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Institution Template 1 -Form Fill

IDENTIFICATION PARTICULARS
Q01

Do you agree to participate in the survey?

Q02

Interviewer Name

Q03

NFID

Q04

Supervisor Name

Q05

NFID

Q06

State name

Q07

State code

Q08

District name

Q09

District code

Q10

Block name

Q11

Block code

Q12

Gram panchayat name

Q13

Gram Panchayat code

Q14

Revenue village name

Q15

Village census code

Q16

Type of District – aspirational or developed?

Q17

Is the institution located in the main village or hamlet?

Q18

What is the name of the hamlet?

Q19

Number assigned to institutional consumer.

Q20

Address

Q21

Date of visit

Q22

Time of visit (Railway Time)

Q23

GPS Coordinates for the Location:

RESPONDENT & INSTITUTION PARTICULARS
A01

Name of respondent

A02

Please mention your designation

A03

Contact telephone number (11 digits)

A04

Age (in completed years)

A05

Sex of respondent

A06

What is the type of institution is being interviewed?

A07

Type of building where your institution is located (for most of the housing structure, in case there is a mix of kutcha and pucca building material).

A08

Is this building owned or rented?

A09

How many floors does the building have?

A10

How many rooms does building have?

A11

Does your building have a separate kitchen?

A12

If there are cooking/heating fuels used by your institution, what are these?

A13

How much is the total amount spent monthly on fuels for cooking/heating for the institution?

A14

Does the building have toilets?

A15

Is/are the toilet(s) functional and currently in use?

A16

Does the toilet(s) have a functional electric light connection?

A17

Does the building have a piped water (tap) connection?

A18

What are the current sources of drinking water for this building?

DETAILS OF ELECTRICITY CONNECTION, USAGE, BILLING AND PAYMENTS
B01

Does the institution have an electricity connection?

B02

Do you have a single electricity connection or a dual connection?

B03

What is the reason for taking a dual/second electricity connection

B04

What is the tariff category of your connection?

B05

Is your institution benefitting from any of the following government schemes related to rural electrification?

B05_1

Pradhan Mantri Sahaj Bijli Har Ghar Yojana (Saubhagya)

B05_2

Deen Dayal Upadhyaya Gram Jyoti Yojana (DDUGJY)

B05_3

Pradhan Mantri Ujjwala Yojana (PMUY) – LPG connection

B06

For how many years has your institution been using an electricity connection?

B07

Is the electricity connection currently functional?

B08

Do you have a single electricity connection or a dual connection?

B09

What is the reason for taking a dual/second electricity connection?

B10A

Please tell me which of the following electrical assets are currently owned by your institution? In case your institution owns other electrical assets, please mention these.

B10A_1

Lights

B10A_2

Ceiling Fans

B10A_3

Table fan

B10A_4

Pedestal fan

B10A_5

Cooler(s)

B10A_6

Air conditioners

B10A_7

Electric stove/induction stove

B10A_8

Mobile phones and other chargeable devices

B10A_9

Refrigerator

B10A_10

Television

B10A_11

Water pump

B10A_12

Drinking water filter

B10A_13

Computer/laptop

B10A_14

Photocopier/printer

B10B

Please tell me what electrical assets you would like to buy/own in the future. It could also be more quantity of the assets you currently own.

B10B_1

Lights

B10B_2

Ceiling Fans

B10B_3

Table fan

B10B_4

Pedestal fan

B10B_5

Cooler(s)

B10B_6

Air conditioners

B10B_7

Electric stove/induction stove

B10B_8

Mobile phones and other chargeable devices

B10B_9

Refrigerator

B10B_10

Television

B10B_11

Water pump

B10B_12

Drinking water filter

B10B_13

Computer/laptop

B10B_14

Photocopier/printer

B11

Can you tell me what are the various electrical appliances used regularly in your institution?

B12

Which appliances did you have before you had an electricity connection?

B13

Do all rooms in the institution have electric points with active connections?

B14

How many lights and fans are there in the institution?

B14_1

Lights

B14_2

Fans

B15

Usually, how many lights and fans are used on a regular basis?

B15_1

Lights

B15_2

Fans

B16

How many two pin and three pin plug points/charging points are there in the institutional building?

B16A

Number of two pin plugs

B16B

Number of three pin plugs

B17

Do you use an extension cord to increase the number of charging points?

B18

Is the electricity requirement the same throughout the year, or are there times when the electricity load requirement is more?

B19

In which months is there a higher electricity load requirement?

B20

From which sources does this institution receive electricity from the main grid (state electricity supply board) or from a mini grid/solar plant?

B21

Which is your primary connection?

B22

Is your mini grid/solar plant connection prepaid?

B23A

Main grid

B23A_1

One time connection cost

B23A_2

Monthly fixed charge/Monthly recharge amount

B23A_3

Cost per unit

B23B

Mini grid/solar plant

B23B_1

One time connection cost

B23B_2

Monthly fixed charge/Monthly recharge amount

B23B_3

Cost per unit

B24

Do you have a single phase or three phase connection?

B25

What was the source of funds for the connection cost?

B26

Who did the electrical wiring inside the institutional premises?

B27

Are you supposed to get electricity on a daily basis or on some days of the week?

B28

How many hours per day (minimum) is the electricity to be supplied?

B29

Usually, is the electricity supply provided on a daily basis?

B30

If not daily, usually on how many days in a week is electricity supplied?

B31

In the last 7 days, how many days did the institution receive electricity supply?

B32

Usually, is the electricity supply reliable on the days of supply?

B33

Usually, how long is electricity supplied (on the days of supply)?

B33A

Duration during the day

B33B

Duration of supply during night

B34

Usually, is the electricity voltage adequate/good?

B35

Usually is there low voltage during the day or evening/night?

B36

Are there frequent electricity outages/disruptions?

B37

What are the different reasons for disruptions in electricity supply?

B38

Do electricity outages/disruptions occur throughout the year, or are they more in some seasons?

B39

How often do you face electricity outages/disruptions?

B40

Usually, how long does an outage last?

B41

Can activities which are dependent on electricity be undertaken in a planned manner in your institution, or are the activities unplanned due to unpredictable electricity availability?

B42

Which appliances are most affected by low voltage or electricity disruptions?

B43

Does your institution have the following devices?

B43_1

Generator

B43_2

Inverter

B43_3

Single solar plate and battery

B43_4

Petromax (LPG lantern)

B43_5

Kerosene lantern/hachak

B43_6

Solar lantern

B44

Which of the following statements are true?

B45

What are the different challenges you face in the electricity supply?

B46

What are the different coping arrangements in your institution during the times when the electricity supply is inadequate?

B47

What is the monthly cost incurred for these coping arrangements?

B47A

Before mini-grid installation:

B47B

After mini-grid installation

B48

On a scale of 1 to 5 (1=extremely dissatisfied and 5=extremely satisfied) can you rate the quality (hours of supply, voltage, load capacity, outages and the purposes for which the electricity can be used at home) of electricity that you receive for institutional use purposes?

B49

Is your electricity connection metered?

B50

What is the type of meter installed?

B51

Does anyone come to read the meter regularly?

B52

If not on meter readings, on what basis are electricity bills generated?

B53

Does the institution pay electricity bills, or is electricity supplied for free?

B54

What is the reason for non-payment?

B55

Referring to your last monthly electricity bill or last bill paid, please tell me:

B55_1

Main grid monthly bill (Rs)

B55_2

Fixed cost (Rs.)

B55_3

Number of units consumed

B55_4

Rate per unit (Rs.)

B55_5

CA Number

B56

In the last one year, can you tell me

B56_1

Average monthly bill in summer months (April-June)

B56_2

Maximum monthly bill paid last year

B56_3

Minimum monthly bill paid last year

B57

Do you usually receive a hard copy bill or an online bill?

B58

At what frequency do you get electricity bills?

B59

When did you get the last electricity bill?

B60

How do you usually pay the bill?

B61

When did you pay the last electricity bill?

B62

Are you given receipts for bill payment?

B63

According to you, is the electricity bill affordable?

B64

On a scale of 1-5 (1=Extremely dissatisfied and 5=Extremely satisfied), are you satisfied with the amount of electricity bill you receive?

B65

On a scale of 1-5 (1=Extremely dissatisfied and 5=Extremely satisfied), are you satisfied with the frequency at which you receive the electricity bill?

B66

If you are not satisfied, what are the reasons thereof?

B67

What is the source of funds for payment of electricity bills?

B68

Do you currently have electricity dues over a month?

B69

Were any bills waived off?

B70

Who decided to waive off the overdue amount?

B71

What kind of service improvements would you like to have in terms of number of hours of service?

B72

What other kinds of service improvements/assurance would you like to have?

B73

For your current electricity bill, what would be your expected hours of electricity supply?

B74

What are the other expectations from electricity service improvements?

B75

I am now going to read you some possible electricity service improvement scenarios. Compared with your current electricity services, please tell me whether this improvement is relevant for your institution. In case, the improvement option is relevant for your institution, please tell me the additional amount (to your current monthly bill) that you are willing to pay.

B75_1

8 – 12 hours, with adequate voltage

B75_2

12 - 16 hours, with adequate voltage

B76

What may be the source of funds for potential contribution for improvements from the institution?

B77

Do you get electricity on a daily basis from the mini grid/solar plant?

B78

Do you get electricity round the clock from the mini grid/solar plant?

B79

Do you have problems with voltage fluctuations (when the lights are dim and the other appliances do not work so well) from the mini grid/solar plant supply?

B80

How frequently do you have voltage fluctuations?

B81

Are you able to operate high(er) wattage equipment like heaters/water heaters, electric cookstoves, ironing machines, blender-mixer, etc. whenever you require, or are they operated during specified times of the day?

B82

Do you have an MCB (automatically operated electrical switch for a miniature circuit breaker to prevent damage to an electrical circuit due to high current usage)?

B83

Do you have an electricity meter supplied by the mini grid/solar plant?

B84

Does the meter work on a pre-paid basis (you have to charge at the beginning of the month/ before usage) or work on a post-paid basis (meter read and bills generated at the end of the month/after usage)?

B85

Does someone/operator come to read the mini grid/solar plant meter every month?

B86

Usually, what are the number of electricity units that are used by your institution in a month?

B87

What was the amount of your last bill?

B88

Usually, on what day of the month is the meter reading taken?

B89

Does your institution have an electricity passbook from the mini grid/solar plant, where the meter reading, bill amount and payment is noted?

B90

How is the bill provided to your institution?

B91

Does the institution pay electricity bills, or is electricity supplied for free?

B92

Usually on what day of the month is payment of the electricity bill made?

B93

What is the reason for non-payment?

B94

How frequently do you pay the electricity bill?

B95

Currently, does your institution have any unpaid electricity bills for more than one month for the mini grid/solar plant-based supply?

B96

Is solar electricity adequate for all your institution needs?

B97

If your institution increases electricity utilization by operating electrical gadgets for a longer time, or buy additional electrical appliances, will the solar electricity be adequate?

B98

On a scale of 1 to 5 (1=extremely dissatisfied and 5=extremely satisfied) can you rate the quality of electricity that you receive from the mini grid/solar plant?

B99

If the electricity services further improve in terms of the load that is provided to the institution, would your institution be willing to pay for the services? If yes, would you prefer to pay a higher (than domestic connection rate) fixed cost or a higher cost per unit, or both?

B100

What would be the increase over the current total bill amount that your institution will be willing to pay?

B101

What may be the source of funds for potentially higher monthly bills due to improved electricity service?

B102

If you are asked to choose an electricity service provider, what will be your criteria for selection?

B103

If you are asked to choose an electricity service provider from this list, which one will you select?

INFORMATION ABOUT INSTITUTIONAL ESTABLISHMENTS WITHOUT ELECTRICITY CONNECTION
C01

Did the institutional establishment ever have an electricity connection?

C02

If yes, why was the connection disconnected?

C03

What is the reason for not having an electricity connection?