Subcontractor HSSE

Prequalification Questionnaire
PEC-HS-FRM-X-13807 Rev 1

SECTION 1: POLICY, LEADERSHIP AND COMMITMENT

1.1 HSSE policy documents

Does your company have a documented HSSE Policy? If YES, please attach a signed and
dated copy yes
Who has overall and final responsibility for HSSE in your organisation? Operation manager
Who is the most senior person in the organisation responsible for this policy? Provide name,
title and experience.eng .wael Samir QA /QC manager
When the HSSE Policy has been signed and reviewed? January 2019

1.2 Availability of policy statements to employees

Itemise the methods by which you have drawn your policy statements or any changes in the
policy to the attention of all your employees; provide evidence of communication

1.3 Commitment to HSSE through leadership

How are senior managers personally involved in HSSE management?commited with all
safety rules and aware people of any unsafe act
Provide evidence of commitment at all levels of the organisation like records and Minutes of
Safety Committee meetings, Management walk through meetings etc.
How do you promote a positive culture towards HSSE matters? Through toolbox talk and
safety training

SECTION 2: HAZARDS AND RISK MANAGEMENT

2.1 Hazards and risk assessment

What techniques are used within your company for the identification, assessment, control,
and mitigation of hazards and their effects? Through a discussion meeting of all managers
and supervisors
Please provide your company’s risk assessment procedure and sample risk assessments/job
safety analysis
How are risk assessments communicated to the workforce? Printed paper fix on a board
inside any workshop
What techniques are used within your company to identify security risks?

2.2 Exposure of the workforce

What systems are in place to monitor and control the exposure of your workforce to
chemicals, noise, radiation, etc.? Submit relevant procedure noisy and gas monitering
2.3 Handling of chemicals
a) What techniques are used within your company for the identification, assessment, control,
and mitigation of hazards encountered from chemical or physical agents? Provide relevant
chemical handling procedure, sample COSHH assessment, chemical hazards register etc.

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 Subcontractor HSSE
Prequalification Questionnaire
PEC-HS-FRM-X-13807 Rev 1

How is your workforce advised on potential chemical or physical agents encountered in the
course of their work?

2.4 Personal protective equipment

a) What arrangements/procedure does your company have for the provision and upkeep of
protective equipment/ clothing, both for standard and specialised activities? Submit your PPE
procedure

SECTION 3: PLANNING, OBJECTIVES, TARGETS AND LEGAL

REQUIREMENTS

3.1 Objectives and targets

How do you monitor HSSE performance against targets for defined key areas and activities?
Do you have HSSE Objectives? If YES, submit a copy
Do you have Key Performance Indicators (KPIs)? If YES, submit a copy
Do you have an HSSE improvement plan? If YES, submit a copy

3.2 Legal requirements

How do you identify and ensure compliance with new industry or regulatory standards that
may be applicable to your activities? Please submit a copy of your HSE legal register
How do you communicate the contractual and legal requirements to the workforce?

SECTION 4: ORGANISATION, ROLES, RESPONSIBILITIES AND

RESOURCES

4.1 Organisation
Please provide an overall company HSSE organisation chart
Please provide a Project specific HSSE organisation chart
Please provide the relevant document describing the roles, responsibilities, experience and
competency requirements of key HSSE personnel, Project/ Site Manager, Security Manager,
Supervisors etc.

SECTION 5: TRAINING AND COMPETENCY

5.1 Competence and general HSSE training

What arrangements/procedure does your company have to ensure all employees have
knowledge of basic industrial HSSE, your Company HSSE policies and practices? Provide
training procedure detailing new employee induction/ orientation requirements, Job specific
training requirements etc. as evidence

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 Subcontractor HSSE
Prequalification Questionnaire
PEC-HS-FRM-X-13807 Rev 1

What arrangements does your company have to ensure existing staff HSSE knowledge is up
to date? Are retraining periods established? If YES, elaborate please. (If training is provided
in-house please give details of content)
Please provide a Project HSSE training matrix/plan
5.2 Competence and training of managers, supervisors, senior site staff and HSSE
advisors
Have the managers and supervisors received formal HSSE training in their responsibilities
with respect to conducting work as per HSSE requirements? If YES please provide evidence
Does the Training Matrix identify the HSSE training requirements of managers, supervisors,
senior staff, HSSE advisors etc.?
Please provide the HSSE competency assessment criteria for managers, supervisors, senior
staff and HSSE advisors etc.

5.3 Specialised training

How have you identified areas of your company’s operations where specialised training is
required to deal with potential hazards? (Please itemise and provide details of training given)
If the specialised work involves radioactive, asbestos removal, chemical, or other
occupational health hazards, how are the hazards identified, assessed & controlled?

5.4 HSSE qualified staff – additional training

Does your company employ a competent HSSE trainer and/or a qualified HSSE Advisor to
provide training in more than the basic requirements? If YES, please provide qualification
details and career profile

SECTION 6: DOCUMENTATION, IMPLEMENTATION AND

OPERATIONAL APPROACH

6.1 HSSE Documentation / HSSE Management System

Do you have a company HSSE manual (or Operations Manual with relevant sections on
HSSE) which describes in detail your company approved HSSE working practices relating to
your work activities? If YES, please attach a copy
Is your Company’s HSSE Management system certified to an international standard (ISO /
OHSAS)? If YES, please provide a copy of certificate
How do you ensure that the working/operating practices and procedures used by your
employees’ onsite are consistently in accordance with your HSSE policy objectives and
arrangements?
Does your company have standardised the working/operating procedure? If YES, provide the
Standard Operating Procedures (SOP)
Does your company have any project specific HSSE Plan? If YES, provide a sample copy

6.2 Equipment control and maintenance

How do you ensure that plant and equipment used within your premises, onsite or at other
locations by your employees are correctly registered, controlled, and maintained in a safe

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 Subcontractor HSSE
Prequalification Questionnaire
PEC-HS-FRM-X-13807 Rev 1

work condition? Please submit a copy of ‘Equipment control and maintenance procedure’ or
relevant procedures
Does your ‘Equipment control and maintenance procedure’ address the requirement of third
party inspection and do you maintain a log of equipment third party certification? If YES,
submit a sample copy of each
Does your company maintain an equipment inspection/ maintenance log? If YES please
submit a copy
Are ‘Equipment Maintenance/inspection log’ records verified periodically by internal audits
and/or relevant management authorized personals? If YES, provide evidence

6.3 Assessing the suitability of the Sub/Contractors

How do you assess HSSE competence and records of subcontractors/ companies with whom
you place contracts?
Where do you describe the standards you require your subcontractors to meet? Provide
subcontractor management procedure
Do you conduct prequalification assessments, pre-mobilisation assessment, performance
evaluation, etc. on your subcontractors? Please submit a copy of each
How do you ensure these standards are met and verified by subcontractors?

6.4 Road Safety Management

a) What procedure/ standards does your company have for mitigating road and vehicle accidents
associated with your operations? Provide relevant procedure
b) Does your company have Journey Management Plan (JMP)? Who is accountable for JMP?
Provide sample JMP
c) Are all your vehicles fitted with In Vehicular Monitoring System (IVMS) or relevant monitoring
system? Provide sample monitoring report as evidence
d) Did all drivers attend a defensive driving training and/or Project specific driving training?
Provide training records as evidence

6.5 Environmental Management

Do you have an Environment Management System in place in accordance with ISO 14001
standard? If YES please provide a copy of Aspect/ Impact register and objectives & targets of
any on-going project as a sample
Please provide sample environmental management plan and a waste management plan of
any on-going project
Do you calculate and report greenhouse gas emissions from your activities and operations? If
YES submit a sample copy of the report

6.6 Health Management

a) Is there a pre-employment medical and fitness to work scheme in place? If YES provide a
copy
b) Do you have a drugs and alcohol policy in your organisation? If YES, does it include
pre-employment and random testing?
c) Do you have a health monitoring and/or surveillance programme? If YES provide a copy

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 Subcontractor HSSE
Prequalification Questionnaire
PEC-HS-FRM-X-13807 Rev 1

d) What system is in place to ensure adequate standards of catering, hygiene, water and
sanitation, access to first aid, and access to recreation activities for accommodation of personnel
and at the worksite?

6.7 Security Management

a) Do you have a Company Security Management System, Security Standard or similar which
describes in detail your company approved security Standard Operating Procedures relating
to your work activities? If YES, please provide a copy
b) Do you have a system or procedure for managing the security of your personnel when
travelling? If YES, please provide a copy
Do you have a process for evaluating third party security service providers? If YES, please
provide a copy

SECTION 7: BEHAVIOUR, COMMUNICATION AND CONSULTATION

7.1 How is your company structured to manage and communicate HSSE effectively? Provide
evidence like minutes of HSSE communication meetings including safety committee meetings
and Management walk-through meetings
7.2 What provision does your company make for HSSE communication meetings? (What type of
meetings, communications and how often). Please provide evidence

SECTION 8: CRISIS AND INCIDENT MANAGEMENT

8.1 Emergency response procedure

a) What arrangements are in place for managing emergencies?
b) Please provide a sample Emergency Response Plan (ERP)
c) Does your ERP covers all potential emergency scenarios such as fires/ explosion, H2S
evacuation, terrorist attack, release of toxic gas or flammable materials, security breach, etc.?
Provide evidence

8.2 Incident investigation and Lessons learned

Does your company have an Incident Investigation Procedure? Submit a copy
Who conducts incident investigations? Are they trained and competent to perform
investigations? Please elaborate
How are learnings or findings following an investigation, or a relevant incident occurring
elsewhere, communicated to your employees? Provide evidence like HSSE Alerts, Lessons
Learned, mass TBT and etc.
Are near misses, unsafe behaviours and unsafe conditions reported? If YES, please describe
and provide evidence
Please submit sample of your incident investigation report

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 Subcontractor HSSE
Prequalification Questionnaire
PEC-HS-FRM-X-13807 Rev 1

Does the preventive/corrective actions closed out in time and tracked through ‘Action tracking
register’? Submit sample ‘Action tracking register’

SECTION 9: COMPLIANCE ASSURANCE AND CORRECTIVE ACTION

9.1 Do you have a written procedure on HSSE auditing? If YES, please provide a copy. Are the internal
auditors trained and competent? Provide sample certification & summary of their professional profile

9.2 Do your company’s HSSE Plans include schedules for internal and external auditing? If YES,
provide sample audit schedule

9.3 How are findings communicated to management and reviewed?

9.4 Please provide the latest 3rd party audit report

9.5 How does your company register and follow non-conformances with procedures, specifications,
standards and contract requirements? Please provide sample Action tracking system/ register

9.6 Does your company’s HSSE Plan/Manual cover inspections? Please provide details including type
of inspections, frequency and roles & responsibilities; provide a sample inspection schedule for all
tasks, areas, components, plant, equipment etc.

SECTION 10: PERFORMANCE MEASUREMENT, REVIEW AND

IMPROVEMENT

10.1 Management and performance monitoring of work activities

What arrangements does your company have for monitoring HSSE performance by
management and supervisors? Provide evidence of leading and lagging indicators,
management involvement in HSSE review meetings and etc.
What type of performance criteria are used in your company? Provide examples

10.2 HSSE performance achievement awards

Has your company received any award for HSSE performance achievement? Please provide
certificates and/or photographs as evidence

10.3 Statutory notifiable incidents

a) Has your company suffered any statutory notifiable incidents in the last five years (safety,
occupational health, and environmental)? (Answer with details including dates, country, most
frequent types, causes and follow-up preventative measures taken)
b) Has your company suffered any significant security breaches in the last five years? (Answer
with details including dates, country, most frequent types, causes and follow-up preventative
measures taken)

10.4 Improvement requirements and prohibition notices

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 Subcontractor HSSE
Prequalification Questionnaire
PEC-HS-FRM-X-13807 Rev 1

Has your company suffered any improvement requirement / prohibition notices by the relevant
national regulatory body for HSSE / other enforcing authority? Has your company been prosecuted
under any HSSE legislation in the last five years? (If your answer is YES, please give details).

10.5 HSSE performance records

Have you maintained your records of your incidents and HSSE performance for the last five
years? If YES, please complete Attachment 1.
How often is HSSE performance reviewed? By whom?

SECTION 11: HSSE MANAGEMENT – ADDITIONAL FEATURES

11.1 Memberships of Associations

Is your company an active participant in a prominent HSSE association? Does your company
participate in any HSSE forums/events? Provide all related evidences such as certificates,
photographs etc.

11.2 Additional features of your HSSE management

Does your company have any other HSSE features or arrangements not described elsewhere in your
response to the questionnaire? (As any specific system, procedure, software etc. meant to improve/
promote positive HSSE culture either with a pro-active approach or reactive approach)

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 Subcontractor HSSE
Prequalification Questionnaire
PEC-HS-FRM-X-13807 Rev 1

ATTACHMENT 1 – HSSE PERFORMANCE TRENDS

Year
Description
Man Hours1
Number of Fatalities2
Number of Lost Time
Incidents
Number of Restricted
Workday Cases
Number of Medical
Treatment Cases
Number of First Aid
Cases
Number of Near Misses
LTIFR per 200,000
manhours
RIFR per 200,000
manhours
Occupational Health
illness ( work related)
Environmental Incidents
(Major)
Environmental Incidents
(Serious)
Environmental Incidents
(Medium)
Environmental Incidents
(Minor)
Green House gas
emissions (tCO2e)
Security Incidents
(Major)
Security Incidents
(Serious )

1Include exposure hours and HSSE statistics expended by subcontractors performing work subcontracted by you.
2 For each Fatality, provide a description of the incident, the root / contributing causes, and the action plans to
prevent reoccurrence.

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 Subcontractor HSSE
Prequalification Questionnaire
PEC-HS-FRM-X-13807 Rev 1

Security Incidents
(Medium)
Security Incidents
(Minor)

DEFINITIONS:

Fatality: Any work-related injury or illness that resulted in death. Fatalities arising from suicide,
inexplicable personal behaviour or natural causes shall be excluded.

Lost Time Incidents: Any work related fatality, injury or illness which prevents that person from
doing any work for any day excluding the day of the incident.

Restricted Workday Cases: A work-related injury or illness is RWC if it results in restriction of

work or motion, or transfer to another job.

Restricted work means after an injury or illness:

 The employee is kept by you from performing one or more of the routine functions of their
job or from working the full workday that they have been supposed to work otherwise; or

 The employee is recommended by a physician or other licensed health care professional

not to perform one or more of the routine functions of their job, or not work the full workday
that they have been supposed to work otherwise

Transfer to another job means after an injury or illness (not the day of the injury or illness) the
employee is assigned to a job by you other than their regular job for part of the day

Medical Treatment Cases: MTC is a work-related injury or illness that results in medical treatment
beyond first aid. MTC excludes death, one or more days away from work and one or more days of
restricted work. In order a work-related injury or illness to be a MTC, the employee must receive
medical treatment remaining at work while not being restricted. ‘Medical treatment’ is defined as
combating disease or disorder by management and care of a patient. It does not include:

 Visiting a physician or other licensed health care professional only for observation or
counselling
 Conducting diagnostic procedures (X-rays and blood tests, administering prescription
medications only for diagnostic purposes such as using eye drops in order to dilate pupils)
 First aid

First Aid Case: First Aid Case is a work-related injury or illness that requires the person
receiving treatment from a qualified First Aid Attendant and is not an injury/illness that is
categorised as ‘Recordable’. The following types of treatment are considered as first aid:

 To use medications that are non-prescription at non-prescription strength

 To administer tetanus immunisations (other immunisations, Hepatitis B vaccine, rabies
vaccine, etc. are considered medical treatment)
 To clean, flush, or soak wound that are on the surface of the skin
 To use wound coverings (bandages, BandAids TM, gauze pads, etc.), or to use SteriStrips
TM or butterfly bandages

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 Subcontractor HSSE
Prequalification Questionnaire
PEC-HS-FRM-X-13807 Rev 1

 To use hot or cold therapy

 To use totally non-rigid means of support (elastic bandages, wraps, non-rigid bask belts,
etc.)
 To use temporary immobilisation devices (splints, slings, neck collars, or back boards)
during transportation of an accident victim
 To drill a fingernail or toenail for relieving pressure, or to drain fluids from blisters
 To use eye patches
 To use simple irrigation or a cotton swab for removing foreign bodies that are not
embedded in or adhered to the eye
 To use simple means (irrigation, tweezers, cotton swab, etc.) for removing splinters or
foreign material from all areas but eyes
 To use finger guards
 To use massages
 To drink fluids for relieving heat stress

Near Misses: An incident that under slightly different circumstances, could have caused harm to
people, environment, assets or company reputation, but did not.

Lost Time Injury Frequency Rate (LTIFR): The frequency of lost time injuries per 200,000 hours
worked/at risk.

Recordable Case: Recordable Cases are the sum of the number of Fatalities, Lost Time
Injuries/Illnesses, Restricted Workday Cases and Medical Treatment Cases

Recordable Injuries Frequency Rate (RIFR): The frequency of recordable injuries per 200,000
hours worked/at risk.

Environmental Incidents (Major severity): Major pollution event leading to long-term widespread
damage or Statutory Notices, extensive clean up requiring national/ international support to contain
and/ or clean up

Environmental Incidents (Serious severity): Substantial pollution event leading to large-scale

regional damage or Statutory Notices, clean up may require national support and result in delays
to schedule

Environmental Incidents (Medium severity): Moderate pollution event leading to local damage,
Statutory Notices, clean up and corrective action

Environmental Incidents (Minor Severity): A low or contained pollution event, slight or no effect,
no offsite impact, minor breach requiring corrective action e.g. few litres of liquid spill

Green House Gases: Are the six gases listed in the Kyoto Protocol: carbon dioxide (CO2);
methane (CH4); nitrous oxide (N2O); hydrofluorocarbons (HFCs); perfluorocarbons (PFCs); and
sulphur hexafluoride (SF6) which contribute to global warming
Security Incident (Major severity): One or more fatalities resulting from a security incident,
property or equipment damage/theft in excess of $1M, kidnap or bomb threat
Security Incident (Serious severity): Life changing injuries resulting from a security incident,
property or equipment damage/theft ($100k - $1M), sexual assault, extortion/blackmail, missing
person
Security Incident (Medium severity): LTI, medical treatment or RWC resulting from a security
incident, possession of illegal items or property or equipment damage/theft ($10k - $100k)

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 Subcontractor HSSE
Prequalification Questionnaire
PEC-HS-FRM-X-13807 Rev 1

Security Incident (Minor severity): Non-recordable injuries/FAC resulting from a security

incident, minor criminal acts or attempts or property or equipment damage/theft (<$10k)

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