FORM I

Application for registration of establishments employing Contract Labour [Rule 17(1)]

1	Name & location of the establishment: 		Er. C.S. AZAD, EXECUTIVE ENGINEER, 	
2	Postal address of the establishment: 
	O/o THE EXECUTIVE ENGINEER, CIVIL BUILDING MAINTENANCE DIVISION M-422, PWD (GNCTD), PTS MALVIYA NAGAR, NEW DELHI-110017.	
3	Full name and address of the Principal Employer (furnish father’s name in case of individuals): 
	
Er. C.S. AZAD, EXECUTIVE ENGINEER, O/o THE EXECUTIVE ENGINEER, CIVIL BUILDING MAINTENANCE DIVISION M-422, PWD (GNCTD), PTS MALVIYA NAGAR, NEW DELHI-110017.	
4	Full name and address of the manager or person  responsible for the supervision & control of the establishment: 
	
Er. C.S. AZAD, EXECUTIVE ENGINEER,
CIVIL BUILDING MAINTENANCE DIVISION M-422, PWD (GNCTD), PTS MALVIYA NAGAR, NEW DELHI-110017.	
5	Particulars of work carried on in the establishment: 
	
As Annexed	
6	Particulars of Contractors and Contract Labour: 		
	(a)	Names and addresses of the Contractors: 

As Annexed	
	(b)	Nature of work in which contract labour is employed or to be employed: 
		
	(c)	Maximum number of contract labour to be Employed on any day through each contractor: 		
	(cc)	Estimated date of commencement of each Contract work under each contractor: 		
	(d)	Estimated date of termination of employment of contract labour under each contractor: 		
7	Amount and particulars of Registration fee deposited: 		

Declaration: I hereby declare that the particulars given above are true to the best of my knowledge and belief.

Place :

Date:
Signature & Seal of

the Principal Employer

Annexure-A

S.No./
Agmt. No	

Name of work
	(a) Names and 
addresses of the 
Contractors:
	(b) Nature of work in which contract labour is employed or to be employed:	(c)Maximum number of contract labour to be Employed on any day through each contractor:	(cc)Estimated date of commencement of each Contract work under each contractor:	(d)Estimated date of termination of employment of contract labour under each contractor:	
1.
63/15-16	A/R & M/O Saket Court Complex (Non-Residential) under sub-division M-4223, CBMD M-422, PWD, New Delhi. dg. 2015-16. (SH: providing of services of computer operator, skilled, semi-skilled and un-skilled labour etc).	M/s. Imanullah & Co.,
17, WEST LAXMI MARKET, STREET NO. 5, 
Delhi-110051	Labour Supply at Saket Court Complex, New Delhi.	24	24/12/2015	23/06/2016	
2.
73/15-16	Construction of Boundary Wall for Bifurcation School with concentina coil fencing in GGSSS Dera, New Delhi (School ID:- 1923023).	M/s Ranjit Construction,  
1678/2, Gobindpuri, Extension, 
Gali No.2, Kalka Ji 
New Delhi-110019	Construction Work at GGSSS Dera, New Delhi (School ID:- 1923023). 	22	23/01/2016	25/04/2016	
3.
82/15-16	Re construction of fallen boundary wall, Repair of any other portion of wall which is damaged, pointing of old wall to increase the life, leveling and removal of malba from the play ground and seepage of some rooms at SKV Sultanpur(School ID: 1923061).	M/s Jagdish Associates,
H. No. 1882, Jagram Mandir Marg,
Kotla Mubarakpur, 
New Delhi-110003.	Repair/Renovation at SKV Sultanpur (School ID: 1923061).	30	05/02/2016	04/05/2016	

FORM I

Application for registration of establishments employing Contract Labour [Rule 17(1)]

1	Name & location of the establishment: 		Er. C.S. AZAD, EXECUTIVE ENGINEER, 	
2	Postal address of the establishment: 
	O/o THE EXECUTIVE ENGINEER, CIVIL BUILDING MAINTENANCE DIVISION M-422, PWD (GNCTD), PTS MALVIYA NAGAR, NEW DELHI-110017.	
3	Full name and address of the Principal Employer (furnish father’s name in case of individuals): 
	
Er. C.S. AZAD, EXECUTIVE ENGINEER, O/o THE EXECUTIVE ENGINEER, CIVIL BUILDING MAINTENANCE DIVISION M-422, PWD (GNCTD), PTS MALVIYA NAGAR, NEW DELHI-110017.	
4	Full name and address of the manager or person  responsible for the supervision & control of the establishment: 
	
Er. C.S. AZAD, EXECUTIVE ENGINEER,
CIVIL BUILDING MAINTENANCE DIVISION M-422, PWD (GNCTD), PTS MALVIYA NAGAR, NEW DELHI-110017.	
5	Particulars of work carried on in the establishment: 
	A/R & M/O EDUCATIONAL BUILDING UNDER SUB-DIVISION M-4222, NEW DELHI DURING 2015-16 (SH : PROVIDING OF SERVICES OF COMPUTER OPERATOR, SKILLED, SEMI SKILLED AND UN-SKILLED STAFF ETC.).	
6	Particulars of Contractors and Contract Labour: 		
	(d)	Names and addresses of the Contractors: 
	M/s. Imanullah & Co.,17, WEST LAXMI MARKET, STREET NO. 5, 
Delhi-110051
	
	(e)	Nature of work in which contract labour is employed or to be employed: 
	A/R & M/O EDUCATIONAL BUILDING UNDER SUB-DIVISION M-4222, NEW DELHI DURING 2015-16 (SH : PROVIDING OF SERVICES OF COMPUTER OPERATOR, SKILLED, SEMI SKILLED AND UN-SKILLED STAFF ETC.).
	
	(f)	Maximum number of contract labour to be Employed on any day through each contractor: 	21 Nos. of Workers.	
	(dd)	Estimated date of commencement of each Contract work under each contractor: 	30.08.2015	
	(e)	Estimated date of termination of employment of contract labour under each contractor: 	28.02.2016	
7	Amount and particulars of Registration fee deposited: 		

Declaration: I hereby declare that the particulars given above are true to the best of my knowledge and belief.

Place :

Date:
Signature & Seal of

the Principal Employer