Appendix M: Template, Contract HSE Performance Report

Contractor HSE Performance Report

CONTRACTOR
CONTRACT NUMBER
CONTRACT NAME
DATE(S) OF CONTRACT

SUBJECT RATING COMMENT

Leadership and Commitment Did management promote a strong HSE culture?
Were sufficient resources allocated to manage HSE?
Were all deficiencies cleared promptly and effectively?

Implementation of HSE Policy Was Policy communicated and enforced?

Implementation of Contract HSE Was the Contract HSE Plan followed and updated as
Plan required?
Effectiveness of HSE Were the resources provided adequate?
Organization Did all systems perform to standard?
Did the organization learn from mistakes?
Employee HSE Induction and Completed to standard and on time?
Training
Sub-Contractor HSE Did sub contractors perform to the same standard as
Management the contractor?
Were efforts made to improve when deficiencies were
noted?
HSE Personnel: Competence Were personnel competent?
Did they provide effective training and advice?
Did management respect their role?
HSE Meetings Was a cascaded hierarchy of meetings in place,
effective and attended by all personnel?
Tool Box Talks Were these conducted to standard?
Driving/Journey Management Were all vehicles to specification?
Was journey management followed and controlled?

Quality of Contractor’s HSE Was documentation available, comprehensive, in correct

Manual and Documentation
Emergency Response Procedures
Safety Rules/Job Instructions
Accident Investigation Procedure
languages and used?
Were all credible scenarios supported by procedures?
Were procedures tested and improved when found
lacking?
Were correct rules in place based upon job hazard
analysis?
Were all incidents investigated to standard?

Implementation of HSE Were the requirements of the Manual followed and

Standards Manual incorporated in to contractor standards?
Briefly summarize major contravention’s of standards
FATALITIES Describe in detail any fatalities (cross reference to
reports), comment on contractor response to
investigation recommendations
LTIF Brief comment on reasons for LTIs. Comment on
contractor response to investigation recommendations
TRCF
 Man-hours worked/Total
workforce
Maintenance and Control of Plant Was equipment maintained and capable of completing
the work?
Maintenance and Control of Was equipment maintained and capable of completing
Other Equipment the work?
Camp Facilities/Hygiene Were standards maintained?
Were there any outbreaks of illness?
Site Restoration Completed to the standard required?
Waste Management Conducted according to standard?

HSE Audits Summarize the main findings and conclusions

HSE Inspections Summarize the main findings and conclusions
Management Review Was this carried out?
Was this a ‘learning’ organization prepared to improve?

Data Compiled By ________________________ Reviewed By _____________________

Date ________________________ _____________________

Recommendations on Future Use of Contractor

Unconditional Conditional Not to be used again
(list conditions below) (list reasons why)

Contract Holder Contract Owner

Date_____________________ Date_____________________
HSE Advisor

Date: