OWA Vendor Pre-Qualification System

Transcription

1 OWA Vendor Pre-Qualification System March 2008 Vendor s Name An OWA Vendor is defined as any individual or company hired to provide services or supplies under contract to the OWA. The steps of the OWA Vendor Pre-Qualification System are as follows: 1) Both Consultants or Contractors interested in working with the OWA must complete either Form 1 or Form 2 and send in with the documentation listed below to Orphan Well Association, 640 5th Avenue SW, Calgary, AB, T2P 3G4 2) OWA will review the documentation submitted by the Vendor and will evaluate and decide if the Vendor is a) Approved b) Approved with Conditions or c) Rejected. 3) OWA will indicated the approval of the Vendor with a signed copy of the MSA or CSA returned to the Vendor with any Conditions attached in writing. FORM 1 FOR VENDORS WITH A VAILD COR OR SECOR Vendors are to send in a completed Form 1 with the following: Copy of valid COR or SECOR Certificate Any supporting documentation requested in Form 1 Safety Manual including all forms (i.e. Safety Program or Safety Management System) Proof of $2,000,000 Comprehensive General Liability Insurance Proof of $1,000,000 Automotive Liability Insurance Proof of WCB account in good standing in Alberta Signed Contractor Service Agreement with attached rate schedule or bid for Contractors (or Signed Master Service Agreement with attached rate schedule for Consultants) FORM 2 FOR VENDORS WITHOUT A VALID COR OR SECOR Vendors are to send in a completed Form 2 with the following: Letter of Intent that company is working towards COR or SECOR if available. Any supporting documentation requested in Form 2 Safety Manual including all forms (i.e. Safety Program or Safety Management System) Proof of $2,000,000 Comprehensive General Liability Insurance Proof of $1,000,000 Automotive Liability Insurance Proof of WCB account in good standing in Alberta Signed Contractor Service Agreement with attached rate schedule or bid for Contractors (or Signed Master Service Agreement with attached rate schedule for Consultants) March 2008 OWA Vendor Pre-Qualification Form 1 Page 1 of 4

2 OWA VENDOR PRE-QUALIFICATION FORM 1 FOR VENDORS WITH A VALID COR OR SECOR GENERAL INFORMATION Complete Company Name Complete Company Address Areas (provinces) of Operation & Phone Fax Number and HSE & Phone Is this a full time position? HSE Contact Phone Number Company Website Address 24 Hour Emergency Phone Describe all types of services or work the Vendor proposes to conduct for the OWA: SAFETY PROGRAM INFORMATION Does your company have a valid Alberta Partnerships in Health and Safety Certificate of Recognition (COR) or Small Employer s Certificate of Recognition (SECOR)? If, stop and complete Form 2. Do not send in Form 1. If, please continue. Certificate of Recognition Number Expiry Date: Does your company have a Health and Safety Management System? Has it been audited? Date of Audit Name of Auditor Name of Audit Company Audit Protocol Used Audit score achieved March 2008 OWA Vendor Pre-Qualification Form 1 Page 2 of 4

3 ENVIRONMENTAL PERFORMANCE Does your company have an environmental management system? Has your company been involved in any reportable spills or releases in the past three years? If yes, please provide the following information: Year. of Spills Volume of Spills (m 3 ) Type(s) of Material Has your company received any environmental charges and/or fines within the last three years? If yes, please describe below and attach details. Administrative fines Convictions SAFETY PERFORMANCE Has your company (including management, supervisors, workers including contract workers and contract consultants working for your company) had any of the following within the last three years? If yes, please describe below and attach details. Fatalities Lost time injuries (a worker misses at least one day of work due to a work related injury) Medical aid injuries (medical aid or medical treatment required to treat a work related injury i.e. required a hospital visit or on-site ambulance) Restricted duty injuries (temporary restrictions or limitations to a worker s regular job duties due to a work related injury) Vehicle incidents (work related incidents which involve a worker used vehicle on any roadway and which result in damages excluding normal wear and tear) Description: Please provide an approximate estimate of kilometers driven on an annual basis by all management, supervisors and workers in your company. March 2008 OWA Vendor Pre-Qualification Form 1 Page 3 of 4

4 REGULATORY COMPLIANCE Has your company received any OH&S stop work orders or administrative fines or convictions within the last three years? If yes, describe below and attach details. Are there any Health and Safety related judgments, claims or suits pending or outstanding against your company? If yes, describe below and attach details. Has your company or any of your clients received any letters regarding concerns about work performed by your company from the Alberta Energy and Utilities Board, EUB within the last three years? If yes, describe below and attach details. Has your company or any of your clients received any letters regarding concerns about work performed by your company from Alberta Environment, AENV within the last three years? If yes, describe below and attach details. WORKPLACE POLICIES/PROGRAMS Does your company have a Substance Abuse policy? Does your company have a Working Alone policy? Does your company have a Workplace Violence policy? Does your company have a Disciplinary policy? Does your company have an Industrial hygiene program? Does your company have a Fatigue management program? Does your company have a Fleet Safety or Journey Management program? Are any of the above part of your Safety Management System or Safety Program? If, please explain why below. March 2008 OWA Vendor Pre-Qualification Form 1 Page 4 of 4

5 REFERENCES List the names of recent client organizations that you have worked for and who may be contacted for references for recent projects March 2008 OWA Vendor Pre-Qualification Form 1 Page 5 of 4

6 OWA VENDOR PRE-QUALIFICATION FORM 2 FOR VENDORS WITHOUT A VALID COR OR SECOR GENERAL INFORMATION Complete Company Name Complete Company Address Areas (provinces) of Operation & Phone Fax Number and HSE & Phone Is this a full time position? Company Website Address 24 Hour Emergency Phone Describe all types of services or work the Vendor proposes to conduct for the OWA: SAFETY PERFORMANCE Has your company (including management, supervisors, workers including contract workers and contract consultants working for your company) had any of the following within the last three years? If yes, please describe below and attach details. Fatalities Lost time injuries (a worker misses at least one day of work due to a work related injury) Medical aid injuries (medical aid or medical treatment required to treat a work related injury i.e. required a hospital visit or on-site ambulance) Restricted duty injuries (temporary restrictions or limitations to a worker s regular job duties due to a work related injury) Vehicle incidents (work related incidents which involve a worker used vehicle on any roadway and which result in damages excluding normal wear and tear) Description: Please provide an approximate estimate of kilometers driven on an annual basis by all management, supervisors and workers in your company. March 2008 OWA Vendor Pre-Qualification Form 2 Page 1

7 If the answer is to any of the questions below, please describe where requested or attach detailed evidence or documentation. N/A = n Applicable MANAGEMENT INVOLVEMENT AND COMMITMENT 1) Does your company have a written safety manual? If, attach. Does it address worker health as well as safety? Does it include an environmental policy? Does it include a written company policy statement? 2) Do you do regular reviews and updates of your manual? If, when was the last time your manual was updated? 3) Do you have clearly defined safety responsibilities documented for the following? If, check applicable boxes: Managers Contractors Workers Supervisors Subcontractors Visitors Others 4) Do your Managers visit your work sites regularly? How often? Do you have a documented policy for this? HAZARD IDENTIFICATION AND CONTROL 8) Have you reviewed all the jobs that your supervisors or workers do, and identified any critical tasks? *Critical tasks are tasks that may are highly hazardous or potentially unsafe. 9) Do you have documented safe work procedures for the critical tasks identified above? If, list three (3) critical tasks that you have documented safe work procedures for below. N/A If, explain why. 10) Do you have a system for identifying the hazards, assessing the risks, and identifying corrective actions to take prior to work being conducted? If, does it include the following? Pre-job planning by having documented safe work procedures developed for critical tasks March 2008 OWA Vendor Pre-Qualification Form 2 Page 2

8 N/A Safe work permit system Pre-job safety meetings on the work site Stopping work to re-evaluate hazards, risks and corrective actions when conditions change to on work site e.g. tail gate safety meeting held when new equipment arrives on location or when weather and site conditions change Other, describe or attach detail. If, describe how you identify and deal with hazards on work site. 11) Do you have a way to assess the risks* associated with identified hazards? For example, do you use a risk matrix? *Risk is measured by evaluating the severity of Consequence versus the Probability of occurrence. 12) Do you have a process for Near Miss* reporting? *Near Miss is an event that actually occurred that could have resulted in an accident or incident. 13) Do you have an Emergency Response Plan (ERP) in place for each of your worksites? If, explain why below or attach details. 14) Do you have a program for regular equipment inspection and maintenance? If, is it documented in your safety manual? RULES AND WORK PROCEDURES 15) Are your workers informed of their right to refuse unsafe work if that feel that there are unsafe conditions for their specific job tasks? 16) Do your workers have access to copies of pertinent legislation, regulations and standards? Check all that are available to them. OH&S Regulations WCB Regulations TDG Regulations WHMIS Regulations Other, describe 17) Do you have a Working Alone policy? 18) Do you have a Workplace Violence policy? 19) Do you have a Substance Abuse policy? 20) Do you have a disciplinary policy and procedure? March 2008 OWA Vendor Pre-Qualification Form 2 Page 3

9 21) Do you have minimum Personal Protective Equipment PPE requirements for supervisors and workers? Does this include contractors, subcontractors and visitors? 22) Do you have safe work procedures/rules in place for the following: a) Safe vehicle driving b) Regular vehicle inspections such as walk arounds c) Ground disturbance d) Required PPE (Personal Protective Equipment) e) Excavations f) Confined space entry g) Working in potential H2S environment h) Required respiratory equipment as per Respiratory Code of Practice i) Fire protection, fire safety j) Emergency equipment and procedures k) Daily equipment pre-use checks by operators l) Heavy equipment operation m) Equipment safety devices n) Loading and unloading equipment for transportation o) Power line clearances p) Working at heights and fall protection q) Materials Handling including Hazardous Goods (WHMIS) and/or Transportation of Dangerous Goods (TDG) and/or mineral fibers r) Housekeeping 23) Do you have specific work procedures for specialized services or work performed by your company? If, list below or attach details. N/A If, explain why. TRAINING 24) Do you provide technical, operator, or on-site training to your supervisors and workers to ensure that they are competent to do their work? If, describe below or attach details. 25) Do you regularly evaluate your workers ability to perform their job in a competent and safe manner? 26) Do you provide safety training to your supervisors and workers? March 2008 OWA Vendor Pre-Qualification Form 2 Page 4

10 If, describe below or attach details. N/A 27) Please list below the courses (both safety and technical) required for your supervisors and workers or attach details. 28) Do you keep training records for your supervisors and workers? 29) Do you offer an orientation program and/or training for new workers or short term workers such as casual labour or summer students? If, and you have a New Worker Orientation Program, is it aligned with CAPP IRP #16? (CAPP Industry Recommended Practice) COMMUNICATION 30) Does your management communicate to your workers the importance of safety and their management commitment to safety? 31) During pre-job planning, are your workers involved with developing safe work procedures for your company? 32) Do you hold pre-job safety meetings with all workers on each work site before work starts? If, are these safety meetings documented? 33) List any other ways you communicate the importance of health and safety with your workers. ACCIDENT/INCIDENT REPORTING AND INVESTIGATION 34) Do you have a procedure for reporting accidents and incidents? If, describe below or attach details. 35) Do you have a procedure in place to investigate and follow-up on accidents and incidents? 36) Do you know the difference between describing an accident and identifying the causes of the accident? 37) Do you know what a root cause analysis is and how it would be used in and accident/incident investigation? CONTRACT MANAGEMENT IF APPLICABLE 38) Do you have a program for managing contractors or subcontractors working under your supervision? March 2008 OWA Vendor Pre-Qualification Form 2 Page 5

11 39) Do you consider safety (in addition to rates and competence) as a factor when hiring contractors and subcontractors? 40) Do you have a program to evaluate the safety performance of contractors or subcontractors prior to hire? 41) Do you conduct regular pre-job safety meetings with your contractors or subcontractors? 42) Do you have a program in place for inspecting contractors or subcontractors safety performance on the job site? N/A HEALTH AND ENVIRONMENTAL CONTROLS IF APPLICABLE 43) Do you have a waste management policy or program? 44) Do you have a documented spill reporting procedure? 45) Do you have require spill kits on your work sites, for your company or for your contractors, or subcontractors? 46) Do you have a system in place to control hazardous materials that will be brought to, used on, and removed from the worksite? 47) Are your work sites and procedures periodically audited by an external auditor for health and environmental controls? REFERENCES List the names of recent client organizations that you have worked for and who may be contacted for references for recent projects March 2008 OWA Vendor Pre-Qualification Form 2 Page 6