CONTRACTOR HSE PRE-QUALIFICATION QUESTIONNAIRE (GROUPS 1-3)

TO BE COMPLETED BY THE CONTRACTOR AND VERIFIED/SCORED BY THE HSE

ASSESSOR DURING THE SITE VERIFICATION:

Name of the Company

Address

PAINT ART DECOR

MUSSAFAH M-3 SANIYYA, ABU DHABI.UAE
POST BOX NO: 29092

Name of the Person

(Including position, title & e-mail address)
completing this Checklist:

MOHAMMED KAMAL AL ZUBIDI

GENERAL MANGER
Paintart.pabm@gmail.com

Nature of Business

INTERIOR DESIGN & FALSE CEILING

WORKS

Telephone #

02-5552771

Fax #

02-5552779

Statement: I, certify that the details provided in this assessment are true and correct to the best
of my knowledge.
Signature with Date

S.No.
1
1.1

2
2.1

2.2

EVALUATION FACTORS

MAX
SCOR
E

LEADERSHIP AND COMMITMENT

Commitment to HSE through Leadership
Are senior managers personally involved in
HSE management?
Is there evidence of commitment at all
levels of the organization?
Is there a positive culture towards HSE
matters?

10
YES

HSE POLICY AND STRATEGIC

OBJECTIVES
HSE Policy documents
Does your company have an HSE Policy
document? (If yes please attach a copy).
Who has overall and final responsibility for
HSE in your organization?
Who is the most senior person responsible
for this policy being implemented at
premises/ sites where his employees are
working? (Provide name, title and
experience).
Availability of Policy statements to
employees
Itemize the methods by which you have
drawn your HSE Policy statement to the
attention of all your employees?
What are the arrangements for advising
employees of changes in the HSE Policy?

10

ORGANIZATION, RESOURCES AND

COMPETENCE

3.2

Organization - commitment &

communication
How is management involved in HSE
activities, objective setting and monitoring?
How is your company structured to manage
and communicate HSE matters effectively?
What provision does your company make
for internal HSE communication meetings?
Competence and training of managers/
supervisors/ senior site staff/ HSE
advisors
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 to conducting
work to HSE requirements.
If YES please give examples. Where the
training is given in-house please describe
the content and duration of courses.

3.3

Competence and general HSE training

3.1

CONTRACTORS
RESPONSE

What arrangements does your Company

have to ensure new employees have
knowledge of basic industrial HSE, and to
keep this knowledge up to date?
What arrangements does your Company
have to ensure new employees have
knowledge of your HSE policies and
practices?

10

10

10

SCORE
AWARDED

REMARKS /
AREA OF
IMPROVEMEN
T

3.4

3.5

3.6

What arrangements does your Company

have to ensure new employees have been
Instructed and given information on specific
hazards arising out of the work being
undertaken? What training do you provide
to ensure that all employees are aware of
Group company requirements?
What arrangements does your Company
have to ensure existing staff HSE
knowledge is up to date?
(If training is provided in-house please give
details of content)
Specialized Training
Have you identified areas of your Company
where specialized training is required to
deal with potential dangers? (If YES please
itemize and provide details of training given)
If the specialized work involves radioactive,
asbestos removal, chemical or other
occupational health hazards, how are the
hazards identified, assessed and
controlled?
HSE qualified staff additional training
Does your company employ any staff who
possesses HSE Qualifications that aim to
provide training in more than the basic
requirements?
Assessment of suitability of Subcontractors / other companies
How do you assess:
HSE competence
HSE record of the subcontractors and
companies with whom you place contracts?
Where do you spell out the standards you
require to be met?
How do you ensure these are
met and
verified?

RISK EVALUATION AND MANAGEMENT

4.1

Hazards and effects assessment

What techniques are used within your
Company for the identification, assessment,
control and recovery of HSE hazards and
effects?
Exposure of the workforce
Do you have in place any systems to
monitor the exposure of your workplace to
hazards like chemicals or physical agents?
Handling of chemicals
How is your workforce advised on the
hazards encountered in the course of their
work?
Personal protective equipment
What arrangements does your company
have for provision and maintenance of PPE
both standard issue and that required for
specialized activities?
Waste Management

4.2

4.3

4.4

4.5

Does your company have in place systems

for identification, classification and
management of waste?

10

10

10

10

10

10

10

5
5.1.1

5.1.2
5.2

5.3

5.4

6
6.1

6.2

6.3

6.4

PLANNING, STANDARDS AND

PROCEDURES
HSE or Operations Manuals
Do you have a company HSE manual (or
Operations Manual with relevant sections
on HSE), which describes in detail your
Company approved HSE working practices
relating to your work activities?
(If the answer is YES please attach a copy)
How do you ensure that the working
practices and procedures used by your
employees on-site are consistently in
accordance with your HSE policy objectives
and arrangements?
Crisis and Emergency Management
Procedures to be Established
Equipment control & Maintenance
How do you ensure that plant and
equipment used by your employees within
your premises, on-site, or at other locations,
is correctly managed and maintained in a
safe working condition?
Standards
Where do you spell out the standards you
require to be met?
How do you ensure these are met and
verified?
Is there an overall structure for producing,
updating and disseminating standards?
Road Safety Management
How is road safety managed and what
arrangements does your company have for
combating road and vehicle incidents?
IMPLEMENTATION AND MONITORING
Management and performance
monitoring of work activities
What arrangements does your company
have for supervision and monitoring of HSE
performance?
What type of performance criteria are used
in your company; give examples?
What arrangements does your company
have for communicating the results and
findings of this supervision and monitoring
to your management and employees?
HSE performance achievement awards
Has your Company received any award for
HSE achievement?
Statutory Notified incidents / dangerous
occurrences
Has your company suffered any statutory
notified incidents in the last three years
(safety, occupational health and
environmental)? Answer with details
including dates, most frequent types,
causes and follow-up preventative
measures taken.
Improvement requirement and
Prohibition Notices
Has your company suffered any
improvement requirement or prohibition
notices by the relevant national body,
regulatory body for HSE or other enforcing
authority or been prosecuted under any
HSE legislation in the last three years? (If

10

10
10

10

10

20

20

your answer is YES please give details.)?

6.5

6.6

HSE performance records

Have you maintained records of your
incidents and HSE performance for the last
five years?
(If YES, please give following details for
each year, number of Lost Time Injuries,
number and type of other injuries e.g. MTC,
RWC, F.A., total hours worked by workforce
for each corresponding year, frequency
rates, and your company definition of a Lost
Time incident).
How is health performance recorded?
How is environmental performance
recorded?
How often is HSE performance reviewed?
By whom?
Incident investigation and reporting

20

20

Who conducts incident investigations?

How are the findings of an investigation, or
from a relevant incident occurring
elsewhere, communicated to your
employees?
Are near misses reported?
7
7.1

8
8.1

8.2

8.3

AUDIT AND REVIEW

Auditing
Do you have a written procedure on HSE
auditing and how does this procedure
specify the schedules and standards for
auditing (including unsafe act auditing)?
Do your company HSE Plans include
schedules for auditing and what range of
auditing is covered?
How the effectiveness of auditing is verified
and how does management report and
follow up audits?
HSE MANAGEMENT ADDITIONAL
FEATURES
Certification & Accreditation
Does your Company have certification such
AS 14001, OHSAS 18001, etc.?
Additional features of your HSE
Management
Does your Company have any other HSE
features or arrangements not described
elsewhere in your response to the
questionnaire?
Does your company hold HSE membership,
or actively support any industry or trade
organization?

10

10