank A/c no: 3761002100024938, A/c Name: SMS WATER GRACE ENVIROPROTECT PRIVATE LIMITED, Bank Name: Punjab
National Bank, IFS code: PUNB0376100, Branch: Dharampeth, Nagpur of the “Operator” & inform to “Operator” by
Email/Whats App/Letter.

19. “Operator” is not authorized to collect, transport and dispose Radioactive Waste. “Occupier” should take all
the required precautions to ensure that no such waste will be mixed up or added to the bio medical waste bags or
containers. In case if any accident occurs due to addition of , Radioactive Waste or Hazardous waste in the Bio
– medical Waste by negligence of the “Occupier” , “The Occupier” will be held responsible for all the Damages.

20. “Occupiers” should make themselves aware about the provision of ‘BMW’ (Management & Handling) rules, 1998,
framed under Environment Protection Act, 1986 and revised/modified as of March 2018.

21. Any Faulty/Incorrect information regarding the membership will result in the termination of membership of
“OCCUPIER”

22.Any Changes in the customer name, address and contact detail should be informed in writing immediately. For
any temporary stoppage of services the written intimation to the “Operator”. should be given well in advance,
otherwise the “Occupiers” may not get the consideration from exemption in the charges of said period.

23.Any Additional increase in the rates will be payable with immediate effect during the enforcement period of
the contract.

We have understood all the above and accept the same.

MEMBER SIGNATURE/SEAL
Signature Upload upto 2MB

PHOTOGRAPH

Photo Upload upto 2MB