ID Application form validity Period Till 

                                                 
Coastal Energen Private Ltd
IDENTITY CARD APPLICATION FORM - O & M
CONTRACTOR DETAILS
Name of the Associate with
Company Seal SR TURBO ENERGY PRIVATE LTD

Work category O&M Others

Nature of Work

Contact No of Supervisor with In-

Charge Signature
EMPLOYEE DETAILS

Name

Sex / Blood Group Design.

Age & Date of Birth

Permanent Address

Contact No Signature of Employee

EMERGENCY CONTACT DETAILS
Contact Person Name Relation Contact No

Documents Required for Identity Card

01. Energen work order/Intro about company – to be mailed by Energen HoD/Package Owner

02. Employees ID proof (Aadhar card must) /Address proof

03. Medical Certificate with Health Register (Form 17) - (For Others Work category not required)

04. ESI for Employees / WC Policy for ESI Exemption employees

05. Register of Workmen – FORM 13

OFFICE USE ONLY
 Site IC Signature - Associate Agency Steag - HOD Signature CEPL - HOD Signature

CEPL - HR Signature Steag-Safety IC Signature CEPL - Safety IC Signature

Identity Card Validity From                                          to                                            
 Old ID ref. No.

Others

PHOTO
 Steag - HR Signature

Energen -Security IC Signature

ID Application form validity Period Till                                                  
Coastal Energen Private Ltd
IDENTITY CARD APPLICATI
ON FORM - O & M Old ID ref. No.

CONTRACTOR DETAILS
Name of the Associate with
Company Seal THERMONIX TECHNOLOGIES PRIVATE LIMITED

Work category O&M Others

Nature of Work

Contact No of Supervisor with

In-Charge Signature
EMPLOYEE DETAILS

Name

Sex / Blood Group Design.

PHOTO
Age & Date of Birth

Permanent Address

Contact No Signature of Employee

EMERGENCY CONTACT DETAILS
Contact Person Relation Contact No
Name

Documents Required for Identity Card

01. Energen work order/Intro about company – to be mailed by Energen HoD/Package Owner

02. Employees ID proof (Aadhar card must) /Address proof

03. Medical Certificate with Health Register (Form 17) - (For Others Work category not required)

04. ESI for Employees / WC Policy for ESI Exemption employees

05. Register of Workmen – FORM 13

OFFICE USE ONLY

Site IC Signature - Associate

Agency Steag - HOD Signature CEPL - HOD Signature Steag - HR Signature

CEPL - Safety IC Energen -Security IC

CEPL - HR Signature Steag-Safety IC Signature Signature Signature
Identity Card Validity From                                          to