AN UNDERTAKING BY A CONTRACTOR FOR COMPLIANCE OF ALL LAWS,

AS APPLICABLE

GENERAL INFORMATION:
Name of Contractor

Designation –Incharge/ Supervisor/ Owner

Work Order and Vendor Code No.
Contact No
EIC Name
Location and Nature of Work (Unit / Plant name)
Labour License (LL) Valid up to From ________________To 20_____
Nature of Labour License
No of Workers mentioned in the Labour License Nature _____________________

Number of workers___________

Workmen Compensation Policy valid Up to From ________________To 20______

Nature of WC Policy
No of Workers mentioned in the WC Policy Nature _____________________

Number of workers___________

COMPLIANCES:
Salary Paid up to Month _________Year ______ Yes / No
Please mentioned date of Payment________

Cash/Bank Payment Cash No. of Workmen________

Bank No. of Workmen_________

PF Challan /ECR Paid up to Month _________Year

______ Yes / No

PF Challan /ECR covered for all workmen Yes / No

If any deviation please specify reason
Salary Paid as per the Minimum Wages Yes / No
Bonus Paid as per the Bonus Act Yes / No
ATTACHMENTS:
Wage Register (Form No. 17) for the Month Yes / No
_________Year 20______

Attendance Register attached (Form No. 16) for the Yes / No

Month _________Year 20______

1. If any violation or non-compliance is discovered at a later date, I shall be answerable to the authorities,
courts for such violations and non-compliance and the Principal Employer shall not be responsible or liable
for such violations and non-compliance in any manner whatsoever. I hereby fully agree to indemnify the
Principal Employer from associated losses, costs and risks suffered by it in the event of any violations and
non-compliances on my part.

CONTRACTOR SIGNATURE WITH SEALNAME________________________

Notes:
1. Contractor to submit the undertaking before passing any of his running or final bill.
2. Documents to be attached wherever is necessary
---------------------------------------------------------------------------------------------------------------------------------------------------------------------

EIC Remarks Compliances Checked and Verified

Signature of EIC _________________________

Employee Code _________________________