Form 26

(see rule 65(2) & rule 66)

CERTIFICATE BY THE PRINCIPAL EMPLOYER

Certified that I have engaged the applicant/contractor ………………………………………………………………….…………

(Name and registration number of the contractor establishment) as a contractor in my Establishment,

namely, …………………….( Name and registration number of the establishment).

That the contract work shall commence from ……………(date) and shall be effective till ………….(date).

I undertake to be bound by all the provisions of the Occupational Safety, Health and Working

Conditions Code, 2020 and State rules made thereunder, in respect of the employment of contract labour by

the applicant in my Establishment.

Signature of Principal Employer

Name and address of the Establishment

Registration Number………………..

Place: ………………………..… Date: ……………………………