PROJECT- Boundary Wall Construction for

Beumer Group

SAFETY LAPSES – PENALTY LETTER

Date:

Location:

Name of staff:

Kind Attn:

It is for
your information that a penalty of Rs.( ) is imposed against you for thefollowing
safety violations.

ITEM DESCRIPTION OF SAFETY VIOLATIONS PENALTY

Prepared by: (Name & Designation)

Approved by: Approved by:

SHE manager Project Manager

Please tick as appropriate

Accounts Department – Please deduct the above mentioned amount accordingly from
theprogress payment.

Cash payment of has been paid on

to site SafetyCommittee Secretary.

Acknowledgement of payment by