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Out Side Pass

This document is a gate pass from Indian Oil Corporation Limited's (IOCL) Paradip Refinery Project, allowing Sankarsan Pradhan of CREW (P) Ltd. to transport materials outside the refinery. It lists one item - a VFD drive model ACS850 made by ABB. The gate pass must be signed by Pradhan and IOCL officials to authorize removing the materials from the refinery and verifying their transport outside. It also requires recommendation and signature from the CISF security unit at Paradip Refinery.

Uploaded by

Vijay
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
0% found this document useful (0 votes)
93 views45 pages

Out Side Pass

This document is a gate pass from Indian Oil Corporation Limited's (IOCL) Paradip Refinery Project, allowing Sankarsan Pradhan of CREW (P) Ltd. to transport materials outside the refinery. It lists one item - a VFD drive model ACS850 made by ABB. The gate pass must be signed by Pradhan and IOCL officials to authorize removing the materials from the refinery and verifying their transport outside. It also requires recommendation and signature from the CISF security unit at Paradip Refinery.

Uploaded by

Vijay
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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( Refineries Division )

PARADIP REFINERY PROJECT


PARADIP - DIST:-JAGATSINGHPUR, ODISHA

CONTRACTOR'S MATERIAL(S) GATE PASS ( NON - RETURNABLE )

GATE PASS NO._______________

Shri SANKARSAN PRADHAN authorized representative of M/S CREW (P) Ltd whose specimen signatu
hereby allowed to take the materials belonging to the said agency / contractor outside IOCL Refinery, Paradip as
LOCATION FROM
DESCRIPTION OF THE QUANTITY WHERE THE MODE OF TRANSPORT / REGD
SL.NO.
MATERIALS WITH UNIT MATERIALS IS/ NO. OF VEHICLES.
ARE TO BE SHIFTED
1 2 3 4 5
1 VFD Drive Model - ACS850 Make:ABB 01No

----------------------------------------- -------------------------------------------------------- --------------------------------------------


Dated signature of the authorized Dated signature with designation of the
Verified & allowed the materials
representive of the contractor authorized officer / signatory of IOCL/
outside IOCL / PDRP, para
taking the materials ( Out Side ) PDRP, paradip.
Recommendation of consultant Date:

Time ( Out ):

Rank:

Name:

CISF UNIT PDRP, Paradip


DATE:_28.08.17___________
____

cimen signature is appended below is


y, Paradip as mentioned below:

MATERIALS
INCOMMING CHALLAN PURPOSE REMARKS
NO. / DATE, IF ANY
6 7 8
269/15.04.17

------------------------------------ ----------------------------------
d the materials to be taken Dated signature of the Duty
CL / PDRP, paradip. officer / shift In-charge,CISF
( Refineries Division )
PARADIP REFINERY PROJECT
PARADIP - DIST:-JAGATSINGHPUR, ODISHA

CONTRACTOR'S MATERIAL(S) GATE PASS ( NON - RETURNABLE )

GATE PASS NO._______________

Shri SANKARSAN PRADHAN authorized representative of M/S CREW (P) Ltd whose specimen sig
hereby allowed to take the materials belonging to the said agency / contractor outside IOCL Refinery, Paradip
LOCATION FROM
DESCRIPTION OF THE QUANTITY WHERE THE
SL.NO.
MATERIALS WITH UNIT MATERIALS IS/
ARE TO BE SHIFTED
1 2 3 4
1
2
3
4
5
6
7
8
9
10

----------------------------------------- --------------------------------------------------------
Dated signature of the authorized Dated signature with designation of the
representive of the contractor authorized officer / signatory of IOCL/
taking the materials ( Out Side ) PDRP, paradip.
Recommendation of consultant Date:

Time ( Out ):

Rank:

Name:

CISF UNIT PDRP, Paradip


sion )
Y PROJECT
NGHPUR, ODISHA

PASS ( NON - RETURNABLE )

DATE:________________

/S CREW (P) Ltd whose specimen signature is appended below is


contractor outside IOCL Refinery, Paradip as mentioned below:

MATERIALS
MODE OF TRANSPORT / REGD
INCOMMING CHALLAN PURPOSE REMARKS
NO. OF VEHICLES.
NO. / DATE, IF ANY
5 6 7 8

----------------------------------------------------------- ----------------------------------
Verified & allowed the materials to be taken Dated signature of the Duty
outside IOCL / PDRP, paradip. officer / shift In-charge,CISF
( Refineries Division )
PARADIP REFINERY PROJECT
PARADIP - DIST:-JAGATSINGHPUR, ODISHA

CONTRACTOR'S MATERIAL(S) GATE PASS ( NON - RETURNABLE )

GATE PASS NO._______________

Shri SANKARSAN PRADHAN authorized representative of M/S CREW (P) Ltd whose specimen sig
hereby allowed to take the materials belonging to the said agency / contractor outside IOCL Refinery, Paradip
LOCATION FROM
DESCRIPTION OF THE QUANTITY WHERE THE
SL.NO.
MATERIALS WITH UNIT MATERIALS IS/
ARE TO BE SHIFTED
1 2 3 4
1
2
3
4
5
6
7
8
9
10

----------------------------------------- --------------------------------------------------------
Dated signature of the authorized Dated signature with designation of the
representive of the contractor authorized officer / signatory of IOCL/
taking the materials ( Out Side ) PDRP, paradip.
Recommendation of consultant Date:

Time ( Out ):

Rank:

Name:

CISF UNIT PDRP, Paradip


sion )
Y PROJECT
NGHPUR, ODISHA

PASS ( NON - RETURNABLE )

DATE:________________

/S CREW (P) Ltd whose specimen signature is appended below is


contractor outside IOCL Refinery, Paradip as mentioned below:

MATERIALS
MODE OF TRANSPORT / REGD
INCOMMING CHALLAN PURPOSE REMARKS
NO. OF VEHICLES.
NO. / DATE, IF ANY
5 6 7 8

----------------------------------------------------------- ----------------------------------
Verified & allowed the materials to be taken Dated signature of the Duty
outside IOCL / PDRP, paradip. officer / shift In-charge,CISF
( Refineries Division )
PARADIP REFINERY PROJECT
PARADIP - DIST:-JAGATSINGHPUR, ODISHA

CONTRACTOR'S MATERIAL(S) GATE PASS ( NON - RETURNABLE )

GATE PASS NO._______________

Shri SANKARSAN PRADHAN authorized representative of M/S CREW (P) Ltd whose specimen sig
hereby allowed to take the materials belonging to the said agency / contractor outside IOCL Refinery, Paradip
LOCATION FROM
DESCRIPTION OF THE QUANTITY WHERE THE
SL.NO.
MATERIALS WITH UNIT MATERIALS IS/
ARE TO BE SHIFTED
1 2 3 4
1
2
3
4
5
6
7
8
9
10

----------------------------------------- --------------------------------------------------------
Dated signature of the authorized Dated signature with designation of the
representive of the contractor authorized officer / signatory of IOCL/
taking the materials ( Out Side ) PDRP, paradip.
Recommendation of consultant Date:

Time ( Out ):

Rank:

Name:

CISF UNIT PDRP, Paradip


sion )
Y PROJECT
NGHPUR, ODISHA

PASS ( NON - RETURNABLE )

DATE:________________

/S CREW (P) Ltd whose specimen signature is appended below is


contractor outside IOCL Refinery, Paradip as mentioned below:

MATERIALS
MODE OF TRANSPORT / REGD
INCOMMING CHALLAN PURPOSE REMARKS
NO. OF VEHICLES.
NO. / DATE, IF ANY
5 6 7 8

----------------------------------------------------------- ----------------------------------
Verified & allowed the materials to be taken Dated signature of the Duty
outside IOCL / PDRP, paradip. officer / shift In-charge,CISF
( Refineries Division )
PARADIP REFINERY PROJECT
PARADIP - DIST:-JAGATSINGHPUR, ODISHA

CONTRACTOR'S MATERIAL(S) GATE PASS ( NON - RETURNABLE )

GATE PASS NO._______________

Shri SANKARSAN PRADHAN authorized representative of M/S CREW (P) Ltd whose specimen sig
hereby allowed to take the materials belonging to the said agency / contractor outside IOCL Refinery, Paradip
LOCATION FROM
DESCRIPTION OF THE QUANTITY WHERE THE
SL.NO.
MATERIALS WITH UNIT MATERIALS IS/
ARE TO BE SHIFTED
1 2 3 4
1
2
3
4
5
6
7
8
9
10

----------------------------------------- --------------------------------------------------------
Dated signature of the authorized Dated signature with designation of the
representive of the contractor authorized officer / signatory of IOCL/
taking the materials ( Out Side ) PDRP, paradip.
Recommendation of consultant Date:

Time ( Out ):

Rank:

Name:

CISF UNIT PDRP, Paradip


sion )
Y PROJECT
NGHPUR, ODISHA

PASS ( NON - RETURNABLE )

DATE:________________

/S CREW (P) Ltd whose specimen signature is appended below is


contractor outside IOCL Refinery, Paradip as mentioned below:

MATERIALS
MODE OF TRANSPORT / REGD
INCOMMING CHALLAN PURPOSE REMARKS
NO. OF VEHICLES.
NO. / DATE, IF ANY
5 6 7 8

----------------------------------------------------------- ----------------------------------
Verified & allowed the materials to be taken Dated signature of the Duty
outside IOCL / PDRP, paradip. officer / shift In-charge,CISF
( Refineries Division )
PARADIP REFINERY PROJECT
PARADIP - DIST:-JAGATSINGHPUR, ODISHA

CONTRACTOR'S MATERIAL(S) GATE PASS ( NON - RETURNABLE )

GATE PASS NO._______________

Shri SANKARSAN PRADHAN authorized representative of M/S CREW (P) Ltd whose specimen sig
hereby allowed to take the materials belonging to the said agency / contractor outside IOCL Refinery, Paradip
LOCATION FROM
DESCRIPTION OF THE QUANTITY WHERE THE
SL.NO.
MATERIALS WITH UNIT MATERIALS IS/
ARE TO BE SHIFTED
1 2 3 4
1
2
3
4
5
6
7
8
9
10

----------------------------------------- --------------------------------------------------------
Dated signature of the authorized Dated signature with designation of the
representive of the contractor authorized officer / signatory of IOCL/
taking the materials ( Out Side ) PDRP, paradip.
Recommendation of consultant Date:

Time ( Out ):

Rank:

Name:

CISF UNIT PDRP, Paradip


sion )
Y PROJECT
NGHPUR, ODISHA

PASS ( NON - RETURNABLE )

DATE:________________

/S CREW (P) Ltd whose specimen signature is appended below is


contractor outside IOCL Refinery, Paradip as mentioned below:

MATERIALS
MODE OF TRANSPORT / REGD
INCOMMING CHALLAN PURPOSE REMARKS
NO. OF VEHICLES.
NO. / DATE, IF ANY
5 6 7 8

----------------------------------------------------------- ----------------------------------
Verified & allowed the materials to be taken Dated signature of the Duty
outside IOCL / PDRP, paradip. officer / shift In-charge,CISF
( Refineries Division )
PARADIP REFINERY PROJECT
PARADIP - DIST:-JAGATSINGHPUR, ODISHA

CONTRACTOR'S MATERIAL(S) GATE PASS ( NON - RETURNABLE )

GATE PASS NO._______________

Shri SANKARSAN PRADHAN authorized representative of M/S CREW (P) Ltd whose specimen sig
hereby allowed to take the materials belonging to the said agency / contractor outside IOCL Refinery, Paradip
LOCATION FROM
DESCRIPTION OF THE QUANTITY WHERE THE
SL.NO.
MATERIALS WITH UNIT MATERIALS IS/
ARE TO BE SHIFTED
1 2 3 4
1
2
3
4
5
6
7
8
9
10

----------------------------------------- --------------------------------------------------------
Dated signature of the authorized Dated signature with designation of the
representive of the contractor authorized officer / signatory of IOCL/
taking the materials ( Out Side ) PDRP, paradip.
Recommendation of consultant Date:

Time ( Out ):

Rank:

Name:

CISF UNIT PDRP, Paradip


sion )
Y PROJECT
NGHPUR, ODISHA

PASS ( NON - RETURNABLE )

DATE:________________

/S CREW (P) Ltd whose specimen signature is appended below is


contractor outside IOCL Refinery, Paradip as mentioned below:

MATERIALS
MODE OF TRANSPORT / REGD
INCOMMING CHALLAN PURPOSE REMARKS
NO. OF VEHICLES.
NO. / DATE, IF ANY
5 6 7 8

----------------------------------------------------------- ----------------------------------
Verified & allowed the materials to be taken Dated signature of the Duty
outside IOCL / PDRP, paradip. officer / shift In-charge,CISF
( Refineries Division )
PARADIP REFINERY PROJECT
PARADIP - DIST:-JAGATSINGHPUR, ODISHA

CONTRACTOR'S MATERIAL(S) GATE PASS ( NON - RETURNABLE )

GATE PASS NO._______________

Shri SANKARSAN PRADHAN authorized representative of M/S CREW (P) Ltd whose specimen sig
hereby allowed to take the materials belonging to the said agency / contractor outside IOCL Refinery, Paradip
LOCATION FROM
DESCRIPTION OF THE QUANTITY WHERE THE
SL.NO.
MATERIALS WITH UNIT MATERIALS IS/
ARE TO BE SHIFTED
1 2 3 4
1
2
3
4
5
6
7
8
9
10

----------------------------------------- --------------------------------------------------------
Dated signature of the authorized Dated signature with designation of the
representive of the contractor authorized officer / signatory of IOCL/
taking the materials ( Out Side ) PDRP, paradip.
Recommendation of consultant Date:

Time ( Out ):

Rank:

Name:

CISF UNIT PDRP, Paradip


sion )
Y PROJECT
NGHPUR, ODISHA

PASS ( NON - RETURNABLE )

DATE:________________

/S CREW (P) Ltd whose specimen signature is appended below is


contractor outside IOCL Refinery, Paradip as mentioned below:

MATERIALS
MODE OF TRANSPORT / REGD
INCOMMING CHALLAN PURPOSE REMARKS
NO. OF VEHICLES.
NO. / DATE, IF ANY
5 6 7 8

----------------------------------------------------------- ----------------------------------
Verified & allowed the materials to be taken Dated signature of the Duty
outside IOCL / PDRP, paradip. officer / shift In-charge,CISF
( Refineries Division )
PARADIP REFINERY PROJECT
PARADIP - DIST:-JAGATSINGHPUR, ODISHA

CONTRACTOR'S MATERIAL(S) GATE PASS ( NON - RETURNABLE )

GATE PASS NO._______________

Shri SANKARSAN PRADHAN authorized representative of M/S CREW (P) Ltd whose specimen sig
hereby allowed to take the materials belonging to the said agency / contractor outside IOCL Refinery, Paradip
LOCATION FROM
DESCRIPTION OF THE QUANTITY WHERE THE
SL.NO.
MATERIALS WITH UNIT MATERIALS IS/
ARE TO BE SHIFTED
1 2 3 4
1
2
3
4
5
6
7
8
9
10

----------------------------------------- --------------------------------------------------------
Dated signature of the authorized Dated signature with designation of the
representive of the contractor authorized officer / signatory of IOCL/
taking the materials ( Out Side ) PDRP, paradip.
Recommendation of consultant Date:

Time ( Out ):

Rank:

Name:

CISF UNIT PDRP, Paradip


sion )
Y PROJECT
NGHPUR, ODISHA

PASS ( NON - RETURNABLE )

DATE:________________

/S CREW (P) Ltd whose specimen signature is appended below is


contractor outside IOCL Refinery, Paradip as mentioned below:

MATERIALS
MODE OF TRANSPORT / REGD
INCOMMING CHALLAN PURPOSE REMARKS
NO. OF VEHICLES.
NO. / DATE, IF ANY
5 6 7 8

----------------------------------------------------------- ----------------------------------
Verified & allowed the materials to be taken Dated signature of the Duty
outside IOCL / PDRP, paradip. officer / shift In-charge,CISF
( Refineries Division )
PARADIP REFINERY PROJECT
PARADIP - DIST:-JAGATSINGHPUR, ODISHA

CONTRACTOR'S MATERIAL(S) GATE PASS ( NON - RETURNABLE )

GATE PASS NO._______________

Shri SANKARSAN PRADHAN authorized representative of M/S CREW (P) Ltd whose specimen sig
hereby allowed to take the materials belonging to the said agency / contractor outside IOCL Refinery, Paradip
LOCATION FROM
DESCRIPTION OF THE QUANTITY WHERE THE
SL.NO.
MATERIALS WITH UNIT MATERIALS IS/
ARE TO BE SHIFTED
1 2 3 4
1
2
3
4
5
6
7
8
9
10

----------------------------------------- --------------------------------------------------------
Dated signature of the authorized Dated signature with designation of the
representive of the contractor authorized officer / signatory of IOCL/
taking the materials ( Out Side ) PDRP, paradip.
Recommendation of consultant Date:

Time ( Out ):

Rank:

Name:

CISF UNIT PDRP, Paradip


sion )
Y PROJECT
NGHPUR, ODISHA

PASS ( NON - RETURNABLE )

DATE:________________

/S CREW (P) Ltd whose specimen signature is appended below is


contractor outside IOCL Refinery, Paradip as mentioned below:

MATERIALS
MODE OF TRANSPORT / REGD
INCOMMING CHALLAN PURPOSE REMARKS
NO. OF VEHICLES.
NO. / DATE, IF ANY
5 6 7 8

----------------------------------------------------------- ----------------------------------
Verified & allowed the materials to be taken Dated signature of the Duty
outside IOCL / PDRP, paradip. officer / shift In-charge,CISF
( Refineries Division )
PARADIP REFINERY PROJECT
PARADIP - DIST:-JAGATSINGHPUR, ODISHA

CONTRACTOR'S MATERIAL(S) GATE PASS ( NON - RETURNABLE )

GATE PASS NO._______________

Shri SANKARSAN PRADHAN authorized representative of M/S CREW (P) Ltd whose specimen sig
hereby allowed to take the materials belonging to the said agency / contractor outside IOCL Refinery, Paradip
LOCATION FROM
DESCRIPTION OF THE QUANTITY WHERE THE
SL.NO.
MATERIALS WITH UNIT MATERIALS IS/
ARE TO BE SHIFTED
1 2 3 4
1
2
3
4
5
6
7
8
9
10

----------------------------------------- --------------------------------------------------------
Dated signature of the authorized Dated signature with designation of the
representive of the contractor authorized officer / signatory of IOCL/
taking the materials ( Out Side ) PDRP, paradip.
Recommendation of consultant Date:

Time ( Out ):

Rank:

Name:

CISF UNIT PDRP, Paradip


sion )
Y PROJECT
NGHPUR, ODISHA

PASS ( NON - RETURNABLE )

DATE:________________

/S CREW (P) Ltd whose specimen signature is appended below is


contractor outside IOCL Refinery, Paradip as mentioned below:

MATERIALS
MODE OF TRANSPORT / REGD
INCOMMING CHALLAN PURPOSE REMARKS
NO. OF VEHICLES.
NO. / DATE, IF ANY
5 6 7 8

----------------------------------------------------------- ----------------------------------
Verified & allowed the materials to be taken Dated signature of the Duty
outside IOCL / PDRP, paradip. officer / shift In-charge,CISF
( Refineries Division )
PARADIP REFINERY PROJECT
PARADIP - DIST:-JAGATSINGHPUR, ODISHA

CONTRACTOR'S MATERIAL(S) GATE PASS ( NON - RETURNABLE )

GATE PASS NO._______________

Shri SANKARSAN PRADHAN authorized representative of M/S CREW (P) Ltd whose specimen sig
hereby allowed to take the materials belonging to the said agency / contractor outside IOCL Refinery, Paradip
LOCATION FROM
DESCRIPTION OF THE QUANTITY WHERE THE
SL.NO.
MATERIALS WITH UNIT MATERIALS IS/
ARE TO BE SHIFTED
1 2 3 4
1
2
3
4
5
6
7
8
9
10

----------------------------------------- --------------------------------------------------------
Dated signature of the authorized Dated signature with designation of the
representive of the contractor authorized officer / signatory of IOCL/
taking the materials ( Out Side ) PDRP, paradip.
Recommendation of consultant Date:

Time ( Out ):

Rank:

Name:

CISF UNIT PDRP, Paradip


sion )
Y PROJECT
NGHPUR, ODISHA

PASS ( NON - RETURNABLE )

DATE:________________

/S CREW (P) Ltd whose specimen signature is appended below is


contractor outside IOCL Refinery, Paradip as mentioned below:

MATERIALS
MODE OF TRANSPORT / REGD
INCOMMING CHALLAN PURPOSE REMARKS
NO. OF VEHICLES.
NO. / DATE, IF ANY
5 6 7 8

----------------------------------------------------------- ----------------------------------
Verified & allowed the materials to be taken Dated signature of the Duty
outside IOCL / PDRP, paradip. officer / shift In-charge,CISF
( Refineries Division )
PARADIP REFINERY PROJECT
PARADIP - DIST:-JAGATSINGHPUR, ODISHA

CONTRACTOR'S MATERIAL(S) GATE PASS ( NON - RETURNABLE )

GATE PASS NO._______________

Shri SANKARSAN PRADHAN authorized representative of M/S CREW (P) Ltd whose specimen sig
hereby allowed to take the materials belonging to the said agency / contractor outside IOCL Refinery, Paradip
LOCATION FROM
DESCRIPTION OF THE QUANTITY WHERE THE
SL.NO.
MATERIALS WITH UNIT MATERIALS IS/
ARE TO BE SHIFTED
1 2 3 4
1
2
3
4
5
6
7
8
9
10

----------------------------------------- --------------------------------------------------------
Dated signature of the authorized Dated signature with designation of the
representive of the contractor authorized officer / signatory of IOCL/
taking the materials ( Out Side ) PDRP, paradip.
Recommendation of consultant Date:

Time ( Out ):

Rank:

Name:

CISF UNIT PDRP, Paradip


sion )
Y PROJECT
NGHPUR, ODISHA

PASS ( NON - RETURNABLE )

DATE:________________

/S CREW (P) Ltd whose specimen signature is appended below is


contractor outside IOCL Refinery, Paradip as mentioned below:

MATERIALS
MODE OF TRANSPORT / REGD
INCOMMING CHALLAN PURPOSE REMARKS
NO. OF VEHICLES.
NO. / DATE, IF ANY
5 6 7 8

----------------------------------------------------------- ----------------------------------
Verified & allowed the materials to be taken Dated signature of the Duty
outside IOCL / PDRP, paradip. officer / shift In-charge,CISF
( Refineries Division )
PARADIP REFINERY PROJECT
PARADIP - DIST:-JAGATSINGHPUR, ODISHA

CONTRACTOR'S MATERIAL(S) GATE PASS ( NON - RETURNABLE )

GATE PASS NO._______________

Shri SANKARSAN PRADHAN authorized representative of M/S CREW (P) Ltd whose specimen sig
hereby allowed to take the materials belonging to the said agency / contractor outside IOCL Refinery, Paradip
LOCATION FROM
DESCRIPTION OF THE QUANTITY WHERE THE
SL.NO.
MATERIALS WITH UNIT MATERIALS IS/
ARE TO BE SHIFTED
1 2 3 4
1
2
3
4
5
6
7
8
9
10

----------------------------------------- --------------------------------------------------------
Dated signature of the authorized Dated signature with designation of the
representive of the contractor authorized officer / signatory of IOCL/
taking the materials ( Out Side ) PDRP, paradip.
Recommendation of consultant Date:

Time ( Out ):

Rank:

Name:

CISF UNIT PDRP, Paradip


sion )
Y PROJECT
NGHPUR, ODISHA

PASS ( NON - RETURNABLE )

DATE:________________

/S CREW (P) Ltd whose specimen signature is appended below is


contractor outside IOCL Refinery, Paradip as mentioned below:

MATERIALS
MODE OF TRANSPORT / REGD
INCOMMING CHALLAN PURPOSE REMARKS
NO. OF VEHICLES.
NO. / DATE, IF ANY
5 6 7 8

----------------------------------------------------------- ----------------------------------
Verified & allowed the materials to be taken Dated signature of the Duty
outside IOCL / PDRP, paradip. officer / shift In-charge,CISF
( Refineries Division )
PARADIP REFINERY PROJECT
PARADIP - DIST:-JAGATSINGHPUR, ODISHA

CONTRACTOR'S MATERIAL(S) GATE PASS ( NON - RETURNABLE )

GATE PASS NO._______________

Shri SELVAKUMAR.G authorized representative of M/S CREW (P) Ltd whose specimen signatu
hereby allowed to take the materials belonging to the said agency / contractor outside IOCL Refinery, Paradip
LOCATION FROM
DESCRIPTION OF THE QUANTITY WHERE THE
SL.NO.
MATERIALS WITH UNIT MATERIALS IS/
ARE TO BE SHIFTED
1 2 3 4
1
2
3
4
5
6
7
8
9
10

----------------------------------------- --------------------------------------------------------
Dated signature of the authorized Dated signature with designation of the
representive of the contractor authorized officer / signatory of IOCL/
taking the materials ( Out Side ) PDRP, paradip.
Recommendation of consultant Date:

Time ( Out ):

Rank:

Name:

CISF UNIT PDRP, Paradip


sion )
Y PROJECT
NGHPUR, ODISHA

PASS ( NON - RETURNABLE )

DATE:________________

CREW (P) Ltd whose specimen signature is appended below is


contractor outside IOCL Refinery, Paradip as mentioned below:

MATERIALS
MODE OF TRANSPORT / REGD
INCOMMING CHALLAN PURPOSE REMARKS
NO. OF VEHICLES.
NO. / DATE, IF ANY
5 6 7 8

----------------------------------------------------------- ----------------------------------
Verified & allowed the materials to be taken Dated signature of the Duty
outside IOCL / PDRP, paradip. officer / shift In-charge,CISF

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