Form - I

[See : Rule 17(1)]

Email ID :- gaurangi.gupta@adityabirla.com Application Year / No. :- 2024 / 1

Application for Registration Amendment of Employing Contract Labour -

1. Name and location of the Establishment ADITYA BIRLA RENEWABLES ENERGY LIMITED
OLD SURVEY NO 468,SURVEY NO 545,
JALOYA,DEVPURA

2. Postal address of the Establishment OLD SURVEY NO 468,SURVEY NO 545

JALOYA,DEVPURA

3. Type of business, trade, industry, manufacture or CONSTRUCTION OF WIND SOLAR PLANT

occupation carried on in the establishment

4. Full name and address of Principal Employer, PAWAN KUMAR JAIN

(furnish father's name in the case of individuals)
NEAR BY FULSAR PSS SURVEY NO:68- P/5,P/6,
15-P/1,14-P/1,14-P/4,13-P/1, AT
FULSAR,TA:TALAJA
5. Full name and address of the Manager or person
responsible for the supervision and control of the
establishment

6.Particulars of the contractors and contract labour

Name and address of Nature of work in which Maximum number of Estimated date of
contractor contract labour is contract labour to be termination of
1 employed or is to be employed on any day employment of contract
employed labour through each contractor 4
2 3

K P ENERGY LTD CONSTRUCTION 250 30/6/2024

K P HOUSE, OPP ISWAR OF WIND POWER
FARM,JUNCTION BRTS PLANT
CANAL
ROAD,BHATAR,SURAT-339
5017
SUZLON GLOBAL TECHNICAL 10 30/6/2024
SERVICE LTD SUPERVISION OF
5,SHRIMALY WIND TURBINE
SOCIETY,NEAR SHRI
KRISHNA COMPLEX
NAVRANGPURA,AHMEDAB
AD-380009
KPI GREEN ENERGY CONSTRUCTION 200 30/6/2024
LIMITED OF WIND POWER
KP HOUSE,OPP.ISHWAR PLANT
FARM JUNCTION BRTS,NR
BLISS IVF CIRCLE
CANAL
ROAD,BJATAR.SURAT
 Form - I

[See : Rule 17(1)]

Email ID :- gaurangi.gupta@adityabirla.com Application Year / No. :- 2024 / 1

7. Particulars of treasury receipt enclosed : Treasury Amount: RS. 1,800.00

I here by declare that the particulars given above are true to the best of my knowledge and belief.

Principal Employer

Seal and Signature