HSE Questionnaire prequalification of bidders Model

Contract Title
Company Name
completed by
Function
Signature Dated
To describe
Piece to be
Reply in Reserved for Tuat Project
attached
submission

1. HSE Policy and Procedure

1.1 Does the bidder has a HSE policy? Yes No If answer Yes

1.2 Does the bidder has internal regulations and code of ethics? Yes No If answer Yes

1.3 The tenderer he HSE procedures formalized in a HSE plan? Yes No Yes

2. Risk assessment
2.1 Does the analysis Contractor HSE risks in its business method? Yes No If answer Yes

2.2 The analysis makes it risk being an HSE action plan? Yes No Yes

2.3 Risk assessment HSE bidder is it documented? Yes No Yes

3. Regulation and HSE standards

3.1 The application of the Algerian regulations in HSE is it evaluated? Yes No Yes

3.2 Are Internationnaux standards in HSE considered Yes No Yes

The requirements of the HSE described by the group TouatGaz they correspond If answer Yes
3.3 Yes No
with the HSE requirements of bidders

4. Personal, skills and training

The Contractor has a HSE training matrix applicable to various businesses

4.1 Yes No Yes
bidder?

4.2 Does the contractor has an HSE specialist to monitor operations? Yes No Yes

4.3 The employees of the bidder has specific authorizations relating to HSE? Yes No If answer Yes

5. Internal Communication

5.1 Are the HSE guidelines distributed to staff by a comprehensive fashion by all? Yes No If answer Yes

5.2 Are mangement of safety meetings conducted regularly? Yes No Yes

5.3 Are risk education animations performed by a specialist HSE? Yes No Yes

6. Audit, Control, Inspection

6.1 Is the bidder audited and / or certified on its mangement system HSE? Yes No If answer Yes

A monitoring the proper implementation of HSE requirements is regularly

6.2 Yes No Yes
performed by HSE supervision of a specialist?

6.3 The facilities and equipment used are they regularly checked Yes No Yes

7. Management and Analysis HSE gaps

7.1 Are incidents and accidents analyzed method? Yes No Yes

7.2 Are risk situations identified by staff? Yes No Yes

7.3 An action plan there is to correct gaps in HSE? Yes No If answer Yes

8. HSE Management of subcontractors

8.1 If the bidder uses subcontracting companies, are they identified? Yes No If answer Yes

A prevention plan based on common risk analysis is it establishes with

8.2 Yes No Yes
each subcontractor?
Is the activity staff outsourcing supervised by HSE specialists tenderer or Yes
8.3 No Yes
subcontractor?

9. Environmental aspects

9.1 Does the bidder has a waste management procedure? Yes No If answer Yes

9.2 Does the bidder puts in place a waste traceability system? Yes No Yes

Bidders he systematically applies the protection measures against the risks of

9.3 Yes No Yes
pollution?

Questionnaire bidder 12/21/2019○

 HSE Questionnaire prequalification of bidders Model

Contract Title
Company Name
completed by
Function
Signature Dated
To describe
Piece to be
Reply in Reserved for Tuat Project
attached
submission

10. Management of emergencies

10.1 The overall he bidder staff has insurance for medical coverage Yes No If answer Yes

10.2 He has the tenderer an emergency management plan and medical evacuation? Yes No Yes

Does the bidder staff has the skills and means to ensure the medical
10.3 Yes No Yes
emergency?

11. Management of Health persoennel

He has the staff of medical fitness issued by a company doctor to intervene in

11.1 Yes No If answer Yes
areas of southern Algeria?

11.2 Food safety, food hygiene are they regularly checked Yes No Yes

11.3 Is tenderer's staff with the individual protections? Yes No Yes

12. Reporting and Performance HSE

A minimum annual reporting HSE is regularly provided to management of the
12.1 If answer Yes
bidder? Yes No

12.2 he says regular reporting stock of events and environmental monitoring? Yes No Yes

12.3 Results HSE they are analyzed and therefore an annual action plan HSE? Yes No Yes

Questionnaire bidder 12/21/2019○