A B C D
Section 1: Leadership and Commitment
A B C D
Section 3: Organization, Responsibilities, Resources, Standards and Documentation (contd)
A B C D
Section 4: Hazards and Effects Management
A B C D
Section 4: Hazards and Effects Management (contd)
A B C D
Section 5: Planning and Procedures
HSE or operations manuals: Item 5(1) (a) and (b)
No HSE procedures / Basic HSE Contractor has written Contractor has
manual is available procedures/manual exist HSE procedures to cover all
procedures/manual to HSE precautions/manual,
cover all hazardous typical contractor HSE
operations Plan requirements with a
system of updating and
dissemination to
employees
Equipment control and maintenance: Item 5(2)
No defined programme to Program relies on outside A written programme In addition to C, periodic
ensure control and sources, i.e. company outlining supervisory inspections conducted by
maintenance of plant inspections. Supervisory guidelines, top management or by
and / or equipment inspection of equipment responsibilities, teams of specialists
confined to worksite frequency and follow-
personnel only up is in effect
Transport Safety Management: Item 5(3)
No special attention paid Importance of transport Company has a Company has a complete
to transport safety as an safety acknowledged but general management strategy and set of plans
area of hazardous left to core business strategy with some and procedures covering
activities managers/supervisors to procedures for its vehicles, drivers and
enact individually component issues operations management
Section 6: Implementation and Performance Monitoring
Management and performance monitoring of work activities: Items 6(1)
No system for formally Informal/incidental Company has a Company has a
monitoring HSE monitoring HSE system for monitoring comprehensive system
performance at all performance only HSE performance in for monitoring
key areas performance in all areas
with feedback to
employers for
improvement and has
received awards for
achievement
A B C D
Section 6: Implementation and Performance Monitoring (contd)
Statutory notifiable incidents, dangerous occurrences, improvement requirements and prohibition notices:
Items 6(2)
More than one One occurrence of a Occurrences relate to No occurrences in the last
occurrence of major major incident in the last minor incident(s) only five years
incident in last five years five years
HSE Performance records (Latest year injury rate comparison to contractors three preceding years
average): Item 6(3) (a) - (d)
Contractor supplied Rate is not improving Shows only minor rate Rate steadily improving
insufficient information to improvement by more than 20 per cent
establish rate or rate per year
increases
Incident Investigation and reporting: Item 6(4) (a) - (d)
Procedure are available Procedure are available Procedure are As in C but with the
but Findings not generally and Findings available and Findings addition of details of
communicated communicated to key communicated to all implication for improving
personnel only via limited employees via specific HSE performance
company internal memo company notice
or similar media
Contractor : _____________________________________________
Address : _____________________________________________
Date : _____________________________________________
Phone : _____________________________________________
Circle the number, which best represents this evaluation based on the criteria for
rating purposes attached.
SUBTOTAL X1/4
SECTION 7 AUDIT AND REVIEW 0 3 7 10
SUBTOTAL X1
SECTION 8 EMERGENCY RESPONSE
0 3 7 10
PROCEDURE
SUBTOTAL X1
SECTION 9 SHE MANAGEMENT
0 2 5 8
ADDITIONAL FEATURES
SUBTOTAL X1
TOTAL RATING (SECT 1 SECT 9)
The numerical values below are the weighted ratings calculated above. The total
represents the overall score for the Contractor.
EVALUATED BY:
NAME NAME
TITLE TITLE
DATE DATE