9form Ohsms Prequalification Questionnaire
Transcript of 9form Ohsms Prequalification Questionnaire
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Power & Water Utility Company for Jubail and Yanbu (MARAFIQ Document ID No : MSSM-1-SF-002
Page 1 of 17
Rev. No.: 0
Date of issue: 2 Oct 2011
!CCUPA"I!#A$ %A$"% A#' AF"Y MA#A)M#" MA#UA$
FORM NO. 102
OHSMS PRE-QUALIFICATION QUESTIONNAIRE
MARAFIQ Power & Water Utility CompanyC!#"RAC"!R PR*QUA$IFICA"I!# QU"I!##AIR
C!MPA#Y
#AM
C!MPA#Y A''R +
C!#"AC" '"AI$
ubmitted by (PRI#",
Po-ition+'e-i.nation,
'ate ubmitted,
i.nature,("/e information pro0ided i-a11urate and .enuine
* listed in the evidence column indicates mandatory evidence to be provided.
Item Que-tion An-wer 0iden1eAtta1/ed
'etail- of 0iden1eAtta1/ed
Appro0al (Marafi2 u-e only("i13 & Initial
A. What are the companysmain activities? Tick box if
attached
REJECTED......................
REERRA!......................
A""R#$ED................. .....
D. %o& 'on( have yo) beenin b)siness? Tick box if
attached
REJECTED......................
REERRA!......................
A""R#$ED................. .....
*. Do yo) maintain ac)rrent +)a'ityAss)rance "ro(ramme?
Tick box ifattached
REJECTED......................
REERRA!......................
A""R#$ED................. .....
J. "'ease provide ,examp'es of &ork yo) Tick box if
REJECTED......................
REERRA!......................
PROPRIETARY NOTICETHIS DOCUMENT CONTAINS INFORMATION PROPRIETARY TO MARAFIQ. ANYDISCLOSURE OR USE IS EXPRESSLY PROHIBITED EXCEPT UPON WRITTEN PERMISSIONBY MARAFIQ.
IMPORTANTOnly document with stamps are considered
ofcial.
Doc. No._______________
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Power & Water Utility Company for Jubail and Yanbu (MARAFIQ Document ID No : MSSM-1-SF-002
Page 2 of 17
Rev. No.: 0
Date of issue: 2 Oct 2011
!CCUPA"I!#A$ %A$"% A#' AF"Y MA#A)M#" MA#UA$
Item Que-tion An-wer 0iden1eAtta1/ed
'etail- of 0iden1eAtta1/ed
Appro0al (Marafi2 u-e only("i13 & Initial
have carried o)t recent'yin -a)di Arabia?
attached A""R#$ED......................
. Are yo) prepared forarafi/ to approach
previo)s c'ients forreferences?
Tick box if
attached
REJECTED......................
REERRA!......................
A""R#$ED................. .....
". %o& many peop'e doyo) emp'oy? Tick box if
attached
REJECTED......................
REERRA!......................
A""R#$ED................. .....
-. %ave yo) ever had acontract ref)sed orterminated on %-E(ro)nds?
Tick box ifattached
REJECTED......................
REERRA!......................
A""R#$ED................. .....
$. Do yo) have a %-E"o'icy? Tick box if
attached 0
REJECTED......................
REERRA!......................
A""R#$ED................. ....
.1. Do yo) have a forma'-afety ana(ement-ystem 2--3 detai'in(the %-E arran(ements?
Tick box ifattached 0
REJECTED......................
REERRA!......................
A""R#$ED................. .....
A4. Do yo) have a %ea'th 5-afety Committee? 6f1es7 p'ease (ive detai'sof str)ct)re and a(enda?
Tick box ifattached
REJECTED......................
REERRA!......................
A""R#$ED................. ....
PROPRIETARY NOTICETHIS DOCUMENT CONTAINS INFORMATION PROPRIETARY TO MARAFIQ. ANYDISCLOSURE OR USE IS EXPRESSLY PROHIBITED EXCEPT UPON WRITTEN PERMISSIONBY MARAFIQ.
IMPORTANTOnly document with stamps are considered
ofcial.
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Power & Water Utility Company for Jubail and Yanbu (MARAFIQ Document ID No : MSSM-1-SF-002
Page 3 of 17
Rev. No.: 0
Date of issue: 2 Oct 2011
!CCUPA"I!#A$ %A$"% A#' AF"Y MA#A)M#" MA#UA$
Item Que-tion An-wer 0iden1eAtta1/ed
'etail- of 0iden1eAtta1/ed
Appro0al (Marafi2 u-e only("i13 & Initial
.
AE. Who is the competentperson for theor(anisation?
Tick box ifattached
REJECTED......................
REERRA!......................
A""R#$ED................. .....
A%. What forma' %-E/)a'ifications do theyhave?
Tick box ifattached 0
REJECTED......................
REERRA!......................
A""R#$ED................. .....
A8. %o& many %-E"ersonne' do yo)emp'oy7 p'ease (ivedetai's inc')din(/)a'ifications?
Tick box ifattached
REJECTED......................
REERRA!......................
A""R#$ED................. .....
A9. %as the company everbeen prosec)ted ors)b:ect to po'iceinvesti(ation for hea'thand safety matters?
Tick box ifattached
REJECTED......................
REERRA!......................
A""R#$ED................. ....
.A+. Do yo) have s)itab'e
ins)rance and have yo)comp'ied &ith anyins)rer re/)irements?
Tick box ifattached 0
REJECTED......................
REERRA!......................
A""R#$ED................. .....
AT. Do yo) s)bscribe to anyind)stry or safety re'ated Tick box if
REJECTED......................
REERRA!......................
PROPRIETARY NOTICETHIS DOCUMENT CONTAINS INFORMATION PROPRIETARY TO MARAFIQ. ANYDISCLOSURE OR USE IS EXPRESSLY PROHIBITED EXCEPT UPON WRITTEN PERMISSIONBY MARAFIQ.
IMPORTANTOnly document with stamps are considered
ofcial.
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Power & Water Utility Company for Jubail and Yanbu (MARAFIQ Document ID No : MSSM-1-SF-002
Page of 17
Rev. No.: 0
Date of issue: 2 Oct 2011
!CCUPA"I!#A$ %A$"% A#' AF"Y MA#A)M#" MA#UA$
Item Que-tion An-wer 0iden1eAtta1/ed
'etail- of 0iden1eAtta1/ed
Appro0al (Marafi2 u-e only("i13 & Initial
or(anisations? attached A""R#$ED......................
AW. Are yo) a member of areco(nised ind)stry or
%-E specificor(anisation i.e. 6#-%766R- etc?
Tick box if
attached
REJECTED......................
REERRA!......................
A""R#$ED................. .....
A;. Where do yo) (ainaccess to )p to datehea'th and safetyinformation and bestpractice ()idance?
Tick box ifattached
REJECTED......................
REERRA!......................
A""R#$ED................. .....
4C. %o& often do yo) revie&yo)r %-E arran(ementsand ens)re )p
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Power & Water Utility Company for Jubail and Yanbu (MARAFIQ Document ID No : MSSM-1-SF-002
Page ! of 17
Rev. No.: 0
Date of issue: 2 Oct 2011
!CCUPA"I!#A$ %A$"% A#' AF"Y MA#A)M#" MA#UA$
Item Que-tion An-wer 0iden1eAtta1/ed
'etail- of 0iden1eAtta1/ed
Appro0al (Marafi2 u-e only("i13 & Initial
any %-E trainin(re/)ired to meet there/)irements ofarafi/s --?
Tick box ifattached
REERRA!......................
A""R#$ED................. .....
4#. %o& do yo) revie& andmeas)re yo)r hea'th andsafety performance?
Tick box ifattached 0
REJECTED......................REERRA!......................
A""R#$ED................. .....
4R. Do yo) have safety r)'esfor &ork activities? Tick box if
attached
REJECTED......................
REERRA!......................
A""R#$ED................. .....
4=. Can yo) provide arafi/&ith a %-E "'an forcompany activities orprevio)s &ork?
Tick box ifattached
REJECTED......................
REERRA!......................
A""R#$ED................. .....
4>. "rovide &orkedexamp'es of the
fo''o&in( < Risk Assessment
2specific3
ethod
-tatement2specific3
6nspection Report
2specific3
Tick box if
attached 0
REJECTED......................
REERRA!......................
A""R#$ED................. .....
CA. "rovide &orked REJECTED......................
PROPRIETARY NOTICETHIS DOCUMENT CONTAINS INFORMATION PROPRIETARY TO MARAFIQ. ANYDISCLOSURE OR USE IS EXPRESSLY PROHIBITED EXCEPT UPON WRITTEN PERMISSIONBY MARAFIQ.
IMPORTANTOnly document with stamps are considered
ofcial.
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Power & Water Utility Company for Jubail and Yanbu (MARAFIQ Document ID No : MSSM-1-SF-002
Page " of 17
Rev. No.: 0
Date of issue: 2 Oct 2011
!CCUPA"I!#A$ %A$"% A#' AF"Y MA#A)M#" MA#UA$
Item Que-tion An-wer 0iden1eAtta1/ed
'etail- of 0iden1eAtta1/ed
Appro0al (Marafi2 u-e only("i13 & Initial
examp'es of %-E6nspections carried o)tby yo)r %-E personne'?
Tick box ifattached 0
REERRA!......................
A""R#$ED................. .....
CD. "rovide detai'ed
information of theaccidents and incidentsin the 'ast , years2inc')de statistica'records3.
Tick box ifattached 0
REJECTED......................
REERRA!......................
A""R#$ED................. .....
C*. What is yo)ror(anisations proced)refor reportin(7 recordin( 5investi(atin( accidents 5incidents?
Tick box ifattached 0
REJECTED......................
REERRA!......................
A""R#$ED................. .....
CJ. "rovide detai's of yo)rirst Aid arran(ementsinc')din( trainin(provider information?
Tick box ifattached 0
REJECTED......................
REERRA!......................
A""R#$ED................. .....
C. "rovide detai's of yo)rEmer(encyArran(ements &hen on ac'ients site?
Tick box ifattached
REJECTED......................REERRA!......................
A""R#$ED................. .....
C". Do yo) or any of yo)rs)b
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Power & Water Utility Company for Jubail and Yanbu (MARAFIQ Document ID No : MSSM-1-SF-002
Page 7 of 17
Rev. No.: 0
Date of issue: 2 Oct 2011
!CCUPA"I!#A$ %A$"% A#' AF"Y MA#A)M#" MA#UA$
Item Que-tion An-wer 0iden1eAtta1/ed
'etail- of 0iden1eAtta1/ed
Appro0al (Marafi2 u-e only("i13 & Initial
C-. Do yo) )se e/)ipmentthat co)'d present a riskd)rin( &ork activities? 6f1es7 provide detai's
Tick box ifattached
REJECTED......................
REERRA!......................
A""R#$ED................. ....
.C$. %o& do yo) ens)re the
competence and s)itab'eof hea'th and safetyperformance of s)b