APPLICATION FOR REGISTRATION AS CONTRACTORS OF ALL CATEGORIES 1. Name of applicant : in block letters) 2. Full address : 3. Officer to whom application : is made 4. In the case of individuals who are partners of Ragistered firms or in the case of firms : of Contgractors the following details should be furnished. 5. Whether the firm is a private/ public Limited concern or individual Hindu Family individual on a Reg. Partnership firm attested copies of Deep and Articles of Association enclosed Name of partners with their : liabilities 7. Name of person holding of : Attorney 8. Place of business : 9. Category to which Registration : is sought 6. Details of financial capacity (enclose solvency certificate : of bank guarantee) 7. Particulars of experience on works, labour command, equipment and other facilities on : hand and technical assistance available etc. 12. State whether he is registered contractor in any other office : in the P.W.D. 13. States whether the applicant was penalised in connection with any contract with Government : If so, give details 14. State whether any of his previous application for registration in any of the offices in Kerala P.W.D. : has been rejected 15. State whether the applicant or an any of his partners of shareholders is/are dismissed Govt. Servant (s) 16. State whether the applicant has under his employment, dismissed : Government servant 17. State whether the applicant has produced plumbing/electrical licence from completant authority : (only in the case of contractors executing the specified works) I have read and understood tghe rules regarding the Registration of Contractors published in G.O.(P) 69/PW dated 26.4.69 and amended from time to time. Signature of Applicant. APPLICATION FOR REGISTRATION AS CONTRACTORS OF ALL CATAGORIES 1. Name of applicant : (in block letters) 2. Full Address : 3. Officer to whom application : is made 1. In the case of individuals who are partners of Registered firms or in tghe case of firms of : contractors the follwing details should be furnished. 2. Whether the firm is a private/public Limited concern or individual Hindu Family individual on a Reg. : Partnership firm attested copies of Deep and Articles of Association enclosed 6. Name of partners with their liabilities : 7. Name of person holding of Attorney : 8. Place of business : 9. Category to which Registgration is sought : 10. Details of financial capacity (enclose solvency certificate of bank guarantee) : 11. Particulars of experience on works, labour command, equipment and other : facilities on hand and technical assistance available etc. 12. State whether he is registered contractor : in any other office in the P.W.D. 13. State whether the applicant was penalised in connection with any : contract with Government. If so, give details 14. State whether any of his previous application for registration in any : of the offices in Kerala P.W.D has been rejected 15. State whether the applicant or an any of his partners of shareholders : is/are dismissed Govt. Servant (s) 16. State whether the applicant has under his employment, dismissed : Government servant 17. State whether the applicant has produced plumbing/electrical licence : from competant authority (only in the case of contractors executing the specified works) I have read and understood the rules regarding the Registration of Contractors published in G.O. (P) 69/PW dated 26.4.69 and amended from time to time. Signature of Applicant. APPENDIX - 11 (See Rule 31) FORM OFFICE Fees paid Period for which licence isto continued in force Special conditions (if any) on which the licence isgranted. Provisions for preventingand extinguishing fire Whether the premises are tobe used during the dayor/and during the night. Purposae for which theplace is proposed to be used Whether the licence isannual or temporary Material of which the roofand enclosures are made ofproposed to be made Size and description withnumber of main doors. Situation of the place ofbuilding Name of the of the place ofbuilding Name of applicant and placeof abode Any authority granting a licence under this Act, may, for reasons recorded in writing revoke or suspend the same when he has reason to believe. a) That the licence has been fraudulently obtained. b) That the enclosed place or building has been used for other purposes of public resort of entertainement than that for which the licence was granted: c) That the place or building can no longer be safely used for the purpose for which the licence was granted. (Signed (Seal) (Signature) AUTHORITY GRANTING LICENCE (Designation
