SIEMENS EHS selection questionnaire for contractors Version 1.4 strc: C44, D87IDC, SECTOR = Location: Bawancr Jrolucteteel Mera, Oethe Country: 77 db cq Postal Code: 770.29 Contractor Contact Person: Mr. Rajesh Mittert Contact Person Phone No: FS //CE F672 ‘Scope of work conducting for Siemens: Yes 1 |Do you have an EHS Policy and EHS Management System? o (Please provide the relevant supporting documents.) 2 |Do you conduct risk management and document the results? (Please provide the relevant supporting documents.) ‘+ Identification of hazards and aspects of activities and working environment + Evaluation of risks age a oe © Measures for risk reduction / risk control 3. |Do you have guidelines/specifications (e.g, standard operating procedures) for safe ‘work, working with machinery/equipment and substances, to avoid incidents? Qjgqgo0 0 Qa 4 |Do you ensure that applicable required trainings and / or certificates of qualification are in place? Oo 5 |Do you ensure that people acting are fit for work, qualified and briefed? {6 |Do you provide your employees all necessary personnel protection equipment and ‘consequently ensure the proper use? ae ofol g Rested Version 1:4 of August 2017 HREHSSIEMENS EHS selection questionnaire for contractors Version 1.4 legislation? 7 |In the last five years did you or one of your affiliated companies have any pending legal and / or official proceedings for a breach of Health and Safety or Environmental | [) Number of fata s (Brief explanation: ) Number of accidents 0. 8 | How many fatalities / accidents with days lost 2 1 day did you have in the last 3 years? ‘Comments: Contractor Name, given name Date Signature EHS Expert Name, given name Department Date Signature, Restices Page 2 0t2 Version 14 of August 2017 HREHS