FORM XIII

( See Rule 75 )
Register of Workmen Employed by Contractor
Name & Address of Employer/Contractor Name & Address of Establishment in/under which contract is carried on Name & Address of Principal Employer
Secure Parking Solutions Pvt.Ltd. Secure Parking Solutions Pvt.Ltd. Secure Parking Solutions Pvt.Ltd.
G-3/1, MLD Commercial Centre,
Andheri East, Mumbai - 400093
Nature of work and Location of Work : Secure Parking Solution Pvt.Ltd. (VIVIANA MALL THANE)

Sr. Date of Signature of Date of Resons for

No. Name of the Workmen Age or DOB Sex Father Name Designation Permanent Address of workmen Local Address commencemen Thum impression termination of terminatio Remarks
t of workmen employment n

1 2 3 4 5 6 7 8 9 10 11 12

BHOOPESH DASHARATH DASHARATH At - MASALIPADA , Post - HALDANI , ROOM NO .414/2 ,At -TALAVLI , NEAT
1 SINGH 13 Aug 1985 Male SINGH CASHIER NAWAPUR NANDURBAR , MARATHI SCHOOL , GHANSOLI NAVI 25 Feb 2014
MAHARASHTRA 425 426 MUMBAI , MAHARASHTTRA -400 708
PARERA NAGAR , OPPO. PRAGATI
USHA TUKARAM TUKARAM CHAWL RAHIVASHI SANGATHNA, PADA PARERA NAGAR , OPPO. PRAGATI CHAWL
2 BHILLARE 10 Jun 1980 Female BHILLARE WARDEN NO.3 , LOKMANYA NAGAR THANE - 400 RAHIVASHI SANGATHNA, PADA NO.3 , 27 May 2016
606 LOKMANYA NAGAR THANE - 400 606

VASANT KAMESHWARRAO ROOM NO. 5, GOTYA PATIL CHAWL, ROOM NO. 5, GOTYA PATIL CHAWL, PADA
3 KAMESHWARRAO 02 Oct 1996 Male CHICHULA WARDEN PADA NO. 3 NEAR SAI BABA MANDIR, NO. 3 NEAR SAI BABA MANDIR, 17 Sep 2018
CHICHULA LOKMANYA NAGAR THANE (W) 400 606 LOKMANYA NAGAR THANE (W) 400 606

SUNITA RAMKALESH ROOM NO. 4, CHAWL NO. 3,RAJIV ROOM NO. 4, CHAWL NO. 3,RAJIV
4 PATEL 01 Apr 1989 Female RAMKALESH PATEL WARDEN GANDHI NAGAR, WAGLE ESTATE,ROAD GANDHI NAGAR, WAGLE ESTATE,ROAD 22 Feb 2019
NO. -29 , THANE -400 604 NO. -29 , THANE -400 604

SATYANAND PARMANAND BHALERAV CHAWL, LOKMANYA NAGAR , BHALERAV CHAWL, LOKMANYA NAGAR ,
5 PARMANAND PANT 21 Jan 1976 Male PANT WARDEN PADA NO . 03, NEAR NAVTARUN MITRA PADA NO . 03, NEAR NAVTARUN MITRA 04 Dec 2020
MANDAL, THANE (W) -400 606 MANDAL, THANE (W) -400 606
At./ Post - BHAVANI NAGAR KARJAT, TAL 1/4, SURAKSHA NAGAR, BHATVADI,
6 BASANT A NAYAK 18 Aug 1984 Male A NAYAK WARDEN - KARJAT , DIS - AHAMEDNAGAR 414 GHATKOPAR (W) 400 086 10 Dec 2021
402
INDIRA NAGAR , PADA NO. 2 , RUPA DEVI
CHITAUDI, CHITAWAN ,SARAIHARAKHU PADA, NEAR LAXMI MEDICLE WAGLE
7 DEEPIKA SATISH PATIL 29 Jul 1994 Female SATISH PATIL CASHIER MARIAHU , JAUNPUR , UTTAR PRADESH - ESTATE , THANE , MAHARASHTRA -400 27 Mar 2022
222 141 604

Gharatghar, Tal.Jawali, Gange Satara, Panchavati, Plot no.68/B, Room no.165,

8 AMRUTA TANU HATPALE 14 Oct 2000 Female TANU HATPALE WARDEN Dist. Satara - 415012 Sector - 5, Ghansoli, Navi Mumbai - 03 May 2022
400701
ROOM NO. 502, BILD. NO. 28, ASHOK ROOM NO. 502, BILD. NO. 28, ASHOK
9 AAMIR KHAN 27 Oct 1990 Male YUSUF KHAN IT NAGAR ,NEAR JAIN MANDIR, BHIVAND NAGAR ,NEAR JAIN MANDIR, BHIVAND 06 May 2022
THANE , MAHARASHTRA- 421 302 THANE , MAHARASHTRA- 421 302

SHAILESH NAGAR,DEVRI
PADA,ZOPZDPATTI,MUMBAI PUNE SHAILESH NAGAR,DEVRI
RUCHIKA RAMESH ROAD,NEAR SHIVALAL TEMPLE , PADA,ZOPZDPATTI,MUMBAI PUNE
10 PAWAR 31 Jan 1990 Female RAMESH PAWAR WARDEN 19 May 2022
BANJARA BASTI,MUMBRA , THANE -400 ROAD,NEAR SHIVALAL TEMPLE , BANJARA
612 BASTI,MUMBRA , THANE -400 612

BABULAL CHAWL, RAJA SHIVAJI BABULAL CHAWL, RAJA SHIVAJI VIDYALAY

DHANANJAY MAHADEV MAHADEV VIDYALAY ROAD , NEAR NARESH KIRANA ROAD , NEAR NARESH KIRANA STORE ,
11 KAMBLE 24 Jun 1986 Male KAMBLE SUPERVISOR STORE , LOKMANYA NAGAR , PADA NO. LOKMANYA NAGAR , PADA NO. 4 ,THANE 27 May 2022
4 ,THANE , MAHARASHTRA - 400 606 , MAHARASHTRA - 400 606

ROOM NO. 2 , BHOYE CHAWL, KOKNI

0 SELVAS ROAD, At -/Post - PADA, NEAR SHIVSENA SHAKHA,AAPNA
12 YOHAN DIWANJI GAVIT 10 Jun 1986 Male DIWANJI GAVIT SUPERVISOR 2 SAKHARSHET, TAL - JAWAR, DIS - BAZAR, TIKUJINIVADI ROAD, THANE 400 04 Jul 2022
PALGHAR , MAHARASHTRA 401 603 610
 KALISHANKAR ROOM NO. 1, JAI MAA SANTOSHI ROOM NO. 1, JAI MAA SANTOSHI CHAWL,
13 NEHA KALISHANKAR KORI 08 Jan 2000 Female KORI WARDEN CHAWL, WAGHOBA NAGAR, KALWA (E) WAGHOBA NAGAR, KALWA (E) THANE 21 Jul 2022
THANE 400 605 400 605

RAHUL SHRIMANT SHRIMANT At . POST - CHOPDI ,TAL -PATAN , DIS - SUDARSHAN COLONY, SHASTRI NAGAR ,
14 SURYAVANSHI 01 Sep 1990 Male SURYAVANSHI DRIVER SATARA , MAHARASHTRA - 415 205 NEAR YASHODHAN SCHOOL, THANE (W) - 13 Aug 2022
400 606

RAGHUNATH NAGAR, BHAGWAN RAGHUNATH NAGAR, BHAGWAN

MHATRE CHAWAL, CHAWL NO. 2, ROOM MHATRE CHAWAL, CHAWL NO. 2, ROOM
15 MEENAKSHI KAMBLE 01 Oct 1987 Female NAMDEV KAMBLE CASHIER NO. 4, NEAR ANAND VIDYALAYA, NO. 4, NEAR ANAND VIDYALAYA, 27 Aug 2022
ASHELEPADA ULHASNAGAR -421 004 ASHELEPADA ULHASNAGAR -421 004

JAIHIND SOCIETY, ROOM NO, 16, ROAD JAIHIND SOCIETY, ROOM NO, 16, ROAD
SHRUTIKA JAYWANT NO. 22, NEAR ROOPA DEVI MANDIR, NO. 22, NEAR ROOPA DEVI MANDIR,
16 SHINDE 19 May 1992 Female JAYWANT SHINDE CASHIER RUPA DEVI PADA, THANE , WAGLE RUPA DEVI PADA, THANE , WAGLE ESTATE 27 Aug 2022
ESTATE , THANE - 400 604 , THANE - 400 604

PRADNYA RAVINDRA RAVINDRA ROOM NO. 502, BILD. NO. 28, ASHOK ROOM NO. 502, BILD. NO. 28, ASHOK
17 BANSODE 26 Oct 1985 Female BANSODE WARDEN NAGAR ,NEAR JAIN MANDIR, BHIVAND NAGAR ,NEAR JAIN MANDIR, BHIVAND 01 Oct 2022
THANE , MAHARASHTRA- 421 302 THANE , MAHARASHTRA- 421 302
KRISHNA NAIK CHAWL, NEAR SAHYOG KRISHNA NAIK CHAWL, NEAR SAHYOG
SCHOOL CHIRAGNAGAR, THANE, SCHOOL CHIRAGNAGAR, THANE,
18 RANVEER SHIVAJI JAHIR 20 Jul 2001 Male SHIVAJI JAHIR DRIVER JEKEGRAM ,THANE ,MAHARASHTRA -400 JEKEGRAM ,THANE ,MAHARASHTRA -400 22 Dec 2022
606 606

KALPESH RAMESH RAMESH ROOM NO. 502, BILD. NO. 28, ASHOK ROOM NO. 502, BILD. NO. 28, ASHOK
19 PARBALKAR 07 Jul 2003 Male PARBALKAR WARDEN NAGAR ,NEAR JAIN MANDIR, BHIVAND NAGAR ,NEAR JAIN MANDIR, BHIVAND 03 Mar 2023
THANE , MAHARASHTRA- 421 302 THANE , MAHARASHTRA- 421 302

CHANDRAKANT BHOSLE , NEAR

BHOIWADA POLIS STATION ,528 NEW CHANDRAKANT BHOSLE , NEAR
AMOL DINKAR DINKAR B.D.D. CHAWL DAHIWALKAR BUVA BHOIWADA POLIS STATION ,528 NEW
20 LOKHANDE 11 Jun 1993 Male LOKHANDE WARDEN B.D.D. CHAWL DAHIWALKAR BUVA MARG 09 Mar 2023
MARG , NAIGAON , DADAR - MUMBAI -
400 014 , NAIGAON , DADAR - MUMBAI -400 014

SHANKAR NIVAS, ROOM NO. 3, SHASTRI SHANKAR NIVAS, ROOM NO. 3, SHASTRI
21 SAHIL GAJANAN LAD 11 Jan 2003 Male GAJANAN LAD WARDEN NAGAR , KALWA (W) ,THANE , NAGAR , KALWA (W) ,THANE , 06 Apr 2023
MAHARASHTRA -400 605 MAHARASHTRA -400 605

PREM NAGAR, SUDHAR SANGH, UNNAT PREM NAGAR, SUDHAR SANGH, UNNAT
22 VISHAL MAHESH PAL 6/12/2003 Male MAHESH Supervisor NAGAR ROAD NO2, GOREGAON (WEST) NAGAR ROAD NO2, GOREGAON (WEST) 19 Apr 2023
MUMBAI, MAHARASHTRA-400062 MUMBAI, MAHARASHTRA-400062

NEAR SAI BABA MANDI, SAINATH MITRA NEAR SAI BABA MANDI, SAINATH MITRA
23 MANDA SAGAR PATIL 1/24/2000 Female SAGAR CASHIER MANDAL, AMAR BHAU SATHE NAGAR MANDAL, AMAR BHAU SATHE NAGAR 01 May 2023
ROOD NO-22 THANE WEST 400604 ROOD NO-22 THANE WEST 400604

SUKHSHANTI CHS, ROAD NO 34, SUKHSHANTI CHS, ROAD NO 34,

SARIKA ABHIJEET RUPADEVI PADA NO 02, SATHE NAGAR RUPADEVI PADA NO 02, SATHE NAGAR
24 SATPUTE 5/11/1995 Female ABHIJEET CASHIER INDIRA NAGAR, VTC THENE PO WAGLE INDIRA NAGAR, VTC THENE PO WAGLE 01 May 2023
THANE 400604. THANE 400604.

MANJU PHULCHAND 02-Jun-85 PARKING WARDEN ZO-32 THAKKAR BAPPA COLONY, CST ZO-32 THAKKAR BAPPA COLONY, CST
25 SUVASIYA Female PHULCHAND ROAD S G BARVE MARG, INDIRA GANDHI ROAD S G BARVE MARG, INDIRA GANDHI 16 May 2023
NAGAR, CHEMBUR, MUMBAI 400071 NAGAR, CHEMBUR, MUMBAI 400071

MAMTA RAMDAS TA-RAVER DASANUR NIMBHORA TA-RAVER DASANUR NIMBHORA

26 BHALERAO 3/20/2002 Female RAMDAS PARKING WARDEN JALGAON MAGARASTRA-425506 JALGAON MAGARASTRA-425506 01 Jun 2023

SHIV BHUVAN BUILDING, SHIVAAJI SHIV BHUVAN BUILDING, SHIVAAJI

27 YUKTI NILESH WADVANA 5/8/2001 Female NILESH PARKING WARDEN NAGAR, MULUND CHECK NAKA, THANE, NAGAR, MULUND CHECK NAKA, THANE, 12 Jun 2023
THANE, MAHARASTRA 400604 THANE, MAHARASTRA 400604

LAXMAN WARD NO.12 GRAM DHANWANI MAFI, POLE D B/H SHANKAR MANDIR, KING
28 ANAND BADGOTE 4/10/2005 Male BADGOTE PARKING WARDEN THE HARSUD DHANWANI MAFI, KING NGR, DONGRIPADA 400615. 14 Jun 2023
KHANDWA MADHYA PRADESH 450116
 SURAJ RAJNARAYAN ASST. CAR PARK
29 GOUD 7/8/1995 Male RAJNARAYAN MANAGER 15 Apr 2022
30 SAPNA VISHAL SHARMA 11/12/1986 Female VISHAL PARKING WARDEN 29 Jun 2023
AKSHAY KASHINATH 59 TAKE WADI ADAVALI DIS -RATNAGIRI 59 TAKE WADI ADAVALI DIS -RATNAGIRI
31 DARDE 9/15/2000 Male KASHINATH PARKING WARDEN PIN NO -415802 PIN NO -415802 10 Jul 2023

HARIPUR (GONAULI) HARIPUR HARIPUR (GONAULI) HARIPUR

32 PAWAN NISHAD 6/1/2002 Male PARKING WARDEN JAUNPUR ,KERAKAT UTTER PRADESH JAUNPUR ,KERAKAT UTTER PRADESH 10 Jul 2023
222146 222146

KAJAL HARISHCHANDRA ROOM NO 23 CHAWL NO 5 LOKMANYA ROOM NO 23 CHAWL NO 5 LOKMANYA

33 RAO 6/12/2004 Female HARISHCHANDRA PARKING WARDEN NAGARPADA NO 4 BHINDE RAILWAY NAGARPADA NO 4 BHINDE RAILWAY 04 Jul 2023
COLONY THANE WEST-4000606 COLONY THANE WEST-4000606

SANJANA ROSHAN
34 KUDATADKAR 4/2/1992 Female ROSHAN PARKING WARDEN 05 Jul 2023

SATHE NAGAR WAGLE TMT BUS DEPO SATHE NAGAR WAGLE TMT BUS DEPO
35 SUNNY KISAN SAUDA 31 Jul 1999 Male KISAN PARKING WARDEN ROAD NO34 JAI BHOLENATH CHAWL ROAD NO34 JAI BHOLENATH CHAWL 25 Jul 2023
THANE ( W ) PIN COAD 400604 THANE ( W ) PIN COAD 400604
NEHA PANCHDEV
36 MAURYA 18 Sep 2001 Female PANCHDEV CASHIER 11 Aug 2023

SAKSHI GOVIND BHIND JK CHEMICAL KHARGE CHAWL BHIND JK CHEMICAL KHARGE CHAWL
37 PANDORE GOVIND 13 Oct 2003 Female GOVIND CASHIER POKHRAN ROAD NO1 LAXMI NAGAR POKHRAN ROAD NO1 LAXMI NAGAR 21 Aug 2023
PANDORE THANE MAHARASHTRA 400606 THANE MAHARASHTRA 400606

ANKIT DINESH JAI BHIM NAGAR NO 2MIDC PIPE LINE JAI BHIM NAGAR NO 2MIDC PIPE LINE
38 CHAURASIYA 17 Jun 2005 Male DINESH CASHIER NEAR HANUMAN TEMPLE KALWA NEAR HANUMAN TEMPLE KALWA THANE- 23 Aug 2023
THANE-400605 400605
PIYUSH MAHESH
39 CHAUHAN 20 Nov 2003 Male PARKING WARDEN 25 Aug 2023

ROOM NO 1 GANESH CHAWAL GANESH ROOM NO 1 GANESH CHAWAL GANESH

NAGAR PADA NO3 JUNI PIPE LINE NAGAR PADA NO3 JUNI PIPE LINE PARERA
40 HITESH SURESH KADAM 04 Sep 1992 Male SURESH PARKING WARDEN PARERA NAGAR LOKMANYA NAGAR PIN NAGAR LOKMANYA NAGAR PIN CODE 08 Aug 2023
CODE 400606 400606

SUMIT RAJENDRA ASHTAVINAYAK SOCIETY KAMGAR ASHTAVINAYAK SOCIETY KAMGAR

41 RAJBHAR RAJENDRA 22 Jul 2004 Male PARKING WARDEN HOSPITAL ROAD NEAR RATION SHIOP HOSPITAL ROAD NEAR RATION SHIOP 23 Aug 2023
RAJBHAR JIJAMATA NAGAR THANE WEST-400604 JIJAMATA NAGAR THANE WEST-400604

VIKASH KUMAR
42 GANNORE 02 Oct 2004 Male 27 Sep 2023
ALPESH YASHWANT SHIVRAI GALI ROAD NO 16 AMBIKA SHIVRAI GALI ROAD NO 16 AMBIKA
43 GHOLAM 09 Feb 1990 Male NAGAR NO2 THANE WEST NAGAR NO2 THANE WEST 26 Sep 2023

MANOHAR HATE ROOM NO 2 CHAWL MANOHAR HATE ROOM NO 2 CHAWL NO

NO 212 GROUP NO-1 ASHOK NAGAR 212 GROUP NO-1 ASHOK NAGAR TAGOR
44 AJAY MANOHAR HATE 18 Aug 1996 Male TAGOR NAGAR VIKHROLI EAST MUMBAI NAGAR VIKHROLI EAST MUMBAI 01 Sep 2023
MAHARASTRA 400083 MAHARASTRA 400083