SERVICE CERTIFICATE

OUTWARD NO.:
DATE:

This is to certify that, Shri.______________________________is working / has worked in this

company since from date _________ to date __________on __________________
post as a permanent employee / seasonal employee / under contract awarded to firm
M/s.______________________________ vide order no.________________for the period
___________ to ___________. ,
During his service tenure he was successfully performed the following duties on boiler.

1) 2) 3)
He bears a good moral conduct further there is no break in his service period.
The details of the boiler on which the employee has performed his duties.

Sr. No Blr.Reg.no. Type of Blr. Blr.Rating or Blr.W.P. in Remarks

H.S. M2 Kg/cm2

Following details of the boiler is mandatory for the sugar manufacturing companies / seasonal
boiler operation companies.

Sr.No. Season Year Actual working days on boiler Total days Remarks
Season Off season

The service particulars submitted above were verified by us and which is correct as
per the company record / Boiler log book and therefore this certificate is issued to
Shri._________________________________ as per his request for appearing the Boiler
Operation Engineer’s Exams held on dated ________________ at Mumbai.

If any of the information in the certificate is found to be untrue, false or

misrepresenting, then the person shall be punishable and he shall liable for action under the
law in-force.

B.O.E./C.E. Head of the Department Owner/Company Authorised Signatory

(To be signed by the (Signature with name, (Signature with Name, Designation &
B.O.E. under whose Designation & Office office rubber stamp)
Supervision candidate rubber stamp)
has worked with his
Name, Designation & Verified above particular with company record and
Cert. No., Date) found correct.

Joint/Dy.Director of Steam Boilers M.S.

(Signature with office stamp)