Hydro
Aluminium Metal
Primary Production Kurri Kurri
Contractor OH&S Evaluation (Company Questionnaire)V1.1

Hydro Aluminium Kurri Kurri Pty Ltd is committed to providing a safe and healthy environment for all persons entering the site. A component of that commitment requires companies who work on site to demonstrate they have the same commitment to OHS and have systems in place to meet Hydro’s expectations.

The OHS Evaluation must be completed and returned to the Contracts and Supply Coordinator for evaluation prior to any company performing work on site or being added to Hydro’s list of approved suppliers. Hydro Aluminium is committed to its Occupational Health & Safety Policy. As part of this policy Hydro Aluminium expects all Contractors to work to the same level of commitment, in all aspects of their work, to ensure a safe place of work for all on site. The answers to the questions set out in this evaluation will be confidential and shall only be used by Hydro Aluminium for the purpose of assessing the ability of Contractor company to perform the tendered work in a safe and healthy manner.

If you have any questions regarding the completion of the questionnaire please contact the Hydro Aluminium Contracts and Supply Coordinator. Electronic copies of the evaluation form are available upon request.

Company Details

Trading Name

Describe the type of work undertaken by your company

Number of employees

Addresses of the main office and/or facilities relevant to work to be performed on Hydro site.

Main Office / Street & Number
City/Town
State / Postcode
Main Facility/Workshop
(if different to main office) / Street & Number
City/Town
State / Postcode

Statement of accuracy:

The information contained in this questionnaire is a true and accurate representation of the systems the company I represent has in place (at the time of completing) to ensure the health and safety of its employees and the employees of sub-contractors working under the direction of the company.

Name of person completing questionnaire:
Signature: / Date:
Position held in Company represented:
Postal Address / Company Address / Telephone
Hydro Aluminium Kurri Kurri Pty Ltd / Hydro Aluminium Kurri Kurri Pty Ltd / (61 2) 4937 1555
PO Box 1 / ABN 55 093 266 221 / Fax
Kurri Kurri NSW 2327 / Hart Road / (61 2) 4937 3452
Australia / Loxford via Kurri Kurri NSW 2327
Australia

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Contractor OH&S Evaluation V1.1
Company Questionnaire

Safety Program

Does the company have a written Health and Safety Policy?

If yes, please attach a copy of the policy to this questionnaire

Does the company have a written safety program, OHS Manual or Safety Management System? Does the company have a written Health and Safety Policy?

If yes, please attach a copy of the index or contents page to this questionnaire

Is the manual readily available to your employees?
Will a copy of the manual be kept at the work site?
Are Health & Safety responsibility part of Job/Position Descriptions?

If yes, please attach copies of Job/Position Descriptions to this questionnaire.

Injury/Incident Reporting & Safety Performance

Does the company have a formal system for the reporting, recording and investigation of incidents, injuries and illnesses?

If yes, please attach copies of a recent incident report/investigation and details of actions.

Please enter the Company’s Injury Frequency Rates for the past 3 years

Note: frequency rates are to be calculated per million hours worked / 20 / 20 / 20

LTIFR

/ Number of injuries where the person was not able to return to work on the next rostered shift following the injury

RDFR

/ Number of injuries where the person was not able to return to full pre-injury duties on the next rostered shift following the injury

MTIFR

/ Number of injuries where the person was required treatment (beyond first aid) form a doctor or medical personnel

For the last year, please provide the following:

a)Number of lost time injury cases
b)Number of restricted work cases
c)Number of medical treatment injuries
d)Number of fatalities
e)Employee hours worked

Are lost time injury reports and report summaries sent to the following? How often?

Yes/No / Frequency of reporting (monthly, quarterly etc.)
Site Manager/Superintendent
State/Regional Manager
CEO/Managing Director

Safety Communication

Does the Company have a Safety Committee/Safety Representative(s)?

If yes, please provide details (positions) of the Committee Members/Safety Representatives.

Committee Chairperson / Name & Job Title
Committee Member/Safety Representatives / Name & Job Title
Does the company hold regular site safety meetings?
What frequency are meetings held?

Please attach a copy of a recent field supervisor’s safety meeting minutes to this questionnaire.

Does the company hold regular "toolbox" safety meetings?
What frequency are meetings held?

Please attach examples of a recent toolbox safety meeting record/minutes to this questionnaire.

Inspection/Audit

Does the company conduct project or work site safety inspections?
Who conducts inspections/audits? (Name/Title)
How often are inspections/audits conducted?
Do inspections/audits include sub contractors?

Please attach a copy of a recent project or work site inspection/audit to this questionnaire.

Does the company have a system of inspecting plant, tools and equipment prior to entry to site and while they are on site?

Please attach examples of registers, inspection checklists and inspection frequencies for plant, tools and equipment relevant to the work to be done on site to this questionnaire.

Training

Does the company have an induction program for employees?

If yes, please attach a copy of the training agenda/topics covered in inductions.

Does the induction program cover the following:

Yes/No/NA
/
Comments
Personal Protective Equipment
Foot protection
Eye protection
Hand protection
Hearing protection
Respiratory protection
Scaffolding
Housekeeping
Fire protection
First aid facilities
Emergency procedures
Hazardous substances
Excavation and Trenching
Confined spaces
Working at Heights
Signs, barricades, flagging
Electrical safety
Rigging and crane safety
Incident/Injury Reporting
Consultation Process
Does the company have a system for recording training, qualifications, competencies and licences of its employees?

If yes, please attach a copy of an employee’s training records to this questionnaire

Does the company have a program for newly hired or promoted Supervisors?

If yes, does training include instruction on the following?

Yes/No
/
Comments
OHS Legislation & Duty of Care
Safe work practices
Safety supervision
Toolbox meetings
Emergency procedures
First aid procedures
Equipment inspection procedures
Injury/incident investigation
Fire protection and prevention
Lock out/tag out procedures

Personal Protective Equipment.

What PPE do you provide for your employees and sub-contractors?

Employees
/
Sub-contractors
Type of PPE /
Yes/No/NA
/
Yes/No/NA
Foot protection
Eye protection
Hand protection
Hearing protection
Respiratory protection
Safety Harnesses/Fall Protection
Other (specify)
Other (specify)
Other (specify)
Other (specify)

How is the issue and use of PPE controlled?

Hazard Identification and Risk Assessment

Does the company have a system for conducting risk assessments?

If yes, please attach a copy of 2 recent risk assessments to this questionnaire

Does the company have a system to manage hazardous substances?
Does the company keep a register of hazardous substances

If yes, please attach a copy of the register to this questionnaire

Are Material Safety Data Sheets (MSDS) available where hazardous substances are stored/used?

Disciplinary Policy

Does the company have a Disciplinary Policy in place?

If yes, please attach a copy of the policy to this questionnaire

Alcohol and Other Drugs Policy

Does the company have an Alcohol and Other Drugs Policy in place?

If yes, please attach a copy of the policy to this questionnaire

Rehabilitation

Does the company have an Injury Management/Rehabilitation Policy/Program for employees who suffer work related injury/illnesses?

If yes, please attach a copy of the policy/program to this questionnaire

Does the company have a company doctor?
Do you have a WorkCover accredited Rehabilitation Coordinator?

List of Attachments

(Please indicate which of the following documents are attached to your completed questionnaire)

Document / Yes/No
Copy of Health and Safety Policy
Index/Contents page of safety program or Safety Management System
Copies of Job/Position Descriptions outlining OHS responsibilities
Copies of two (2) recent injury/incident investigation reports
Copy of a recent site supervisor’s safety meeting minutes
Copies of recent ‘toolbox’ meeting minutes.
Copies of equipment registers, inspection checklists and inspection frequencies
Recent project/work site inspection/audit report.
Induction training agenda/list of topics covered
Sample of an employee’s training records
Copies of 2 recent risk assessments
Copy of hazardous substance register
Copy of Disciplinary Policy
Copy of Alcohol and Other Drugs Policy
Copy of Injury Management/Rehabilitation Policy/Program
Postal Address / Company Address / Telephone
Hydro Aluminium Kurri Kurri Pty Ltd / Hydro Aluminium Kurri Kurri Pty Ltd / (61 2) 4937 1555
PO Box 1 / ABN 55 093 266 221 / Fax
Kurri Kurri NSW 2327 / Hart Road / (61 2) 4937 3452
Australia / Loxford via Kurri Kurri NSW 2327
Australia