ATTACHMENT - 5

FORM OF SAFETY RECORD

The Bidder shall submit the safety performance records in terms of LTIR, TRIR and
the Severity Rate covering the past five years and the Bidder's safety, health,
environment and security plan to be used for the Work.

LTIR, TRIR and severity rate shall be calculated using the following data and formulas.

No. of
LTIR (Loss TRIR (Total
Total No. of Lost Medical No. of
No. of Total No. of Time Recordable Severity
Year Manhour Time Treatment Recordable
Lost days Fatality Incident Incident Rate
Worked Accident (except first case
Rate) Rate)
aid)

(g)=(b)/(a) (g)=(f)/(a) (g)=(c)/(a)

(a) (b) (c) (d) (e) (f)=(b)+(e)
x 200,000 x 200,000 x 200,000
2013 3 080 458 16 252 0 7 23 1,039 1,493 16,361
2014 1 917 707 14 169 0 9 23 1,460 2,399 17,625
2015 2 466 809 11 151 0 4 15 0,892 1,216 12,243
2016 2 802 665 11 227 0 10 21 0,785 1,499 16,199
2017 3 915 225 6 108 0 7 13 0,306 0,664 5,517