Supplier / Contractor Pre-Award HSSE Questionnaire (Version 1 - 1 June 2011)

Supplier / Contractor A.N. Other plc

Date of Assessment Wednesday, September 01, 2010
Completed By John Smith

Required KPIs are listed on the 2nd tab

HSSE stands for Health, Safety, Security & Environment

Please cover all aspects in your responses to the questions
Response
Keyword Question Document
Answer:
1 Leadership & HSSE Culture Management gives HSE actions priority. Senior Management attends and leads HSE Meetings, HSE
Audits and Incident Investigation. HSE training is conducted for management personnel as appropriate.
How are senior managers personally involved in HSE management for example objective-
Committment to HSE a) setting and monitoring? Management also encourages personnel to report all incidents, unsafe acts, unsafe conditions and
aspects through 1.1 Near Misses. A "no blame" culture is implemented and learning points from incidents within and outside
leadership b) Provide evidence of commitment at all levels of the organisation? the company communicated to all personnel
Answer: Evidence of this commitment at all levels of organization can be seen in the HSE minutes of meetings held at all levels of company organization HSE MS reviews and HSE Management Committee Meetings at senior management level, HSE Steering committee meetings at Project Management Level, Supervisors HSE Meetings at line management level and Pre-job and toolbox meetings at site level. Also, HSE is included in the agenda of other projects and company management meetings. Personnel at every level of FIDDIL organization have their specified set of HSE responsibilities. HSE implementation is a direct responsibility of the MD, Senior Management, Line Management and all personnel.

c) How do you promote a positive culture towards HSE matters? Answer: Positive HSE Culture is promoted through leadership by example on the part of Managers and supervisors. Extensive education and awareness is carried out and the company also implements an HSE incentive scheme to reward positive HSE performance and initiatives.

2 HSSE Policy & Strategic Objectives

Answer:
The Managing Director has ultimate HSE responsibility and issues the HSE Policy. He also approves all
Does your company have an HSE policy document?
a) If the answer is YES please attach a copy.
HSSE Policy HSE Procedures. The MD provides all financial
Answer: andattached
Yes. See material document.
resources required for the implementation
of the HSE Management System in the company. The HSE Coordinator is the Management
Representative on HSE and provides professional advise to Management on HSE issues and monitors
the implementation of the HSE Management System. Each Manager/Supervisor is responsible for the
HSE Performance of His department and must lead by example. The Managers/Supervisors are
b) Who has overall and final responsibility for HSE in your organisation? responsible for monitoring and controlling their personnel to ensure that they work in line with approved
HSE Policy Documents

procedures. They make PPEs, working materials and other resources available to the workers. All
Managers report to the MD while the supervisors report to the Managers. The personnel are
responsible for carrying out their work in line with approved procedures. They are responsible for using
all safety equipment and PPE provided correctly and must carry out their work in the manner that does
Who is the most senior person in the organisation responsible for this policy being carried out
2.1 c) at the premises and on site where his employees are working? Provide name and title. not compromise their safety or that of their colleagues.
Answer: The most senior person responsible for implementing the policy in the premises is the respective HSE Coordinator (Sunday Augustine) with the following qualifications- General HSE level 1 and 3, National certification in safety and health(NEBOSH), Certificate in T-BOSIET, NEBOSH Level 3 certificate Occupational health and Safety. The most senior person responsible for implementing the policy on sites where the work is being carried out is the respective Project HSE Officer of the project under which that work is being carried out. Different Projects have different HSE Officers.

Communication in Fiddil is both vertical (up -down, down - up) and lateral.

Itemise the methods by which you have drawn your policy statements to the
d) attention of all your employees?

e) What are your arrangements for advising employees of changes in the policy?
HSE contract strategic

Does your company have strategic HSE objectives?

a) If the answer is YES please attach a copy.
HSE Objectives
objectives

2.2

Itemise the methods by which you have communicated your strategic HSE objectives to the
b) attention of all your employees?

3 Organisation, responsibilities, resources, standards and documentation

Organisational structure for HSE management

a) How is your organisation structured to manage and communicate HSE effectively?

b) Do HSE meetings promote HSE awareness?

3.1

c) Do client and contractor meet regularly to discuss and action any interface situations?

What provision does your company make for HSE communication meetings?
d) Please provide an organisation chart
Organisation chart
HSE training of managers, supervisors and HSE critical

Have the managers and supervisors at all levels who will plan, monitor, oversee and carry out
a) the work received formal HSE training in their responsibilities with respect to conducting work
to HSE requirements?

If YES please give details. Where the training is given in-house please describe the content
b) and duration of courses. Please provide an example of training matrix.
Training matrix
positions

How have you identified areas of your companys operations where specialised training is
3.2 c) required, for instance training related to health hazard such as radiation, asbestos and
chemicals?

d) What specialist HSE resources does your organisation have available?

e) How does your company provide HSE specialised training for HSE staff?

What arrangements does your company have to ensure new employees have knowledge of
a) basic industrial HSE, and to keep this knowledge up to date?
Details of content
General HSE training

What arrangements does your company have to ensure new employees also have knowledge
3.3 b) of your HSE policies, practices and company requirements?
Details of content

What arrangements does your company have to ensure new employees have been instructed
c) and have received information on any specific hazards arising out of the nature of the Details of content
activities?
Cometence assurance

Does your organisation have a competence system in place?

a) If YES, please describe the scope and content of your competence system.

3.4

What arrangements does your company have to ensure existing staff HSE knowledge is up to
b) date?

Does your company have a contractor management process or system?

a) If yes, provide an outline of the process.
Contractor management process outline
Contractor management process

b) How do you assess contractors, HSE competence or HSE performance?

3.5

c) Where do you define the company standards you require your contractors to meet?

d) How do you ensure these standards are met and verified?

a) How do you identify new industry or regulatory standards that may be applicable to your activities?
HSE standards

3.6
Supplier / Contractor Pre-Award HSSE Questionnaire (Version 1 - 1 June 2011)

Supplier / Contractor A.N. Other plc

Date of Assessment Wednesday, September 01, 2010
Completed By John Smith

Required KPIs are listed on the 2nd tab

HSSE stands for Health, Safety, Security & Environment

Please cover all aspects in your responses to the questions
Response
Keyword Question Document
HSE standards

3.6 b) Is there an overall structure for producing, updating and disseminating standards?

Are your company standards aligned with OGP/industry guidelines or recommended practices?
c) If yes state which one.

4 Risk Management

Risk Assessment & How does your company identify hazards, assess risk, control and mitigation
4.1 a)
Control consequences, to a level as low as reasonably practicable?

Do you have specific policies and programmes on specific health hazards e.g. substance
a) abuse, blood borne thogens, malaria pandemic diseases etc.
Health Hazards

What type of health hazards (chemical, vibration, noise, radiation, etc) are
4.2 b) associated with the scope of your services? Explain how occupational health
hazards are identified, assessed and controlled.

What systems are in place to control these hazards and monitor the effectiveness of these
c) controls? Is workers regular exposure monitoring part of these systems?

What type of safety hazards (mechanical guarding, work at height, lifting and hoisting, confined
Safety hazards

a) space entry, explosive atmospheres etc.) are associated with the scope of your services?

4.3

What systems are in place to control these hazards and monitor the effectiveness of these
b) controls?
Logistics hazards

What type of logistics hazards (land transport, air transport, marine transport, materials
a) handling etc.)are associated with the scope of your services?

4.4

What systems are in place to control these hazards and monitor the effectiveness of these
b) controls?
Environmental hazards

What type of environmental hazards (chemical spill, atmospheric emissions, waste disposal
a) etc.) are associated with the scope of your services?

4.5

What systems are in place to control these hazards and monitor the effectiveness of these
b) controls?
Security hazards

What type of security hazards (terrorism, hostage taking, robbery, hostile local population etc.)
a) are associated with the scope of your services?

4.6

What systems are in place to control these hazards and monitor the effectiveness of these
b) controls?
Social responsibility

a) What type of social hazards are associated with the scope of your services?
hazards

4.7

What systems are in place to control these hazards and impacts and monitor the effectiveness
b) of these controls?

5 Planning & Procedures

Do you have a company HSE-MS manual (or operations manual with integrated HSE
HSE operations requirements) which describes in detail your company approved HSE working practices relating HSSE-MS manual index & supporting
5.1 a)
manual to your work activities? information
If the answer is YES please attach a copy of an index and relevant supporting documentation.

How do you ensure that infrastructure, plant and equipment used within your operations (own
Infrastructure and
5.2 a) premises, client site, or at other locations) are correctly certified, registered, controlled and
equipment integrity maintained in a safe working condition?

Management of How do you manage changes and assess associated risks e.g. personnel, equipment,
5.3 a)
change processes, documentation?
Emergency planning

a)
and response

What arrangements does your company have for emergency planning and response?

5.4

b) Which emergency situations are included?

6 Implementation and performance monitoring

HSE-MS implementation and active performance monitoring of work

What arrangements does your organisation have for monitoring the implementation of your
a) HSE-MS?

How does your company assure the implementation of work procedures within your work-site
b) operations e.g. compliance with procedures, toolbox talks, safety meetings, supervision, job
observations?

How do you monitor employee HSE performance e.g. hazard identification systems, HSE
c) participation?
activities

6.1

d) What active HSE monitoring is performed (i.e. where no incident has occurred)?

e) How do you report and correct deficiencies identified?

f) How do you communicate the results of active performance monitoring to relevant personnel?
Supplier / Contractor Pre-Award HSSE Questionnaire (Version 1 - 1 June 2011)

Supplier / Contractor A.N. Other plc

Date of Assessment Wednesday, September 01, 2010
Completed By John Smith

Required KPIs are listed on the 2nd tab

HSSE stands for Health, Safety, Security & Environment

Please cover all aspects in your responses to the questions
Response
Keyword Question Document

Safety performance
6.2 a) See separate spreadsheet called Contractor Assessment KPI Data
indicators

a) How is health performance monitored and recorded?

b) How is environmental performance monitored and recorded?

HSE performance monitoring

c) How is security performance monitored and recorded?

6.3 d) How and what near miss incidents are reported?

e) How often is HSE performance reviewed? By whom?

f) How is logistics performance monitored and reported?

g) Do you record vehicle incidents?

a) What types of HSE incident are investigated?

HSE incident and investigation follow-up

b) What process is used to investigate HSE incidents?

6.4 c) Who conducts HSE incident investigations?

How are the findings of an incident investigation followed up to ensure effective prevention of
d) recurrence?

e) How is incident learning communicated to all relevant personnel?

Statutory notifiable Has your company suffered any statutory notifiable incidents in the last five years (safety,
occupational health and environmental)? Details of statutory notifiable incidents
incidents or non 6.5 a) Answers with details including dates, country and location, summary of incident and follow-up or non compliance notices
compliance notices preventative measures taken.

7 HSE auditing and management review of HSE-MS

Do you have a written procedure for HSE auditing?

a) If yes, please attach a copy.
Audit procedure

Who is involved in conducting HSE audits? How are audit team members selected to have
b) specific expertise and be independent from the activities being audited?
What are the qualifications required for auditors?
Audits

7.1

How does your company schedule HSE audit and what scope of auditing is covered? e.g.
c) internal, regulatory compliance, supplier/contractor, HSE management system implementation.

d) How does management follow up on audit findings and ensure effective close out of action items?
Management review and follow-up

Do you have a written procedure for management review of the HSE-MS? Management review procedure for
a) If yes, please attach a copy HSE-MS

7.2 b) How often are HSE-MS reviews conducted and who is involved in the process?

c) How are identified actions and improvement efforts recorded and tracked to effective completion?

8 HSE management - additional features

Certification of your
8.1 Please provide information on any certification which you have received from certification bodies
HSE-MS

Membership of Describe the nature and extent of your companys participation in relevant industry, trade, and
8.2
associations governmental organisations

Additional features of Does your organisation (globally, regionally or locally) have any HSE features or arrangements
8.3
your HSE-MS not described elsewhere in your response to the questionnaire?

9 Company specific information

END
Supplier pre-qualification Questionnaire - HSSE Data
See Glossary of terms for definition of each item

Current
EXPOSURE Year -1
Year
Total Manhours worked
Exposure - Driving (km)
Exposure - Site Work (hours)

Current
SAFETY Year -1
Year
Fatalities FAT
Lost Time Incidents LTI
Lost Workday Cases LWC
Restricted Workday Cases RWC
Medical Treatment Cases MTC
First Aid Cases
Total Recordable Cases (sum FAT, LWC, MTC, or RWC)
TRC

Near Miss Incidents

Fatal Accident Rate (per 108 hours) FAR

Lost Time Injury Frequency (per 10 hours)
6
LTIF
Total Recordable Case Frequency (per 106 hours)
TRCF

Current
Year -1
ENVIRONMENT Year
Loss of Primary Containment (recordable LOPC
Year -2 Year -3 Year -4

Year -2 Year -3 Year -4

Year -2 Year -3 Year -4