Form 'A' - Application For Certificate Of Competency As Boiler Attendant Class - Ii Page 4
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6(Annexure 2)
Format of practical experience certificate / service certificate and
Testimonials of good character with age from the employer
(To be issued on the letter head of the concerned mill/factory/workshop)
Service / Experience Certificate
This is to certify that Sri ………………..……….aged……..….S/o…..….....…………is working in our
organization as a fireman / asst fireman / operator / asst operator / boiler attendant from dd/mm/yy
to dd/mm/yy. The specification of the boiler / boilers on which the candidate is working / has
worked are as follows:
Sl.No. Specifications
Boiler 1
Boiler 2
Boiler 3
Boiler 4
1.
Registration
No. of Boiler
2.
Date of Boiler
registration
/
date of first PO
issued
3.
Working
Pressure
2
(Kg/Cm
)
4.
Heating
2
Surface (M
)
5.
Type of Boiler
He bears good conduct and character. This certificate is issued to
Sri
……………………………appears for 1
st
nd
class / 2
class boiler attendant examination. The age of
the candidate as per the records is ………………….
Signature:
Counter Signature:
Name & Seal:
Name & Seal:
(Under whom candidate
is employed)
(Owner or Agent of mill/
Factory or workshop)
Contact no:
Contact no:
Email address:
Email address:
Place:
Place:
Date:
Date:
*INCOMPLETE SERVICE CERTIFICATE IS NOT A VALID DOCUMENT
*THE CERTIFICATE WILL BE SUBJECTED TO VERIFICATION
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