Version history
Issue / Author / Verified by / Reason for change
Nov. 2013 / Bogenreiter / Implementation of versioning, adaptation of sign sheet
Feb. 2014 / Bogenreiter / Header fixed
Dec. 17 / Bogenreiter / Aistleitner / Adaptation to german version
Construction Site / Business Location / Building with Address:
(delete as applicable)
The Siemens AG expressively points out that the legal requirements regarding safety at work on the construction site / the business location / the building must be complied with.
Responsibility concerning work safety of employees belonging to your company lies with your company.
The requirements of Siemens AG and the on-site safety regulations (e.g. visitor info) as well as those of the corresponding site manager / location manager / building manager (construction coordination) are to be fully complied with.
Work safety directives of the Siemens AG installation / location / building manager must be followed.
Your employees must be briefed in regard to safety-related matters. Minutes are to be kept and copies must be submitted to the installation / location / building manager of Siemens AG upon request.
Your employees must be fitted with the necessary personal protective equipment (PPE). The PPE is to be used by the employees.
Utilized tools and work equipment must comply with the legal requirements (inspection, safety devices).
Should non-compliance with these requirements result in problems with the main ordering party, Siemens AG retains the right to take legal action as well as the option to remove employees, due to non-compliance with environment, health, safety (EHS) regulations, from the construction site and the company premises.
further informations and agreements
Is the instruction document “AS-A111 – EHS – Instruction sheet for employees of external companies” signed and available? (in case of order > 50 TEUR this will be confirmed by SCM)no yes
On site inspection done on by .
EHS topics discussed on site : no yes
Work permits required : no yes, which :
Visitor information has been hand over : no yes
Site (area of work) for the timeframe starting
……… until ……….for the tasks
to be done in the responsibility of company
is released by
Name / Function / Company / Phone Number
Emergency
Additional Notes:
For the Siemens AG :
(Name, Official Position, Date, Signature)
For the external company:
(Name, Official Position, Date, Signature)
AS-A110e - EHS Requirements for external companies at the site Seite 2 / 2