Qhse Prequalification Questionnaire

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Branch of SINOPEC International Petroleum Service State Approved

Corporation Doc No. HSE-FOM-047


Version V1.0
QHSE PREQUALIFICATION QUESTIONNAIRE Issue date 03-10-19
NOTE: THE FORM SHALL BE SUBMITTED IN SOFT COPY (IN FLASH DISK OR CD) & HARD COPY IN THE ENVELOPE
ADDRESSED TO LCD, SINOPEC SERVICE

Name Of Vendor:

Type of Service Initiated for Pre-Qualification:

Date Applied:

Registered Address with Contact Information Focal Point Contact Information


Name:
Address:
Position:
Contact Number:
Email:
Contact Number:
QHSE QUESTIONNAIRE
NO. QUESTIONS YES / NO REMARKS
All Legal Documents Submitted (CR,VAT, GOSI and Yes See Attachment commercial:
1.
License if Required ) registration
Sales Tax/VAT
General Organization for Social
Insurance

Does Your company have full time HSE employee for Yes See HSE Organisational Chart
2.
managing the business?
Yes See Attachment
3. Does Your Company have HSE policy?
Yes Company policies are in
4. Does the policy address legal requirements?
compliance with applicable
Saudi Arabia legal
requirements and with other
requirements to which the
organization subscribes ( ISO ,
ASME , OSHA , BSI)
Does Your Company Hold any accreditation such as Yes ISO 9001
5.
API, ISO etc. OHSAS 18001
LEEA Full accreditation ( on
going )
Does your company identify the training needed based Yes Competency Mapping ( skills,
6.
on the job task? knowledge and abilities) is
company a process of
identifying the training needed
based on the job task
Does your company have formal incident investigation Yes See Attachment
7.
process to prevent reoccurrence of similar incidents?
Does your company report all events (Near Miss, Yes See Attachment N°10_HSP-
8. Incidents, BBO) and its tracked with proper corrective 005 Incident Reporting
action?
Does your company have QA/C manual to meets the Yes QSM-001 - Quality Manual
9.
service quality as intended?
10.
Do you provide safe and adequate transportation to and Yes  Journey Management is a
from the work site for your employees? four concepts that we used
as a tool to make road
journeys safer for
Branch of SINOPEC International Petroleum Service State Approved
Corporation Doc No. HSE-FOM-047
Version V1.0
QHSE PREQUALIFICATION QUESTIONNAIRE Issue date 03-10-19

everyone in our company. It


incorporates written policies
and a standardized
journey planning process
to promote and enhance
driver safety.
( See Attachments :
Journey Management
Policy and Journey
Management Log)

 Provide on the job training


and information about
workplace policies such as
speed limits and parking
procedures. Ensure that
drivers are trained in safe
driving practices, basic
safety checks, proper use
of safety features and how
to report defects.
Does your company have formal medical assessment N/A
11. program to verify the employees are fir to work?
Considerations.
Does your company have heat stress prevention YES See Attachment HEAT STRESS
12.
program and implementation?
WORK INSTRUCTIONS
Does you company provide the proper PPE (e.g.,hard YES PPE Policy (See Attachment N°16)
hat, safety glasses, safety shoes, hearing protection, PPE Register (See Attachment N°18)
13.
gloves) that meets ANSI specifications to its
employees?
Does your company provide where required it to use YES
14.
flame resistant clothing (FRC) is required
NOTE: THE FORM SHALL BE SUBMITTED IN SOFT COPY (IN FLASH DISK OR CD) & HARD COPY IN THE ENVELOPE
ADDRESSED TO LCD, SINOPEC SERVICE
Does your company have formal training for defensive
15.
training?
Does your company vehicle used for business activities
16.
equipped with Vehicle Tracking System?
Submitted By: Date: Signature

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