Gate Pass Approval Format
In reference to the Work Order/Service Order No. ………………………………… dtd. ………………………………… awarded to M/s. …………………………………………………….........................…
against Manpower Supply(MPS)/Job Contract(JC)/ Temporary Job (please mark tick) following manpower’s are to be engaged in the work of …………………………………………………………………
in ……………..…………………………………… department for the period from …………………………. to ………………………vide CNFA reference no.
…………………………………………............ (if not then specify reason) dtd..………………………………….. Manpower Nos. as per IE Study: MPS ………………. / JC …………….. / Temporary Job
……………… Actual Manpower Nos. Engaged in the Department: MPS ………………. / JC …………….. / Temporary Job …………….... Differential Manpower Nos.: MPS ………………. / JC
…………….. / Temporary Job ………………
Monthly Qualificatio
Sl. No. Name of Employee D.O.B. Aadhar Card No. UAN No. ESIC No. Designation Skill Category Experience Address/ Location From Contact No. Photo
Salary n
Contractor Signature & Seal Site In-charge HOD User Department Cluster Head (BHR&ES) Incharge Gatepass Office (HR&ES)
Out of the total gate pass no……………., / following ………….. No of manpowers will be accomodated in the shramik vihar No/s……………...………, Room No/s………………………., Bed No/s……………… as per the allotment letter
no………………………………., dated…………………………………..
N.B.: Incomplete Form in any respect subject to rejection/cancellation of the gate pass. Gate entry shall be valid for the above purpose only and all the fields are required to fill mandatory.
