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Title

Enter the Full Company Name

Previous Company Name

Address

Town or City

Postcode/ Zip code

Post box number (PO Box)

Telephone

Email

Website

CEO Name

CEO Email

CEO Phone Number

Contact Person for Business Enquiry Name

Contact Person for Business Enquiry Email

Contact Person for Business Enquiry Phone Number

Head of QA Name

Head of QA Email

Head of QA Phone Number

Head of HSE Name

Head of HSE Email

Head of HSE Cell Phone

Contact Person for Finance Name

Contact Person for Finance Email

Contact Person for Finance Phone Number

Parent Company Name, if applicable

Registration Year

Company Type

Customs Authorisation Number (Europe only)

Trade License Expiry Date

Have you supplied goods or services to Abraj ?

what goods or services have you provided ?

Name of Service

Level of Service

Nature of work normally subcontracted

Present work load (% of capacity)

Forecast work load next 12 months

Nature Of Business

Do you have a documented quality management system ?

State applicable standards used

Is the system certified by an accredited body ?

If yes, name of Certifying Authority

Expiry date of certificate

If not certified, please provide a brief status of your intentions and if applicable, your progress regarding certification.

Do you have Periodic management review with regard to Quality systems efficiency ?

Do you have a system of measuring and monitoring Key Performance Indicators as regards the effectiveness of Quality systems ?

Are all parts of the organisation subject to internal audit ?

Do you have a structured system for experience/ technology transfer ?

State the latest statistics and the trend with regard to Customer Satisfaction ?

What methods of monitoring product quality do you utilize ?

Remarks (You may provide additional information here which might not have been covered above)

Does your organisation operate a formal Health & Safety Management System ?

State applicable standards or guidelines used

Is the system certified ?

Do you have a documented Drugs/ Alcohol abuse policy ?

Do you have a formal risk assessment process that identifies hazards, risks and ensures the implementation of the associated control measures ?

Do you have a structured system to provide appropriate Health and Safety training for all staff ?

Do you conduct monitoring/ internal audits of your Health and Safety arrangements to demonstrate the effectiveness of the system ?

Do you have an annual Health and Safety plan that reflects objectives, targets and actions to improve Health & Safety performance ?

Does your organisation operate a documented Environmental Management System ?

Do you have a formal procedure for qualifying suppliers ?

Do you have a defined system for supplier development ?

How is the suppliers quality and timely delivery monitored and controlled ?

Do you assess the competence of your sub-contractors with respect to Health & Safety matters ?

Does your organisation audit suppliers/ sub-contractors on a regular basis ?

Do you have a documented procedure regarding competence assurance ?

Do you define and make available competence requirements for all jobs ?

Do you have a documented procedure regarding the provision of training ?

Do you plan and monitor training needs ?

Do you evaluate employee satisfaction annually ?

Do you have a defined system of contract review

Do you have a system for technical inspection at material receipt ?

Indicate the extent of control of measuring instruments

Do have an independent department for monitoring quality at various levels of production ?

Do you have defined procedure for monitoring the correctness and completeness prior to delivery ?

Does the company operate a formal system for managing Product/ Service non-conformances ?

Do you have documented procedures for design review ?

Do you have a system for information to and approval from customer, concerning deviations, modification/ design changes of the product ?

Do you have documented procedures for packing that is in conformity with customers requirements ?

What is the on-time delivery performance to customers during the last two years, based on the customers required date for deliverables ?

What is the trend in cost of rejections and rework over the last 3 years ?

Statement Type

Bank Account Number

Bank Name

Bank Pranch

Address Line 1

Address Line 2

Postcode

Swift

IBAN

Sort/ BLZ/ ABA

IFSC Code

Corresponding Bank Account Number

Corresponding Bank Name

Corresponding Bank Branch

Corresponding Address Line 1

Corresponding Address Line 2

Corresponding Town or City

Corresponding Postcode

Corresponding Swift

Corresponding IBAN

Corresponding Sort/ BLZ/ ABA

Corresponding IFSC Code

Vat Registration Number (in applicable)

Is Supplier Critical to Abraj Energy Services core business. Indicate as appropriate.

Critical: Suppliers of goods / services where poor quality could cause increased cost or affect Abraj Energy Services reputation with customers.

Non-Critical: Suppliers of goods / services (e.g. stationery) where poor quality will not significantly affect the company, neither in cost nor reputation.

Restrictions on use / Limitations / Scope of Supply

test

ProductProfile

Certifying Authority of Quality Management

Certifying Authority of Health and Safety

State applicable standards or guidelines used in environment

Is the system certified in environment ?

Certifying Authority of environment

Remarks in Supply Chain Management (You may provide additional information here which might not have been covered above)

Remarks in Human Resources (You may provide additional information here which might not have been covered above)

Remarks in Process Management (You may provide additional information here which might not have been covered above)

Remarks in Operational results (You may provide additional information here which might not have been covered above)

Town or City (Details of Bank Data)

CurrentTaskID

Reference No

Corresponding Country

Country

Country (Details of Bank Data)

Country of Registration

Corresponding Preferred currency for transaction

Preferred currency for transaction

Fax

Company Registration Number

Category

Payment Terms

Do you have operational procedure specific to your scope of work. If yes please attach copy of those procedures

Do you have HSE MS? If yes, please provide a copy

Do you have written HSE policy in place? Is yes attach copy of the same.

Do you have written HSE procedures (For example; Electrical safety, Lifting and hoisting procedure, Road Safety, Permit to work etc..) If yes attach copy of those procedures.

Do all your employees have valid HSE induction and Valid H2S card? If yes attach few sample for reference

Does your organisation have competence system in place? What are the minimum mandatory HSE training requirements for the staff who will be assigned for Abraj activities? Attach updated training /compe

Does your vehicles are RAS certified, especially the vehicles deployed for Abraj activities?

Does you vehicles fitted with IVMS especially the vehicles used for Abraj. If yes kindly provide copy of your last 3 months IVMS report.

Do you have journey manager in place to monitor all your journeys?

Does journey manger have completed all training ladder to become journey manager (HSE Induction, H2S, IFR, Defensive driving, HSE tools and skills, CMC, safety leadership & Journey management)? If yes

Do all drivers have valid defensive driving training for the applicable type of vehicles used under Abraj? If yes please provide training record of drivers.

What are the PPE requirements in your organization? Is there any procedure for PPE requirements? If yes provide a copy of the same.

Does your organisation provide mandatory PPE for all employees for the required scope of work?

Do you have Risk assessment for the scope of work? If yes attach copy of risk assessment.

What arrangement does your company have for emergency planning and response? Which emergency situations are included in your ERP? Provide a copy of ERP.

What types of HSE incidents are investigated? What process is used to investigate HSE incidents and who does investigation?

How are the findings following an investigation, or a relevant incident occurring elsewhere, communicated to your employees?

Is there a system to track the action items related to incident, inspections or audits? If yes, provide a copy.

Has your organization been audited by any external agency / client? If yes provide a copy of audit report.

What arrangement does your organization have for medical examination of employees? Provide a sample report of medical examination.

What HSE communication tools are implemented in your organization? Provide examples.

How you monitor HSE performance of your organization? Are there any targets set? Attach copy of HSE Plan

Do you carry out regular inspection for your equipments & record results of those inspections?

Do you maintain all equipment certificates?

Does your organization have rewarding scheme as well as disciplinary actions in case of any violation against company policy?

Does your organization confirm that the current workforce do not include anyone who is previously dismissed for infringements relating to road safety or other serious infringement.

Please confirm do you comply with applicable legal requirements.

Does your organisation have suffered fatality in last 3 years? If yes kindly submit copy of your investigation report.

Has your company suffered any statutory modifiable incidents in the last five years (safety, occupational health and environment)? (Answer with details including dates, country, most frequent types, c

Do you have Quality Management system in place & it is being implemented.

Does your company being certified to ISO 9001 certification or any other international standards. If yes please provide copy of your certificate.

How are the senior managers personally involved in HSE management for example objective setting & monitoring?

Provide evidence of commitment at all levels of the organisation?

How do you promote a positive culture towards HSE matters?

Does your company have an HSE policy document? If the answer is YES please attach a copy.

Who has overall and final responsibility for HSE In your organisation?

Who is the most senior person in the organisation responsible for this policy being carried out at the premises and on site where his employees are working? Provide name, title and experience.

Itemise the methods by which you have drawn your policy statement to the attention of all your employees?

What are your arrangements for advising employees of changes in the policy?

Does your company have strategic objectives? If the answer is Yes please provide a copy.

Itemise the methods by which you have communicated your strategic HSE objectives to the attention of all your employees?

How is your organization structured to manage and communicate HSE effectively?

Do HSE meetings promote HSE awareness?

Do client & contractor meet regularly to discuss & action any interface situation?

What provision does your company make for HSE communication meetings? Please provide an organization chart.

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 req

b) How have you identified areas of your company operation where specialized training is required, for instance training required to health hazards such as radiation, asbestos and chemicals?

c) What specialist HSE resources does your organization have available?

d) How does your company provide HSE specialized training for HSE staff?

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 & 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?

What arrangements does your company have to ensure existing staff HSE knowledge is up to date? (If training is provided in-house please give details of content)

Does your organization have a competence system in place? If Yes, please describe the scope & content of your competence system.

ContractorManagementProcessOutline

How do you assess contractors, HSE competence or HSE performance?

Where do you spell out the company standards you require your Contractors to meet?

How do you ensure these standards are met and verified?

a) What techniques are used within your company for the identification, assessment, control and mitigation of hazards and effects? Attach a copy of process which you follow.

b) Do you have specific policies & programmes on specific health hazards? For example substance abuse, blood borne pathogens, malaria pandemic disease etc.

a) How is your workforce advised on potential hazards (chemicals, noise, radiation, etc.) encountered in the course of their work?

b) What systems are in place to monitor the exposure of your workforce to chemical or physical agents

a) What type of safety hazards (mechanical guarding, working at height, lifting & hoisting, confined space entry, explosive atmosphere ) are associated with the scope of your services.

b) What systems are in place to control these hazards & monitor the effectiveness of these controls?

a) What type of logistics hazards (land transport, air transport, marine transport, material handling) are associated with the scope of your services?

Logistics Hazards

a) What type of environmental hazards ( chemical spill, atmospheric emissions, waste disposal ) are associated with the scope of your services?

Environmental Hazards

a) What type of security hazards ( terrorism, hostage taking, robbery, hostile local population ) are associated with the scope of your services?

SecurityHazards

SocialResponsibilityHazards

a) What types of social hazards are associated with the scope of your services?

Do you have a company HSE manual (or Operations Manual with relevant sections on HSE) that describes in detail your company approved HSE working practices relating to your work activities? If the answ

a) How do you ensure that plant and equipment used within your premises, on-site, or at other locations by your employees are correctly registered, controlled and maintained in a safe working conditio

Is there an overall structure for producing, updating and disseminating standards?

Are your company standard aligned with industry guidelines or recommended practices? If yes state which one?

HSEStandard

a) How do you manage changes & assess associated risks, for example personnel, equipment, process & documentation.

a) What arrangement does your company have for emergency planning and response?

b) Which emergency situations are included?

a) What arrangements does your company have for supervision, monitoring & implementation of HSE MS?

b) How does your company ensure the implementation of work procedures within your worksite operations, for example compliance with procedures, toolbox talks, safety meetings, supervision, job observat

c) How do you monitor employee HSE performance for example hazard identification system, HSE participation?

d) What active HSE monitoring is performed?

e) How do you report and correct deficiencies identified?

f) How do you communicate the results of active performance monitoring to relevant personnel?

Number of fatality

Number of lost time injuries

Number of restricted work cases

Number of medical treatment cases

Number of First aid cases

Number of near miss incidents

Fatal accident rate

Lost time incident frequency

Total recordable incident frequency

a) How is health performance monitored & recorded?

b) How is environmental performance monitored & recorded?

c) How is security performance monitored & recorded?

d) How often is HSE performance reviewed? By whom?

e) How is logistics performance monitored & reported?

Do you record vehicle incidents?

a) What types of HSE incidents are investigated?

b) What process is used to investigate HSE incidents?

c) Who conducts incident investigations?

d) How are the findings following an investigation, or a relevant incident occurring elsewhere, communicated to your employees?

e) Has your company suffered any statutory notifiable incidents in the last five years (safety, occupational health and environmental)? (Answers with details including dates, country, most frequent ty

a) Do you have a written procedure on HSE auditing? If Yes, please attach a copy?

b) Who is involved in conducting HSE audits? How audit team members are are selected to have specific expertise and be independent from activities being audited? What are the qualifications required f

c) How does your company schedule HSE audit and what scope of auditing is covered? For example internal, regulatory compliance, supplier / contractors, HSE management system implementation.

d) How does management follow up on audit findings & effective close out of action items?

a) Do you a written procedure for management review of HSE MS? If yes please attach a copy?

b) How often are HSE MS reviews conducted and who is involved in process?

c) How are identified actions & improvement efforts recorded and tracked to effective completion?

a) Please provide information on any certification which you have received from certification bodies?

a) Describe the nature and extent of your companys participation in relevant industry, trade, and governmental organisations?

a) Does your company have any other HSE features or arrangements not described elsewhere in your response to the questionnaire?

Evidence of policy and the same is communicated to all members in the organisation (b) Availability of objectives and KPIs

whether internal audits are carried out, and internal audit log covering the past two (2) years

Analsyis of data carried out for customer satisfaction, Objective, KPIs, supplier performance etc..

Does your organization have a contractor management process system? If yes please provide an outline of the process

HSETrainingOfManagers

Contractor Full Name

ContractorAddress

ContractorDesignatedHSE

ContractorFax

ContractorTelephone

Procurement Manager

Procurement Manager Approved Date

HSE

HSE Approved Date

Assistant Finance Manager

Assistant Finance Manager Approved Date

Finance Manager

Finance Manager Approved Date

Finance GM

Finance GM Approved Date

Supply Chain Manager Approved Date

Supply Chain Manager

GM-CS

GM-CS Approved Date

ContractorNameL2

ContratorAddressL2

ContractorTelephoneL2

ContractorFaxL2

ContractorEmailL2

ContractorHESL2

IsDraft

Comment

CurrentApprover

FinanceManagerIsApplicable

SupplyChainManagerIsApplicable

Blocked Supplier List Checked

AssistantManagerStatus

SupplyStatus

Attachments