conditions set forth in thi The information provided in this questionnaire is complete a accurate t "Name of Person Completing Questionnaire: ‘Signature:E-mail Address Contact Telephone (021) 89383033 Emergency Telephone 0821 2292 1498 Describe the type of work your company does | List any contractor license or special li ¢ license oF special license oF certification that are applicable to the work you will perform TRUCKING & GENERAL CARGO How many company owned vehicles does the company have Do any of these vehicles transport chemical ( oil, ‘gas, grease, solvent, welding, etc )? Please describe Does your company have written health and safety policy? if yes please attach the copy of documents _ | Does your company have objective and program for health and safety? ifves please describe, and seni the copy of 50 NONE NOT YET NOT YET documents Does your company have safety communication program eg. safety talk / safety briefing / safety peceting? if-ves please attach the sample of document NOT YET Does your company define steering or committee for Health and safety? ifyes please attack the ‘structure of comittee ave Health and safety “Does your company hi : organization ‘structure? Ifyes please provide copy of document pany have safety Inspection? If yes pl the copy of document NOT YET NOT YET NOT YET