Contractor Qualification Questionnaire All information provided will be treated in strictest confidence. Contractors are to provide all relevant details and documents as indicated.Contractor DetailsContractor Name: ________________________ Contractor contact person: _________________________ Designation: ____________________________ Tel: ______________ Email: ______________________Description of Contract: ________________________________________________________________________S/No Items Answers *Points Remarks1. Is an EHS Director or EHS Manager assigned directly to the company? Yes0 No 01 2 5 (Please provide details)2. Is the EHS Director or EHS Manager part time or full-time position assigned for responsibilities? (Please describe.) Full 0Part 01 2 3 (Please provide details)3. What percentage (%) of supervisors has completed (EHS) safety related course certificates with the company? 1 2 3 (Please provide a copy of certificates)4. Number of Project Managers with a Construction Safety Course Certification with the company? 1 2 3 (Please provide a copy of certificates)5 Provide all (safety related) accident statistics on record for the last three (3) major projects undertaken. Information on statistics should include total man-hours worked, accident free man-hours, total number of accidents (RIR/recordable incidents), first aid cases, near miss cases, total man-days lost, number of lost time incidents (LTI), causes & specific nature of injuries and part of body injured for (Recordable Injuries), all fatalities with root cause of incident from each project. (Separate all EHS accident statistics by project to include name of project, location of project and dates of project duration) meaning show three separate projects with EHS accident data.6. Total number of LTI’s (Lost Time Incidents) based on recent 3 major Projects (If worked on M+W Project, please use them). Combine project totals. 1 2 3 (Please provide details)7. What is the Total (Recordable Injury Rate) on the last three major projects? Include M+W Projects if worked.Rate = Cases X 200,000 ÷ Total employee hours 1 2 3 (Please provide details)8. Average man days lost based on recent 3 major Projects (If worked on M+W Project, please use them). (Lost workday case) injuries involving days away from work. Rate = Cases X 200,000 ÷ Total employee hours 1 2 3 (Please provide details)9. Does company have EHS training programs and award programs for workers and supervisors? Yes 0No 01 2 3 (Please provide details)10. Clearly defined EHS responsibilities and accountabilities for managers, supervisors, and employees? Yes 0No 01 2 3 (Please provide details)11. Does company have an active EHS discipline policy? Yes 0No 01 2 3 (Please provide details)12. Does the company have Stop Work Policy for all employees on the project? Yes 0No 01 2 3 (Please provide details) TOTAL: of 35 points S/No Items Answers *Points Remarks13. Has the company received a “safety award” from an organization for EHS programs or achievements? Yes 0No 01 2 3 (Please provide details)14. Has the company obtained OHSAS 18001 and ISO 14001 certification? OHSAS 18001 is an Occupation Health and Safety Assessment Series (health and safety management systems). ISO 14001 is an International organization for standardization (environmental management systems) Yes 0No 00 15 (Please provide a copy of certificates)14a. If no, OHSAS 18001 and ISO 14001 certification: 15. Does the company have an EHS Policy? Yes 0No 01 2 3 (Please provide a copy)16. Is EHS included in the company organization? Yes 0No 01 2 3 (Please provide company ORG chart)17. Does the company have an EHS (safety) committee? Yes 0No 01 2 5 (Please provide a copy of latest list participants)18. Is the company EHS committee meeting conducted regularly? How often? Yes 0No 01 2 3 (Please provide a copy of meeting minutes/schedule)19. Does company have EHS rules and regulations available to employees? Yes 0No 01 2 3 (Please provide a list and examples)20. Is an EHS Inspection/Audit program active? Yes 0No 01 2 3 (Please provide a copy of program)21. Is a hazard identification and risk control method active? Yes 0No 01 2 3 (Please provide a copy of form & risk matrix)22. Is a written process to report, investigate, and record incidents active? Yes 0No 01 2 3 (Please provide a copy of form/incident)23. Does company use & understand the HES-related government and local regulations pertaining to your construction safety program? Yes 0No 01 2 3 (Please provide a copy of all regulations/codes)24. List all EHS related Vietnam Governmental and Ministry EHS regulations were obtained from. Yes 0No 01 2 3 (Please provide a copy of the completed list)25. Does the company require health exam & health insurance for every employee? Yes 0No 01 2 3 (Please provide proof)26. Total no. of employees employed within company? Please indicate here: 27. No. of foreign workers employed with company? What positions? Please indicate here: (List country & name of positions)28. Percentage (%) of permanent EHS Personnel in the company with respect to total permanent staff. 1 2 3 TOTAL : of 56 points S/No. Items Answers *Points Remarks Other relevant supporting information:29. Does company have an environmental policy? Yes 0No 01 2 3 (Provide copy of document)30. Does company provide EHS induction training? Yes 0No 0
1 2 3 (Provide copy of training materials)
31. Does company require workers on site to wear PPE? Safety glasses, work boots, hard hat & high visibility vest? Explain details. Yes 0
No 0
1 2 3
TOTAL: of 9 points
OVERALL TOTAL SCORE % : of 100 points
Prepared by:
Name: Designation:
Date: Signature:
* Points column is for M+W use only
Evaluation
Comments by the Evaluator #1:
Evaluations done by: ____________________________________________________
Name/ Signature/ Date
Comments by the Evaluator #2:
Evaluations done by: ____________________________________________________
Name/ Signature/ Date
đang được dịch, vui lòng đợi..
