Vehicle Entry Pass

Employee Vehicle Contractor Vehicle To, Security Department, Jindal Power Limited, Tamnar Name of Employee Designation Name of Contractor M/s Name of Subcontractor M/s Scope of Work: Work Order No.: Vehicle Reg. No. Drivers License No. Insurance Policy No. PUC No.: Fitness / Worthiness Certificate No. Type of Vehicle: Drivers Name: Validity: Department

4X250 MW & 4X600 MW Hired Vehicle

Date of application: Employee Code

Validity: Validity: Validity:

(applicable in case of public transport/carrier/heavy lifting equipments) I/We certify that the particulars furnished above are true to best of our/my knowledge and belief Signature of Employee/Contractor: For only Hired / Contractor Vehicle:

Signature of HOD

Gate Pass Validity up to

Signature of HR & Admin

Gate Pass Validity up to Signature of Security For Office Use Only (Security)

Vehicle gate Pass No. Issued Validity From To