CONTRACTOR SUBSCRIPTION FORM

Contractor Subscription Form

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Company Details

Company Name / Concerned Person Name *
Started Operations in the year *
About your Company
Concerned Person Position *
PAN *
About your Core Competency

Communication Details

Landline
Email*
Present Address *
Mobile*
Website
Permanent Address*

Assignments

Lastly done / Currently doing Contract Work for the company
Lastly done / Currently doing Contract Work Value (in Rs)

Machineries / Equipment's Owning

S No Machineries / Equipment's Name
1
2
3
4
5
S No Machineries / Equipment's Name
6
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8
9
10
Workforce Available
Skilled
(in no's)
Semi-Skilled
(in no's)
Unskilled
(in no's)
Company
Client 1
Client 2
Client 3
Type of Project
No of Floors
Total area of your work
( In Sq Ft )
Total value of your work done ( In Rs )
Total no of your workforce engaged to complete your task
Started in the month & year
Finished in the month & year
Reference of Particular Project Incharge

Professional Reference 1

Name *
Company
Position
Off Landline
Off Email ID
Mobile *
Personal Email ID *
Relationship *

Professional Reference 2

Name *
Company
Position
Off Landline
Off Email ID
Mobile *
Personal Email ID *
Relationship *

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Our products are created and developed by the very same people that use them. More than a decade of deep industry expertise in healthcare and business allows us to provide innovative healthcare IT solutions around the world.

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Rajanikanth+91-8904358724
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