FORM XII

(See Rule 72(2)(a)) MUSTER ROLL

Name & address of the Contractor : R.K.ENGINEERING - C/O Universal MEP Projects & Engineering Services Ltd, Faridabad, Haryana

Name & Address of Establishment in/under which contract is carried on:- BOMBAY HOSPITAL TRUST, KHASRA NO. 269, RAMCHANDRAPURA, JAIPUR (RAJASTHAN) - 302018

Nature & Location of work:- FIRE FIGHTING & JAIPUR (RAJASTHAN)

Name & Address of the Principal Employer:- BOMBAY HOSPITAL TRUST, KHASRA NO. 269, RAMCHANDRAPURA, JAIPUR (RAJASTHAN) - 302018

Period - June - 2023

S
NO.
Name of the Workman Father's Name SEX 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Remarks

1 Jay Prakash Nishad Raj Dev Nishad M P P A S P P P P P P S P P A P P P S P P P P P P S P A P P A 22

2 Rahul Kumar Sudarshan M P P A S P P P P P A S P P P P P P S A A P P A P S A P A A P 19

3 Ravindra Nishad Shiv Pujan M P P A S A P A P A P S P A P P P P S P A P A P P S P A A P P 18

4 Keshwar Mainejar M P P P S P P P P P A S P A P A P P S P A A P P P S P A P P P 21

5 Ramesh Bhola M P P P S P P P P P P S P P P P A P S A P P P P A S P P P P A 23

6 Arvind Kumar Gopichand Baitha M P P P S P P P A P A S P A P P P P S P A P A P A S P P P A P 20

123
Date: 31-05-2023
Signature of the Contractor
Place: Jaipur (Rajasthan)
 FORM XIII
(See Rule 72(2)(a))
REGISTER OF WAGES

Name & address of the Contractor : R.K.ENGINEERING - C/O Universal MEP Projects & Engineering Services Ltd, Faridabad, Haryana
Name & address of establishment in/ under which contract is carried on:- BOMBAY HOSPITAL TRUST, KHASRA NO. 269, RAMCHANDRAPURA, JAIPUR (RAJASTHAN) - 302018
Nature & Location of work: FIRE FIGHTING & JAIPUR (RAJASTHAN)
Name and Address of Principal Emoloyer : BOMBAY HOSPITAL TRUST, KHASRA NO. 269, RAMCHANDRAPURA, JAIPUR (RAJASTHAN) - 302018
Wage period - June - 2023
S. No. Name of workman Designation No. of Wage Rate Unit of Piece Amount of wages earned Total Deductions Total
Serial No.in nature of work working Work Rate Deduction
done days done Basic Dearness Overtime Other cash PF Ded ESIC Ded
register of Wage Allowance Payments
workmen s indicating
employed by nature of
contractor payments

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

1 Jay Prakash Nishad 1 Skilled 22 283 0 0 6226 0 0 0 6226 747 47 794

2 Rahul Kumar 3 Skilled 19 283 0 0 5377 0 0 0 5377 645 41 686

3 Ravindra Nishad 16 Unskilled 18 259 0 0 4662 0 0 0 4662 559 35 594

4 Keshwar 17 Unskilled 21 259 0 0 5439 0 0 0 5439 653 41 694

5 Ramesh 20 Skilled 23 283 0 0 6509 0 0 0 6509 781 49 830

6 Arvind Kumar 21 Skilled 20 283 0 0 5660 0 0 0 5660 679 43 722

Total 123 0 0 33873 0 0 0 33873 4064 256 4320

UR (RAJASTHAN) - 302018

Initial of
authori
Net Pay Time and Place of Signature/thumb sed
date of Payment impression of employees represe
payment Initial of ntative
Contrac of
tor or principa
his l
Represe employ
ntative er
17 18 19 20 21 22

5432

4691

4068

4745

5679

4938

29553
 FORM XV
[See Rule 77 (2) (b)]

WAGE SLIP
Name and address of Contractor:- R.K.ENGINEERING - C/O Universal MEP Projects &
Engineering Services Ltd, Faridabad, Haryana
Name and address of establishment in /under which contract is carried on : BOMBAY
HOSPITAL TRUST, KHASRA NO. 269, RAMCHANDRAPURA, JAIPUR (RAJASTHAN) - 302018
Nature and location of work : FIRE FIGHTING & JAIPUR (RAJASTHAN)
Name and address of principal employer :- BOMBAY HOSPITAL TRUST, KHASRA NO. 269,
RAMCHANDRAPURA, JAIPUR (RAJASTHAN) - 302018
Name and Father’s Name of he workman :- Jay Prakash Nishad & Raj Dev Nishad
For the month :- June-2023
Sex and identification:- Male
Token/Ticket No. 1
No. of Rate of daily No. of units Dates on Overtime hours Gross Deducti Actually Signature of the
days wages/piece worked in which and amount of wages ons if wages paid contractor or his
worked rate case of overtime overtime payable any representative
piece rate worked
workers wages

1 2 3 4 5 6 7 8 9
22 283 0 NA 0 6226 794 5432

Place :-Jaipur, Rajasthan Signature of the Contractor

Date: 30-06-2023

FORM XV
[See Rule 77 (2) (b)]
WAGE SLIP
Name and address of Contractor:- R.K.ENGINEERING - C/O Universal MEP Projects &
Engineering ServicesofLtd,
Name and address Faridabad, Haryana
establishment in /under which contract is carried on : BOMBAY
HOSPITAL TRUST, KHASRA NO. 269, RAMCHANDRAPURA, JAIPUR (RAJASTHAN) - 302018
Nature
Name andandaddress
locationofofprincipal
work : employer
FIRE FIGHTING & JAIPUR
:- BOMBAY (RAJASTHAN)
HOSPITAL TRUST, KHASRA NO. 269,
RAMCHANDRAPURA, JAIPUR (RAJASTHAN) - 302018
Name and Father’s Name of he workman :- Rahul Kumar & Sudarshan
For the month :- June-2023
Sex and identification:- Male
Token/Ticket No. 3
No. of Rate of daily No. of units Dates on Overtime hours Gross Deducti Actually Signature of the
days wages/piece worked in which and amount of wages ons if wages paid contractor or his
worked rate case of overtime overtime payable any representative
piece rate worked
workers wages

1 2 3 4 5 6 7 8 9
19 283 0 NA 0 5377 686 4691

Place :-Jaipur, Rajasthan Signature of the Contractor

Date: 30-06-2023
 FORM XV
[See Rule 77 (2) (b)]
WAGE SLIP
Name and address of Contractor:- R.K.ENGINEERING - C/O Universal MEP Projects &
Engineering ServicesofLtd,
Name and address Faridabad, Haryana
establishment in /under which contract is carried on : BOMBAY
HOSPITAL TRUST, KHASRA NO. 269, RAMCHANDRAPURA, JAIPUR (RAJASTHAN) - 302018
Nature
Name andandaddress
locationofofprincipal
work : employer
FIRE FIGHTING & JAIPUR
:- BOMBAY (RAJASTHAN)
HOSPITAL TRUST, KHASRA NO. 269,
RAMCHANDRAPURA, JAIPUR (RAJASTHAN) - 302018
Name and Father’s Name of he workman :- Ravindra Nishad & Shiv Pujan
For the month :- June-2023
Sex and identification:- Male
Token/Ticket No. 16
No. of Rate of daily No. of units Dates on Overtime hours Gross Deducti Actually Signature of the
days wages/piece worked in which and amount of wages ons if wages paid contractor or his
worked rate case of overtime overtime payable any representative
piece rate worked
workers wages

1 2 3 4 5 6 7 8 9
18 259 0 NA 0 4662 594 4068

Place :-Jaipur, Rajasthan Signature of the Contractor

Date: 30-06-2023

FORM XV
[See Rule 77 (2) (b)]
WAGE SLIP

Name and address of Contractor:- R.K.ENGINEERING - C/O Universal MEP Projects &
Engineering ServicesofLtd,
Name and address Faridabad, Haryana
establishment in /under which contract is carried on : BOMBAY
HOSPITAL TRUST, KHASRA NO. 269, RAMCHANDRAPURA, JAIPUR (RAJASTHAN) - 302018
Natureand
Name andaddress
locationofofprincipal
work : employer
FIRE FIGHTING & JAIPUR
:- BOMBAY (RAJASTHAN)
HOSPITAL TRUST, KHASRA NO. 269,
RAMCHANDRAPURA, JAIPUR (RAJASTHAN) - 302018
Name and Father’s Name of he workman :- Keshwar Singh & Mainejar
For the month :- June-2023
Sex and identification:- Male
Token/Ticket No. 17
No. of Rate of daily No. of units Dates on Overtime hours Gross Deducti Actually Signature of the
days wages/piece worked in which and amount of wages ons if wages paid contractor or his
worked rate case of overtime overtime payable any representative
piece rate worked
workers wages

1 2 3 4 5 6 7 8 9
21 259 0 NA 0 5439 694 4745

Place :-Jaipur, Rajasthan Signature of the Contractor

Date: 30-06-2023

FORM XV
[See Rule 77 (2) (b)]
WAGE SLIP
Name and address of Contractor:- R.K.ENGINEERING - C/O Universal MEP Projects &
Engineering ServicesofLtd,
Name and address Faridabad, Haryana
establishment in /under which contract is carried on : BOMBAY
HOSPITAL TRUST, KHASRA NO. 269, RAMCHANDRAPURA, JAIPUR (RAJASTHAN) - 302018
Natureand
Name andaddress
locationofofprincipal
work : employer
FIRE FIGHTING & JAIPUR
:- BOMBAY (RAJASTHAN)
HOSPITAL TRUST, KHASRA NO. 269,
RAMCHANDRAPURA, JAIPUR (RAJASTHAN) - 302018
Name and Father’s Name of he workman :- Ramesh & Bhola
For the month :- June-2023
Sex and identification:- Male
Token/Ticket No. 19
No. of Rate of daily No. of units Dates on Overtime hours Gross Deducti Actually Signature of the
days wages/piece worked in which and amount of wages ons if wages paid contractor or his
worked rate case of overtime overtime payable any representative
piece rate worked
workers wages

1 2 3 4 5 6 7 8 9
23 283 0 NA 0 6509 830 5679

Place :-Jaipur, Rajasthan Signature of the Contractor

Date: 30-06-2023

FORM XV
[See Rule 77 (2) (b)]
WAGE SLIP
Name and address of Contractor:- R.K.ENGINEERING - C/O Universal MEP Projects &
Engineering
Name ServicesofLtd,
and address Faridabad, Haryana
establishment in /under which contract is carried on : BOMBAY
HOSPITAL TRUST, KHASRA NO. 269, RAMCHANDRAPURA, JAIPUR (RAJASTHAN) - 302018
Nature
Name andandaddress
locationofofprincipal
work : employer
FIRE FIGHTING & JAIPUR
:- BOMBAY (RAJASTHAN)
HOSPITAL TRUST, KHASRA NO. 269,
RAMCHANDRAPURA, JAIPUR (RAJASTHAN) - 302018
Name and Father’s Name of he workman :- Arvind Kumar & Gopichand Baitha
For the month :- June-2023
Sex and identification:- Male
Token/Ticket No. 19
No. of Rate of daily No. of units Dates on Overtime hours Gross Deducti Actually Signature of the
days wages/piece worked in which and amount of wages ons if wages paid contractor or his
worked rate case of overtime overtime payable any representative
piece rate worked
workers wages

1 2 3 4 5 6 7 8 9
20 283 0 NA 0 5660 722 4938

Place :-Jaipur, Rajasthan Signature of the Contractor

Date: 30-06-2023
 FORM IX
[see rule 74]
Register of Workmen Employed by Contractor
Name & address of the Contractor : R.K.ENGINEERING - C/O Universal MEP Projects & Engineering Services Ltd, Faridabad, Haryana

Name & address of establishment in/ under which contract is carried on:- BOMBAY HOSPITAL TRUST, KHASRA NO. 269, RAMCHANDRAPURA, JAIPUR (RAJASTHAN) - 302018

Nature & Location of work: FIRE FIGHTING & JAIPUR (RAJASTHAN)

Name and Address of Principal Emoloyer : BOMBAY HOSPITAL TRUST, KHASRA NO. 269, RAMCHANDRAPURA, JAIPUR (RAJASTHAN) - 302018

Signature or
thumb
Nature of Date of Date of
Serial Father's/Husband's Permanent Home address of workman (Village and impression of
Name and surname of workmen Age and Sex Employment/D Present Address Commencement of termination of Remarks
No Name Tahsil/ Taluca and Distt.) workman
esignation Employment employment

Village - Jeerota, Near Bombay Hospital, Bombay Hospital turst sitapura

1 Jay Prakash Nishad 40 & M Raj Dev Nishad Skilled Jaipur, Rajasthan industrial area Jaipur Rajsthan 1.09.2021

Village - Jeerota, Near Bombay Hospital, Bombay Hospital turst sitapura 30.09.2021
2 Ramesh 28 & M Bhola Skilled Jaipur, Rajasthan industrial area Jaipur Rajsthan 1.09.2021

Village - Jeerota, Near Bombay Hospital, Bombay Hospital turst sitapura

3 Rahul Kumar 24 & M Sudarshan Skilled Jaipur, Rajasthan industrial area Jaipur Rajsthan 1.09.2021

Village - Jeerota, Near Bombay Hospital, Bombay Hospital turst sitapura 31.01.2022
4 Pintu 20 & M Baiju Nishad Unskilled Jaipur, Rajasthan industrial area Jaipur Rajsthan 1.09.2021

Village - Jeerota, Near Bombay Hospital, Bombay Hospital turst sitapura 30.09.2021
5 Arjun Tiwari 29 & M Parshuram tiwari Unskilled Jaipur, Rajasthan industrial area Jaipur Rajsthan 1.09.2021
Village - Jeerota, Near Bombay Hospital, Lila Patti, Vill - Kathakuiyan, Katya 31.05.2022
6 Arvind Kumar 18 & M Shivnath Unskilled Jaipur, Rajasthan Kushinagar, Kathakuiyan, U.P - 274303 1.12.2021

Village - Jeerota, Near Bombay Hospital, Harnava, Asothar, Fatehpur, U.P - 28.02.2022
7 Dharmendra Kumar 30 & M Hori Lal Unskilled Jaipur, Rajasthan 212620 1.12.2021
Village - Jeerota, Near Bombay Hospital, Lila Patti, Vill - Kathakuiyan, Katya 31.05.2022
8 Arun Kumar 18 & M Sudarshan Unskilled Jaipur, Rajasthan Kushinagar, Kathakuiyan, U.P - 274303 1.12.2021
Village - Jeerota, Near Bombay Hospital, Lila Patti, Vill - Kathakuiyan, Katya 31.12.2021
9 Dinesh 34 & M Mahendra Unskilled Jaipur, Rajasthan Kushinagar, Kathakuiyan, U.P - 274303 1.12.2021

Village - Jeerota, Near Bombay Hospital, Bombay Hospital turst sitapura 30.11.2022
10 Ramesh 28 & M Bhola Skilled Jaipur, Rajasthan industrial area Jaipur Rajsthan 1.06.2022

Village - Jeerota, Near Bombay Hospital, Bombay Hospital turst sitapura 30.11.2022
11 Arjun Tiwari 29 & M Parshuram tiwari Unskilled Jaipur, Rajasthan industrial area Jaipur Rajsthan 1.06.2022

Bombay Hospital turst sitapura 30.11.2022

12 Shailesh Nisad 18 & M Pawari Unskilled Village - Kathkuiyan, Kushinagar, U.P industrial area Jaipur Rajsthan 1.07.2022

Village - Jeerota, Near Bombay Hospital, Lila Patti, Vill - Kathakuiyan, Katya 30.11.2022
13 Arun Kumar 18 & M Sudarshan Unskilled Jaipur, Rajasthan Kushinagar, Kathakuiyan, U.P - 274303 1.07.2022

Lila Patti, Vill - Kathakuiyan, Katya 31.08.2022

14 Keshwar 19 & M Mainejar Unskilled Bombay Hospital, Sitapura, Jaipur, Rajasthan Kushinagar, Kathakuiyan, U.P - 274303 1.08.2022

Lila Patti, Vill - Kathakuiyan, Katya 30.11.2022

15 Durgesh Kumar 25 & M Bhola Unskilled Bombay Hospital, Sitapura, Jaipur, Rajasthan Kushinagar, Kathakuiyan, U.P - 274303 1.09.2022

16 Ravindra Nishad 41 & M Shiv Pujan Unskilled Bombay Hospital, Sitapura, Jaipur, Rajasthan Padri Piparpati, Kushinagar, UP 1.11.2022

Lila Patti, Vill - Kathakuiyan, Katya

17 Keshwar 19 & M Mainejar Unskilled Bombay Hospital, Sitapura, Jaipur, Rajasthan Kushinagar, Kathakuiyan, U.P - 274303 1.12.2022
 31.01.2023
18 Arvind Kumar 21 & M Gopichand Baitha Skilled Bombay Hospital, Sitapura, Jaipur, Rajasthan Gaurijagdish Gauri Jagadish Kushinagar 1.12.2022

30.04.2023
19 Anand Prakash 25 & M Umesh Prasad Unskilled Bombay Hospital, Sitapura, Jaipur, Rajasthan Gaurijagdish Gauri Jagadish Kushinagar 1.12.2022

Village - Jeerota, Near Bombay Hospital, Bombay Hospital turst sitapura

20 Ramesh 28 & M Bhola Skilled Jaipur, Rajasthan industrial area Jaipur Rajsthan 02.05.2023

21 Arvind Kumar 21 & M Gopichand Baitha Skilled Bombay Hospital, Sitapura, Jaipur, Rajasthan Gaurijagdish Gauri Jagadish Kushinagar 02.05.2023

Signature of the Contractor

 FORM XVII REGISTER OF FI
[See Rule 77(2)(d)]

Name & address of the Contractor : R.K.ENGINEERING - C/O Universal MEP Projects & Engineering
Name & address of establishment in/ under which contract is carried on:- BOMBAY HOSPITAL TRU
302018
Nature & Location of Work: FIRE FIGHTING & JAIPUR (RAJASTHAN)
Name and Address of Principal Emoloyer : BOMBAY HOSPITAL TRUST, KHASRA NO. 269, RAMCHAN

Sl. Name of workmen Father's/ Designatio Act/ Date of

No. Husband's n Ommission Offence
Name for which
fine
imposed

No Fine For the Month of June - 20

 STER OF FINES
ojects & Engineering Services Ltd, Faridabad, Haryana
OMBAY HOSPITAL TRUST, KHASRA NO. 269, RAMCHANDRAPURA, JAIPUR (RAJASTHAN) -

A NO. 269, RAMCHANDRAPURA, JAIPUR (RAJASTHAN) - 302018

Whether Name of Rate of Amount Date on Remarks

Employee person in Wages of fine which fine
showed whose imposed realized
cause presence
against fine employee's
explanation
was
heard(in
case of
contractors)

h of June - 2023

Signature of the Contractor

 FORM XVI

[See Rule 77(2)(a)] REGISTER OF DEDUCTIONS FOR DAMAGES OR LOSS

Name & address of the Contractor : R.K.ENGINEERING - C/O Universal MEP Projects & Engineering Services Ltd, Faridabad, Haryana
Name & address of establishment in/ under which contract is carried on:- BOMBAY HOSPITAL TRUST, KHASRA NO. 269, RAMCHANDRAPURA, JAIPUR (RAJASTHAN)
- 302018
Nature & Location of Work: FIRE FIGHTING & JAIPUR (RAJASTHAN)
Name and Address of Principal Emoloyer : BOMBAY HOSPITAL TRUST, KHASRA NO. 269, RAMCHANDRAPURA, JAIPUR (RAJASTHAN) - 302018
Sl. Name of Father's/ Designati Particulars Date of Whether Name of Amount No. of Date of recovery Remar
No. workmen Husband's on of damage damage or workmen person in deduction installmen First Last ks
Name or loss loss showed whose imposed ts installme installme
cause presence nt nt
against employee's
deduction explanation
was heard

No Deduction For Damage or Loss For the Month of June - 2023

Signature of the Contractor

 FORM XVIII REGISTER OF ADVANCES
[See Rule 77(2)(d)]
Name & address of the Contractor : R.K.ENGINEERING - C/O Universal MEP Projects & Engineering Services Ltd, Faridabad, Haryana
Name & address of establishment in/ under which contract is carried on:- BOMBAY HOSPITAL TRUST, KHASRA NO. 269, RAMCHANDRAPURA, JAIPUR (RAJASTHAN) - 302018
Nature & Location of Work: FIRE FIGHTING & JAIPUR (RAJASTHAN)
Name and Address of Principal Emoloyer : BOMBAY HOSPITAL TRUST, KHASRA NO. 269, RAMCHANDRAPURA, JAIPUR (RAJASTHAN) - 302018
Sl. Name of Father's/ Nature of Earnings Date and Purpose (s) for No of Amount of Date on Signature or
No. workmen Husband's Name Employment during a amount of which advance installments Installment which thumb
wage period advance made by which repaid with total impression of
advance to date of amount the worker
be repair postponem paid
ent granted

No Advance Paid For The Month of June - 2023

Signature of the Contractor

 FORM XIX
[See Rule 77(2)
REGISTER OF OVERTIME
(e)]

Name & address of the Contractor : R.K.ENGINEERING - C/O Universal MEP Projects & Engineering Services Ltd, Faridabad, Haryana
Name & address of establishment in/ under which contract is carried on:- BOMBAY HOSPITAL TRUST, KHASRA NO. 269, RAMCHANDRAPURA, JAIPUR
(RAJASTHAN) - 302018
Nature & Location of Work: FIRE FIGHTING & JAIPUR (RAJASTHAN)
Name and Address of Principal Emoloyer : BOMBAY HOSPITAL TRUST, KHASRA NO. 269, RAMCHANDRAPURA, JAIPUR (RAJASTHAN) - 302018
S.No. Name Father' Sex Designa Date on Wages on Total O.T. Normal Normal O.T. rate Normal O.T. Total Date on which
of s/ tion and which O.T. on worked or Hour rate earning earning earning overtime O.T.
workm Husban Depart O.T. each production in payment made
en d's ment work occasion case of
Name was put piece-rated
on

No Overtime paid for the Month of June - 2023

Signature of the Contractor