BRIT Project House, AERB Complex, Anushaktinagar, Mumbai-400094 Ph: 022-25565535, 022-27887702 Email: sales@britatom.gov.in, jacob@britatom.gov.in web: www.britatom.gov.in

APPLICATION FOR ORDERING UNSEALED SOURCES (Radio-chemicals/Radio-Labelled compounds) Please fill separate A1 forms for each product

Customer Code: 1.Conginee 2. Invoicee

Name* Name*

Designation* Designation*

Institution* Institution*

Address* Address*

PIN code

PIN code GST No.*

Phone* Phone*

Email id* Email id* 3. Product Details

(a)Radio-isotope*: (b)Code (c)Specific Activity (d)Half-life (e)Quantity* (specify in units of Ci/Bq)

4. AERB authorization details for the above-mentioned radioisotope (a)Authorization reference number* (b)Authorized Quantity* (c)Validity*

5. Purpose of use (if others, please specify exact end use)* On humans Investigation on animals Research Others 6. Delivery Details*: Required on by Personal Collection

Air , Nearest airport 7. Remarks, If any 8. I undertake to ensure that radio-active material

supplied against this application will not be used otherwise than mentioned above. I have read and agree to all terms and conditions of sale laid out in Annexure I.

Signature of Consignee Date and seal:

9. This application may be treated as purchase order of the above radio-active material, subject to its acceptance by BRIT and terms of sale laid out in Annexure I. PO No.:

Signature of person authorized to sign PO on behalf of the Institution Date and Seal:

*Mandatory fields ---------------------------------------------------------------------------------------------------------------------------

Office Use only Payment received details: Passed on to:

For

IGA:

A1 FORM

BRIT Project House, AERB Complex, Anushaktinagar, Mumbai-400094 Ph: 022-25565535, 022-27887702 Email: sales@britatom.gov.in, jacob@britatom.gov.in web: www.britatom.gov.in

Annexure I Terms and Conditions of Sale

1. TDS: No Income Tax is deductible under Section 196 of IT Act, 1961 on payments made to Board of Radiation and Isotope Technology (BRIT), since BRIT is a Government of India department under Department of Atomic Energy.

2. Regulatory Clearance: The consignee should get the source procurement NOC from Atomic Energy Regulatory Board (AERB) (https://aerb.gov.in/index.php/english/elora). The Consignee will be responsible for the use, storage and safe disposal of the radio-active product.

3. Order placement: A1 form duly filled and signed by the person authorized to sign PO and by the person authorized to handle the radioisotope is to be forwarded along with relevant source procurement NOC from AERB. Scanned copies are acceptable. Unsigned/partially filled forms will not be processed. Purchase orders issued by organizations will not be considered for order processing.

4. Price Validity: All products will be charged as per the prices prevailing at the time of supply. Packing and freight charges will be extra. The prices are government approved and there is no scope for any form of negotiations. Taxes and levies are applicable as per the existing government guidelines.

5. Payment: (a) The supply will be made only on receipt of 100% advance payment. If the order is waived from advance

payment under any special circumstances, the payment has to be made within 30 days of receipt of Consignment.

(b) Non-payment within 30 days of supply will lead to appropriate interest and stopping all further supply to the defaulters as per BRIT policy.

(c) Payment method: (i) Online from BRIT website: www.britatom.gov.in through State Bank Collect’s payment portal having net

banking ( any bank), credit/debit cards or cash/DD/ cheque (SBI). (ii) Electronic Payment – NEFT/RTGS, etc- BRIT customer number is to be provided while making the

payment. Name of beneficiary : PAO, BRIT Parking A/c No. : 30394337226 IFSC Code : SBIN 0001268 Bank name & Branch : SBI, BARC, Trombay, Mumbai-400085 CHEQUES ARE NOT ACCEPTABLE.

6. Delivery: (a) The consignment can be delivered either by Air to the nearest feasible airport or can be collected personally

from BRIT Project house, AERB complex, Anushaktinagar ONLY. Supply is not done by any other means like Road/Rail or Sea.

(b) All efforts will be made to supply the products on the scheduled dates. In exceptional cases, supply may get postponed due to any unforeseen situation beyond our control.

(c) Despatch advice indicating the date of dispatch of the consignment will mailed to the registered consignee email id. The consignee should arrange for prompt collection of the consignment. The AWB Nos. for consignments send via Air can be viewed from BRIT website (http://www.britatom.gov.in/htmldocs/airway.html) a day after the scheduled date of despatch.

(d) Non- collection of radioactive consignments from the Airport cargo is not acceptable at any cost. This will lead to 100% penalty and stopping all further supply to the party involved.

7. Cancellation: Order cancellation should be intimated at least four days in advance to the scheduled date of supply. Any cancellations made after this period/non-collection of consignments within two days of supply will attract a penalty of 100% order value which will be adjusted against the advance payment.

8. Resale/Reassignment: The radioactive material supplied against this application must not be sold or transferred to any other user or otherwise disposed off without prior permission from AERB/BARC safety council.

9. Complaints: Any complaint should be brought to BRIT’s notice ASAP to help us trace/redress the discrepancy. 10. Terms and Conditions: The terms & conditions of supply stated above only will apply. BRIT is not bound by any

other terms & conditions stipulated by the applicant in any /tender/RFQ/PO.

A1 FORM