Get Draft Moa For Empanelment Of Authorised Local Chemist - Echs

This guide provides a clear and supportive overview of how to complete the Draft MoA for Empanelment of Authorised Local Chemist with ECHS online. It walks through each section, helping users navigate the information needed for successful submission.

Follow the steps to complete the Draft MoA effectively.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the name of the ECHS Polyclinic at the designated section. This identifies the location for which the chemist is applying for empanelment.
3. Fill in the date of the agreement in the format of 'Date/Month/Year' to ensure clarity on when this agreement becomes effective.
4. Complete the name of the Authorised Local Chemist in the specified field, ensuring that it matches the registered business name for legal accuracy.
5. Review and input the agreed percentage discount on MRP, making sure it is not less than 15 percent, as stipulated in the terms.
6. Ensure that all obligations regarding the delivery timelines and product standards are acknowledged and understood, confirming the commitment to supply medicines within the specified timeframe.
7. Fill out the payment terms section, detailing how often billing will occur and what specific details must be included in each bill.
8. Provide the details of the Performance Bank Guarantee, ensuring that the appropriate amount based on the type of ECHS Polyclinic is correctly stated.
9. Sign the document in the designated areas for both the Authorised Local Chemist and the Station Commander, ensuring proper authorization.
10. Include witness signatures as required, which helps to validate the agreement. Ensure that all witness names are clearly printed next to their signatures.
11. Once all sections are accurately completed, save changes, then download the final document. You will have the option to print or share the form as needed once it's finalized.

Complete your documentation online today to ensure a smooth empanelment process.