Greetings of the day !

Please find attached farmer questionnaire and individual farmer assessment sheet.

A. Background: CORP SCAN intends to conduct farmer level survey in various districts of
southern states of India namely Andhra Pradesh, Telangana, Gujarat, Karnataka,
Kerala, Madhya Pradesh, Maharashtra, Orissa. This survey is part of monitoring and
evaluation of Central sponsored scheme-National Mission on Medicinal Plants
Cultivation, National AYUSH Mission being conducted by CORP SCAN in these States.

B. Scope of Work

The agency would be engaged to carry out the field survey work in various districts of
above States. The agency and his team will interact with beneficiary farmers and collect
the primary data on the pre-tested questionnaire provided by CORP SCAN. These
information and format will be provided by CORP SCAN – refer as enclosed. The key
tasks of the survey are given below:

i. Farmers have to be interviewed and primary data need to be collected on CORP

SCAN formats (farmer questionnaire and individual farmer assessment sheet
attached)

ii. Data Entry of the collected primary data in MS-EXCEL template provided by CORP
SCAN within stipulated time.

iii. Documentary evidence viz. photographs of survey conducted

C. Details of work

Details of farmers to be covered in different states

S.N. State No of district to No of farmers to be surveyed

be covered (approximately)

1 Andhra Pradesh 8 5344

2 Telangana 5 540

3 Karnataka 8 6500

4 Maharashtra 10 8700

5 Madhya Pradesh 15 8500

6 Kerala 8 5421

7 Gujarat 10 6400

8 Orissa 5 2600

Total 69 44,005
  An agency can give quotation for one or more states

 Total Number of samples mentioned above is indicative and may increase or

decrease based on list of beneficiaries to be provided by concerned
implementing Department

D. Budget Available

The per questionnaire approved budget available for survey work and data entry is Rs.
50/- (Fifty Only) inclusive of all (tax, travel, boarding and lodging cost, etc.)

E. Deliverable:

 MS-Excel file with data entry as per CORP SCAN format of all the interviews
conducted

 Hard copy of filled in farmers Questionnaires and farmers individual assessment

sheet in soft copy

Agencies, who are interested to conduct the survey, may submit their financial quotations as
per format given below:-
S. No. Name of States Financial Quotes in Rupees
(Per Questionnaire)

The financial quotations should be submitted by Post / by hand in sealed envelope at the address
mentioned below latest by 26th Dec 2018 (Wednesday) by 14:00 Hrs. (2PM) . You can also send
by email to biz@corpscan.com || CC to : corpscan@vsnl.net

Address:
Project Coordinator
M/s Corp Scan Group
Corp Scan Tower
12 / 27 Plot 2 Mohit Nagar,
Old Palam Road
Dwarka,
New Delhi 110078
Ph: +91-9643510422

Best Regards

Himanshu Shekhar
---------------------------------------
Chief Operating Officer

Corp Scan Group

New Delhi, India

+91-11-25081968
+91-9811099051

www.corpscan.com
 M &E of Projects funded under Centrally Sponsored Scheme of National Mission on
Medicinal Plants of NMPB
Farmers Questionnaires
Sanctioned No/ Serial
Project Year State
No
Name of Farmers and
Gender Male Female
Address
Village Block/ Tehsil Category General OBC SC ST
District
Details of Land Holding (Ha)
Own Land Land on Lease Total Land Holding
Name of Cluster Date of Joining the Cluster
Name of Field Specialist Date of field visit
Performance of cultivation () Very Good Good Average Poor
Area Approved for cultivation of medicinal plant (ha)
Details of Medicinal Plant Cultivation under Mission
Plant Crop Duration No. of Plants per ha.
Name (months) 2013-14 2014-15 2015-16 2016-17
As per Actual As per Actual As per Actual As per Actual
Approved Approved Approved Approved

Survival rate of Medicinal Plants (%)

Crop Name with
2013-14 2014-15 2015-16 2016-17
Species

Crop Production and their Disposal

Quantity Produced (kg) Quality Sold (kg) Rate Received (Rs/kg)
Crop 2013-14 2014-15 2015-16 2013-14 2014-15 2015- 2013-14 2014-15 2015-16
Cultivated 16

To whom you sold the produce

Name of the Local Traders at In Local Mandi Ayurvedic Others, Please
Crop Plant Village Level Pharmacies specify

FROM WHICH CROP YOU HAVE DIVERTED THE AREA TO MEDICINAL CROPS
Crop Code: Cotton-1, sugarcane-2, maize-3, Bajra-4, Jawar-5, Paddy-6, Ragi-7, wheat-8, gram -9, pea-10,
Lintil- 11, Arhar -12, Moong-12, Urd-13, Soyabean-14, and Rapeseed Mustered -15, Sunflower-16, Safflower-
17, Linseed-18, Niger-19, Other crops specify-20
Benefits availed for growing Medicinal Plants (Tick the applicable): Elite planting material / Assured
Irrigation / Fertilizer / Insecticide / Pesticide / PP Equipment / Drip / Sprinkler / Training/ Cash subsidy
Had you taken the loan for Medicinal Plant Cultivation (Yes – 1, No – 2)
If yes please specify the amount of loan (Rs.)
Name of Bank Amount of Loan Received (Rs.) Rate of Interest Charged (%)

Amount of Subsidy Provided by State Mission under the Scheme

Name of the Plant Amount of 1st Installment Received Amount of 2nd Installment If not received from State
Species Received Mission, reasons thereof

OBSERVATIONS 2013-14 2014-15 2015-16 2016-17

1. Area Cultivated (Code: Total-1. Partially-2, Nil-3)
2. Whether Crops Raised are in Accordance of Approval (Code: Yes-1, No-2)
3. Mode of Grant-in-Aid Received (Code: Cash-1, QPM & Other Inputs-2, Cash
& QPM/Other Inputs Both-3, Not Received-4)
4. Sale of Produced (Code: To Buyer with MoU signed-1, Open Market-2,
 M &E of Projects funded under Centrally Sponsored Scheme of National Mission on
Medicinal Plants of NMPB
Pharmaceutical Industries-3, To Farmer for Seed-4, Used Own Seed
Purposes-5, Not Sold-6, Not Applicable-7
5. Had you Received any Amount for Storage (Code: Yes-1, No-2), if yes
please give the details.
6. Mode of Payment Received for Produce (Code: Cash-1, Cheque-2)
7. Source of Planting Materials (Code: Own-1, Provided by Mission-2, Cluster
Head-3, Received from NMPB funded nursery-4, Other if any-5)
8. Quality of Planting Material Used (Code: Very Good-1, Good-2, Poor-3)
9. Price of Quality Planting Material (Code: High-1, Reasonable-2)
10. Technical support received (Source Code: NMPB/SMPB-1, Forest Dept.-2,
Horticulture Dept.-3, Research Institute-, NGO-5, Other-6 (Specify), None-7)
11. Have you attended any demonstration and medicinal plant Yes /No
RECOMMENDATION Code: (grant in aid utilised in between: Above 10-25% - 1; Between 26-50%
- 2; Between 51-75% - 3; Fully (100%) utilised - 4; Not able to utilised for
the purposes, it was released - 5)
Remarks

OBSERVATIONS OF THE CLUSTER HEAD (ORGANISATION) FOR IMPROVEMENT IN SCHEME

i) Adaptability of species at Farmer level (Codes: Good-1; Avarege-2; Poor-3)

ii) Scope for more area coverage (Codes: Good-1; Avarege-2; Poor-3)
iii) Arrangement for assured marketing/ processing (Codes: Good-1; Avarege-2; Poor-3;
None-4)
iv) Availability of processing centre/Warehouse (Codes: Good-1; Avarege-2; Poor-3; None-4)
v) Availability of Technical Institutions (Codes: Good-1; Avarege-2; Poor-3; None-4)
vi) Types of the Technical Input received from the Institutions (GAP-1; GCP-2; Value
addition-3; Marketing-4; Other (if any)-5

Note: 1. The report should be supplemented with photographs indicating the name of species, age of
the plantation, location and date of capturing the photograph on the back side of the photograph if
available.

Signature of Farmer/ Beneficiary

Signature of other family member

During field verification, take the photographs of the standing crops/tress Specify any identifying
spot about the farmer and his location to justify that the NPC representatives have visited the farmer
house and field -----------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------------------
------------
Signature of Field Specialist Place ………………
Name of Field Specialist Date……………
 M &E of Projects funded under Centrally Sponsored Scheme of National Mission on Medicinal
Plants of NMPB
Individual Farmers Assessment Sheet
(Cultivation Status under National Mission on Medicinal Plants)
Project Year Sanctioned No/ Serial No
Name of Farmer Name Name of Father/Husband
& Address Village Tehsil / Block
District State
Name of the Field Specialist Date of Field Verification
Details of Land Holding (Ha)
Own Land Land on Lease Total Land Holding
Area approved for cultivation under National Mission on Medicinal Plants Area (ha):
Crops Cultivated
Sl. Crops Raised Area Approved Area Cultivated (in ha)
No. Main Crop Inter Crop (ha) 2016-17 2015-16 2014-15 2013-14
1.
2.
No. of Medicinal Plants per ha.
Plant Name Crop Duration 2013-14 2014-15 2015-16 2016-17
(months) As per Actual As per Actual As per Actual As per Actual
Approved Approved Approved Approved

Survival rate of Medicinal Plants (%)

Crop Name with Species 2013-14 2014-15 2015-16 2016-17

Crop Production and their Disposal

Sl. Crop Quantity Produce (Kg.) Quantity Sold (Kg.) Rate Received (Rs./Kg.)
No. Raised 16-17 15-16 14-15 13-14 16-17 15-16 14-15 13-14 16-17 15-16 14-15 13-14
1.
2.
To whom you sold the produce
Amount of Subsidy Provided by Sate Mission Under the Scheme Rs.
Name of the Plant Amount of 1st Amount of 2nd Installment If not received from State Mission,
Species Installment Received Received reasons thereof

Term Loan Details

Name of Bank Amount of Loan Received (Rs.) Rate of Interest Charged (%)

OBSERVATIONS 2013-14 2014-15 2015-16 2016-17

1. Area Cultivated (Code: Total-1. Partially-2, Nil-3)
2. Whether Crops Raised are in Accordance of Approval (Code: Yes-1, No-2)
3. Mode of Grant-in-Aid Received (Code: Cash-1, QPM & Other inputs-2,
Cash & QPM/Other Inputs both-3, Not Received-4)
4. Sale of Produced (Code: To Buyer with MoU Signed-1, Open Market-2,
Pharmaceutical industries-3, To farmer for seed-4, Used own seed purposes-
5, Not sold-6, Not applicable-7
5. Had you Received any Amount for Storage (Code: Yes-1, No-2), if yes
please give the details.
6. Mode of Payment Received for Produce. (Cash -1; Cheque -2)
7. Source of Planting Materials (Code: Own-1, Provided by Mission-2, Cluster
Head-3, Received from NMPB Funded Nursery-4, Other if any-5)
8. Quality of Planting Material Used (Code: Very Good-1, Good-2, Poor-3)
9. Price of Quality Planting Material (Code: High-1, Reasonable-2)
10. Technical Support Received (Source Code: NMPB/SMPB-1, Forest Deptt.-
2, Horticulture Deptt.-3, Research Institute-, NGO-5, Other-6 (Specify),
None-7)
11. Have you Attended any Demonstration and Medicinal Plant Yes /No
RECOMMENDATION Code: (grant in aid utilised in between: above 10-25% - 1; Between 26-
50% - 2; Between 51-75% - 3; fully utilised - 4,; Not able to utilised for
the purposes, it was released - 5)
Remarks