HS.SAF.09.

F08

CONTRACTOR SITE ACCESS PERMIT

New Renewal Area Change / Additional
1. Contract Details
CLP 1414F – Supply of FTA & ASC 832 Ext -
Contract Number: Contract SAP No:
13.12.2015 28.02.2019
Contract Start Date: Contract End Date:

Peak Workforce: 30 CN000643

EMAL Reg. No:
Scope of Work (Brief): Warranty services for the supplied FTA & ASC

Area of Work: RED CLP PP CH CMS GS ALL

Type of Contract : Manpower Supply Service Provider Contractor

2. Contractor

Company Name: Fives

Company Address: Office 2001, Mazaya Business Avenue, JLT, Dubai, UAE

Telephone: +971 4 329 6291 Fax:

P.O Box No: 337115 Email: Akhil.anantha@fivesgroup.com

3. Contractor Site Representative

Rajesh.pandey@fivesgroup.com
Name: Rajesh Pandey Mob: 056 828 3699 Email:

4. Contractor EHS Representative

Akhil Ananthakrishnan 056 442 6832 Akhil.anantha@fivesgroup.com
Name: Mob: Email:

5. Status Of Pre-Mobilization Requirements:

SUBMITTED PENDING N/A
1. EHS Plan
2. List of Employees
3. List of Equipment/power tools/ machinery
4. List of mobile equipment
5. List of lifting equipment
6. List of Chemicals & their SDS’s (Safety & Data Sheets)
7. Nomination of Contractor H&S Representative
8. Training & Competency Record / Certificates
9. Approved Logistic Plan / Laydown Area drawing
Additional Requirements/ Comments:

6. Approvals
Contractor Contract Owner EMAL Contractor / EHS Security
Coordinator
Requirements Met Entry Allowed Entry Allowed Entry Allowed
YES NO YES NO YES NO Y ES NO
Name: Rajesh Pandey Name: Santhosh Sreenath Name: Name:
Position: Operations Manager EMAL ID: ssreenath@ega.ae EMAL ID: EMAL ID:
Sign: Sign: Sign: Sign:
7. Closure of Permit

Environmental Clearance Name: Sign: Date:

H & S Clearance Name: Sign: Date:

Revision: 1(31-Oct-2012)Page 1 of 1