FORM IV
(Prescribed under Rule 21(1) of the West Bengal Contract Labour(Regulation & Abolition) Rules)
Application for License
BCT CONSULTING PVT. LTD.
Prestige Meridian - II 12 Floor Unit 1202 30 M GRoad,
Name & address of the contractor (including his father's name
Bangalore-560001, Nabadiganta Shilpo Nagari, Nabadiganta
incase of individuals)
Shilpo Nagari, Bidhannagar, North 24 Parganas, PS:-
Electronic complex, PIN- 700091
Date of Birth and age(incase of individuals) 01/01/1970
Particular of establishment where contract labour is to be employed
PRICEWATERHOUSECOOPERS PROFESSIONAL SERVICES
LLP
PLOT NO. 56 & 57, BLOCK- DN, SECTOR- V, SALT LAKE,,
(a)Name & address of the establishment
Nabadiganta Shilpo Nagari, Nabadiganta Shilpo
Nagari, Bidhannagar, North 24 Parganas, PS:-Electronic
complex, PIN- 700091
(b)Type of Business, trade, industry, manufacture or
occupation which is carried on in the establishment
(c)Number and date of Certificate BNG20/CLR/000848 Date: 03/06/2023
MR. SUTIRTHA DATTA
(d)Name & Address of the Principal Employer 139, BIDHANPALLY, RATHTALA, GARIA, KOLKATA -
7000084, Ward-111, PS - Regent Park, Kolkata- 700084
Particular of Contract Labour
(a)Nature of work in which Contract Labour is employed or is
to be employed in the establishment
(b)Duration of the proposed contract work (give particulars of
1032 Day(s), From 22/02/2023 To 20/12/2025
proposed date of ending)
VELLORE MADHAVAN MURLIDHARAN
, Nabadiganta Shilpo Nagari, Notified Area - Nabadiganta
(c)Name & address of the agent or Manager of Contractor at
Shilpo Nagari,
the work site
Bidhannagar, PS - Electronic complex,
North 24 Parganas, PIN- 700091, West Bengal
(d)Maximum number of Contract Labour proposed to be
12
employed in the establishment on any date.
(e)(i)Category/designation/nomenclature of the contractor
IT STAFFING
labour, namely, fitter, welder,carpenter, mazdor etc.
(e)(ii)Rate of Wages, DA and other cash benefits paid/ to be paid to each category(i.e (a):Unskilled (b)Semi Skilled (c)Skilled
(d)Highly Skilled etc.)of contract labour
Rate of Wages,DA and other cash benefits paid/ to be paid to
0
Unskilled Category of contract labour
Rate of Wages,DA and other cash benefits paid/ to be paid to
0
Semi-skilled Category of contract labour
Rate of Wages,DA and other cash benefits paid/ to be paid to
550
Skilled Category of contract labour
Rate of Wages,DA and other cash benefits paid/ to be paid to
0
Highly_Skilled Category of contract labour
Hours of Work: 8 hr(s), Overtime: 0 hr(s),
(e)(iii)Hours of Work,Overtime and Overtime Wages
Overtime Wages: 0(per hour)
e(iv)Other Condition of service like leave (annual leave,casual
Annual leave: 14, Casual leave: 10, Sick leave 14,
leave,sick leave,maternity leave etc)Holidays etc.of the
Maternity leave: 0, Other leave: 0, Holiday(s): 1
contract labour
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Date of receipt of application: 01/11/2025 Signature of the Applicant (Contractor)
Ref. No.- CAF250A750298 Name: BCT CONSULTING PVT. LTD.
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Whether the contractor was convicted of any offence within
the preceding five years. If so, give details
Whether there was any order against the contract or revoking
or suspending license or forfeiting security deposit in respect 01/01/1970
of an earlier contract. If so, the date of such order.
Whether the contractor has worked in any other establishment
within the past five years. If so. give details of the principal
employer, establishment and nature of work
8.Whether a certificate by the principal employer in Form V is
Form V enclosed
enclosed
Amount:Rs.1,250.00
GRN: 192025260320793288
9.Amount of Licence Fees/ Security deposit treasury challan
GRN Time: 01/11/2025 12:13:46
and date
Id. No.: 05030120251761979351
BRN Time: 01/11/2025 12:13:41
Note:-The application shall be accompanied by demand draft and the challan for the appropriate amount and a certificate in
Form V from the principal employer........................ date of the receipt of the application with "demand draft " and the challan
for fees/security deposit
Declaration: I hereby declare that the details given above are correct to the best of my knowledge and belief.
Date of receipt of application: 01/11/2025 Signature of the Applicant (Contractor)
Ref. No.- CAF250A750298 Name: BCT CONSULTING PVT. LTD.
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