Form EST2002F-01 v 1.

2 Page 1/2
Statement of Competency
insert This is to verify that Insert Name of INSERT COMPANY NAME ID#      
Company logo
has been assessed and certified in the following competencies required by Senior Signal Engineer Field.
 Signalling competency
under supervision.
that he/she is
able to perform
Design only valid
Safeworking Commissioni while
& LEVEL 2 – the tasks ng Signalling working for
Certified as being covered by the
Qualification able to perform Commissioning ManagerLX Monitor – (Cerberus,
/ Engineer the Broderson, Sears
Competency;
s the identified and that the Tester in Charge Apply Standard nominated
Circuit templates
Rail Signal Engineercompetency
Accreditation supporting      signalling
Commission new/altered Organisation
independently and and
Electrical Eng Degree
without documentation Test/Certify new/altered
Circuitsignalling
Post Grad ... supervision in has been Inspect signalling Testing
infrastructure contracted to
routine activities.
Electrical Lic. (     
received and Points CorrespondenceRelay/ Equipmentor employed
/ Wire analysis
Also competent to recorded. by ARTC or
Investigate Wrongperform
Side Failures-
complex Incidents Track Circuit Correspond
Wire / Null Count / Bell continuity
ARTC relies on Alliance
activities
Disconnect Signalling under
Infrastructure this certification Signal aspect sequence
Strap & Function /Partner.
Through Testing
supervision of a as Function
Authorise / Perform level 3 person. Insulation / Megger Testing
Conditions
Design demonstrating Test to Power Supply Earth leakage
LEVEL 3 – competency
apply for
Documentati Design
Certified as being Site transferring
on Update able to perform (Circuit book)
Ins the
the identified
Documentation Update, Check, Certify Principles (Design Integrity) Testing
pe Competency
competency
Circuit Correlationindependently
Field Checkand Mechanical Interlocking - cti to work with
Interlocking Relay, Electromechanical
on a different
Project without
supervision in all Organisation
Route Set Interlocking s
Manageme activities. Can
Coach others and Signal, L X’ing Sighting/
Processor Interlocking Focusing
This
nt be a team leader. Microlok, Harmon, Westrace, VPI, &Certificate
Track Insulation Bonding is
Project Scope andASSESSOR
Equipment/Systems GeoLogic issued under
Signal Condition/Assessment Inspections
CERTIFICATIO
Project Works Program Level Crossing- Use WMS Defect Systemthe respective
Project ResourcesN.& Staff Auto signals, Relay,Detailed
Processor Rail Safety
Site surveys
The Assessor Legislation
Design Management Coded Track Circuits (
Signalling
hereby Certifies requirements
LEVEL 0 – No LX Monitor – (Cerberus,
certified that details on Standards & Sears for the
Broderson,
knowledge on the this Certificate Signalling Documentati relevant
subject of Competency Equipment on jurisdiction.
LEVEL 1 – have been Test & Certify Write Signal standards
Training assessed in Track Circuits DC, HVI, AF Signal standards
accordance with Review
Exposure. Basic
skill level attained the ARTC Track Circuits (Overlay)
Risk Assess Signals Standards
but requires Standards, Track Circuits Coded ( assess Waivers
Risk
coaching Has Procedures and
knowledge &
Axle Counter (     Conduct Type approvals
Instructions for Point Motor Setup/Adjust
Understanding of
Assessment; Audit Maint/Const Documentation
the Standards. (insert type) Signals Standards Induction
Person may that the
applicant has (     ) This
perform the
demonstrated Maintain certificate is
ETS, OTS, Master Staff & Keys
Assessed by: Applicant’s
Telemetry Acceptance: ARTC Endorsed by:
Assessor’s Signature:       Signature:
Control     
Systems Manager’s Signature:      
Assessor’s Name:       Name:       Manager’s Name:      
Date:       Date:       Date:       Valid Until:      

VER 20/08/03
 Form EST2002F-01 v 1.2 Page 2/2

Statement of Competency
for Insert Name of INSERT COMPANY NAME
as Senior Signal Engineer Field.

insert
Company logo Applicant Agreement to ARTC Standards
A. The Applicant hereby agrees to perform all work in accordance with ARTC Standards, Procedures and
Practices and Instructions. The applicant agrees to maintain access to the ARTC Standards documents by
Applicant Details means of the Engineering Extranet. The applicant agrees to regularly review the recent changes register
Name:       on the Engineering Extranet and to study and apply all new standards and related information in the
performance of work on ARTC infrastructure.
Address:      
B. The Applicant agrees to not perform work for which he/she does not have a valid Certified Competency.
     
      C. The Applicant agrees to maintain a Work Experience Logbook/Record in accordance with ARTC
Competency Standards, for all work undertaken after 1 January 2008 and to make this available for any
Telephone:       future Competency Review.
Insert photo here D. The Applicant agrees to manage access to ARTC infrastructure locations, information and documents. The
applicant agrees to share or distribute this information only in so far as it is required for the approved work
and tasks.
E. The Applicant agrees to comply with any ARTC policy for security of keys for ARTC locations and
equipment. The applicant agrees that any security keys that are applicable to ARTC locations or
equipment will not be lent out for any reason. The applicant further agrees to keep safe these keys and
not to allow them to be copied in any manner.

Applicant Other details assessed Applicant must carry the Track Safety Awareness/Rail Safety Induction card with photo
under other processes/procedures. identification when working on ARTC infrastructure.
Included for information only.
 National Standard for Health Applicant’s Agreement: Witnessed by (Organisation Representative):
Assessment of Rail Safety Worker
Category:      
Valid to:       Signature: Representative’s Signature:

 OHS Induction
Ref #:       Name:       Representative’s Name:      
State:      
 Rail Safety Induction
Date:       Date:      
Ref#:      
Valid to:      
State:      
ID#