Contractor Periodic Evaluation

Assessment Date : 01-Sep-2023 Period : 08/2023

Contract : 4600073387 - XCMG XDR80TE Maintenance and Repair Service
Contractor : PT XCMG Group Indonesia
Contract Duration : 15-Aug-2022 to 14-Dec-2023 (104 days remaining)
Department Holder : EPC-Engineering Planning & Capital
Contract Engineer :
Project Manager : 0000011134 - WINCHRISTIANTO SIHOTANG
Sponsor : 0000010665 - ROSMANA EKO SAPUTRA
Contractor Project Manager : Helen Yang
Assessment Score : 87.83 % Result : Acceptable

Controlling Description Score

A - Personal Injury and Incidents

B - Golden Rules and other Safety violations

1. Any Golden Rules Violation ? No

2. Any Safety Violation as mentioned PTVI CLA ? No

C - Health and Safety Behavioral - Violation of PTVI EHS Policies, Standards and Procedures

1. Appropriate PPE always worn Yes

2. Supervisor Role/Function is always available at workplace Yes

3. Standard Hand Tools are always used at workplace Yes

4. Key Personnel Composition comply with project's contract document Yes

5. Workplace Risk, Hazard and Condition Changes are addressed on JSA Yes

D - EHS Meetings, Inspections, Behavioral Dialog & JCC

1. EHS Meetings (Weekly Safety Talk and Daily Tool Box Meeting) are performed regularly Yes

2. Equipments Inspection (engine pre-use / start, power tools, wire rope, etc) is performed regularly Yes

3. Site Observation Inspection (SOI) is performed weekly Yes

4. Job Cycle Check (JCC) is performed monthly Yes

5. Appropriate Safety Risk / Hazard Signages are installed at workplace Yes

E - Management System - Compliance

1. Housekeeping and 5S Moderate

2. Emergency Response Plan Communication (all crews understood) Moderate

3. Orientation and Training Program Implementation Moderate

4. Maintenance / Inspections Program Implementation Moderate

Action Plans of Golden Rules and Safety Violations, SOI and JCC Findings, Management of Changes and Meeting
5. Moderate
Recommendations

Notes

Classification Criteria Vale Project Manager Contractor Project Manager

Excellent 95.00 % 100.00 %
Digitally signed by
Acceptable 80.00 % 94.99 % ezw2891
Improvement Required 50.00 % 79.99 % Date: 2023.09.01
08:20:07 +08'00'
Unacceptable 25.00 % 49.99 %
Disqualified 0.00 % 24.99 %