HSE KEY PERFORMANCE INDICATOR CONTRACTOR

2021
Contractor Name:
Contract No:
Contract Title:
Risk Level: MEDIUM
Contract Period: Start Date: End Date:
Work Location:
Trailling Metric (*)
Cases Target Site Cases Target Site
Recordable Injures (MTC, RWC, LWC, FAT) 0 Property Damage ( HC and Non HC) 0
First Aid Case 0 Property Damage ( Electrical ) 0
Motor Vehicle Incident Responsible (MVI-R) 0
Motor Vehicle Incident Non-Responsible (MVI-NR) 0
Fire Incident 0
(*) Trailling Metric BSP Target. Contractor shall refer to this target. Not Allowed to change this target
Leading Metric
Total Actual Achievement per Month
Target Target
Parameter (YTD)
Annual Monthly
YTD Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep % Month
1. Commitment to HSE through Leadership
1 Management site visit
a.General Manager 2
b. Project Manager 4
c. Head Security/ Deputy Head Security 720
2 Contractor Management Checklist (CMCL) 24
2. Policies and Strategic Target
1 HSE Policy Socialization 100%
2 Drugs/Substance Abuse and Alcohol Policy Socialization 100%
3 HSE Target/Goals Socialization 100%
4 Mentoring Program with COPI 24
5 Knowledge Sharing 12
6 Be Safety Leader 24
3. Organization, Responsibilities, Resources, Contractor Management, and Standard
1 HSE Conmunication and Meeting Programs :
a. Daily Toolbox Meeting 720
b. Weekly Safety Meeting 48
c. Monthly Safety Meeting 12
d. COPI Weekly Safety Talk 24
e. COPI & HSE Contractor Forum 12
f. COPI Driver Safety Forum 12
2 HSE Awareness and Promotion Programs
a. HSE Banner/ Bulletin K3 12
b. Recognation 4
3 Training / Competency Review
a. Gada Pratama 100%
b. Gada Madya 100%
c. Gada Utama 100%
d. Defensive Driving 100%
e. Basic Fire Fighting (BFF) 100%
f. Basic First Aid (BFA) 100%
g. Development Security Training 100%
h. Electronic Acces Control (ACS dan CCTV) 100%
i. Voluntary Principle On Security and Human Right 100%
j. Facility Security Officer Training 100%
k. Refresh FSO Training 100%
l. HSE Orientasi 100%
4. Hazard and Risk Management
1 HIRADC/ JSA 100%
2 Occupational Health Program(s)
a. Medical Check Up (MCU) 100%
3 Waste Management Plan & Environmental Program
a. Manifest Sampah Organik dan Non-Organik/ House Keeping 12
4 Socio-Economic Aspect management As per Event
5 PPE Inspection & Maintenance Program
a. PPE Inspection 4
5. Planning and Procedures
1 Equipment Inspection & Maintenance
a. Daily Vehicle Inspection 5760
b. Weekly Vehicle Inspection 180
c. Fire Extinguisher Inspection 12
d. First Aid Kit Inspection 12
2 Emergency Response Program
a Emergency Reponse Procedure Communication 4
b. Emergency Drill 12
3 Management Of Change As Per Actual
4 HSE Inspection Checklist (Level-1) 4
6. HSE Performance Monitoring
1 HSE Plan Communication 100%
2 Leading Metric
a. I-Care 2295
b. Hazard Hunting 12
c. Near miss Jika Menemukan Nearmiss
d. Ride Along- LSR N/A
3 Speed Violation Assurance 100%
4 Implementasi Protokol COVID 19 :
a. Pengisian Personal Daily Log (PDL) 100%
b. Protokol COVID 19 - Patrol 96
7. HSE Audit and Management Review
1 HSE Internal Audit 1 Yearly
2 HSE Management Review 1 Yearly
8. Contractor HSE Management System (C-HSE MS) Implementation
1 Kickoff Meeting (target date) 09/09/2021 0 telah dilakukan
2 Pre-Mobilization Audit (PMA) and/or Mobilization Audit (MA) 07/10/2021 0 telah dilakukan
3 Work In-Progress Audit (target date) 0
4 Final Evaluation (target date)
Total
Prepared By Review By Approve by Acknowledge by

Admin Security head Security Security Coordinator Coorporate Head Div Operation Coorporate
(**) as applicable

Hazard Hunting = 1 submission/month/employee

PJSM Audit, PTW Audit, Ride Along Audit obligated for selected Personnels (Site Leaders Teams ) = follow to COPI target
Contractor Supervisory Checklist = TBA