FOR THE USE BY CONTRACTING AGENCY DEPARTMENT ‘The above details were checked / verified and are in order. Salary were disbursed in presence of me / salary remitted to the account of individual on or before due date. ‘The contractor has complied the following: 01. Attendance Register 02. Wage register 03. Wage slips for the month were given to the workers. 04. Photo ID Cards were given to all workers. 05. All workers working under this contract got ESI SMART CARD. 06. Maintaining Register of Workmen employed by contractor- FORM XIII 07. Employment cards - Form XIV were given to all workers” 08. Forms V,VI-A, VI-B given to HR/Welfare (Applicable only ‘Commencement/Completion of contract period) 09. Obtained labour license (applicable only if employed > 20 workers) 10. PF form — 13 (applicable only while obtaining NOC / Last Bill) 11, One month notice to be issued to workers before Completion of contract period / one month salary to be paid. 12. Register of overtime / deduction / Fines /Advance maintained. 13. PF, ESI Challan with Name List and Online verification completed. SIGNATURE WITH SEAL & DATE OF CONTRACTING / EXECUTING AGENCY OFFICIAL FOR USE OF WELFARE SECTION The contractor has completed all the statutory formalities, payment may be réleased. (OR) Since the contractor is yet to comply some statutory obligations, itis requested that Rs. may be withheld towards SIGNATURE & SEAL OF WELFARE OFFICIAL USE BY CONTRACTING AGENCY + Forwarded to Finance & Accounts Department to release the payment for the month of SIGNATURE WITH SEAL & DATE OF CONTRACTING / EXECUTING AGENCY OFFICIAL General Instructions: ‘This format is issued only for running bills and not for full and final payment. For full and final payment, Welfare will issue a clear letter stating that all formalities to statutory obligations have been completed, payment (full & final) may be released. Copies of all related documents may be kept with concerned departments for future inspections by statutory authorities.