Name & Address of the Contractor/ Establishment. The Indian Hume Pipe Co. Ltd., B2/82, Mohan Cooperative

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1 Name & Address the Principal Employer/ Establishment Name, Designation & Address the Contact Person for Principal Employer Name & Address the Contractor/ Establishment Name, Designation & Address the Contact Person for Contractor/ Establishment Jal Board, Govt. NCT, Office the Executive Engineer (C ) DR-XV, Jal Sadan, Lajpat Nagar, New Shri Adarsh Kumar, Executive Engineer (C) DR-XV, Jal Sadan, Lajpat Nagar, New The Indian Hume Pipe Co. Ltd., B2/82, Mohan Cooperative Industrial Estate, Mathura Road, Opposite - Seble Cinema, Badarpur, New Shri Harish Chandra Kushwaha, Sr. Project Manager The Indian Hume Pipe Co. Ltd., B2/82, Mohan Cooperative Industrial Estate, Mathura Road, Opposite - Seble Cinema, Badarpur, New Name, Address & PAN No. and EPF No. the Sub - Contractors Engaged Name Executive/ Partner/ Prop/ Director & PAN No. Site/ Work Place where Contract Labour is to be engaged Maximum No workers to be engaged Name & Designation Authorised representative PE/Contractor for Verifying/witness the wage disbursment Date payment wages Website M/s Rahul Construction PAN - BLPPR5311A EPF - Deposited in Company's Code No.DS/NHP/3449 ESI - Not applicable Shri Rahul Yadav Ghitorni 5 Shri Naresh Baghel 7th the Month

2 FORM XIII [See Rule 75] Register Workmen Employed by Contractor Name and address Contractor Name and address establishment in/ under which contract is carried on : - The Indian Hume Pipe Co. Ltd, B-2/82, Mohan Estate, Mathura Road- Opp - Seble Cinema,Co-operative Industrial Badarpur, Nature and location work : Sl. No. Name and surname workmen Age and Sex Father's/Husba nd's name Nature Employ ment/ Designat ion Permanent Home Address workmen (Village and Tahsil/ Taluk and District) Local Address Bank Account No. Bank Name Date Commence ment employment Signature or thumbimpression workmen Date termination employment Reasons for termination Sunil Ramjeet SW Plant, Ghitorni, New Sep Amarnath Kunnulal SSW Name and address Principal Employer Excavation, Laying, jointing Pipe lines, construction Chambers and other related The Executive Engineer (C) civil works. Providing, Sewerage facilities in the areas covering Rangpuri Pahari,Nangal Dewat, Dr XV., Jal Board, Govt. NCT. Jal Sadan, Lajpat Nagar, New Ghitorni Village, Ghitorni Extension and Ghitorni Enclave Plant, Ghitorni, New Sep. 14 Remarks 3 Rajmani Ramawtar USW Vill. Bewana, Post Bewana, Dist. Ambedkar Nagar Sewage Plant, Ghitorni, New Treatment Sep Left job 4 Sonu Parashram USW Vill. Dhanetara (Aatdih) Post Kediyapur, Dist. Ambedkar Plant, Ghitorni, New Nagar, Sep Lal Chandrabhan Yadav 6 Rinku Yadav USW Amarjeet USW Plant, Ghitorni, New Plant, Ghitorni, New Sep Sep. 14

3 M/S RAHUL CONTRACTOR April - 16 Annexure "B" Sr. No. Category Workmen Minimum Daily wages payable 1 Skilled Semi-Skilled Un-Skilled 353 Annexure "C" Sr. No. Category Count 1 Supervisiors 1 2 Crane Operator 1 4 Other 3 Annexure "D" Sr. No. Particulars Remark 1 Maximum No. Workers Employed at Location 5 2 Details Bonus paid for Last Year NIL 3 Details Encashment Leave NIL 4 Details Unpaid wages NIL

4 EPF Code No.: Name & Address the Contractor: Name & Location Work: Name & Address the Estt. In/under which Contract is carried on: Name & Address Principal Employer: M/S RAHUL CONTRACTOR PAYSHEET OF WORKER DEPLOYED AT GHITORNI SITE COMPANY'S CODE NO.DS/NHP/3449 M/s Rahul Contractor, Jamalpur, Mauja Durgapur, Jatiyari, Ambedkar Nagar Construction work at Ghitorni The Indian Hume Pipe Co. Ltd., B2/82, MCIE, Opp.Seble Cinema, Mathura Road, Badarpur, New -44 Jal Board, Lajpat Nagar, New Month Apr-16 Sr. No. Name the Workman Father's Name AGE Sr. No.in the register workme Design ation/ Nature Work Done No. days Worked Daily Rate wages / Piece Rate Basic Wages Amount wages Earned Dearn ess Allow ance Overt ime Other cash payment (Nature payment to be indicated) n 1 Sunil Ramjeet 20 1 SW Amarnath Kunnulal 29 2 SSW Sonu Parashram 19 3 USW Lal Chandrabhan Yadav 19 4 USW Rinku Yadav Amarjeet 20 5 USW Total Deduction if any (Indicate Nature) EPF Total Deduction Net Amount paid TOTAL

5 M/S RAHUL CONTRACTOR PAYSHEET OF WORKER DEPLOYED AT GHITORNI SITE EPF Code No.: COMPANY'S CODE NO.DS/NHP/3449 Name & Address the Contractor: M/s Rahul Contractor, Jamalpur, Mauja Durgapur, Jariyari, Ambedkar Nagar Name & Location Work: Construction work at Ghitorni Name & Address the Estt. In/under which Contract The Indian Hume Pipe Co. Ltd., B2/82, MCIE, Opp.Seble Cinema, Mathura Road, Name & Address Principal Employer: Jal Board, Lajpat Nagar, New S. NO. NAME FATHER'S NAME MONTH - APRIL Sunil Ramjeet A A A A A A A A A A A A A A A A A A P A A A A A A A 2 Amarnath Kunnulal A A A A A A A A A A A A A A A A A A P A A A A A A A 3 Sonu Parashram A A A A A A A A A A A A A A A A A A P A A A A A A A 4 Lal Chandrabhan Yadav A A A A A A A A A A A A A A A A A A A A A A A A A A 5 Rinku Yadav Amarjeet A A A A A A A A A A A A A A A A A A P A A A A A A A