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Safe TO Work in Trinidad & Tobago (STOW-TT)

Improving Health, Safety and Environmental Standards among SMEs in the Energy Sector (ATN/ME-9560-TT) COMPONENT III: Implementation of HSE Standards Among SMEs

PROCEDURAL MANUAL

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TABLE OF CONTENTS Introduction.................................................................................................................................................. 3 Grant Funds for Component III ................................................................................................................ 3 Independent Assessor Fees..................................................................................................................... 4 Eligibility....................................................................................................................................................... 4 Selection Criteria ........................................................................................................................................ 5 Procedures for Executing Component III................................................................................................ 6 Advertising Procedure ........................................................................................................................... 6 Application and Selection Procedures ................................................................................................ 7 Documents for use in Component III:.................................................................................................. 8 Procedures for Implementing the STOW-TT requirements ............................................................. 9 Procedures for Auditing Companies..................................................................................................10 Procedures for Payment of Grant Resources to SMEs..................................................................11 Flow Charts of Procedures for Executing Component III...............................................................13 Flow Chart for Implementation of the STOW-TT Minimum HSE Requirements .................... 13 Flow Chart for Auditing SMEs ........................................................................................................14 ENERGY CHAMBERs Internal Controls .........................................................................................15 APPENDIX 1.............................................................................................................................................17 Application for Grant Form..................................................................................................................18 Accessing ENERGY CHAMBERS Online Local Content Questionnaire....................................20 Accessing the STOW-TT Online HSE Management System (HSE MS) Self Check Questionnaire........................................................................................................................................21 Incident Profile ......................................................................................................................................22 APPENDIX 11...........................................................................................................................................23 Memorandum Of Understanding........................................................................................................24 Consulting & Confidentiality Agreement ...........................................................................................29 Terms of Reference for Independent Assessors - Implementation ..............................................34 Terms of Reference for Independent Assessors - Auditing...........................................................37 Reimbursement Request Form ..........................................................................................................40

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Introduction
The purpose of this manual is to provide the guidelines on how Component III of the Safe TO Work in Trinidad & Tobago (STOW-TT) project is to be implemented. STOW-TT is seeking to level the playing field for small and medium sized enterprises (SMEs) in Trinidad & Tobagos energy services sector by creating industry wide health, safety and environmental (HSE) requirements for prequalifying contractors; and by assisting contractors to meet the uniform HSE requirements. In Component I of the project, the STOW-TT Minimum HSE Requirements were developed and accepted among the major operating companies as the standard for prequalifying contractors. In Component II, HSE Professionals were trained to work as Independent Assessors to assist contractors seeking certification to the STOW-TT Minimum HSE Requirements. Component III tests the work of the Independent Assessors and the STOW-TT certification system on a pilot group of approximately 30 small and medium sized enterprises (SMEs). Independent Assessors trained in Component II will advise the selected SMEs on how to implement the STOW-TT requirements and will then audit the SMEs for compliance with the requirements. Independent Assessors will not be allowed to advise a company on how to implement the STOW-TT requirements and also audit the same companys level of compliance with these standards. STOW-TT targets companies providing services to the energy sector including but not limited to companies involved in operations such as landscape gardening and grounds maintenance, maintenance of administrative buildings, cargo transport, painting and diving as well as companies involved in lifting and drilling operations. Implementation and certification will commence with eight (8) small and medium sized enterprises (SMEs), selected from the membership of the Energy Chamber, followed by a wider group of 22 SMEs.

Grant Funds for Component III


Initial Group of Companies For the eight (8) SMEs selected to participate in the initial group, the project will consider a grant of 50% of the Independent Assessors commercial fees up to a maximum of $TT30,000/SME to implement the STOW-TT Minimum HSE Requirements. Additionally, the project will consider a grant of 50% of the Independent Assessors commercial fees up to a maximum of $TT12,000/SME to audit SMEs to the requirements.

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Wider Group of Companies For the twenty-two (22) SMEs selected to participate in the wider group, the project will consider a grant of 30% of an Independent Assessors commercial fees up to a maximum of $TT18,000/SME to advise the selected SMEs on the implementation of the STOW-TT Minimum HSE Requirements. Further, the project will consider a grant of 30% of an Independent Assessors commercial fees up to a maximum of $TT 7,200/SME to audit the level of an SMEs compliance with the STOWTT Minimum HSE Requirements.

Independent Assessor Fees


The Energy Chamber will be selecting from Independent Assessors who have gone through rigorous training and have been authorized to work with SMEs on behalf of the STOW Implementation Board. For quality control and to expose all trained and authorized Independent Assessors to the STOW-TT certification process, the Energy Chamber will assign Independent Assessors to SMEs during the pilot. Outside the pilot phase, SMEs are free to select an Independent Assessor of their choice from a list authorized by the STOW Implementation Board. All Independent Assessors must sign an agreement with the Energy Chamber prior to being assigned to an SME. The agreement makes explicit provision for the Energy Chamber to provide oversight for the consultancy and to review and sign off on the deliverables of the consultancy along with a member of the STOW Implementation Board. Two classifications of Independent Assessors have been accredited to participate in the advisory and audit process i.e. Independent Assessor and Senior Independent Assessor. The Independent Assessor is only authorized to certify companies at the lowest level (low risk) of certification, while the Senior Independent Assessor is permitted to certify companies at all levels (low, medium, high risk) of certification. Detailed information on the certification levels can be found in the STOW-TT Administration Manual at www.stowtt.energy.tt The fee structure for Independent Assessors during the pilot is as follows:($TT/ day) Senior Independent Assessor Independent Assessor $2,500.00 up to a maximum of $3,000.00 $1,500.00 up to a maximum of $2,000.00

Eligibility
Companies meeting the following requirements may apply for the grant:-

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1. 2. 3.

Companies owned, controlled and operated by Trinidad & Tobago nationals Companies with gross annual sales of less than or equal to $TT 40.0 million Companies with that are able and committed to providing counterpart (own) funds to become certified to the STOW-TT Minimum HSE Requirements The first eight (8) companies must be members of the Energy Chamber for at least 2 years.

4.

The STOW-TT Project Office at the Energy Chamber will verify that each applicant meets these requirements before evaluating the applicant against the selection criteria. Applicants that do not meet these requirements will not be considered for the grant. Applicants must provide the following as proof that they are eligible for the grant: Proof of companys incorporation in Trinidad & Tobago Audited financial statements for 2007 and 2008 Financial capability statement from the SMEs Bank or letter from the SMEs Chief Executive Officer or equivalent stating that funds are available and have been committed for certification to the STOW-TT Minimum HSE Requirements The STOW-TT Project Office will verify the applicants membership from the Energy Chambers records.

Selection Criteria
Eligible SMEs will be selected based on the following criteria: Criteria A. Percentage of sales to the energy sector (max 20 points) < 50% 50 69% 70 89% 90 - 99% 100% B. Track record of prequalification for work with any of the major upstream and downstream operating companies over the past 10 years (max 20 points):>1 year 1-3 years 4-6 years 7-10 years C. Companys Local content score (max 20 points) < 50% Max Score

0 5 10 15 20

3 8 12 20 0 Page 5 of 40

50 69% 70 89% 90 - 99% 100% D. Status of Companys HSE Management System (max 40 points) <65% compliant 65-<70% compliant 70-<75% compliant 75-<80% compliant Total Points for five (5) criteria

5 10 15 20

0 20 30 40 100

Procedures for Executing Component III


Advertising Procedure
Initial Group of companies The Energy Chamber will advertise the opportunity directly to its energy services members via email, the Energy Chambers weekly e-newsletter, and the STOW-TT website at www.stowtt.energy.tt. The advertisement will outline the eligibility requirements presented on page 4 of this Manual and will state that only companies meeting the requirements will be allowed to participate as beneficiaries under Component III of the project. Interested companies will be asked to download the application form (Appendix I) from the STOW-TT webpage at www.stowtt.energy.tt. Follow-up telephone calls will be made and reminder emails sent to ensure that all eligible members are aware of the opportunity and the deadline. The application documents include an application form, the online STOW-TT HSE Management System Self Check Questionnaire to assess the state of the companys HSE Management System and the Energy Chambers online Local Content Questionnaire. The application form and the instructions to access the online questionnaires are included in Appendix I. Companies will have two weeks to apply from the date of the first advertisement. Wider group of companies The Energy Chamber will advertise the opportunity in the daily newspapers and the STOW-TT website at www.stowtt.energy.tt, asking interested and eligible companies to download the application documents (Appendix I) from the STOW-TT webpage at www.stowtt.energy.tt. The advertisement will outline the eligibility requirements presented on page 4 of this Manual and

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will state that only companies meeting the requirements will be allowed to participate as beneficiaries under Component III of the project. The application documents include an application form, the online STOW-TT HSE Management System Self Check Questionnaire to assess the state of the companys HSE Management System and the Energy Chamber online Local Content Questionnaire. The application form and the instructions to access the online questionnaires are included in Appendix I. Companies will have two weeks to apply from the date of the first advertisement.

Application and Selection Procedures


1. Interested companies must complete and return the following application documents to the Energy Chambers Executive Office by the stipulated deadline: a. Application Form (App-Form at Appendix I) b. Energy Chambers Local Content questionnaire. N.B. This questionnaire is online at www.energy.tt (See LC-QUEST at Appendix I for Instructions) c. STOW-TT HSE Management System Self Check Questionnaire N.B. This questionnaire is online at www.energy.tt (See HSEMS-QUEST at Appendix I for Instructions) d. Companys Incident Profile (See SAFETY-FORM at Appendix I) Items (a) and (d) MUST be signed by the Chief Executive Officer of the SME or equivalent. 2. All applications must be accompanied by the following supporting documents: Proof of companys incorporation in Trinidad & Tobago All documented evidence e.g. letters from major oil and gas companies, of having been prequalified under HSE to conduct work over the past 10 years Companys Organization Chart Companys HSE Management System Documentation / HSE Manual Audited financial statements for 2007 and 2008 Financial capability statement from the SMEs Bank or letter from the SMEs Chief Executive Officer (or equivalent) stating that funds are available for certification to the STOW-TT requirements All applications (with supporting documents) must be returned to the STOW-TT Project Office, at the Energy Chambers Executive Office in a sealed envelope clearly marked STOW-TT SME Grant Application before the deadline. The application should be sent to: The STOW-TT Project Coordinator Suite B2.03 Atlantic Plaza Atlantic Avenue Point Lisas

3.

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Electronic applications will be accepted and can be sent to: natalie@energy.tt and keina@energy.tt. 4. Hard copy applications reaching the Energy Chambers Executive Office after the deadline for receipt of applications will not be considered and will be returned to the sender unopened. Electronic applications reaching the Energy Chambers Executive Office after the deadline for receipt of applications will not be considered and the applicant will be informed accordingly by email. An evaluation committee comprising several members of the STOW Implementation Board will review each application to confirm compliance with defined eligibility requirements presented on page 4 of this Manual. Eligible applications will be scored according to the defined selection criteria presented on page 5 of this Manual. Applications received without the necessary supporting documents as stated in Item 2 above will not be considered and the STOW-TT Project Office will notify the SME accordingly by letter. Companies will be selected based on their final score. In the initial group, the top eight (8) companies (based on final score) will be invited to participate in Component III of STOWTT. In the wider group, the top twenty-two (22) companies will be invited to participate in Component III of STOW-TT.

5.

6.

7.

8.

9. If a selected SME is found to have provided inaccurate information or falsified records, the SME will be disqualified from receiving the grant and the next highest scoring company will be included for the grant. The Energy Chamber will also take legal steps to recover any money disbursed to an SME who is found to have provided inaccurate information or falsified records. 10. Selected SMEs will be informed via a letter from the STOW-TT Project Office and will be invited to sign a Memorandum of Understanding (MOU at Appendix 11) with the Energy Chamber 11. The ENERGY CHAMBER is not obliged to accept any application

Documents for use in Component III:


The following documents formalize the terms for (a) SMEs to participate as Beneficiaries and (b) for Independent Assessors to advise / audit SMEs under Component III. Samples of these documents are provided in Appendix II. Page 8 of 40

1. Memorandum of Understanding between the Energy Chamber and SME (MOU). This MOU sets out the terms for the SME to participate as a Beneficiary of grant funds under Component III of the project. All SMEs selected as Beneficiaries under Component III will be invited to sign the MOU with the Energy Chamber prior to implementation of the STOWTT Minimum HSE Requirements. 2. Consulting & Confidentiality Agreement (CONSUL-AGREE). This contract between the SME and Independent Assessor sets out the terms and conditions for the Independent Assessor to advise/ audit an SME on implementation of the STOW-TT requirements or audit an SMEs level of compliance with the STOW-TT requirements and is to be signed before the start of the consultancy. 3. Terms of Reference (TOR) for implementing the STOW-TT requirements (TOR-IMP). The TOR will be incorporated in the Consulting & Confidentiality Agreement (CONSUL-AGREE) between the SME and the Independent Assessor. 4. Terms of Reference (TOR) for auditing the SME against the STOW-TT Minimum HSE Requirements (TOR-AUD). The TOR will be incorporated in the Consulting & Confidentiality Agreement (CONSUL-AGREE) between the SME and the Independent Assessor. 5. Request for Reimbursement form for use by the SME to receive the grant funds (REQFORM).

Procedures for Implementing the STOW-TT requirements


The time frame for implementing the STOW-TT Minimum HSE Requirements in an SME is not fixed and will depend on a number of factors including the type of operation and number of processes, the size of the company and the extent to which the companys current HSE Management System is consistent with the STOW-TT Minimum HSE Requirements. The Independent Assessor and the Energy Chamber will agree on the actual timeframe for the consultancy (implementation). Implementation is expected to take no more than 20 consulting days over a 6 month period since the criteria for selection of SMEs are weighted more towards applicants whose current level of compliance to the STOW-TT Minimum HSE Requirements is 65% - <80%, based on the STOW-TT HSE Management System Self Check Questionnaire. This will ensure that the Energy Chamber achieves the targets set out in the projects logframe. To implement the STOW-TT Minimum HSE Requirements in an SME: 1. The Energy Chamber will prepare a schedule for Independent Assessors to work with SMEs. The Energy Chamber will inform each Independent Assessor of their schedule and the SME to which they are assigned.

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2.

The Independent Assessor will scan the SMEs application (including supporting documents) to determine: If he/ she will accept the consultancy The number of consulting days and time period for completing the consultancy If the Independent Assessor does not accept the consultancy, another Independent Assessor will be assigned by the Energy Chamber. If the Independent Assessor accepts the consultancy and there is agreement on the time frame, the Independent Assessor would sign the Consulting and Confidentiality Agreement (CONSUL-AGREE in Appendix II) with the SME. The Independent Assessor will undertake the consultancy as outlined in the Terms of Reference for implementing the STOW-TT requirements (TOR-IMP in Appendix II). The Energy Chamber will provide oversight for the implementation of STOW-TT Minimum HSE Requirements and will review and sign off on the deliverables outlined in the Terms of Reference (TOR) for implementing the STOW-TT requirements (TOR-IMP in Appendix II) along with a member of the STOW Implementation Board. SMEs will forward an updated HSE Management System Documentation/ HSE Manual to the STOW-TT Project Office within a 2 month period after implementation of the STOW-TT requirements.

3.

4.

5.

6.

7.

Procedures for Auditing Companies


The timeframe for auditing is not fixed and the Independent Assessor and the Energy Chamber will have to agree on the actual timeframe for the consultancy (audit). The audit is expected to take no more than 5 consulting days. To Audit an SME: 1. The Energy Chamber will schedule an Independent Assessor to work with an SME and the Independent Assessor will scan the SMEs application and updated HSE Management System Documentation/ HSE Manual to determine: If he/ she will accept the consultancy The number of consulting days to complete the consultancy If the Independent Assessor does not accept the consultancy, another Independent Assessor will be assigned by the Energy Chamber. If the Independent Assessor accepts the consultancy and there is agreement on the timeframe for the audit, the Independent Assessor will sign the Consulting and Confidentiality Agreement (CONSUL-AGREE in Appendix II) with the SME. Page 10 of 40

2.

3.

4.

The Independent Assessor will undertake the consultancy as outlined in the Terms of Reference for auditing the SME against the STOW-TT Minimum HSE Requirements (TORAUD in Appendix II). The Energy Chamber and a member of the STOW Implementation Board will review the Independent Assessors audit report and document satisfaction with the process. The STOW Implementation Board will either issue the STOW-TT certificate of compliance to the SME or direct the STOW-TT Project Office to send the SME a copy of the Independent Assessors report explaining why the certificate will not be issued.

5.

6.

N.B. An Independent Assessor will not be allowed to implement the STOW-TT Minimum HSE Requirements in a SME and audit the same SME for compliance to the STOW-TT Minimum HSE Requirements.

Procedures for Payment of Grant Resources to SMEs


The SME is expected to pay the Independent Assessor in full for satisfactory completion of the consultancy, in accordance with the contract for delivery of these services. The SME will then request reimbursement of the amount paid from the Energy Chamber, up to the maximum value provided under this grant facility as presented on page 3 of this Manual. 1. The Energy Chamber proposes the following payment structure for Independent Assessors selected to assist SMEs in implementing the STOW-TT Minimum HSE Requirements: i. ii. iii. iv. (vi) 10% of contract amount when the Consultant signs the contract 15% of contract amount upon submission of a comprehensive gap analysis, bridging document and Action Plan. 50% of contract amount upon submission of the report indicating successful implementation of the STOW-TT Minimum HSE Requirements. 25% of contract amount when a certificate of compliance is issued at the end of an audit The Energy Chamber proposes that the Independent Assessor forfeit the remaining 25% of fees due if a STOW-TT certificate is not issued at the end of the audit.

2. The following payment structure is proposed for Independent Assessors selected to audit an SMEs compliance to the STOW-TT Minimum HSE Requirements:i. ii. 10% of contract amount quoted fees when the Consultant signs the contract. 40% of the contract amount upon submission of a comprehensive report on the audit process and findings

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iii.

50% of contract amount upon review and signoff by the Energy Chamber and a member of the STOW Implementation Board

3. The Independent Assessor must provide the SME with original invoices according to the schedule outlined above and the SME will pay the Assessor accordingly. 4. The SME will then forward the following documents to the Energy Chamber for reimbursement of funds:i. Completed Request for Reimbursement Form (Appendix II) for 50% of the total amount paid to the Independent Assessor (initial group of 8 companies) up to the maximum defined on Page 3 of this Manual or 30% of the total amount paid to the Independent Assessor (wider group of companies) up to the maximum defined on Page 4 of this Manual. ii. Copies of supporting documents i.e. the Independent Assessors invoices and proof of payment to the Independent Assessor by the SME in the form of copies of cancelled cheques or receipts from the Independent Assessor.

5. The Energy Chamber will pay the SME within 30 days of receiving the disbursement request, subject to signoff of the contract deliverables by the Energy Chamber and a member of the STOW Implementation Board and receipt of supporting documents as outlined above. 6. A list of certified SMEs will be forwarded to the IADB.

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Flow Charts of Procedures for Executing Component III


Flow Chart for Implementation of the STOW-TT Minimum HSE Requirements
SME applies for Grant ENERGY CHAMBER Assess application SME Eligible
Y N

ENERGY CHAMBER

LEGEND:IA MOU SME STOWIB

Independent Assessor Memorandum of Understanding Small & medium sized enterprises STOW Implementation Board

ENERGY CHAMBER evaluates against selection criteria ENERGY CHAMBER evaluates against selection criteria SME Selected
Y N

ENERGY CHAMBER Informs SME

SME signs MOU with ENERGY CHAMBER


ENERGY CHAMBER ENERGY

CHAMBER IA scans application documents


Y N

IA accepts Consultancy
Y

ENERGY CHAMBER assigns

SME & IA sign contract SME pays IA 10% of fees IA submits satisfactory initial reports & SME pays IA 15% of fees IA submits satisfactory final report & SME pays IA 50% of fees IA forfeits 25% of fees
N

SME certified
Y

SME pays IA 25% of fees SME submits reimbursement request to ENERGY CHAMBER with supporting
N

ENERGY CHAMBER & STOWIB


Y

ENERGY CHAMBER refuses

ENERGY CHAMBER reimburses SME

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Flow Chart for Auditing SMEs


ENERGY CHAMBER

assigns IA
LEGEND:IA MOU SME STOWIB Independent Assessor Memorandum of Understanding Small & medium sized enterprises STOW Implementation Board

IA scans application documents


Y

IA accepts Consultancy
Y

ENERGY CHAMBER assigns

SME & IA sign contract SME pays IA 10% of fees IA submits audit report & SME pays IA 40% of fees ENERGY CHAMBER & STOWIB signoff on audit report & SME pays IA 50% of fees SME submits reimbursement request to ENERGY CHAMBER with supporting documents ENERGY CHAMBER refuses

N ENERGY CHAMBER & STOWIB signoff

ENERGY CHAMBER reimburses SME

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ENERGY CHAMBERs Internal Controls


The STOW-TT Project Office Unit will maintain: 1. Copies of all Independent Assessor deliverable reports outlined in the Terms of Reference for Independent Assessors (TOR-IMP and TOR-AUD at Appendix 11) 2. Copies of all certificates issued to SMEs 3. A database of companies certified using the following format: Name of SME Date Certified Certificate Issued by Expiry date of Certificate Relevant Notes The Energy Chamber Accounting Technician will maintain: 1. The financial transactions in Peachtree Accounting Software 2. Copies of all contracts to be financed under Component III 3. A proper filing system of disbursement requests and supporting documents organized by contract 4. A spreadsheet of the financial transactions in the following format: Name of SME Amount of Grant Amount Disbursed Amount Remaining Procedures: 1. The STOW-TT Project Coordinator will approve completed reimbursement requests subject to: Receipt of supporting documents (copies of the Independent Assessors invoice and proof of payment to the Independent Assessor) and - Sign off on deliverables by the Energy Chamber and a member of the STOW Implementation Board. The STOW-TT Project Office will forward a memo signed by the STOW-TT Project Coordinator and a STOW Implementation Board member to the Energy Chamber Accounts Department verifying satisfactory completion of the consultancy 2. The STOW-TT Project Coordinator will submit the approved reimbursement request and supporting documents to the Energy Chamber Accounting Technician for payment 3. The Energy Chamber Accounting Technician will prepare a cheque and payment voucher 4. The Manager, Finance and Administration will review the cheque and payment voucher for accuracy 5. The Manager Finance and Administration and / or any member of the Energy Chambers Executive Council will sign the cheque

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6. The Energy Chambers Accounting Technician will verify that transaction is completed by reviewing financial report and bank statement 7. The Energy Chambers Accounting Technician will advise company to: issue receipt to Energy Chamber for monies received Turnaround time: Within 30 days of receiving the disbursement request

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APPENDIX 1

LIST OF APPLICATION DOCUMENTS

1. Application for Grant Form (APP-FORM) 2. Accessing ENERGY CHAMBERs Online Local Content Questionnaire (LCQUEST) 3. Assessing the STOW-TT Online HSE Management System (HSE MS) Self Check Questionnaire (HSEMS-QUEST) 4. Companys Incident Profile

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APP-FORM Safe TO Work in Trinidad & Tobago (STOW-TT)

Application for Grant Form


Company Name: ______________________________________________________________________ Company Address:____________________________________________________________________ Tel: ______________________ Fax:_________________ Email:_______________________________ Contact Name: ______________________________ Position: _________________________________ Services Offered: ____________________________________________ No. of Sites: ___________

Address of other site(s) to be certified: _____________________________________________________ The company does work: Onshore Offshore Onshore & Offshore

Level of Certification Requested : Low Risk Medium Risk High Risk (See the STOW-TT Minimum HSE Requirements Administration Manual at www.stowtt.energy.tt for details on levels of certification) Annual Sales ($USD):________________________ A. ENERGY CHAMBER Member: Yes No If yes, how long: _____________year(s)

B. Companys income is generated from business with: (Please tick all that may apply) BG T&T Powergen BHP Billiton Nu Iron bpTT PCS Nitrogen Canadian Superior Phoenix Park Gas Processors Ltd EOG Resources Shell Kerr McGee Yara Trinidad Ltd. National Gas Company (NGC) Industrial Plant Services Ltd Petrotrin Industrial Gases Ltd Petro Canada T&T Ltd Atlantic LNG Primera Methanex Repsol YPF Air Liquide Trinity Power National Training Agency Arcelor Mittal Other Energy Operating Companies (Please list)_____________________________________________ ___________________________________________________________________________________ Percentage of companys total income from business with companies selected above:______ C. Companys Employee Profile: (Please submit the companys organizational chart) No. % T&T Nationals % Non Nationals Board Members Executive Staff Professional Staff Technical Staff Secretarial/ Administrative Other Support Staff

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Total Number of Employees: Has the company been visited by the Trinidad & Tobago Occupational Safety and Health (TTOSHA) or any other HSE regulatory body over the last 5 years? Yes No

Is the company Trinidad & Tobago Occupational Safety and Health (TTOSHA) compliant? Yes

No

In signing below, I declare that all information provided on this application for grant under the Safe TO Work initiative as well as the supporting documentation are correct and in no way falsified. I acknowledge that falsification of information will result in disqualification from being considered for the grant and should any disbursements be made to my company, the ENERGY CHAMBER will initiate legal action to recover the amount disbursed.

Company Representative:_____________________________ Name (Block Letters) ______________________ Job Title __________________________ email

____________________________ Signature _______________________ telephone /cell

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LC-QUEST Safe TO Work in Trinidad & Tobago (STOW-TT)

Accessing ENERGY CHAMBERS Online Local Content Questionnaire


Please visit the ENERGY CHAMBERs Energy Services Database webpage at http://www.energy.tt/questionnaire and verify on the alphabetical listing of companies whether your company is already listed in the Energy Services Database. Instructions for Contractors who are NOT listed in the Energy Services Database Visit the Energy Services Database webpage at http://www.energy.tt/questionnaire On the left panel of the Homepage click Apply for an Account Complete the Application Form and click Submit at the bottom of the screen Upon clicking Submit you will get the following message Thank you for submitting your application. You will be contacted by the Chamber within 48 hours 5. The ENERGY CHAMBER will email you a username and password within 48 hours 6. Visit the Energy Services Database webpage at http://www.energy.tt/questionnaire 7. On the left panel of the Homepage, select Log in 8. In the login window, enter the username and password provided by the ENERGY CHAMBER 9. Select Edit My Profile on the left panel 10. Ensure that you check the box at the top next to the statement I certify that I am an authorised official of this company with the authority to update the information included. If you do not your information will not be saved 11. Scroll down to the bottom of the screen and complete the local content questionnaire. 12. Click Update Company to automatically generate your local content score and save your information. Instructions for Contractors who are already listed in the Energy Services Database 1. 2. 3. 4. Visit the Energy Services Database webpage at http://www.energy.tt/questionnaire On the left panel of the Homepage, select Log in In the login window, enter the username and password provided by the ENERGY CHAMBER Select Edit My Profile on the left panel Ensure that you check the box at the top next to the statement I certify that I am an authorised official of this company with the authority to update the information included. If you do not your information will not be saved Scroll down and complete the local content questionnaire. Click Update Company to automatically generate your local content score and save your information. 1. 2. 3. 4.

5. 6.

N.B. If you are already listed in the Energy Services Database and have forgotten your username and/or password, please call/ email Keina at 679-4784 or keina@energy.tt at the Energy Chamber. Page 20 of 40

HSEMS-QUEST Safe TO Work in Trinidad & Tobago (STOW)

Accessing the STOW-TT Online HSE Management System (HSE MS) Self Check Questionnaire
Please visit the ENERGY CHAMBERs Energy Services Database webpage at http://www.energy.tt/questionnaire and verify on the alphabetical listing of companies whether your company is already listed in the Energy Services Database. Instructions for Contractors who are NOT listed in the Energy Services Database Visit the Energy Services Database webpage at http://www.energy.tt/questionnaire On the left panel of the Homepage click Apply for an Account Complete the Application Form and click Submit at the bottom of the screen Upon clicking Submit you will get the following message Thank you for submitting your application. You will be contacted by the Chamber within 48 hours 5. The ENERGY CHAMBER will email you a username and password within 48 hours 6. Visit the Energy Services Database webpage at http://www.energy.tt/questionnaire 7. On the left panel of the Homepage, select Log in 8. In the login window, enter the username and password provided by the ENERGY CHAMBER 9. Select STOW-TT Questionnaire on the left panel 10. Read the instructions on completing the questionnaire then scroll down to the bottom of the screen and click Start Questionnaire. 11. Complete the questionnaire, fill in name of person completing the questionnaire, position, email and telephone number, then click Submit. 1. 2. 3. 4.

Instructions for Contractors who are already listed in the Energy Services Database 1. 2. 3. 4. 5. 6. Visit the Energy Services Database webpage at http://www.energy.tt/questionnaire On the left panel of the Homepage, select Log in In the login window, enter the username and password provided by the ENERGY CHAMBER Select STOW-TT Questionnaire on the left panel Read the instructions on completing the questionnaire then scroll down to the bottom of the screen and click Start Questionnaire. Complete the questionnaire, fill in name of person completing the questionnaire, position, email and telephone number, then click Submit.

N.B. If you are already listed in the Energy Services Database and have forgotten your username and/or password, please call/ email Keina at 679-4784 or keina@energy.tt at the Energy Chamber. Page 21 of 40

SAFETY-FORM

Safe TO Work in Trinidad & Tobago (STOW-TT)

Incident Profile
Please state the companys safety record over the last three years (2007-2010):No. of fatalities: Date of last fatality: No. of lost time injuries: No. of near misses: ___________________________ ____________________________ ____________________________ ____________________________

Company Representative:_____________________________ Name (Block Letters) ______________________ Job Title __________________________ email

____________________________ Signature _______________________ telephone /cell

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APPENDIX 11

LIST OF DOCUMENTS

1. Memorandum of Understanding (MOU) 2. Consulting & Confidentiality Agreement (CONSUL-AGREE) 3. Terms of Reference for Independent Assessors Implementation (TOR-IMP) 4. Terms of Reference for Independent Assessors Auditing (TOR-AUD) 5. Reimbursement Request Form (REQ-FORM)

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MOU Safe TO Work in Trinidad & Tobago (STOW-TT)

Memorandum Of Understanding
Between the Energy Chamber AND [Insert Beneficiary Name] This Memorandum of Understanding (the MOU) between the Energy Chamber (the Chamber) with offices at Suite B2.03 Atlantic Plaza, Atlantic Avenue, Point Lisas, Trinidad; and [SME Name] (the Beneficiary) with offices at [SME ADDRESS], is to formalize the terms for receiving a grant towards certification to the Safe TO Work in Trinidad and Tobago (STOWTT) Minimum HSE requirements. In April 2006, the Energy Chamber was awarded a grant of $US 415,000 from the InterAmerican Development Banks Multilateral Investment Fund to be used to finance the contracting of consulting services and procurement of goods necessary for the execution of the Safe TO Work in Trinidad and Tobago (STOW-TT) project. The project seeks to improve the health, safety and environmental (HSE) standards among smaller energy service contractors by creating industry-wide HSE requirements to prequalify service contractors for work with the major oil and gas companies; and by assisting smaller energy contractors seeking certification to the requirements. The STOW-TT Minimum HSE Requirements were created under Component I of the STOW-TT project. Under Component II, HSE professionals were trained as Independent Assessors or consultants, to assist contractors to become certified to the requirements. The Energy Chamber is now at Component III of the project and will assist a pilot group of 30 small and medium sized companies (SMEs) seeking certification to the STOW-TT Minimum HSE Requirements. The Beneficiary has been selected to be among the pilot companies and will work with the Chambers Independent Assessors (the Consultant) to achieve certification. The Energy Chamber will utilize a portion of the grant funds to offset a percentage of the fees charged by the Consultants.

The Chamber and the Beneficiary agree upon the following:Article 1 Objectives of MOU The objective of this MOU is to facilitate the certification of the Beneficiary to the STOW-TT Minimum HSE Requirements.

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Article 2 Components of the MOU Appendix A and B shall be incorporated in and shall be deemed to be a part of this MOU. Article 3 General Obligations of the Parties 1. To carry out their respective responsibilities in the spirit of the provisions of this MOU. The parties agree to maintain close working relationships in order to achieve the objective of this MOU. Each Party will refrain from any action that may adversely affect the interest of the other Party and will fulfill its commitments with fullest regard for the terms of this MOU. The Parties are committed to resolving any disagreements under this MOU through negotiation between the Parties. The designated Chamber representative responsible for the coordination of activities under this MOU is: Natalie Reece, STOW-TT Project Coordinator, Project Implementation Unit The authorized Beneficiary representative responsible for the coordination of activities under this MOU is: [Insert Beneficiary Representative Name & Job Title], Each Party agrees to inform the other in writing of any change in the named representative. Article 4 Obligations of the Chamber 1. The Chamber will provide to the Beneficiary an Independent Assessor (Consultant) to advise the Beneficiary on implementing the STOW-TT Minimum HSE Requirements and another Independent Assessor to audit the Beneficiary. The cost of the Consultants services will be initially borne by the Beneficiary. Such services shall include all tasks in Appendix A Description of Work and Services which is incorporated in the Consulting & Confidentiality Agreement (the Contract) between the Beneficiary and the Consultant. The Chamber will reimburse the Beneficiary fifty percent (50%) of the amount paid to the Consultant up to a maximum of $TT 30,000 for implementation and $TT 12,000 for the audit. Reimbursement will be subject to signoff by the Chamber and a member of the STOW Implementation Board of the Consultants deliverables outlined in Appendix A Description of Work and Services which is incorporated in the Consulting & Confidentiality Agreement between the Beneficiary and the Consultant. The Chamber Page 25 of 40

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agrees to reimburse the Beneficiary within 30 days of receipt of a completed Request for Reimbursement Form accompanied by copies of the Consultants invoices and proof of payment in the form of cancelled cheques or receipts from the Consultant. All other costs associated with becoming certified to the STOW-TT Minimum HSE Requirements will be the responsibility of the Beneficiary. 4. The Chamber will provide oversight for the consultancy. This includes monitoring the progress of the work of the Consultant, obtaining feedback from the Beneficiary, and recommending mutually beneficial resolutions to issues that may arise. (a) The Chamber may cancel the grant if it determines that representatives of the Beneficiary have committed (1) corrupt practices including, but not limited to bribery, extortion, coercion, fraud or collusion, or (2) it is unlikely that the objectives of this MOU will be achieved. (b) The Parties agree that should there be institutional or organizational changes within the Beneficiary, which in the Chambers opinion may affect the timely execution of the MOUs objectives, the Chamber shall review and evaluate the likely attainment of the objectives and may at its discretion, suspend, condition or cancel the grant. 6. Subject to recommendation of the Consultant and authorization by the STOW Implementation Board, the Chamber will issue a STOW-TT certificate of compliance to the Beneficiary, which will be valid for a period of two years from the date of the certificate. The Chamber reserves the right to conduct random surveillance audits at its own expense between certification periods to ensure that the STOW-TT HSE requirements are still in effect in the Beneficiarys operations. The Chamber also reserves the right to disclose non compliance with the STOW-TT HSE requirements to the public and cancel the Beneficiarys certification. The Chamber will keep a copy of the certificate and database of certified companies which it will make public on its website at www.stowtt.energy.tt. Article 5 Obligations of the Beneficiary 1. The Beneficiary certifies that the information provided in the Beneficiarys Application for Grant Form, in the Local Content questionnaire, the STOW-TT HSE Management System (HSE MS) Self Check Questionnaire, and the supporting documents submitted, are true and correct to the best of its knowledge and agrees to abide by the terms and condition of the Grant programme, including payment of Consultant fees. The Beneficiary agrees to sign the Consulting & Confidentiality Agreement with the Consultant and abide by the terms of the Contract. Page 26 of 40

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The Beneficiary agrees to establish an internal health, safety and environment committee which will be responsible for working with the Consultant and ensuring that the Consultants recommendations are put into effect. The Beneficiary agrees to have its Chief Executive Officer attend a one day session on the pilot programme to ensure that there is support for the certification of the Beneficiary at executive level of the company. The Beneficiary agrees to make timely provision of the resources required for complete and uninterrupted implementation and certification of the Beneficiary to the STOW-TT Minimum HSE Requirements. These resources include financial resources to cover the Consultants fees and financial resources to implement recommendations of the Consultant, as well as allocation of staff and other resources to ensure that the company is certified to the STOW-TT Minimum HSE Requirements. The Beneficiary agrees to give the Consultant access to its health, safety and environmental (HSE) records and documents and any other information requested that relates to the consultancy. The Beneficiary agrees to make staff available to the Consultant for interviews, questions and requests for information. The scheduling of such meetings will be coordinated ahead of time. The Beneficiary agrees to desist from rescheduling meetings with the Consultant unless an emergency arises. The Beneficiary will be held liable for non performance of its obligations under this MOU which prevent or delay the performance of the Consultant in achieving the objectives of the MOU. Sanctions may include cancellation of the grant and the Beneficiary receiving no reimbursement from the Chamber for fees already paid to the Consultant. The Beneficiary agrees to willingly share the experience as a part of the pilot and participate in contractor sessions advocating the STOW-TT initiative. The Beneficiary agrees that the Energy Chamber is joint owner of documents and deliverables of the Consultant under the Consulting and Confidentiality Agreement partially financed with the grant from the Chamber. The Beneficiary is accountable for ensuring that the Consultant adheres to his/ her obligations under the Consulting and Confidentiality Agreement and is timely in producing all deliverables. The Beneficiary undertakes to inform the Chamber of non performance of the Consultant. The Beneficiary agrees to refrain from corrupt practices as defined in Article 4, paragraph 5 (a) (1) of this MOU.

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The Beneficiary agrees to provide the Chamber with feedback on Consultants including unprofessional conduct by the Consultant. The Beneficiary agrees to pay the Consultants fees according to the schedule Consultant Fees outlined in Appendix B Consultants Fees which is incorporated in the Consulting and Confidentiality Agreement between the Beneficiary and the Consultant. The Beneficiary will have the STOW-TT Minimum HSE Requirements in effect for a period of two years after implementation and certification.

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This Memorandum of Understanding is executed this ____________ day of _________ 2009 by the undersigned, acting through their duly authorized representatives.

For the Energy Chamber

_____________________________________________ Dr. Thackwray Driver CEO, ENERGY CHAMBER

For [Insert Beneficiary Name] __________________________________ [Insert Beneficiary Representative Name] [Insert Beneficiary Representative Job Title]

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CONSUL-AGREE

Safe TO Work in Trinidad & Tobago (STOW-TT)

Consulting & Confidentiality Agreement


THIS CONTRACT (Contract) is entered into this ________day of ________2009, by and between [insert Beneficiary Name] (the Client) having its principal place of business at [insert Beneficiary Address], and [insert Consultant Name] (the Consultant) of [insert Consultant Address]. WHEREAS, the Client wishes to have the Consultant perform the services hereinafter referred to, and WHEREAS, the Consultant is willing to perform these services, NOW THEREFORE THE PARTIES hereby agree as follows: 1. Services The Consultant shall perform and / or deliver the work, services and deliverables specified in Appendix A, Description of Work and Services, which is made an integral part of this Contract (the Services). The Consultant shall at all times during performance of the Services cooperate with the employees, contractors, consultants and representatives of the Client. The Consultant shall perform the Services during the period commencing ______________and continuing through ________, or any other period as may be subsequently agreed by the parties in writing. A. Ceiling For Services rendered pursuant to Appendix A, the Client shall pay the Consultant an amount not to exceed $___________ Trinidad & Tobago Dollars. This amount has been established based on the understanding that it includes all of the Consultant's costs as well as any tax obligation that may be imposed on the Consultant. B. Schedule of Payments The Consultant shall invoice the Client as described in Appendix B hereto for Services performed by the Consultant. The Client shall pay the Consultant the fees for such Services set forth in Appendix A hereto (the Fees).

2. Term

3. Payment

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5. Project Administration

A. Representative. The Client designates [insert Client Representative] as Client's Representative; the Clients Representative may be changed by notice in writing to the Consultant. The Clients Representative will be responsible for the coordination of activities under this Contract, for acceptance and approval of the reports and of other deliverables by the Consultant and for receiving and approving invoices for the payment. B. Reports. The deliverables listed in Appendix A, Description of Work and Services shall be submitted in the course of the assignment, and will constitute the basis for the payment to be made under paragraph 3.

5. Performance Standards 6. Confidentiality

The Consultant undertakes to perform the Services at the highest standard of professional and ethical competence and integrity. The Consultant shall not, during the term of this Contract and within two years after its expiration, disclose any proprietary or confidential information relating to the Services, this Contract or the Client's business or operations without the prior written consent of the Client.

7. Ownership Material

of Any studies reports or other material, graphic, software or otherwise, prepared by the Consultant for the Client under the Contract shall belong jointly to the Client and Energy Chamber (the Chamber) and remain the property of the Client and the Chamber. The Consultant may retain a copy of such documents and software. These terms shall apply to any expansion or extension of the scope or term of this Agreement. The Consultant agrees that, during the term of this Contract and after its termination, the Consultant shall be disqualified from providing goods, works or services (other than the Services and any continuation thereof) for any project for Client (1) which may result in a conflict of interest or (2) which become a requirement as a consequence of the Consultants recommendations to the Client, in the delivery of the Services. Conflict of interest means any situation in which Consultant fails to act in interest of Client and only acts for the benefit of itself. For example, a conflict of interest would arise if Consultant as result of this Contract recommends the purchasing of a particular piece of equipment which Consultant manufactures. The Consultant will be responsible for taking out any appropriate insurance coverage.

8. Consultant Not to be Engaged in Certain Activities

9. Insurance

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10. Law Governing The Contract shall be governed by the laws of Trinidad & Tobago, and Contract and the language of the Contract shall be English Language 11. Dispute Resolution Any dispute arising out of the Contract, which cannot be amicably settled between the parties, shall be referred to arbitration in accordance with the laws of the Client's country. The Client and Consultant shall adhere to the highest ethical standards, and report to the Energy Chamber (the Chamber) all suspected acts of fraud and corruption of which it has knowledge or becomes aware. Fraud and corruption are prohibited. The Chamber shall take action in the event of any deed or complaint involving alleged acts of fraud and corruption. The Consultant represents and warrants that the Consultant is an independent contractor in the performance of the Services and that neither the Consultant nor the Consultants employees (if Consultant has employees) shall be considered employees of the Client. The Consultant shall not sub-contract any of the obligations hereunder to any person. The Client shall not be liable for, and the Consultant hereby indemnifies the Client from and against, any claims, whether based on breach of contract, statutory liability, tort (including negligence of any nature) or otherwise, for any losses, damages, liabilities, penalties, fees, fines or other expenses or claims that Consultant or any third party may have, arising out of, or in any way connected with or related to, the Services, including, but not limited to, death of the Consultant or any of her employees, damage to Consultants property or the property of her employees (Losses), except to the extent that such Losses are caused by the negligence of, or breach of this Agreement by, the Client. Notwithstanding any other term of this Agreement, neither party shall be liable for any consequential, indirect or special loss or damage of any kind.

12. Fraud and Corruption

13. Independent Contractor

14. Limitation on Liability

FOR THE CLIENT Signed by ___________________ Title: ______________________

FOR THE CONSULTANT Signed by ____________________ Title: ________________________

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APPENDIX A

1.

DESCRIPTION OF WORK AND SERVICES

[Insert Terms of Reference for Independent Assessors]

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APPENDIX B

1.

CONSULTANTS FEES

Fees: Contract amount : [Insert amount in $TT] Payment Schedule: [Select for implementing the STOW-TT Minimum HSE Requirements} The Client hereby agrees to pay to the Consultant as follows: (vii) 10% of contract amount when the Consultant signs the contract (viii) 15% of contract amount upon submission of a comprehensive gap analysis, bridging document and Action Plan. (ix) 50% of contract amount upon submission of the report indicating successful implementation of the STOW-TT minimum HSE requirements. (x) 25% of contract amount when a certificate of compliance is issued at the end of an audit OR [Select for auditing the Client] iv. v. vi. 10% of contract amount quoted fees when the Consultant signs the contract. 40% of the contract amount upon submission of a comprehensive report on the audit process and findings 50% of contract amount upon review and signoff by the Energy Chamber and a member of the STOW Implementation Board

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CONSULTANTS INVOICE OBLIGATIONS a. Consultant shall render an original invoice to the Client for Services rendered. The Client shall pay all undisputed amounts within 30 days of receipt of such invoice.

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TOR-IMP Safe TO Work in Trinidad & Tobago (STOW-TT)

Terms of Reference for Independent Assessors - Implementation


of the STOW-TT HSE Minimum Prequalification Requirements

Background The Energy Chamber has received funding from the Inter-American Development Bank to implement a project entitled Improving Health, Safety and Environmental Standards Among Smaller Enterprises in the Energy Sector. The project is more commonly known as Safe TO Work in Trinidad & Tobago (STOW-TT). The overall project objective is to improve the ability of smaller local service companies to obtain contracts with the major energy companies. Service companies have not been able to take full advantage of opportunities in the energy sector because they have difficulty complying with the different HSE requirements among the upstream and downstream energy operating companies. The STOW-TT project addresses this issue through its four Components as follows: (i) (ii) (iii) (iv) Development of uniform health, safety and environmental standards; Development of local capacity for training and certification; Implementation of HSE standards among SMEs; and Promotion of HSE standards and dissemination of results.

STOW-TT has created a set of uniform HSE requirements for prequalifying service contractors across the upstream and downstream energy sectors under Component I; and under Component II, has trained HSE Professionals as Independent Assessors to assist service companies in becoming certified to the STOW-TT requirements. Component III involves the certification of a pilot group of service companies to the STOW-TT requirements. Specifically, it involves HSE Professionals who were trained as Independent Assessors under Component II working with selected service companies to implement the STOW-TT requirements and to audit these companies for compliance. [Insert Company Name] was selected to participate in the pilot and has applied to be certified at the [select low risk, medium risk, high risk] level of certification. The Energy Chamber requires an Independent Assessor to implement the STOW-TT minimum HSE requirements in [Insert Company Name] at the requested level of certification.

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Objective: (1) To implement the STOW-TT minimum HSE requirements in [Insert Company Name] at the [select low risk, medium risk, high risk] level of certification, in accordance with the documents STOW-TT Contractor Guidance Manual Health, Safety and Environmental Minimum Prequalification Requirements and STOW-TT Administration Manual - HSE Prequalification Requirements

Characteristics of consultancy: Type of consultancy: Duration: Country of Assignment: Qualifications: Individual Consultant [insert days] consulting days over 6 months Trinidad & Tobago The selected consultant must be an HSE Professional who was trained and authorized to work as an Independent Assessor under the STOW-TT project.

Activities: The consultant will undertake the following activities: 1. Assess the companys HSE management systems by reviewing the results of the companys HSE Management System Self Check Questionnaire and the companys HSE Management System Documentation/ HSE Manual. 2. Carry out a gap analysis on the companys existing HSE Management Systems as they relate to the STOW-TT minimum HSE pre-qualification requirements documented in the STOW-TT Contractor Guidance Manual Health, Safety and Environmental Minimum Prequalification Requirements and the STOW-TT Administration Manual - HSE Prequalification Requirements. The Gap Analysis should be conducted in keeping with [select low risk, medium risk, high risk] level of certification. 3. Prepare a bridging document based on the identified gaps and an Action Plan to bridge the gaps found. The Plan must include milestones and timelines for delivery. 4. Work with and advise the company on how to bridge the gaps found. This will include regular meetings with and surveillance of the company during implementation of the requirements, as well as providing the company with templates as examples of how to proceed.

Deliverables: The consultant will be responsible for the delivery of the following: 1. Gap analysis on [insert Company Name] existing HSE Management systems, bridging document and Action Plan as outlined above.

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2. Fortnightly Progress Reports on the status of implementation. The Progress Report must indicate the progress made in achieving the milestones set out in the Action Plan, including the objectives that have been completed and problems experienced (if any). 3. Final report on the activities undertaken in implementing the requirements which includes an indication of successful implementation of the STOW-TT HSE minimum prequalification requirements in the areas where gaps exist. The implementation must be undertaken in keeping with the [select low risk, medium risk, high risk] level of certification.

Timetable: Deliverable 1 within three (3) weeks of the execution of the contract Deliverable 2 every 2 weeks Deliverable 3 within [insert number of weeks] weeks of the execution of the contract

Reporting: The consultant will report to the [insert job title of companys representative] at [insert Company Name].

[insert company name] inputs: [insert company name] will ensure that the consultant has access to its premises, management and staff as well as relevant HSE documentation. [insert company name] will also make meeting rooms available for the consultant as necessary for discussions with management and staff.

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TOR-AUD
Safe TO Work in Trinidad & Tobago (STOW-TT)

Terms of Reference for Independent Assessors - Auditing of SMEs to the STOW-TT HSE Minimum Prequalification Requirements
Background The Energy Chamber has received funding from the Inter-American Development Bank to implement a project entitled Improving Health, Safety and Environmental Standards Among Smaller Enterprises in the Energy Sector. The project is more commonly known as Safe TO Work in Trinidad & Tobago (STOW-TT). The overall project objective is to improve the ability of smaller local service companies to obtain contracts with the major energy companies. Service companies have not been able to take full advantage of opportunities in the energy sector because they have difficulty complying with the different HSE requirements among the upstream and downstream energy operating companies. The STOW-TT project addresses this issue through its four Components as follows: i) ii) iii) iv) Development of uniform health, safety and environmental standards; Development of local capacity for training and certification; Implementation of HSE standards among SMEs; and Promotion of HSE standards and dissemination of results.

STOW-TT has created a set of uniform HSE requirements for prequalifying service contractors across the upstream and downstream energy sectors under Component I; and has trained HSE Professionals as Independent Assessors to assist service companies in becoming certified to the STOW-TT requirements under Component II. Component III involves the certification of a pilot group of service companies to the STOW-TT requirements. Specifically, it involves HSE Professionals who were trained as Independent Assessors under Component II working with selected service companies to implement the STOW-TT requirements and to audit these companies for compliance. [Insert Company Name] was selected to participate in the pilot and has applied to be certified at the [select low risk, medium risk, high risk] level of certification. The Energy Chamber requires an Independent Assessor to validate that [Insert Company Name]s HSE Management System is compliant with the STOW-TT minimum HSE requirements at the requested level of certification.

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Objective: (2) To audit [Insert Company Name] against the STOW-TT minimum HSE requirements at the [select low risk, medium risk, high risk] level of certification in accordance with the documents STOW-TT Contractor Guidance Manual Health, Safety and Environmental Minimum Prequalification Requirements and STOW-TT Administration Manual - HSE Prequalification Requirements.

Characteristics of consultancy: Type of consultancy: Duration: Country of Assignment: Qualifications: Individual Consultant A maximum of 5 consulting days over two weeks Trinidad & Tobago The selected consultant must be an HSE Professional who was trained and authorized to work as an Independent Assessor under the STOW-TT project.

Activities: The consultant will undertake the following activities: 1) Assess the companys HSE management system by reviewing the HSE Management System Documentation against the STOW-TT HSE Minimum Prequalification Requirements outlined in the STOW-TT Contractor Guidance Manual Health, Safety and Environmental Minimum Prequalification Requirements and STOW-TT Administration Manual - HSE Prequalification Requirements. 2) Meet with the management of [Insert Company Name] to review the audit process 3) Audit of the company Deliverables: The consultant will be responsible for the delivery of the following: A. OR B. An audit report outlining the audit process used and findings / recommendations. The report will include a recommendation to the STOW Implementation Board whether or not the company should be certified at the [select low risk, medium risk, high risk] level of certification. A report explaining why the SME should not be certified, if the SMEs HSE Management System documentation fails to meet the STOW-TT requirements

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Timetable: Deliverable A or B within 14 days of the execution of the contract

Reporting: The consultant will report to the [job title of companys representative] at [insert Company Name].

[insert company name] inputs: [insert company name] will ensure that the consultant has access to its premises, management and staff as well as relevant HSE documentation. [insert company name] will also make meeting rooms available for the consultant as necessary for discussions with management and staff.

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REQ-FORM Safe TO Work In Trinidad & Tobago (STOW-TT)

Reimbursement Request Form

Date:__________________ Company Name: ______________________________________________________________ Amount Requested (numbers and written): __________________________________________ _______________________________________________________Trinidad & Tobago Dollars

STATEMENT OF EXPENSES OR PAYMENTS

Item No.

Name of Independent Assessor

Description of Deliverable

Payment 1/ Date

Amount Paid ($TT)

TOTAL PAID

_____________________________________ Name & Title of Authorized Representative

___________________________ Signature

Payment date is the date when actual payment to the Independent Assessor was made

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