Sr.No Particulars Description PDF Attachment
A 1 Name and Address of Contractor A2Z Infraservices Ltd,
O-116 1st Floor Shopping Mall Arjun Marg
DLF city Phase-1 Gurgaon
2 Website address
3 Name and address of the proprietor/Director/Partners
4 Phone/Mobile Number and E-mail I.D.
of establishment/person in-charge of contract
Mobile No. +91 8860864646
E Mail id.
5 Name and address of the place/site where
the contract workers are to be employed
M/S Surya Maintenance Agency Pvt Ltd
6 Phone/Mobile Number and E-mail ID of person in-charge of the site Mr. Hari Krishan
Mobile No. +91 8800702340
7 Copy of MOA/AOA/Partnership Deed/Properietor's ID Proof
8 Form"V" Issued by P.E.-Rule 21(2)
9 Notice of commencement/completion of contract work-Rule 25(2)
10 Form IV -Rule 21(1)/VIII-Rule29 (2)
11 Agreement with P.E. along with rate&n. of workers for
which contract has been given
12 Letter of extension of contract period, in case of renewal of license
13 Affidavit that wages are being disbursed through account payee cheque/ECS
14 Affidavit for legal compliance including condition of license
15 Challan of License Fee/(Late Fee, If any) G.A.R-7
16 Challan of Security Deposit (G.A.R-7)
17 License No under CLRA Act, 1970
18 Nature of work for which contract workers are to be engaged/employed Facility Services
19 Registration Number/Certificate under
the Delhi Shops 7 Establishment Act, 1954
20 PF Code Number
21 ESI Code Number
22 Half Yearly Return-Rule 82(1)
B 1 Name and address of the Principal Employer
2 Website address
3 Name and address of the Proprietor/Director/Partner of P.E.Estt
4 Phone/Mobile Number of person in-charge of contract work/ site
5 Registration Certificate No. Under CLRA act, 1970