Contract Title:

Contract Number:
Tenderer Name:
Tenderer Address:

Does tenderer have existing contract/s with the company? If yes, please provide details. (c
lease provide details. (contract number and title)
This HSE questionnaire has been developed to consistently assess the Tenderer HSE

The Tenderer shall:

· Answer each question and should be related to the Tender.

· Submit supporting evidence(s) for the answers.
· Supporting evidences should be submitted in one folder with subfolders
· The submission should be truthful and validated (signed, on completion)

PDO will complete the desk top review of the submission and list further data require
The Tenderer will, , receive the reviewed submission and a request for a clarification
It is important that tenders representatives that are able to explain and support the H
Non compliance with the above may result in the submission being rejected.
Following completion of the clarification meeting, PDO will make scoring
ssess the Tenderer HSE capability and capacity.

he Tender.

e folder with subfolders and numbering for each heading.

(signed, on completion) by Tenderer’s Company CEO or most Senior Company representative.

list further data requirements, if required.

quest for a clarification meeting (virtual or face to face) to take place within two weeks.
xplain and support the HSE questions are available. The Tenderer shall make available the requir
being rejected.
ake scoring
pany representative.

hin two weeks.

ake available the required further data.
No. HSE Area Section No.
1 Leadership

a)

b)

Commitment to HSE aspects through

leadership 1.1 c)

d)

a)

b)

HSE Policy Documents 1.2

c)

a)
HSE contract strategic objectives 1.3
 HSE contract strategic objectives 1.3

b)

2 Planning

Risk Assessment & Control 2.1 a)

a)

b)
Health hazards 2.2

c)

a)

Safety hazards 2.3

b)

a)
Logistics hazards 2.4
 Logistics hazards 2.4

b)

a)
Environmental hazards 2.5

b)

AIPSM 2.6 a)

a)
Social responsibility hazards 2.7
b)
3 Support
a)

b)
Organisational structure for HSE
3.1
management c)

d)
 a)

HSE training of managers, supervisors and

3.2
HSE critical positions
b)

c)

a)

b)
General HSE training 3.3

c)

a)
Competence assurance 3.4

b)

a)

HSE standards 3.5 b)

c)
4 Operation
 HSE operations manual / HSE Plan 4.1 a)

Infrastructure and equipment integrity 4.2 a)

Management of Change 4.3 a)

a)

(Sub) Contractor management process 4.4 b)

c)

d)

a)
Emergency planning and response 4.5
b)
5 Performance Evaluation
a)

HSE-MS implementation and active

performance monitoring of work activities 5.1
 b)

HSE-MS implementation and active

performance monitoring of work activities 5.1 c)

d)

e)

f)

Safety performance indicators 5.2 a)

a)
b)

HSE performance monitoring 5.3 c)

d)
e)

Statutory notifiable incidents or non

compliance notices 5.4 a)

a)

b)

Audits 5.5

c)

d)
 a)

Management HSE-MS review and follow-up 5.6

b)

c)
6 Improvement
Certification of your HSE-MS 6.1 a)
a)
b)
c)
HSE incident and investigation follow-up 6.2
d)

e)

Membership of associations 6.3 a)

Additional features of your HSE-MS 6.4 a)

 Questions

How are senior managers personally involved in HSE

management?
Provide evidence of commitment at all levels of the
organisation?

What does top management do to ensure the health and

welfare of employees is established, maintained and given
priority like accommodation, meals, rotation, medical care,
recreation facilities etc?

How are safety behaviours managed and monitored in the

work place?

Does your company have an HSE policy document? If the

answer is YES please attach a copy.

Who has been identified and appointed in the organisation for

overall responsibility and accountability for HSE?

How do you communicate your policies requirements or any

amendments thereof to your employees?

Does your company have strategic HSE objectives?

If the answer is YES please attach a copy.
How do you communicate your strategic HSE objectives to your
employees?

How does your company identify hazards, assess risk, control

and mitigation
consequences, to a level as low as reasonably practicable?

What occupational health procedure / monitoring do you do?

What type of health hazards (chemical, vibration, noise,

radiation, etc.) are
associated with the scope of your services? Explain how
occupational health
hazards are identified, assessed and controlled.

What systems are in place to control these hazards and

monitor the effectiveness of these controls? Is worker’s regular
exposure monitoring part of these systems?

What type of safety hazards (mechanical guarding, work at

height, lifting and hoisting, confined space entry, explosive
atmospheres etc.) are associated with the scope of your
services?

What systems are in place to control these hazards and

monitor the effectiveness of these controls?

What type of logistics hazards (land transport, air transport,

marine transport, materials handling etc.)are associated with
the scope of your services?
What systems are in place to control these hazards and
monitor the effectiveness of these controls?
What type of environmental hazards (chemical spill,
atmospheric emissions, waste disposal etc.) are associated with
the scope of your services?
What systems are in place to control these hazards and
monitor the effectiveness of these controls?

How is base line information and the results of risk

assessments used as input to asset design, selection and
integrity decisions
Which criteria, specifications and standards are defined to
address risks and verify conformity throughout the life cycle of
facilities, equipment and materials?
Which procedures does your company have to ensure facilities
and/or equipment are operated within defined design and
operating limits at all times?
Which processes are in place to identify and manage HSE
critical risk controls/barriers to prevent a incident?
Briefly describe the processes in place to maintain, replace,
test, inspect, calibrate, certify and verify performance of
facilities and equipment?
Has your company established an accessible register of HSE
critical facilities or equipment and their minimum performance
criteria? If yes, please provide a sample.

What type of social hazards are associated with the scope of

your services?
What systems are in place to control these hazards and impacts
and monitor the effectiveness of these controls?

How is your organisation structured to manage and

communicate HSE effectively?
What specialist HSE resources does your organisation have
available?
Do HSE meetings promote HSE awareness?
What provision does your company make for HSE
communication meetings?
Please provide an organisation chart
How company dictates HSE critical positions? Have the
managers and supervisors at all levels who will plan, monitor,
oversee and carry out the work received formal HSE training in
their responsibilities with respect to conducting work to HSE
requirements? Give details and evidences.

Where the training is given in-house please describe the

content and duration of courses.
How have you identified areas of your company’s operations
where specialised training is required, for instance training
related to health hazard such as radiation, asbestos and
chemicals?

What arrangements does your company have to ensure new

employees have knowledge of basic industrial HSE, and to keep
this knowledge up to date?
What arrangements does your company have to ensure new
employees also have knowledge of your HSE policies, practices
and company requirements?
What arrangements does your company have to ensure new
employees have been instructed and have received
information on any specific hazards arising out of the nature of
the activities?

Does your organisation have a competence system in place?

If YES, please describe the scope and content of your
competence system.

What arrangements does your company have to ensure staff

HSE knowledge is up to date?
How do you identify new industry or regulatory standards that
may be applicable to your activities?
Is there an overall structure for producing, updating and
disseminating standards?
Are your company standards aligned with PDO/OGP/industry
guidelines or recommended practices? If yes state details
Do you have a company HSE-MS manual / HSE plan(or
operations manual with integrated HSE requirements) which
describes in detail your company approved HSE working
practices relating to your work activities?
If the answer is YES please attach a copy of an index and
relevant supporting documentation.

How do you ensure that infrastructure, plant and equipment

used within your operations (own premises, client site, or at
other locations) are correctly certified, registered, controlled
and maintained in a safe working condition?

How do you manage changes and assess associated risks e.g.

personnel, equipment, processes, documentation?, Provide
evidence.

Does your company have a (sub)Contractor Management

process or system?
If yes, provide an outline of the process.

How do you assess (sub)contractors, HSE capabilities HSE

competence or HSE performance?

Where do you define the company standards you require your

(sub) contractors to meet?

How do you ensure these standards are met and verified?

What arrangements does your company have for emergency

planning and response?
Which emergency situations are included?

What arrangements does your organisation have for

monitoring the implementation of your HSE-MS?
How does your company assure the implementation of work
procedures within your work-site operations e.g. compliance
with procedures, toolbox talks, safety meetings, supervision,
job observations?
How do you monitor employee HSE performance e.g. hazard
identification systems, HSE participation?
What active HSE monitoring is performed (i.e. where no
incident has occurred)?

How do you report and correct deficiencies identified?

How do you communicate the results of active performance

monitoring to relevant personnel?
Submit HSE statistics in a separate spreadsheet called Tenderer
HSE Statistics
How is health performance monitored and recorded?
How is environmental performance monitored and recorded?

How often is HSE performance reviewed? By whom?

How is logistics performance monitored and reported?

Do you record vehicle incidents?

Has your company suffered any statutory notifiable incidents in

the last five years (safety, occupational health and
environmental)?

Do you have a written procedure for HSE auditing?

If yes, please attach a copy.
Who is involved in conducting HSE audits? How are audit team
members selected to have specific expertise and be
independent from the activities being audited?
What are the qualifications required for auditors?

How does your company schedule HSE audit and what scope of
auditing is covered? e.g. internal, regulatory compliance,
supplier/contractor, HSE management system implementation.

How does management follow up on audit findings and ensure

effective close out of action items?
Do you have a written procedure for management review of
the HSE-MS, including what triggers reviews?
If yes, please attach a copy
How often are HSE-MS reviews, Policies conducted and who is
involved in the process?
How are identified actions and improvement efforts recorded
and tracked to effective completion?

Please provide information on any certification which you have

received from certification bodies
What types of HSE incident are investigated?
What process is used to investigate HSE incidents?
Who conducts HSE incident investigations?
How are the findings of an incident investigation followed up to
ensure effective prevention of recurrence?
How is Learning from Incident communicated to all relevant
personnel?

Describe the nature and extent of your company’s participation

in relevant industry, trade, and governmental organisations

Does your organisation (globally, regionally or locally) have any

HSE features or arrangements not described elsewhere in your
response to the questionnaire?
 Evidences Example

Top Management site visits Plan and

evidences
Weekly, Monthly, Board meeting examples
Annual planning programme for senior
managers visits

Top Management engagement with staff

on welfare
Welfare committee meetings
evidences of actions to address welfare
concerns

BBS Procedure. Online reporting tool. BBS

reviews. Training. management
demonstrate its active commitment to the
BBS

Copy of the current policies for Company

including HSEMS, Driving, Smoking etc

Submit the job description of the person

identified as the one with overall
responsibility for HSE in the organisation
and specify the HSE roles and
responsibilities.

Submit evidence of the formal

communication of company policy to
staff?
Submit the HSE induction slides that
explain the purpose of the policy and the
HSEMS to the employees?
Clarify how do you cater for various
languages for communications

Submit details of the annual HSE planning

that includes objectives for improvement
in HSE.
Submit clarification for choosing themes to
be included into HSE objectives.
Submit evidence of the formal
communication of company HSE objectives
to staff

Submit the company risk register and a

specific risk format for the proposed scope
(use the attached excel version)
Clarify what are the preferred methods in
your organization for undertaking risk
assessments to effectively identify, assess
and treat risks related to personal and
process safety incidents and damage to
assets and/or company value to an
acceptable level.

Evidences of Health Risk Assessment.

Submit the latest inspection or audits
capturing the specific health aspects from
operations
Submit framework for fitness to Work to
include the type of medical / physical
check-up per age group / job category
Submit statistics showing employees have
undergone medical check-ups

Submit samples of the following:

1.HSE plan
2.Mechanical Lifting procedure
3.Permit to work procedure
4.Working at Height
5.Confined Space entry

Submit a sample of a pre-work check

sheet, Tool Box or equivalent?
Submit a sample of company permit to
work system,
Submit a sample of a recent audit of the
company permit to work system?
Submit Road Transport Manual including
verifications / audits
Submit road safety consequence
management for
non-compliance/violation.
Submit statistics and evidences for the last
2 years for implementation of the
consequence management
Submit Road Transport Manual including
verifications / audits
Submit road safety consequence
management for
non-compliance/violation.
Submit statistics and evidences for the last
2 years for implementation of the
consequence management
Submit Waste Management plans,
Submit Aspects and Impacts registers
Submit Details of the waste reduction
measures in your company

Check designs are well-documented and

validated with HSE critical operating limits
clearly identified, and that technical
review actions are closed with deviations
documented.
Verify inspection and maintenance work
has been executed according to plans and
schedules.
Ensure certifications and calibrations are
kept up-to-date.
Monitor, record and analyse overdue
inspection and maintenance, and
unscheduled downtime.
Monitor, record and analyse excursions
from operating envelopes.
Monitor status of critical risk controls/
barriers that prevent major incidents.
Ensure recalls, service bulletins and
modifications are addressed.

Submit details of any social development

programmes that support community
relations?

Submit a current organisation chart.

Submit an organisation chart for the
proposed scope
Submit minutes from meetings from
stated monthly or weekly meetings?
Submit details of how company dictates
HSE critical positions.
Submit details of how HSE critical tasks
and assurance of the persons responsible
for the tasks recorded

Submit training matrix

Submit how you review and update the
HSE training.
Submit historical data (as applicable)
detailing the HSE training reviews and
actions taken to address them.

Submit the HSE Competence profile for

Key staff in company organisation
Submit HSE induction pack

Submit HSE Competency framework

(including criteria, assessment, gaps
identification, and training)
Clarify who conduct the assessments? And
what competency required to conduct the
assessment.
Submit CV, qualification for the qualified
assessor.
Submit 10 completed assessments
Clarify how the identifiable gaps are
addressed.
Submit the latest accredited certificate for
HSEMS (OHSAS18001/ISO14001 and
/ISO45001)
Copy of the most recent HSE plan for a
contract
Documentation demonstrating working
practices: HSE Manual, processes, etc.

Clarify with evidence the preventative

maintenance program .
Provide evidence on the processes in place
to maintain, replace, test, inspect,
calibrate, certify and verify performance of
equipment.
How are frequencies for these type of
activities determined

Submit the company document that

explains change management for the
organisation.
Submit 3 samples for a completed MOCs.

Submit evidences of Subcontractors

management process/framework,
meetings, reviews, performance, HSE
statistics of sub-contractors for the last 5
years

Evidences of pre award HSE evaluation

Submit a sample of a typical contract

document with sub contractors or
vendors?
Evidence of HSE monitoring plan on sub-
contractor, audits.
Submit Emergency response plan. Samples
of ER drills. List of emergency scenarios.
Explain how learning/findings from ER
drills are addressed.

Evidences of HSE monitoring plan,

communication of HSE monitoring plan to
employees, audits, inspections,
Evidences of HSE monitoring plan,
communication of HSE monitoring plan to
employees, audits, inspections,
management reviews, site visits, Action
tracking register.

Submit health performance record

Submit details of the Waste streams for
the last 24 months
Evidences of HSE performance reviews
submit road safety performance records

Answers with details including dates,

country and location, summary of incident
and follow-up preventative measures
taken.

Audit process
Audit schedule
Action tracking
Auditors qualification
Management review process
Evidence of management reviews meeting
Evidence of follow up on actions from
management reviews

Certifications

Submit the company standard for

investigation
Sample of investigation report
Learning from incident
procedure/framework
Qualification of lead incident investigator
Contractor Response
Supporting Evidences
No. HSE Statistics Current Year Year -1 Year -2

1 Total Manhours worked

2 Exposure - Driving (km)
3 Exposure - Site Work (hours)
4 Fatalities (FAT)
5 Lost Time Incidents (LTI)
6 Lost Workday Cases (LWC)
7 Restricted Workday Cases (RWC)
8 Medical Treatment Cases (MTC)
9 First Aid Cases (FAC)
10 Total Recordable Cases (sum FAT, LWC, MTC, or RWC) (TRC)
11 Near Miss Incidents
12 Fatal Accident Rate (per 108 hours) (FAR)
13 Lost Time Injury Frequency (per 106 hours) (LTIF)
14 Total Recordable Case Frequency (per 106 hours) (TRCF)
15 APISM Incidents
Year -3 Year -4