Mobilization Safety Checklist

Contract No. & Job Description:

Subcontract Agreement No:

Subcontractor’s Name:

Assessment Details and any

Item Description Agreed Action Dates
Agreed Remedial Actions

Subcontractor has provided documentary evidence that all Personnel have

received the following training, where appropriate for their jobs:
a) Site Induction (Worksite Hazard Management) All
1 b) Safety Intervention (Worksite Hazard Management).
c) Defensive Driving (Road Safety) All drivers
d) Journey Management (Road Safety) All
e) In Vehicle Monitoring (Road Safety) All
f) Permit to Work (Process Safety) Supervisor/Permit holder .

LCC /Sub contractor shall submit the Residence card & PDO medical
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certificate copies for all the personal deploying to the work

LCC/Subcontractor confirms that all plant, equipment and vehicles on the

Contract have been offered for inspection with registration certificate and
3 have been issued with a valid inspection certificate. For vehicles this means
there are no defects to safety critical items (such as seatbelts, tires, brakes,
steering).

LCC/Subcontractor confirms that all professional drivers are over the age of
4 21 and have more than 2 years driving experience. All drivers (professional
and non-professional) have passed the PDO Defensive Driving course.

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 LCC/Subcontractor confirms that the current workforce does not include
5 anyone who has been previously dismissed for infringements relating to road
safety or other serious infringement.

LCC/Subcontractor commits to provide full time supervision for each work

6 location by supervisors who have been trained in Permit to Work, Safety
Intervention, and Journey Management where required.

All vehicles supplied by the LCC/subcontractor, including busses and pick-up

7 trucks, have been fitted with IVMS. Applicable restrictions to speed and use
of vehicles are monitored and enforced by the Contractor/Sub-contractor

LCC/Subcontractor commits to implement the PDO Journey Management

Procedure or own/main Contractor equivalent procedure to assess, approve,
8
control and monitor road journeys as per the Procedure. Subcontractor
commits to employ adequate journey managers/dispatchers/key controllers.

LCC/Subcontractor commits to provide a fully functional means of

9 communication to teams working in remote areas and where required by
Journey Management Plans

LCC/Subcontractor has notified Contractor of all Sub-subcontractors

employed on the work and will not employ any Sub-subcontractors without
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express approval of the Contractor. Verify your records against their
manpower list.

LCC/Subcontractor does not pay incentives or apply penalties which could

cause unsafe behavior such as speeding, making excessive working hours,
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overloading of vehicles or continuation of work with defective vehicles or lack
of PPE.

LCC/Subcontractor confirms that the current workforce is trained and aware

12 of PDO concession area protocols with respect to Permit requirements /
Journey Management /Commuting rules and Worker welfare requirements.

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Confirmed by LCC / Subcontractor Reviewed by : Project HSEM Contract Manager / Project Manager
Representative:

Name :
Name:
Name :

Signature :
Signature :
Signature

Date :
Date Date

For Verification & Approval from Site

Verified by: Planning / HR Admin Approved by HSE Advisor /Site In charge

Name :
Name :

Signature :

Signature :

Date
Date

Mandatory to be Signed and submitted along with the first invoice

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 Subcontractors are responsible for all contractual obligations as stated below:

➢ Actively participating in the Galfar “Zero Accident” philosophy.

➢ Implementing the requirements of this Safety & Health Management Plan, at a minimum.
➢ Ensuring all work operations follow the Safety & Health Management Plan. Ensuring all
employees work in compliance with the Safety & Health Management Plan.
➢ Providing a safe and healthy working environment for their personnel.
➢ Attending contractor/subcontractor kick-off meeting, pre-construction meetings,
contractor/subcontractor safety meetings, and any other meeting involving HSE, as
requested.
➢ Ensuring new hires attendance at Project induction / Orientation (Passport) Training, they are
coached by experienced staff at site
➢ Ensuring employees are provided and have completed any specialized training as required
by the employee’s job duties.
➢ Conducting daily and weekly audits to monitor compliance with Client’s HSE requirements
and Company HSE program requirements, where more stringent.
➢ Subcontractor Management should conduct periodic safety meetings for supervisors and
employees.
➢ Ensuring all incidents, accidents, and injuries/illnesses are reported immediately to the Galfar
HSEM /Lead and/or designated representative.
➢ Jointly conduct root cause analysis investigations for accidents/incidents and near miss
incidents with Galfar HSE & Project management personnel.
➢ Providing copies of incident investigation reports, statistical reports, injury/illness reports, and
other documents as requested by Galfar.
➢ Maintaining current copies of applicable HSE codes and standards as applicable.
➢ Actively participating in the near miss reporting system.
➢ Carryout the Lesson learnt sessions for the workforce.
➢ Ensure the employees are Fit to work and Medical records are available for scrutiny anytime
during the contract period.
➢ Drivers and Operators shall have valid license and training credentials from approved ATS.

Note: It is a legal requirement that LCCs should carryout the awarded works with their own
manpower and the activity cannot be wholly Sub-sub contracted under any circumstances.

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