LETTER OF UNDERTAKING-(HSE)

To: (Your Organization/Company Name)

We, (HSE Documents Co/ and or your Company Name), agree to undertake full responsibility for
the supply and installation of (mention your activity or any installation name here) at (Electrical
room/location of the activity) room. We confirm that during the installation of the system, all
mandatory occupational health and safety measures, initiatives and SSOW (TBT/PTB, MSRA,
JSA, PTW), will be taken and adopted for our technicians/workforce, client’s employees, residents,
environment and the visitors to fulfil all legal and moral requirements as per (name of the
country/state and the applicable reference numbers of the SOP” s, rules, regulations, standards and
laws). Moreover, our technical installation/MEP/Engineering, etc. team has been provided with all
proper information, personal protective equipment, OSH in-house induction, information and tools
& equipment. They have been trained by our approved HSE trainer.

Declaration:
I/We, (HSE Documents Co/ and or your company Name) shall comply with all applicable OSH legal
and regulations (as per the OSHA, IOSH, OSHAD etc.), at all times and shall be responsible and
liable for any violation thereof.

Job Description Signature Date

HSE Department:

Line Manager:

Project Engineer:

HSE Documents-LOU- Version: 2.0