| ANNEXURE-A |
| Particulars | Description | PDF Attachment |
| Name and Address of the P.E | Mr. Mahipal Singh Bhanot,Facility Director C/o Fortis Hopitals, A - Block, Shalimar Bagh, New Delhi - 110088 | |
| Website Address | https://www.fortishealthcare.com/india/hospitals-in-delhi-ncr/fortis-hospital-shalimar-bagh | |
| Name and address of the Proprietor/Director/Partner | Mr. Mahipal Singh Bhanot,Facility Director C/o Fortis Hopitals, A - Block, Shalimar Bagh, New Delhi - 110088 | |
| Phone/Mobile Number and E-mail I.D. of establishment/person-In-Charge of contract work | Mr. Ankit Kumar Gupta,Unit Head - Human Resources Mobile : 0-8800666744 E-mail : ankit.gupta1@fortishealthcare.com | |
| Name and address of the place /site where the contract workers are to be emloyed | C/o Fortis Hopitals, A - Block, Shalimar Bagh, New Delhi - 110088 | |
| Phone/Mobile Number and E-mail I.D. of person in-charge of the site | Mr. Ankit Kumar Gupta,Unit Head - Human Resources Mobile : 0-8800666744 E-mail : ankit.gupta1@fortishealthcare.com | |
| Copy of Power of Attorney/Board resolution authorizing to act as P.E. | Power of Attorney in the name of Facility Director | Power Of Attorney - FD |
| Copy Of MOA/AOA/Patnership Deed/Proprietors I.D. Proof | Memorandum & Certificate of Incorporation | Memorandum & COI - FHL,Memorandum & COI - FHTL |
| Nature of Work for which contract works are to be engaged/employed | Annexure of Details of Contractor | Details of Contractor |
| Form"V"issued by P.E. to each contractor -Rule 21(2) | Form V | Form V |
| Notice of commencement/completion of contract work-Rule17(2) | Form VI B | Form VI B |
| Application in Form I- Rule 17(2) | Application submitted for Renewal of Reg. Certificate | Application for Renewal of RC |
| Agreement with each contractor alongwith rate &no. of worker for which contract has been given | Valid Contracts & Extension of Contracts | Contracts |
| Letter of extension of contract period issued to contractors, in casr of renewal of licence | Extension of Contracts | Contracts |
| Affidavit by P.E. regarding compliance of Rule 25(2)(V) and that wages to contract worker are being paid | Self Declaration by Principal Employer | Self Declaration by Principal Employer |
| Name and Designation of the person authorized under Rule | Mr. Ankit Kumar Gupta,Unit Head - Human Resources Mobile : 0-8800666744 E-mail : ankit.gupta1@fortishealthcare.com | |
| Challan of Registration Fees(G.A.R-7) | N.A | N.A |
| Registration Certificate No. under C L R A Act, 1970 | Registration Certificate for the F.Y. 2017-18 | Registration Certificate Fortis Hospotel Ltd 2017-18,Registration Certificate Fortis Healthcare Ltd 2017-18 |
| Registration Number/Certificate under the Companies Act,1956 | Memorandum & Certificate of Incorporation | Memorandum & COI - FHL,Memorandum & COI - FHTL |
| Registration Number/Certificate under the Delhi Shops&Establishment Act,1954/Factories Act,1948 | Certificate under Shops & Commercial Establishment Act | Certificate under Shops & Commercial Establishment Act |
| Copy of application for Amendment | Application submitted for Renewal of Reg. Certificate | Application for Renewal of RC |
| Annual Return-Rule 82(2) | Annual Returns under Various Labour Laws | Annual Returns |
