Doc. n.

FORM-COR-PRO-009-E

FORM
Rev. 01 Data 27/02/15

SPECIFIC QUESTIONNAIRE FOR

Pag. 1 di 5
HEALTH, SAFETY AND ENVIRONMENT
Ref. Doc. STD-COR-PRO-001

Specific Questionnaire For Health, Safety And Environment

With reference to the qualification process of your Company, please provide the following documentation for
the HSE evaluation.

Att.:
“See
Item Question Reply
Note
1”
01 LEADERSHIP & COMMITMENT
Does your Company have a dedicated HSE O Positive HSE Culture is promoted through
program of cultural change? leadership by example on the part of Managers
If YES, please provide details. and supervisors. Extensive education and
If NOT, please explain how does your awareness is carried out and the company also
Company promote a positive culture implements an HSE incentive scheme to reward
towards HSE matters? positive HSE performance and initiative
Evidence of this commitment at all levels of
organization can be seen in the HSE minutes of
meetings held at all levels of company
organization – HSE MS reviews and HSE
Management Committee Meetings at senior
management level, HSE Steering committee
meetings at Project Management Level,
Supervisors HSE Meetings at line management
level and Pre-job and toolbox meetings at site
level. Also, HSE is included in the agenda of other
projects and company management meetings.
Personnel at every level of FIDDIL organization
have their specified set of HSE responsibilities.
HSE implementation is a direct responsibility of
the MD, Senior Management, Line Management
and all personnel.

02 POLICY & OBJECTIVES

a Does your Company have HSE Policies? Y yes. See attached document on that FIDDIL
(e.g. Health & Safety Policy, Environment LIMITED POLICY - SIGNED COPY.docx
Policy, Smoking Policy, Alcohol and Drug
Policy, others).
If YES, please provide attachment.
b Does your Company have any strategic Y yes. See attached copy FIDDIL HSE
HSE objectives? If YES, please provide last OBJECTIVES AND TARGETS.docx
year examples.

03 ORGANIZATION AND HSE

RESPONSIBILITIES

Please provide the Organization Chart of
your Company and explain how is your
organization structured to manage HSE
effectively (both at Company level and at
project level).
Y The Managing Director has ultimate HSE
responsibility and issues the HSE Policy. He also
approves all HSE Procedures. The MD provides
all financial and material resources required for
the implementation of the HSE Management
System in the company. The HSE Coordinator is
the Management Representative on HSE and
provides professional advise to Management on

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 Doc. n. FORM-COR-PRO-009-E

FORM
Rev. 01 Data 27/02/15

SPECIFIC QUESTIONNAIRE FOR

Pag. 2 di 5
HEALTH, SAFETY AND ENVIRONMENT
Ref. Doc. STD-COR-PRO-001

HSE issues and monitors the implementation of

the HSE Management System. Each
Manager/Supervisor is responsible for the HSE
Performance of His department and must lead by
example. The Managers/Supervisors are
responsible for monitoring and controlling their
personnel to ensure that they work in line with
approved procedures. They make PPEs, working
materials and other resources available to the
workers. All Managers report to the MD while the
supervisors report to the Managers. The
personnel are responsible for carrying out their
work in line with approved procedures. They are
responsible for using all safety equipment and
PPE provided correctly and must carry out their
work in the manner that does not compromise
their safety or that of their colleagues.
Communication in Fiddil is both vertical (up -
down, down - up) and lateral.

Line Managers and all workers on HSE critical

positions are aware of their reporting lines and act
accordingly. All HOD's are present during HSE
reviews and reports cascaded to their various
departmental teams. The HSE Coordinator sends
out HSE meeting requests to all staff. He ensures
the meeting venue and required equipment
needed for the meeting is available and set up
SEE ATTACHED COPY OF ORANIZATION
CHARTFIDDIL ORGANISATIONAL CHART.docx
04 COMPETENCE ASSURANCE & HSE
TRAINING
a How does your Company ensure and O The HSE departments evaluate the company
measure competency of its personnel? HSE competency requirement for different levels
Please provide details. of personnel using recognized industry standards
and cross learning from organization with good
HSE record. Personnel are assessed against the
requirement for the position and the result of the
evaluation is used to determine the training
required by the personnel. Also provision are
made for personnel to attend general refresher
training on international recognized standard and
company adopted standard

b Please provide a copy of your Company Y

annual HSE training plan, showing subjects
and intended participants.

S/N Personnel Course Training Examina Deadli Venue

Date tion Date ne
Reg.

1. Augustine OHSAS 18001 27th – 30 31st April N/A Gennesaret resources

Sunday Lead Auditor April Port Harcourt

2. Olatunji Olaojo NDT II – Magnetic 23rd – 24th May N/A

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 Doc. n. FORM-COR-PRO-009-E

FORM
Rev. 01 Data 27/02/15

SPECIFIC QUESTIONNAIRE FOR

Pag. 3 di 5
HEALTH, SAFETY AND ENVIRONMENT
Ref. Doc. STD-COR-PRO-001

Testing 24th May

3. Dada Bolu NDT II – Penetrant 5th – 6th May 6th May  

Testing
Gennesaret resources
8. Augustine ISO 9001 Lead 10th – 14th May  
Sunday Auditor 13th May Warri
Gennesaret resources
9. Jessica Odili ISO 9001 Lead 17th – 21st May  
Auditor 20th May Port Harcourt

10. Olatunji Olaojo IOSH Working 10th June 10th June  

Safely Gennesaret resources
Port Harcourt
11. Augustine IOSH Managing 11th – 14th June  
Sunday / Dada Safely 13th June
Bolu

12. Ruth Amadi General HSE 1st – 6th July    

13. Solomon Driving and 1st – 15th July 21st Jul

traffic Safety 11th July y

14. Prince Osai/ Fire Extinguishers 15th – 22nd July 28th Jul

Sunny Jim 19th July y GENNESARET
RESOURCES Port
15. Pius sunday First Aid/CPR 15th –     Harcourt
25th July

16. Augustine ISO 14001 Lead 22nd – 26th July  

Sunday Auditor 25th July

17. Driving and traffic 29th July –    

Safety 3rdAugust
05 DOCUMENT SYSTEM
a Please provide a copy of your HSE Manual. Y LATEST VERSION OF HSSE-MS.docx

b Please provide a table of content of your Y FIDDIL HSE DOCUMENT FILING SYSTEM.docx
Company Document System, highlighting
HSE relevant procedures.

06 RISK ASSESSMENT
a How do you assess Health & Safety risks
related to your activity? Please provide a
copy / an example of your Company /
Project Health & Safety risk assessment,
including measures in place to minimize
risks.
Y Fiddil uses the Hazards and Effects Management
Process (HEMP) to identify, assess and control
hazards and risks related to its activities. Fiddil
uses the As Low as Reasonably Practicable
(ALARP) approach to preventive and corrective
measures. Fiddil also uses Job Hazard Analysis,
Inspections, walk through and jobsite surveys.
Once hazards are identified, safety assessments
are made, and operating procedures are drafted
and distributed to the work force and
management team. Then hazard control
measures put in place to control and mitigate the

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 Doc. n. FORM-COR-PRO-009-E

FORM
Rev. 01 Data 27/02/15

SPECIFIC QUESTIONNAIRE FOR

Pag. 4 di 5
HEALTH, SAFETY AND ENVIRONMENT
Ref. Doc. STD-COR-PRO-001

consequences, to a level as low as reasonably

b How do you assess Environmental Aspects
and Impacts related to your activity? Please
provide a copy / an example of your
Company / Project Environment risk
assessment, including measures in place to
minimize risks.
practicable. Findings are tracked, closed out and
learning points cascaded to the workforce.
FIDDIL RISK ASSESSMENT.docx
Y Through data obtained from site operations and
Statistics gathered during Projects. FIDDIL RISK
ASSESSMENT.docx

07 HSE PERFORMANCE MONITORING

a Please fill in the table chart with your safety O Last Total Fata LTIF TRIFR SR Near
5 Worked lity R Miss
statistical data of the last 5 years, Year man-
according to definitions provided in the note s hours
(“See Note 2”). 2014 96,000 NIL NIL 2 NIL 20
2015 76000 NIL NIL 1 NIL 15
2016 67,200 NIL NIL <1 NIL 7
2017 38,000 NIL NIL <1 NIL 3
2018 <1 NIL 1
48,000 NIL NIL

b In case of Fatality or severe Accidents Y All accidents/incidents (and near-misses) resulting

occurred in the last 5 years, please provide
your accident investigation report and
explain preventive and corrective actions
implemented.
c In case of any Environmental Accident
occurred in the last 5 years, please provide
your accident investigation report and
explain preventive and corrective actions
implemented.
08 OHSAS 18001 and ISO 14001 certificate
Does your Company have valid OHSAS
18001 and ISO 14001 certificates?
If YES, please provide a copy of the
certificates.
(if in any of the following, which occur in the course
any) of the company’s operations must be promptly
reported within 24 hours by radio or any
communication means easily accessible. Such
accidents include: Fatalities, Lost time or other
injuries to company’s personnel/third party.
Damage to Plant and/or equipment.
• Loss of containment - (e.g. Oil Spillage’s)
Outbreak of fire and all such emergencies • Road
traffic accidents etc.• Incidents such as near-
misses and unsafe acts.
Fiddil have not experienced any case of fatality or
severe accident in the last 5 years.
Y An incident deemed to be serious triggers an
(if immediate audit of the process or operations that
any) led to the incident (root cause analysis will be
carried out). The report of this investigation is
communicated to all staff
NO
Y NO

Notes for compilation

1) Column Att.: Y means YES, Attachment REQUIRED – O means Attachment OPTIONAL
2) Definitions related to question 7a:

Fatality: Term that defines a death resulting from a work related injury, regardless of the time
intervening between the injury and the death. Fatalities are included when calculating the number of Lost
Time Injuries and LTI Frequency Rate.

This document is property of Saipem SpA. All rights reserved.

 Doc. n. FORM-COR-PRO-009-E

FORM
Rev. 01 Data 27/02/15

SPECIFIC QUESTIONNAIRE FOR

Pag. 5 di 5
HEALTH, SAFETY AND ENVIRONMENT
Ref. Doc. STD-COR-PRO-001

Lost Time Injury (LTI): A LTI is any work-related injury which renders the injured person temporarily
unable to perform any regular Job or Restricted Work on any day/shift after the day on which the injury
occurred (in this case “any day” includes rest day, weekend day, and holiday). The day of the Accident
is not counted when calculating Lost Workdays. Lost Time Injuries includes: Fatalities, Permanent Total
Disabilities, Permanent partial disabilities and Temporary Permanent Disabilities.

Lost Time Injury Frequency Rate (LTIFR): N. LTI x 1,000,000 / Total Worked Man-hours.
Lost Work Days(LWD): The total number of calendar days in which the injured person was unable to
work as a result of a Lost Time Injury. The calculation of lost workdays starts from the second day when
the accident occurred and includes the number of calendar days counted until the injured person is fit for
work. In the case of a Fatality or Permanent Total Disability no Lost Workdays are recorded.

Medical Treatment Cases (MTC): Term to define any work-related injury (infected wounds, application
of stitches, embedded foreign bodies in the eyes, etc.) that involves neither Lost Workdays nor
Restricted Workdays but which requires repeated treatment by, or under the specific order of a
physician, or could be considered as being in the province of a physician. Medical Treatment does not
include First Aid even if this is provided by a physician or registered professional personnel.

Near Miss: It is an hazardous Event which, under slightly different circumstances, could have caused an
Accident affecting even people, environment or assets.

Severity Rate (SR): N. LWD x 1,000 / Total Worked Man-hours.

Total Recordable Incident (TRI): Term to define the sum of Lost Time Injuries, Work Restricted Cases
and Medical Treatment Cases.

Total Recordable Incident Frequency Rate (TRIFR): N. TRI x 1,000,000 / Total Worked Man-hours.

Work Restricted Cases (WRC): Any work-related injury other than a fatality or lost work day case
which results in a person being unfit for full performance of the regular job on any day after the
occupational injury.
Work performed might be:
• an assignment to a temporary job
• part-time work at the regular job
• working full-time in the regular job but not performing all the usual duties of the job.
An injury can be classified as WRC only upon written non objection statement of the injured person.
Where no meaningful restricted work is being performed, the incident should be recorded as a lost time
injury (LTI).

This document is property of Saipem SpA. All rights reserved.