CORPORATESAFETY,HEALTHAND
ENVIRONMENTALSTANDARD
Pulp & Fibre Business
Document Number:
Title: Contractor Safety Management Procedure ABG/P&FB/SHE/CSMP/3003.00
Issue Date:21.03.2015
Annexure2: Checklist for Contractor Pre-Qualification
Scoring Grid
0 Unacceptable
1 Need Improvement
2 Acceptable
All criteria’s are applicable to Big Contractors (Applicability to Small Contractor’s indicated as YES)
Name of Contractor: Date :
Filled by:
S. Applicable to Small
Criteria Requirements
No Contractors
1 Company details
Company Name:
Address:
Primary Type of Work:
Person Completing Form:
Title/ Phone Number/ Signature/ Date
2 Details of Employees Scoring Criteria
2.1 Organization Chart
2.2 List of Resources (Role/ Position/ Qualification)
Role
Position
Qualification
Experience
2.3 Fulltime Safety /Health Professional
2.4 Manpower (Number)
If answeredYES, provide
2.5 TrainingRecords
records
If answeredYES, provide
2.6 CV for critical roles
records
3 Contractor SHE Program considerations
Does the Company have a written Safety, Health and
3.1 YES
Environmental Policy?
3.2 Substance abuse program / Alcohol Policy YES
3.3 A Written fitness-for-duty policy YES
Has the responsibility for implementation of
YES
3.4 Company’s Safety Policy (ies) been defined?
3.5 Does Management set Corporate Safety goals? YES
Does executive Management review Safety YES
3.6
performance?
If answered YES, provide YES
3.7 Has the Company had a local Safety authority
copies of the
inspection in the last 3 years?
documentation
YES
3.8 Does the Company have a Safety Manual, Safety
If YES, request a copy
Management System?
Document No: ABG/P&FB/SHE/CSMP/3003.00
Thecurrentversionis available at: http://www.abgonstream.com/businesses/pulpandfibre/Pages/pnfhome.aspx
(ABG Pulp & Fibre Business–Company Confidential Document) 1of 41
CORPORATESAFETY,HEALTHAND
ENVIRONMENTALSTANDARD
Pulp & Fibre Business
Document Number:
Title: Contractor Safety Management Procedure ABG/P&FB/SHE/CSMP/3003.00
Issue Date:21.03.2015
3.9 Does the Conduct Medical Checkup of Employees? YES
3.10 Has orientation program for new hires? YES
3.11 Are the Employees insured? YES
Yes / No Frequency YES (Safety
3.12 Does the Company hold Safety meetings? Review on Weekly & Safety
of conducting
Meeting Committee monthly
3.13 Does the Company hold “tool box” Safety meetings? YES
Are equipment / tools / tackles/ vehicles safety YES (Weekly &
3.14 Yes / No Frequency Monthly )
inspections conducted?
YES
3.15 Does the Company perform routine Safety audits?
D-Daily,W-Weekly,M-
What are the processes for On-Site Safety Monthly,Q-Quarterly, S-
YES-
3.16 communication to Employees? Semi-annually, A-
Daily
Annually, N-None
Does the Company perform risk assessment and YES
3.17 method statements?
Does the Company follow Procedures like PTWS, and YES
3.18 SWP?
Conducts audits to ensure that work permit systems are
3.19 YES
followed?
YES
3.20 Does the Company maintain the Equipment List?
YES
Does the Company Maintains operating equipment in
3.21 compliance with regulatory requirements?
YES
Has written incident investigation Procedure and
3.22 maintains incident investigation logs?
YES
Uses incentive award programs to reduce occupational
3.23 injuries and illness?
Disciplinary process for enforcement of your Safety
3.24 YES
program?
Does Company issue Photo Identity card with training
YES
3.25 record tracking card to Employees?
Does Company have PPE Policy and issue PPE to
3.26 YES
Employees?
Has the Contractor participated in emergency mock YES
3.27 drills? Do they have emergency response plans and
Procedures?
YES
3.28 Sub-Contractor performance evaluation process exists?
Document No: ABG/P&FB/SHE/CSMP/3003.00
The current version is available at: http://www.abgonstream.com/businesses/pulpandfibre/Pages/pnfhome.aspx
(ABG Pulp & Fibre Business–Company Confidential Document) 25of 41
CORPORATESAFETY,HEALTHAND
ENVIRONMENTALSTANDARD
Pulp & Fibre Business
Document Number:
Title: Contractor Safety Management Procedure ABG/P&FB/SHE/CSMP/3003.00
Issue Date:21.03.2015
Does the Contractor have sufficient resources
3.29 YES
(Equipment, staff) to complete the work Safely?
Can the Contractors how existing practices at their YES
3.30
reasonable large project Site?
YES
3.31 Do they have appropriate certifications and licensing?
YES
3.32 Do they have any reference / referral information?
Do they have system to ensure use of quality tools,
3.33 tackles, equipment’s, Crane set of their own or even YES
when it hired from othersources?
4 Reference for previous similar work with P& FB
4.1 Pre Job Evaluation YES
4.2 Post job Evaluation YES
4.3 Visit to Contractor’s Site or Work Location YES
4.4 Any Safety Awards YES
5 Injury Illness performance data 2019 2020 2021
5.1 Man-hours spent on Site 10075140 7527107 10.30
5.2 First-Aid Cases 37 18 24
5.3 Medical Treatment Cases 04 04 06
5.4 Restricted Lost Workday Cases NIL NIL NIL
Incident Rate(TRFR) / Lost Time Injury Frequency NIL NIL NIL
5.5 Rate (LTIFR)
5.6 Fatalities NIL NIL NIL
5.7 Insurance Cost NIL NIL NIL
For Big Contractor Percentage Score/Points
Maximum Score Possible 100% 100
Contractor Qualifies (Acceptable) More than 85% 85
Contractor Need improvement 60% up to 85% 60 to 85
Contractor Fails(Unacceptable) Less than60% Less than 60
For Small Contractor Percentage Score/Points
Maximum Score Possible 100% 54
Contractor Qualifies (Acceptable) More than 85% 46
Contractor Need improvement 60% up to 85% 32 to 45
Contractor Fails (Unacceptable) Less than 60% Less than 32
Document No: ABG/P&FB/SHE/CSMP/3003.00
The current version is available at: http://www.abgonstream.com/businesses/pulpandfibre/Pages/pnfhome.aspx
(ABG Pulp & Fibre Business–Company Confidential Document) 26of 41
