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Service Proposal Inquiry: Workplace Information
This form is built to capture working site details for estimating and preparing a proposal for the requested service. Don't worry! We don't share data. All the information collected here will be kept safe and secure with us.
Name of the Organization
Registered Address
Contact Number
Name of the Final Decision Maker
Name of the Contact Person
Company Website
Select the certifications you have
No
ISO 9001
ISO 14001
ISO 45001
IMS
Do you have any other certifications?
What kind of Service you are looking for?
Employee/Contractor Details
Total Number of employees on company payroll
Do you have contractors empaneled in your organization? If yes, how many contractors actively working as on date?
Total number of contractor employees
Do you have operations round the clock (All three shifts)?
Yes
No
Do you have a dedicated team to handle OH&S matters?
Yes
No
Total number of safety personnel as per requirement
Do you have SOPs available for all the operations?
Yes
No
Do you have JSA/JHA or HIRA for all the activities?
Yes
No
Location of Active Working Site #1
Please provide the details of processes / Critical Installations in this location
Total number of contractors deployed
Location of Active Working Site #2
Total Manpower Deployed
Please provide the details of processes / Critical Installations in this location
Total number of contractors deployed
Location of Active Working Site #3
Total Manpower Deployed
Please provide the details of processes / Critical Installations in this location
Total number of contractors deployed
Location of Active Working Site #4
Total Manpower Deployed
Please provide the details of processes / Critical Installations in this location
Total number of contractors deployed
Location of Active Working Site #5
Total Manpower Deployed
Please provide the details of processes / Critical Installations in this location
Total number of contractors deployed
Location of Active Working Site #6
Total Manpower Deployed
Please provide the details of processes / Critical Installations in this location
Total number of contractors deployed
Total Manpower Deployed
Details of Reported Lag Indicators
Have you had any cases of First aid/Safety violation of fatal potential / Fatality of employee in the last 5 years? Write in details, otherwise write "No" for no cases
Have you had any cases of Lost time/Serious injury or Permanent disability in the last 5 years? Write in details, otherwise write "No" for no cases
Have you had any cases of non-injury incidents (e.g., Property damage)/Safety non-compliance (Cost recovery/Penalty imposed/Job stopped) in the last 5 years? Write in details, otherwise write "No" for no cases
What are the applicable statutory compliances that you follow?
Submit
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