Current We are undertaking the following Complete To Who is the Transpower representative responsible for your contract? From Who is the Contractor representative? Work location At which Site will the work take place? For What is the scope of the work to be completed? 1. WORKPLACE CONTROL AND MANAGEMENT: On-site safety supervisor for this project is What is the name of the on-site safety supervisor? On-site safety supervisor phone number 2. HAZARDOUS WORKS We have Hazardous Works associated with our contract Yes No WorkSafe NZ has been advised of our Hazardous Works Yes No WorkSafe notification is attached to this submission Yes No RISK AND HAZARD MANAGEMENT Each day we will maintain an on-site pre-start form where site-specific hazards and appropriate controls to eliminate or minimise the risks will be recorded Yes No We will prepare a written task analysis covering all hazards and appropriate controls associated with our works, and provide a copy before any work commences on site Yes No Are there hazardous substances associated with our subcontract works Yes No If yes, the appropriate Safety Data Sheets and emergency plans must be attached. 4. COMMUNICATION / EMPLOYEE PARTICIPATION The methods we use to communicate safety information to our employees are Pre-start planning meetings Health and safety meetings Other Frequency of above communications 5. EMERGENCIES Our First Aid kit is located at Our First Aid person is First Aid person's phone number We have trained First Aid personnel and procedures in place on site to render assistance in the event of an accident / emergency Yes No In the event of a site emergency or evacuation our personnel will report to our safety representative and assemble at the evacuation area shown on the Emergency Evacuation Plan Yes No 6. ACCIDENT REPORTING, INVESTIGATION AND RECORDS We have an accident / incident reporting / investigation system in place and keep a register Yes No We will immediately notify all accidents, injuries and serious near misses to site management Yes No We will immediately notify WorkSafe NZ if a Notifiable Event occurs while we are completing our work Yes No 7. SAFETY INSPECTIONS AND REVIEWS We agree to undertake safety inspections and reviews Yes No An example of our safety inspection documentation is attached Yes No 8. TRAINING OR INDUCTION All persons under our control on site are given a site specific safety induction Yes No All persons under our control on site (including subcontractors) are appropriately qualified, competent, and / or fully supervised Yes No 9. SUBCONTRACTORS Will you have subcontractors working for you on this scope of works Yes No Accompanying documents Upload file One file only.128 MB limit.Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, mp4, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip. Leave this field blank