Company name Performance Certificate

Performa I

Company name.

Monthly statement on providing tools & tackles, consumables and PPEs as per
contract

Month ..............

1) This is to certify that Tools and tackles are provided as per contract clause: YES / NO

If No, provide details of deficiency ....................................

2) This is to certify that consumables are provided as per contract clause: YES / NO

If No, provide details of deficiency ......................................

3) This is to certify that PPEs are provided to contractors personnel as per contract clause:
YES / NO

If No, provide details of deficiency .......................................

Process/Maintenance In-Charge HSE In-charge

OIM (