Ciena India Employee Transportation Scheme

Subscription Form

Please complete and submit to Facilities

New Subscriber Route Change Request

Name :…………………………………………………..

Designation :………………………………………………….

Employee Code : …………………………………………………..

Residence Address : ……………………………………………………

……………………………………………………..

I hereby give my consent to avail the Transportation facility on group sharing

basis at my own risk and volition. I acknowledge that this Transportation facility is
being provided at the collective request and for the benefit of all the employees
and I agree that the company shall in no manner be responsible for any loss or
damage suffered by the employees due to enjoyment of such facility.

I also affirm that I have read and understood all the rules and regulations of the
Transportation Scheme as set out in Transport Policy Ver. 1.0 and I accept and
agree to abide by the same. I further agree that any claim in respect of any loss
or damage suffered by virtue of availing the Transportation Scheme shall be
made directly against the contractor engaged by the company for provision of
such Transportation facility.

Employee Date:
Signature :