Enclosed With The Form (A) Original RC Book (B) Original Insurance Policy (C) Original Driving License (D) PUC

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Issue No:00 Adani Kattupalli Port Pvt Ltds

Issue Date:01:01:2013 INTEGRATED MANAGEMENT SYSTEM FORMAT MANUAL


Sec/F/02 Requisition form for vehicle Entry Permit (Contractor)

SEC/F/02 REQUISITION FORM FOR VEHICLE ENTRY PERMIT (CONTRACTOR)


REQUISITION FOR (VEHICLES/ EQUIPMENT ENTRY PERMIT)
(FOR CONTRACTOR’S VEHICLE/EQUIPMENT)
TO:SECURITY DEPARTMENT Date: Click here to enter
a date

Please issue Vehicle Entry Permit Form:


Type of vehicle, Trailer / Track / Tanker / Dumper / Tractor / if LMV specify make:……

Vehicle Registration No. …………………………………………………………………………….

Contractor’s Name. …………………………………………………………………………….

Engine No. ……………………………………………………………………………..

Chassis No. ……………………………………………………………………………..

Name & Address of owner:- ………………………………………………………………………………


………………………………………………………………………………
………………………………………………………………………………
………………………………………………………………………………
………………………………………………………………………………

Contact Number of owner. …………………………… Driver:-…………………………………..

Insurance Policy No. ……………………………………………. Valid up to………………………………….

I, the undersigned, certify that the details gives above are correct and true to the best of my
Knowledge, I have checked the Driver’s license and Vehicles documents for correctness and I
Assure that I shall not permit any unauthorized person to handle the vehicle/equipment. I
Take full responsibility for the conduct and behavior of the person engaged by Adani Harira
Ports Pvt. Ltd. Harira

Approved by the Concerned Department Owner/Contractor


Signature:
(Authorized Signatory)

Note: Documents to be produced the verification with requisition and copy of that need to be
enclosed with the form
(a) Original RC Book (b) Original insurance Policy (c) Original Driving License (d) PUC
To be Filled by Security Department
Vehicle entry permits Sr. No.: ……………………………………………………………………….
Date of issue ………………………………………………………………………..
Valid From…………………………………………..To………………………………………………………….

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