Project Address :

Emergency Project Address :

Emergency
Godrej, Nurture Contact : 7057909948 Godrej, Nurture Contact : 7057909948

Ambulance : 8421424304 Ambulance : 8421424304

Card No ............. Name : ................................................................................... Card No ............. Name : ...................................................................................
Age : ...................................................................................... Age : ......................................................................................
Designation : ......................................................................... Designation : .........................................................................
Contractor's Name :.............................................................. Contractor's Name :..............................................................
Photo with Photo with
Contactor stamp Sub-Contractor's Name:........................................................ Contactor stamp Sub-Contractor's Name:........................................................
Authorised Sing :.................................................................. Authorised Sing :..................................................................

Date of Issue :................ Date of Issue :................

Valid Till : ...................... Valid Till : ......................
Medical Test: Y/N Height
Work
Hot
Work
Driver &
Operator
Electrical Painting Machi
ne
Medical Test: Y/N Height
Work
Hot
Work
Driver &
Operator
Electrical Painting Machi
ne
Safety Safety
Height Pass Done: Y/N Safety P. Height Pass Done: Y/N Safety P.
Tools Tools

Project Address :
Emergency Project Address :
Emergency
Godrej, Nurture Contact : 7057909948 Godrej, Nurture Contact : 7057909948

Ambulance : 8421424304 Ambulance : 8421424304

Card No ............. Name : ................................................................................... Card No ............. Name : ...................................................................................
Age : ...................................................................................... Age : ......................................................................................
Designation : ......................................................................... Designation : .........................................................................
Contractor's Name :.............................................................. Contractor's Name :..............................................................
Photo with Photo with
Contactor stamp Sub-Contractor's Name:........................................................ Contactor stamp Sub-Contractor's Name:........................................................
Authorised Sing :.................................................................. Authorised Sing :..................................................................

Date of Issue :................ Date of Issue :................

Valid Till : ...................... Valid Till : ......................
Medical Test: Y/N Height
Work
Hot
Work
Driver &
Operator
Electrical Painting Machi
ne
Medical Test: Y/N Height
Work
Hot
Work
Driver &
Operator
Electrical Painting Machi
ne
Safety Safety
Height Pass Done: Y/N Safety P. Height Pass Done: Y/N Safety P.
Tools Tools

Address Address
Local Local
Contact No.(If any ) Contact No.(If any )

Renewal Date Renewal Date

Signature Signature

Contract Person in case of Emergency ................................................................................. Contract Person in case of Emergency .................................................................................
Contractor No........................................................................................................................ Contractor No........................................................................................................................
"I HAVE UNDERSTOOD THE SITE EHS RULES" "I HAVE UNDERSTOOD THE SITE EHS RULES"
मुझे सभी सुरक्षा नियमों की जानकारी दी गई है| मैं सभी सुरक्षा नियमों का शक्ति से मुझे सभी सुरक्षा नियमों की जानकारी दी गई है| मैं सभी सुरक्षा नियमों का शक्ति से
पालन करुंगा| पालन करुंगा|
Card Holder's Sing..................................... Card Holder's Sing.....................................
1-Please carry ID card always with you & present in case of damand. 1-Please carry ID card always with you & present in case of damand.
2-Please report immediately in case of loss or damage. 2-Please report immediately in case of loss or damage.
3-Please return ID card on expiry of validity or end of Contract . 3-Please return ID card on expiry of validity or end of Contract .

Address Address
Local Contact Local Contact
No.(If any ) No.(If any )

Renewal Date Renewal Date

Signature Signature

Contract Person in case of Emergency ................................................................................. Contract Person in case of Emergency .................................................................................
Contractor No........................................................................................................................ Contractor No........................................................................................................................
"I HAVE UNDERSTOOD THE SITE EHS RULES" "I HAVE UNDERSTOOD THE SITE EHS RULES"
मुझे सभी सुरक्षा नियमों की जानकारी दी गई है| मैं सभी सुरक्षा नियमों का शक्ति से मुझे सभी सुरक्षा नियमों की जानकारी दी गई है| मैं सभी सुरक्षा नियमों का शक्ति से
पालन करुंगा| पालन करुंगा|
Card Holder's Sing..................................... Card Holder's Sing.....................................
1-Please carry ID card always with you & present in case of damand. 1-Please carry ID card always with you & present in case of damand.
2-Please report immediately in case of loss or damage. 2-Please report immediately in case of loss or damage.
3-Please return ID card on expiry of validity or end of Contract . 3-Please return ID card on expiry of validity or end of Contract .
Address Address
Local Contact No.(If any ) Local Contact No.(If any )

Renewal Date Renewal Date

Signature Signature

Contract Person in case of Emergency ................................................................................. Contract Person in case of Emergency .................................................................................
Contractor No........................................................................................................................ Contractor No........................................................................................................................
"I HAVE UNDERSTOOD THE SITE EHS RULES" "I HAVE UNDERSTOOD THE SITE EHS RULES"
मुझे सभी सुरक्षा नियमों की जानकारी दी गई है| मैं सभी सुरक्षा नियमों का मुझे सभी सुरक्षा नियमों की जानकारी दी गई है| मैं सभी सुरक्षा नियमों का शक्ति से पालन
शक्ति से पालन करुंगा| करुंगा|
Card Holder's Sing..................................... Card Holder's Sing.....................................
1-Please carry ID card always with you & present in case of damand. 1-Please carry ID card always with you & present in case of damand.
2-Please report immediately in case of loss or damage. 2-Please report immediately in case of loss or damage.
3-Please return ID card on expiry of validity or end of Contract . 3-Please return ID card on expiry of validity or end of Contract .

Address Address
Local Contact No.(If any ) Local Contact No.(If any )

Renewal Date Renewal Date

Signature Signature

Contract Person in case of Emergency ................................................................................. Contract Person in case of Emergency .................................................................................
Contractor No........................................................................................................................ Contractor No........................................................................................................................
"I HAVE UNDERSTOOD THE SITE EHS RULES" "I HAVE UNDERSTOOD THE SITE EHS RULES"
मुझे सभी सुरक्षा नियमों की जानकारी दी गई है| मैं सभी सुरक्षा नियमों का मुझे सभी सुरक्षा नियमों की जानकारी दी गई है| मैं सभी सुरक्षा नियमों का शक्ति से पालन
शक्ति से पालन करुंगा| करुंगा|
Card Holder's Sing..................................... Card Holder's Sing.....................................
1-Please carry ID card always with you & present in case of damand. 1-Please carry ID card always with you & present in case of damand.
2-Please report immediately in case of loss or damage. 2-Please report immediately in case of loss or damage.
3-Please return ID card on expiry of validity or end of Contract . 3-Please return ID card on expiry of validity or end of Contract .