Rev.

0 (6/2014)

HSE 5% INCENTIVE CLAIMS

(PROJECT TITLE)

(COMPANY NAME)

Prepared by; Reviewed by;

Name:
Name: Position:
Position: Date:
Date:
Verified by; Agreed by;

Name: Name:
Position: Position:
Date: Date:
 Rev.0 (6/2014)

1. Project Background
Project Name
Project W/O No.
Project Period (1st Mob Pre-Siprod)
Project Period (2nd Mob Rig-Up)
Project Period (3rd Mob Rig-Down)
Project Period (4th Mob Well Tie-In)
Project Duration
Project Manhours (Offshore)
Project Marine Spread
Provision of Hook Up and Commissioning
for F9JT-A Infill Drilling Project
DFHD/2014/041A/004
10th August 2015 24th August 2015
16th October 2015 31st October 2015
2nd December 2015 7th December 2015
1st March 2016 19th March 2016
56 Days
39,012 Mhrs
Perdana Sovereign, Nautical Adlin, Grade
One Marin (GOM 6), Petra Galaxy

2. HSE Key Performance

A. Leading Indicators
No Performance Indicators Measurement Target Actual
1 HSE Plan Actual VS Base HSE Base HSE
Implementation Planned Plan 80% Plan 97%
Key HSE Key HSE
Plan 100% Plan 100%
2 Management HSE Visit Actual VS Once Off 28/12/2016
Planned
3 UAUC Reporting Ratio of UAUC 1:150 1:90
reported over
manhours
worked
4 Behavioural Safety Ratio of BS 1:2000 1:673
Reporting reported over
manhours
worked
5 ZeTo Rules Audit Ratio of audit 1:5000 1:975
conducted
over manhours
worked
6 PTW Verification Ratio of 1:5 1:3
verification
over total PTW
issuance
 Rev.0 (6/2014)

B. Lagging Indicators
No Performance Indicators Measurement Target Actual
1 Lost Time Injury No. of lost time 0 0
Frequency (LTIF) injuries per
1,000,000
manhours
worked
2 Total Recordable Case No. of injurious 0.65 0
Frequency (TRCF) incidents per
1,000,000
manhours
worked

C. Other
No Performance Indicators Measurement Target Actual
1 Number of compounds 0 0
from authorities due to
non-compliance

3. Evidence/Supporting Document to be attach with

3.1 Premob briefing report (Refer to Attachment 1)
3.2 HSE Key Performance - Leading indicators submission/report
3.3 HSE Key Performance - Leading indicator summary ( Refer to Attachment 2)
3.4 HSE Key Performance - Lagging indicators (Refer to Attachment 3)
3.5 HSE Key Performance Other (Indicate nil if none compound received from
authorities)
3.6 A copy of last DPR verified by PCSB rep.
 Rev.0 (6/2014)

Attachment 1

PREMOB BRIEFING REPORT

A. Premob Briefing Background

1st Premob Pre-Siprod

Venue Billion Waterfront Hotel, Labuan

Date 7th August 2015
Time 0800 hrs 1630 hrs
No. of Attendances (PCSB Rep.) 5 pax
No. of Attendances (Contractor Mgt. Rep) 6 pax
No. of Attendances (Employee) 29 pax

2nd Premob Rig-Up

Venue Grand Dorsett Hotel, Labuan

Date 12th October 2015
Time 0800 hrs 1630 hrs
No. of Attendances (PCSB Rep.) 4 pax
No. of Attendances (Contractor Mgt. Rep) 9 pax
No. of Attendances (Employee) 31 pax

3rd Premob Well Tie-In

Venue Grand Dorsett Hotel, Labuan

Date 26th February 2016
Time 0800 hrs 1630 hrs
No. of Attendances (PCSB Rep.) 4 pax
No. of Attendances (Contractor Mgt. Rep) 9 pax
No. of Attendances (Employee) 31 pax

B. Summary

F9 Infill Drilling Project is a successful project which started its fabrication

on 25th June 2015 and accomplished fabrication on 17th December 2015.
Then, continue for Offshore mobilization on 10th August 2015 for 1st
campaign and end with last campaign on 1st March 2016. All HSE Plan has
been implemented according to contractual needs with acceptable
percentage.
 Rev.0 (6/2014)

C. Attachment
i. Program Agenda.
ii. Copy of attendance list.
iii. Copy of verified UDAT report.
iv. Pictorial evidence.