3/6/24, 7:35 AM CSHP ONLINE APPLICATION

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Republic of the Philippines

DEPARTMENT OF LABOR AND EMPLOYMENT
Regional Office IV-A

Comprehensive Online Application

ALL CSHP PROCESSING AND APPLICATIONS ARE FREE OF CHARGE

Kindly submit all the neccessary attachments including your Transaction No. to the following email address:
Cavite Provincial Office - cshpcpo.doleiva@gmail.com
Laguna Provincial Office - dolelaguna.cshp@gmail.com
Batangas Provincial Office - cshp.dolebatangas@gmail.com
Rizal Provincial Office - dole4a_rpo_cshp@yahoo.com
Quezon Provincial Office - cshp.qpo4a@gmail.com

NOTE: Kindly use the generated transaction number as subject in your email

Company Profile/License/Registration of Main/General Contractor

Types of Construction Project:

Other Private construction project

Name of Company/Main/General Contractor:

Name of Company/Main/General Contractor

Address:

Address (House #, Street)

Region:

Select Region
Provinces:

Select Province

City/Municipality:

City/Municipality

Barangay:

Barangay

Contact Nos:

09*********

Email Address:

Email Address:

Project Manager

Name of Project Manager

Name of Project Manager

Contact Nos:

Contact Nos:

Email Address:

Email Address:

RULE 1020 Certificate Number

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PCAB License Number

Date of Registration of Rule 1020

dd/mm/yyyy

Copy of Rule 1020 Registration

Choose File No file chosen

PCAB Classification:

PCAB Classification

Contractor's PCAB License Number

PCAB License Number

PCAB Certificate Copy

Choose File No file chosen

PCAB Validity ( Date From)

dd/mm/yyyy

PCAB Validity ( Date To)

dd/mm/yyyy

Sub Contractor

Have some Sub Contractor?

Yes

Name of Subcontractor

Street Address

Region

Select Region
Province

City/Municipality

City/Municipality

Barangay

Barangay

Contact Number

09xxxxxxxxx

Email Address

Scope of Work

Date of Registration of Rule 1020

dd/mm/yyyy
Copy of Rule 1020 Registration

Choose File No file chosen

PCAB License Number

PCAB Validity Date From

dd/mm/yyyy
PCAB Validity Date To

dd/mm/yyyy
Copy of PCAB License or DO174 Registration

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Choose File No file chosen

Add More

Project Profile Description

Name of the Project

Project Name

Upload Notice of Award

Choose File No file chosen

Owner Address

Owner Address (House #, Street)

Region

Select Region
Province

Select Province
City/Municipality

Select City/Municipality
Barangay

Select Barangay

Name of the Project Owner:

Name of the Project Owner

Contact Nos:

Contact Nos:

Email Address:

Email Address

Female Workers:

Male Workers:

No. of Workers on site:

Project Classification:

Project Classification

Total Project Cost:

Total Project Cost

Date of Estimated Start/Execution of the project:

dd/mm/yyyy

Completion Date (Date of project completion)

dd/mm/yyyy

Project Duration (in calendar days)

Project Duration (in calendar days)

Brief Description of Activities/Work Flow

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First Aider assigned to the project

No Name of Personnel Occupation Date of Training Validity Date Upload Copy of ID or Certificate Action

1
First Aide dd/mm/yyyy dd/mm/yyyy Choose File No file chosen 

Add First Aider

Safety Officer assigned to the project

No Name of Personnel Occupation Date of Training Upload Copy of ID or Certificate Action

1
Safety Officer dd/mm/yyyy Choose File No file chosen 

Add Safety Officerr

Other OH Personnel

More than 50 workers?

No

More than 100 workers?

Yes or No?

If Heavy Equipment will be used in the Project

Have Heavy Equipment?

Yes

Upload Certificate of Skills Certificate of

Name of Inspection and Testing Construction Heavy
Heavy of Construction Heavy Name of Equipment (CHE)
No Equipment Equipment (CHE) Date of Expiration Operator operators Validity Date Action

1
Choose File N… dd/mm/yyyy Choose File N… dd/mm/yyyy 

Add Heavy Equipment

Profile of the person who prepared the CSH Program for the abovementioned Project

You can download Comprehensive CSHP Template (https://calabarzon.dole.gov.ph/fndr/mis/files/Form1B_Updated_CSHP_Template_2.docx) here

Enter Fullname

Enter Fullname

Educational Background

Work Experience in OSH

Work Experience in OSH

Other Qualifications

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Other Qualifications

Upload Letter of Intent

Choose File No file chosen

Upload Construction Safety Health Program

Choose File No file chosen

Next

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