Fish River Electrical

Services CC
P.O. Box 1003
MARIENTAL
TEL:063-244762/0817396988
Email: fishricc@gmail.com
V.A.T No: 6861020-01-5
Reg No: CC/2014/04834

APPOINTMENT AS HEALTH AND SAFETY REPRESENTATIVE IN TERMS OF SECTION 10(1)

By the authority of Section 10(1) of the Labour Act, 1992, and by the powers vested in me as the appointed
Section 5(2) to further appoint and assign legal responsibility, I assign you the responsibility and authority
to perform the legal duties of an Health and Safety Representative in terms of this act and regulations.

I (Name) ___________________ the Section 5(2) appointed (title) _____________________________

of FISH RIVER ELECTRICAL herewith appoint you (Name) ________________________________

(Id No) _________________________ in writing as the Health and Safety Representative to be responsible for
compliance with the health and safety legal requirements.

Your appointment will have effect from the date you signed acceptance until your appointment is cancelled or
superseded by a new appointment.
Your geographic area of responsibility is;

__________________________________________________________________________________________
Note; describe geographical area of responsibility,
You are to ensure that you are familiar with the said area of responsibility, and understand and agree with the
boundaries of your area of responsibility.
You are appointed as the health and safety representative in terms of the Section 10(1) of the Labour Act,1992.
Although you will be provided with the training to perform your functions, I wish to refer you to Section 10(1) of the
Labour Act, 1992, and to your appointment letter which relates specifically to the functions you will be required to
perform, in terms of this legislation. You are required to in practice ensure compliance with all the statutory
requirements relating to your work and workplace. You must report all deviations and non-compliance that you
cannot rectify through the reporting structure to me.
As the Health and Safety Representative for your area of responsibility, your functions will include:
1. Review the effectiveness of the Health and Safety measures within your area of responsibility;
2. Assess the potential hazards to the Health and Safety of the employees at the workplace;
3. Investigate the causes of incidents and all complaints from the employees relating to their Health and Safety;
4. Investigate the causes of incidents and all complaints from the employees relating to their Health and Safety;
5. Inspect the workplace and report on such inspection, and the aspects mentioned in (a), (b) and (c) above, to
the employer;
6. Participate in the investigations into incidents, in your designated area as contemplated in section 18.

In accordance with the Labour Act, 1992 and the agreement on health and safety committees you are hereby
appointed as a co-opted, health and safety committee member. These committee meetings take place no less than
once a month. I which to bring to your attention that your rights and powers is stipulated in section 10(1) and the
collective agreement regarding health and safety committees.
Your duties as a member are as follows, but not limited to:
  make recommendations to the employer regarding matters of health and safety of employees in the
workplace;
 report of all incidents in a workplace regarding injuries, damages and occupational health occurrences;
 act in accordance with the collective agreement and constitution and establish and support health and
safety committees to promote the health and safety of employees in the area of work.
You are to ensure that you are familiar with your functional responsibilities, as outlined above as you will be held
responsible for compliance, and if you have any queries in this regard, you are to bring this to the attention of
myself. You will be provided with all the means necessary to enable you to fulfil your responsibilities in terms of this
appointment.
You are to take all reasonably practicable measures, within your area of responsibility, to ensure the general health
and safety of all persons, and compliance with the health and safety requirements as may be imposed by the
company. If you, for any reason, are unable to take such measures, you are to report it through the reporting
structure.
You are given the authority through this appointment to ensure compliance with the legal provisions and
requirements. You are to bring to my attention the need of any additional authority required by you to ensure
compliance with the legal provisions/requirements
Confirm your acceptance of this designation and understanding of the duties involved by signing the
acknowledgement below.
The above appointment and responsibilities are understood and accepted.

I (Name) ____________________________________________ (Id No.) ________________________________ acknowledge and accept the

above appointment and declare that I am familiar with the duties, functions and responsibilities imposed on
me by legislation and this appointment. I undertake to ensure the implementation and adherence to these
impositions within my appointed area of responsibility. I further do possess the competencies as are
prescribed and/or required by the legislation to accept the legal responsibilities through this appointment.

________________________________ _________________________________
(Signature of Appointee) (Date)

________________________________ _________________________________
(Signature of Appointer) (Date)
For and on behalf of
FISH RIVER ELECTRICAL

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