A B C D

1 WORKFORCE MANAGEMENT SYSTEM

2 PHOTO
3 NOTE: NEED TO BE FILLED
4
5 REPORTING DATE 22.05.2023 WORK AREA SHIP REPAIR
6
MARINE ALIGNMENT GUIDE AND ENGG
7 VENDOR CODE DV0004862 VENDOR NAME
SERVICES
8
9 FIRST NAME SAHID HOSEN MOLLA LAST NAME
10
11 FATHER NAME NAJIM UDDIN MOLLA MOTHER NAME
12
13 MOBILE NO EMAIL ID
14
NAME OF PREVIOUS
15 EXPERIENCE
EMPLOYER
16
17 ALTERNATE MOBILE NO ALTERNATE EMAIL ID
18
19 GENDER Male DATE OF BIRTH 22.01.2003
20
21 AGE 20 BLOOD GROUP
22
23 MARITAL STATUS DESIGNATION FITTER
24
25 AADHAR NO 880401530076 LICENCE NO
26
27 QUALIFICATION IF OTHERS
28
29 WORK AREA Ship Repair BUSINESS UNIT
30
31 VALID FROM VALID TO
32
33 PRESENT/RESIDENTIAL BELIDANGA, USTHI, KALARIA, SOUTH COUNTRY INDIA
34 ADDRESS 24 PARGANAS, WEST BENGAL
35 STATE WEST BENGAL
36
37 DISTRICT SOUTH 24 PARGANAS
38 PINCODE 743375
39
40 PERMANENT ADDRESS BELIDANGA, USTHI, KALARIA, SOUTH COUNTRY INDIA
41 24 PARGANAS, WEST BENGAL
42 STATE WEST BENGAL
43
44 PINCODE DISTRICT SOUTH 24 PARGANAS
45 743375
EMERGENCY CONTACT RELATIONSHIP WITH
46 8921031689 Brother
NUMBER NEXT OF KIN
47
POLICE STATION (FOR
48 SECURITY CLEARANCE YES
VERIFICATION)
49

50 DATE OF PCC APPLICATION DATE OF VERIFICATION

51
52 NOTE:
53 1) ALL DETAILS TO BE FILLED WITH ORIGINAL RECORDS AND ALL COLUMNS TO BE FILLED

2) IDENTITY CARD TO BE RETURNED TO THE SECURITY DEPT ON COMPLETION OF WORK/DISENGAGEMENT OF LABORERS/WORKER DUE TO
54
ANY REASON.

3) DETAIL OF ALL INDIVIDUALS TO BE SUBMITTED BY VENDOR TO POLICE FOR VERIFICATION AND DEPOSIT THE SAME TO L&T PRIOR TO ISSUE
55
OF PASS.

4) VENDOR /CONTRACTOR IS RESPONSIBLE TO ENSURE ALL PERSONS WHO ARE APPOINTED BY HIM FOR WORK ARE OF GOOD CHARACTER
56
AND NO CASES ARE PENDING AGAINST THEM
AUTHORITY LETTER FOR CONTRACTOR IDENTITY CARD
PHOTO

1 Name SAHID HOSEN MOLLA

2 Father Name NAJIM UDDIN MOLLA
3 Contractor name MARINE ALIGNMENT GUIDE AND ENGG SERVICES
4 Designation/Type of work FITTER
Aadhar card / Driving License / Voter ID/passport / ration
5 Govt issued ID proof card with photo proof / pan card with address proof (To
be attached),
6 Age/Blood group/DOB 20years/
7 Aadhar Number 880401530076
8 Contact number 0

BELIDANGA, USTHI, KALARIA, SOUTH 24 PARGANAS,

9 Permanent address WEST BENGAL ,SOUTH 24 PARGANAS , WEST BENGAL,
INDIA,

BELIDANGA, USTHI, KALARIA, SOUTH 24 PARGANAS,

10 Temporary address WEST BENGAL,SOUTH 24 PARGANAS , WEST BENGAL,
INDIA, 743375

11 Verification Police verification – Yes/No

12 Next of Kin with relationship Brother

13 Emergency contact number (Next of Kin) 8921031689

14 Work area /Site/Shop SHIP REPAIR

15 Duration: From--To 3 Months

SAFETY INDUCTION CARRIED OUT DATE:______________ SIG OF SAFETY DEPT:____________

Note:
1) Identity card to be returned to the security dept on completion of work/disengagement of
laborers
2) Detail /worker due to any
of all individuals reason.
to be submitted by vendor to police for verification and deposit the same
to Vendor
3) L&T prior to issue ofispass.
/contractor responsible to ensure all persons who are appointed by him for work are
of good character and no cases are pending against them.
Sign of Individual: Sign of Contractor: Sign of Production dept.: Sign of Contract cell:
Name: Name:
PS no: PS no:

Sign of Training Centre:

Sign of IR: Sign of OHC: (Required only for Welders & MHE Sign of CSO:
operators)
Name: Name: Name: Name:
PS no: PS no: PS no: PS no: