SYSTEM OF MANAGEMENT OF THE SAFETY AND

HEALTH IN THE WORK

FT-SST-
LEVEL 7: FORMATS: 012
SG-SST
FORMAT FORM OF FORMATION OF THE PARITARY COMMITTEE ON Date:
SAFETY AND HEALTH AT WORK - COPASST Versión: 001
Page 1 of 2

FORMAT FORM OF FORMATION OF THE PARITARY COMMITTEE ON

SAFETY AND HEALTH AT WORK - COPASST

On the ______ day of the month of ____________ of the year ________, the Joint
Occupational Health Committee (COPASST) of "HERE YOUR COMPANY" was
elected for the period __________________, thus complying with the requirements
of Resolution 2013 of 1986, the Decree 1295 of 1994, Law 776 of 2002 and
Decree 1072 of 2015.

The method used for their election was __________________________________,

with a total number of votes amounting to the sum of _________ and the results
are as follows:
EMPLOYER REPRESENTATIVES

CATEGORY
NAME POSITION
MAIN ALTERNATE

EMPLOYER REPRESENTATIVES

CATEGORY
NAME POSITION
MAIN ALTERNATE

The legal representative of "HERE YOUR COMPANY", designates the official (a)
_____________________________________, as chairman of the committee, and by a

Elaborated: Revised: Approved:

Code: SG-SST-001

Date modified:
 SYSTEM OF MANAGEMENT OF THE SAFETY AND
HEALTH IN THE WORK
FT-SST-
LEVEL 7: FORMATS: 012
SG-SST
FORMAT FORM OF FORMATION OF THE PARITARY COMMITTEE ON Date:
SAFETY AND HEALTH AT WORK - COPASST Versión: 001
Page 2 of 2

vote of the Committee, the official is appointed

_________________________________________________ as secretary of the same.

They sign,

_________________________________ _________________________________
President of the Committee Secretary of the Committee

Elaborated: Revised: Approved:

Code: SG-SST-001

Date modified: