Prequalification For HSE KPI

Co
Contractor Company Name:

Contract Number & Title:
Contract Holder:
Contractor Rep.Name & Contact No.
HSSE stands for Health, S

Please cover all aspects in your r
Keyword Ques
1 Leadership & HSSE Cult
a)
Committment to
HSE aspects
1.1
through
leadership b)
c)
2 HSSE Policy & Strategic Ob
a)
b)
HSE Policy Documents
c)
2.1
Co
Contract Holder:
HSE Policy Documents

2.1
Keyword Ques
d)
e)
HSE contract
a)
objectives
strategic
2.2
b)
3 Organisation, responsibilities, resources, stan

ganisational structure for
a)
HSE management
b)
3.1
c)
Co
Contract Holder:
Organisational structure for

HSE management
3.1
Keyword Ques
d)
HSE training of managers, supervisors and HSE
a)
b)
critical positions
3.2
c)
d)
e)
Co
Contract Holder:

Keyword Ques
a)
General HSE training
3.3
Co
Contract Holder:

Keyword Ques
General HSE training
b)
3.3
c)
Competence
a)
assurance
3.4
b)
management process
a)
b)
3.5
Co
Contract Holder:
Contractor management process

Keyword 3.5 Ques
c)
d)
a)
HSE standards
3.6 b)
c)
4 Risk Management
Risk Assessment
4.1 a)
& Control
Co
Contract Holder:

Keyword Ques
a)
Health Hazards
4.2 b)
c)
Safety hazards
a)
4.3
b)
Co
Contract Holder:

Keyword Ques
Logistics hazards
a)
4.4
Co
Contract Holder:
Logistics hazards
Keyword Ques
4.4
b)
Environmental
a)
hazards
4.5
b)
Security hazards
a)
4.6
b)
responsibility
a)
hazards
Social
4.7
b)
Co
Contract Holder:

Keyword Ques
5 Planning & Procedure
HSE operations
5.1 a)
manual
Infrastructure and
equipment 5.2 a)
integrity
Management of
5.3 a)
change
Emergency a)
planning and 5.4
response
b)
Co
Contract Holder:

Keyword Ques
6 Implementation and performance
HSE-MS implementation and active performance
a)
monitoring of work activities
b)
6.1 c)
d)
e)
f)
Safety
performance 6.2 a)
indicators
Co
Contract Holder:

Keyword Ques
a)
HSE Performance Monitoring
b)
c)
6.3
d)
e)
f)
g)
E incident and investigation
a)
b)
c)
follow-up
6.4
d)
Co
Contract Holder:
HSE incident and investigation

follow-up
6.4 HSSE stands for Health, S
Keyword Ques
e)
Statutory
notifiable
incidents or non 6.5 a)
compliance
notices
7 HSE auditing and management rev
a)
b)
Audits
7.1
Co
Contract Holder:

Keyword Ques
Audits
7.1
c)
d)
Management review and
a)
follow-up
7.2 b)
c)
8 HSE management - additiona
Certification of
8.1 a)
your HSE-MS
Co
Contract Holder:

Keyword Ques
Membership of
8.2 a)
associations
Additional
features of your 8.3 a)
HSE-MS
9 Company specific inform
Welfare Facilities 9.1 a)

Contractors HSE Capability Assessme
No.
HSSE stands for Health, Safety & Environment

Please cover all aspects in your responses to the questions
Question Document
Leadership & HSSE Culture
How are senior managers personally involved in HSE management

for example objective-setting and monitoring?
Provide evidence of commitment at all levels of the organisation?
How do you promote a positive culture towards HSE matters?

HSSE Policy & Strategic Objectives
Does your company have an HSE policy document?

If the answer is YES please attach a copy.
Who has overall and final responsibility for HSE in your organisation?
Who is the most senior person in the organisation responsible for this
policy being carried out at the premises and on site where his
employees are working? Provide name and title.
No.

Question Document
Itemise the methods by which you have drawn your policy statements
to the
attention of all your employees?
What are your arrangements for advising employees of changes in

the policy?
Does your company have strategic HSE objectives?

If the answer is YES please attach a copy.
Itemise the methods by which you have communicated your strategic

HSE objectives to the attention of all your employees?
responsibilities, resources, standards and documentation
How is your organisation structured to manage and communicate

HSE effectively?
Do HSE meetings promote HSE awareness?
Do client and contractor meet regularly to discuss and action any

interface situations?
No.

Question Document
What provision does your company make for HSE communication

meetings?
Please provide an organisation chart
Have the managers and supervisors at all levels who will plan,
monitor, oversee and carry out the work received formal HSE training
in their responsibilities with respect to conducting work to HSE
requirements?
If YES please give details. Where the training is given in-house

please describe the content and duration of courses. Please provide
an example of training matrix.
How have you identified areas of your company’s operations where

specialised training is required, for instance training related to health
hazard such as radiation, asbestos and chemicals?
What specialist HSE resources does your organisation have

available?
How does your company provide HSE specialised training for HSE
staff?
No.

Question Document
What arrangements does your company have to ensure new

employees have knowledge of basic industrial HSE, and to keep this
knowledge up to date?
No.

Question Document

employees also have knowledge of your HSE policies, practices and
company requirements?

employees have been instructed and have received information on
any specific hazards arising out of the nature of the activities?
Does your organisation have a competence system in place?

If YES, please describe the scope and content of your competence
system.
What arrangements does your company have to ensure existing staff

HSE knowledge is up to date?
Does your company have a contractor management process or

system?
If yes, provide an outline of the process.
How do you assess contractors, HSE competence or HSE

performance?
No.

Question Document
Where do you define the company standards you require your

contractors to meet?
How do you ensure these standards are met and verified?
How do you identify new industry or regulatory standards that may be

applicable to your activities?
Is there an overall structure for producing, updating and

disseminating standards?
Are your company standards aligned with Oman Occupational Healt

and Safety Regulations or recommended practices?
Risk Management
How does your company identify hazards, assess risk, control and
mitigation
consequences, to a level as low as reasonably practicable?
No.

Question Document
Do you have specific policies and programmes on specific health

hazards e.g. substance abuse, blood borne pathogens, malaria
pandemic diseases etc.
What type of health hazards (chemical, vibration, noise, radiation,

etc) are
associated with the scope of your services? Explain how
occupational health
hazards are identified, assessed and controlled.
What systems are in place to control these hazards and monitor the
effectiveness of these controls? Is worker’s regular exposure
monitoring part of these systems?
What type of safety hazards (mechanical guarding, work at height,

lifting and hoisting, confined space entry, explosive atmospheres etc.)
are associated with the scope of your services?
effectiveness of these controls?
No.

Question Document
What type of logistics hazards (land transport, air transport, marine

transport, materials handling etc.)are associated with the scope of
your services?
No.

Question Document
What type of environmental hazards (chemical spill, atmospheric

emissions, waste disposal etc.) are associated with the scope of your
services?
What type of security hazards (terrorism, hostage taking, robbery,

hostile local population etc.) are associated with the scope of your
services?
What type of social hazards are associated with the scope of your
services?
What systems are in place to control these hazards and impacts and
monitor the effectiveness of these controls?
No.

Question Document
Planning & Procedures
Do you have a company HSE-MS manual (or operations manual with

integrated HSE requirements) which describes in detail your
company approved HSE working practices relating to your work
activities?
If the answer is YES please attach a copy of an index and relevant
supporting documentation.
How do you ensure that infrastructure, plant and equipment used

within your operations (own premises, client site, or at other
locations) are correctly certified, registered, controlled and
maintained in a safe working condition?
How do you manage changes and assess associated risks e.g.

personnel, equipment, processes, documentation?
What arrangements does your company have for emergency

planning and response?
Which emergency situations are included?

No.

Question Document
mplementation and performance monitoring
What arrangements does your organisation have for monitoring the

implementation of your HSE-MS?
How does your company assure the implementation of work

procedures within your work-site operations e.g. compliance with
procedures, toolbox talks, safety meetings, supervision, job
observations?
How do you monitor employee HSE performance e.g. hazard

identification systems, HSE participation?
What active HSE monitoring is performed (i.e. where no incident has

occurred)?
How do you report and correct deficiencies identified?
How do you communicate the results of active performance

monitoring to relevant personnel?
See separate spreadsheet called Contractor Assessment KPI Data. If

KPI Data for last 5 years is not submitted, you will be required to
outline the reasons for safety KPIs data not being available.
No.

Question Document
How is health performance monitored and recorded?
How is environmental performance monitored and recorded?
How is security performance monitored and recorded?
How and what near miss incidents are reported?
How often is HSE performance reviewed? By whom?
How is logistics performance monitored and reported?
Do you record vehicle incidents?
What types of HSE incident are investigated?
What process is used to investigate HSE incidents?
Who conducts HSE incident investigations?
How are the findings of an incident investigation followed up to

ensure effective prevention of recurrence?
No.

Question Document
How is incident learning communicated to all relevant personnel?
Has your company suffered any statutory notifiable incidents in the

last five years (safety, occupational health and environmental)?
Answers with details including dates, country and location, summary
of incident and follow-up preventative measures taken.
E auditing and management review of HSE-MS
Do you have a written procedure for HSE auditing?

If yes, please attach a copy.
Who is involved in conducting HSE audits? How are audit team

members selected to have specific expertise and be independent
from the activities being audited?
What are the qualifications required for auditors?
No.

Question Document
How does your company schedule HSE audit and what scope of
auditing is covered? e.g. internal, regulatory compliance,
supplier/contractor, HSE management system implementation.
How does management follow up on audit findings and ensure

effective close out of action items?
Do you have a written procedure for management review of the HSE-

MS?
If yes, please attach a copy
How often are HSE-MS reviews conducted and who is involved in the
process?
How are identified actions and improvement efforts recorded and

tracked to effective completion?
HSE management - additional features
Please provide information on any certification which you have

received from certification bodies
No.

Question Document
Describe the nature and extent of your company’s participation in

relevant industry, trade, and governmental organisations
Does your organisation (globally, regionally or locally) have any HSE

features or arrangements not described elsewhere in your response
to the questionnaire?
Company specific information
Accommodation and catering facilities where provided meet

the accepted standards for
- Cleanliness, Hygiene & Housekeeping
- Emergency Respoonse Arrangements
- Occupancy & Illumination
END
rs HSE Capability Assessment Questioniare
END
ssessment Questioniare
To be filled in by the Supplier / Contractor with complete answers substanti

supporting documentation. Responses and any supporting documentation shoul
specifically to the contractor’s local organisation (that is where the contract
conducted)
Response

conducted)
Response

conducted)
Response

conducted)
Response

conducted)
Response

conducted)
Response

conducted)
Response

conducted)
Response

conducted)
Response

conducted)
Response

conducted)
Response

conducted)
Response

conducted)
Response

conducted)
Response

conducted)
Response
e answers substantiated by
documentation should relate To be filled in by the HSE Advisor after conducting Physical
where the contract work is Verification Audit.
Supporting
Physical Verification of Evidences by an Audit
Evidence
Supporting
Evidence
Supporting
Evidence
Supporting
Evidence
Supporting
Evidence
Supporting
Evidence
Supporting
Evidence
Supporting
Evidence
Supporting
Evidence
Supporting
Evidence
Supporting
Evidence
Supporting
Evidence
Supporting
Evidence
Supporting
Evidence
Supporting
Evidence
Contract Holder:
1
1.1
1.2
2
2.1
2.2
2.3
2.4
2.5
2.6
2.7
2.8
2.9
2.10
2.11
2.12
2.13
2.14
2.15
3
3.1
3.2
3.3
3.4
4
4.1
4.2
4.3
Notes:
1
2
Comments:
1
2
3
Contractor HSE KPI Feed
ntractor Company Name:
ntract Number & Title:
ntract Holder:
ntractor Rep.Name & Contact No.
Health
Reported First Aid Cases(FAC)
Total Recordable Occupational Illnesses (TROI)
Personal Safety
Average Number of Employees
Total Man-hours Worked
Safety Walks By Non Management Members (Reports to be submitted to OLNG QHSE Dept.)
Safety Walks By Management (Reports to be submitted to OLNG QHSE Dept.)
Reported Near-Misses
Total Recordable Cases (TRC) F+PTD+LTI+RWC+MTC
Total Recordable Case Frequency (TRCF) YTD
Lost Time Injuries (LTI)
Lost Time Injuries Frequency (LTIF) YTD
Number of Incidents Reported
Non-Compliance to 12 Life Saving Rules
Number of Warnings Issued on Non-Compliance to 12 Life Saving Rules (Attach Copy)
HSE Meetings (Contractors Own Meetings, details to be mentioned under comments section)
Audits / Inspections Carried Out (Contractors Own Audits / Inspections)
Number of Emergency Exercises Conducted (Contractors Own Emergency Exercise)
Road Safety
Defensive Driving Course Compliance (Percentage)
Number of Road Traffic Accidents
Number of Vehicles (Only include vehicles on OLNG Business)
Total Kilometers Driven
Environment
Non - Hazardous Waste Generated (MT)
Hazardous Waste Generated (MT)
Reported Environmental Incidents
tes:
In case of doubt, clarification should be sought from OLNG QHSE Department.
Contractors to ensure reporting of all their incidents with bief descrpition to be included in comments section below
mments:
Contractor HSE KPI Feed
KPI Feedabck
2019 2018 2017 2016 2015
ments section below.

KPI Feedabck

Prequalification For HSE KPI

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What does HSSE stand for and what aspects should be covered in the response?

What does HSSE stand for and what aspects should be covered in the response?

What are the organizational responsibilities and structure for HSE management?

What are the organizational responsibilities and structure for HSE management?

Co

Contractor Company Name:

HSSE stands for Health, S

HSE Policy Documents

3 Organisation, responsibilities, resources, stan

Organisational structure for

HSSE stands for Health, S

HSSE stands for Health, S

Contractor management process

Keyword 3.5 Ques

HSSE stands for Health, S

HSSE stands for Health, S

HSSE stands for Health, S

HSSE stands for Health, S

HSSE stands for Health, S

HSSE stands for Health, S

HSE incident and investigation

7 HSE auditing and management rev

HSSE stands for Health, S

8 HSE management - additiona

HSSE stands for Health, S

9 Company specific inform

Welfare Facilities 9.1 a)

HSSE stands for Health, Safety & Environment

How are senior managers personally involved in HSE management

Provide evidence of commitment at all levels of the organisation?

How do you promote a positive culture towards HSE matters?

Does your company have an HSE policy document?

HSSE stands for Health, Safety & Environment

What are your arrangements for advising employees of changes in

Does your company have strategic HSE objectives?

Itemise the methods by which you have communicated your strategic

responsibilities, resources, standards and documentation

How is your organisation structured to manage and communicate

Do HSE meetings promote HSE awareness?

Do client and contractor meet regularly to discuss and action any

HSSE stands for Health, Safety & Environment

What provision does your company make for HSE communication

If YES please give details. Where the training is given in-house

How have you identified areas of your company’s operations where

What specialist HSE resources does your organisation have

HSSE stands for Health, Safety & Environment

What arrangements does your company have to ensure new

HSSE stands for Health, Safety & Environment

What arrangements does your company have to ensure new

What arrangements does your company have to ensure new

Does your organisation have a competence system in place?

What arrangements does your company have to ensure existing staff

Does your company have a contractor management process or

How do you assess contractors, HSE competence or HSE

HSSE stands for Health, Safety & Environment

Where do you define the company standards you require your

How do you ensure these standards are met and verified?

How do you identify new industry or regulatory standards that may be