BSL FORMAT FOR TEMPORARY (Contractual Worker) & OTHER ORGANIZATIONS GATE PASS (ZTGP)

Request to be made by Contractor / Vendor

Organization Detail : Vendor Code : ________________ Vendor Name : ____________________________________________________
Gate Pass Period : From ___/___/20___ To ___/___/20___ WO/PO/DO/AGT No : ________________________________ Date : ___/___/20___
Subcontractor Detail : SC Vendor Code : ___________ SC Name: _____________________ SC Address : _____________________________________
Principal Employer : BSL [ ] / HSCL [ ] / BPSCL [ ] / INOX [ ] / BPSCL [ ] / OTHER [ ]
Details of Persons for Gate Pass :
Sl Name Grade M/F IP No City State Night DocTyp:IP/PAN ID Mobile Bank Name Account
(For Worker) Permit VoterID/Aadhar mark number
Catg Address DOB Gate Father’s Name PIN Country Sunday / Doc No Blood Aadhar Branch
W/O Holiday Group
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 BSL FORMAT FOR TEMPORARY (Contractual Worker) & OTHER ORGANIZATIONS GATE PASS (ZTGP)
Request to be made by Contractor / Vendor

UNDERTAKING BY THE FIRM :

में प्रमाणित करता हॉ की ऊपर सचीबद्ध सभी कामगार भारतीय नागररक है और उन्हें सबको मैं ब्यक्तिगत रूप से जानता हॉ 1 इन सभी का ककसी भी प्रकार का
अपराधिक मामऱा ककसी भी पुधऱस स्टे शन में ऱॊक्तबत नह ॊ हैं 1 उन सभी को SAIL/ BSL के अन्दर कायय में ऱगाने हे तु SAIL/ BSL सुरऺा के धऱए कोई खतरा
नह ॊ आएगा 1 अगर इन के कायय अविी में ककसी प्रकार असुरऺा उत्पन्न होती हैं तो इसके धऱये में स्वयॊ णजम्मेदार रहॉ गा 1

Proprietor/Contractor Details -- Name : _____________________________ Signature : ________________________ Seal of Firm :

Help for Grade in case of Others:

DRIVER, HELPER, HSW1, HSW2, HSW3, JR-EXEC, PARTNER, PROPRIETOR, SR-EXEC, SUP-SPL, SUPPLIER, TECH-SPL

PHOTO COPIES OF FOLLOWING DOCUMENTS TO BE SUBMITTED AT CISF BY CONTRACTOR/CONTRACT LABOUR :

For Contract Labour : For Others :
1. ID Proof as per Gate pass request. 1. ID Proof as per Gate pass request.
2. Bank A/C Pass Book.
3. Medical Fitness certificate

THIS PART TO BE FILLED BY BOKARO STEEL PLANT :

Engineer In Charge : Safety Department :

Gate Pass Request Number : _________________________ Signature of Safety officer : _________________________

Engineer in Charge Signature : _________________________ Name of Person : _________________________

Engineer in Charge Name : _________________________ Mobile Number : _________________________