This
Agreement is made at __________ on this ______ day of ___________, 2000,
between A B Co. Ltd., a company incorporated under the Companies Act, 1956 and
having its registered office at ________________ hereinafter called "the
Employer" (which expression shall unless repugnant to the context or
meaning thereof include its successors and assigns) of the ONE PART and Shri X
son of _________, resident of _______________ hereinafter called "the
workman" (which expression shall unless repugnant to the context or
meaning thereof, include his heirs, executors, administrators and assigns) of
the Other Part.Whereas
the workman was employed by the employer in its factory in the capacity of
___________ and on ________ he was injured by an accident arising out of and in
the course of his employment, in respect of which he claims that the employer
is liable to pay him compensation under the Workmen's Compensation Act.Whereas
in order to avoid litigation in respect of the said claim, the parties hereto
are desirous that the liability of the employer (if any), shall be satisfied by
the compensation herein agreed to be made.Now
This Deed Witnesseth That It Is Hereby Agreed As Follows:1.
The
employer shall pay the workman the sum of Rs. __________ as compensation for
such injury as aforesaid on __________.2.
The
employer shall also pay the workman the sum of Rs. _________in respect of the
costs of his medical attendance and other expenses.3.
The
workman shall accept the before mentioned payments in fulldischarge
of all liability of the employer to pay compensation under the Workmen's
Compensation Act or any law for the time being in force and doth hereby release
the employer from any and all liability in respect of the injury caused to the
workman and from any and all liability for any damages, which may result to the
said workman in future on account of the said injury.in
witness whereof, the employer hereto has set its hands and seal and the workman
has set his hands hereunto and to a duplicate hereof, the day and the year first
hereinabove written.The
common seal of ABC Co. Ltd. has beenhereunto
affixed pursuant to the Resolution ofits
Board of Directors dated the _____ day of__________,
2000, in the presence of S/Shri______________
and _________________Directors
who have signed in token thereof.Signed
and delivered by A, the withinamed workmanWITNESSES;1.2.