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Contractor Induction Form
SERVICE PROVIDER INDUCTION CHECKLIST
Date
*
MM
DD
YYYY
Contractor Name
*
First Name
Last Name
Contractor Email
*
Contractor Mobile
*
Service Provider
*
This is the organisation you are working for/ representing
Description of works
*
Service Provider has reported to South Bunbury Marketplace prior to the commencement of any works
*
Yes
No
Service Provider has provided a copy of its trade license/qualification to Management
*
Yes
No
Service Provider has provided a Certificate of Currency for Public Liability and Workers Compensation Insurance to Management
*
Yes
No
Service Provider has reviewed the South Bunbury Marketplace Instructions and Procedures Handbook
*
Yes
No
Service Provider has reviewed the South Bunbury Marketplace Rules
*
Yes
No
Service Provider has ensured that all its employees and sub-contractors have received and reviewed the Eaton Fair Shopping Centre Instructions and Procedures Handbook and the South Bunbury Marketplace Rules
*
Yes
No
Service Provider has obtained Special Authorisation Permits (where required) from Management prior to the commencement of any works involving the following:
Restricted Access Areas (see section 9 of the Handbook)
*
Yes
No
N/A
Shutdown of IT Equipment (see section 11 of the Handbook)
*
Yes
No
N/A
Fire System Isolation (see section 5 of the Handbook)
*
Yes
No
N/A
Electrical Works (see section 12 of the Handbook)
*
Yes
No
N/A
Working at Heights or with Hoists, Scaffolding or Platforms (see section 14 of the Handbook)
*
Yes
No
N/A
Hot Works (cutting, welding or naked flame) (see section 13 of the Handbook)
*
Yes
No
N/A
Forklifts, Elevating Work Platforms, Scissor Lifts & Boom Lifts (see section 15 of the Handbook)
*
Yes
No
N/A
Insulated Sandwich Panelling (see section 17 of the Handbook)
*
Yes
No
N/A
Noisy Works (see section 18 of the Handbook)
*
Yes
No
N/A
Service Provider is familiar with the Emergency Procedures and Evacuation Points (see section 4 of the Handbook)
*
Yes
No
Service Provider has access to First Aid equipment (see section 6 of Handbook)
*
Yes
No
Service Provider is familiar with the hazard, injury and incident reporting requirements (see section 7 of the Handbook)
*
Yes
No
Service Provider is familiar with the security and access arrangements (see section 3 of the Handbook)
*
Yes
No
Service Provider is familiar with the location of and instructions regarding the Lifts and Travelators (see section 8 of the Handbook)
*
Yes
No
Service Provider is familiar with the Danger & Out of Service Tag Procedures (see section 10 of the Handbook)
*
Yes
No
Service Provider is familiar with Management’s Housekeeping requirements (see section 19 of the Handbook)
*
Yes
No
Service Provider is equipped with the necessary Personal Safety Equipment (see section 20 of the Handbook)
*
Yes
No
Service Provider is familiar with Management’s Working Alone requirements (see section 21 of the Handbook)
*
Yes
No
Service Provider is familiar with the Workplace Violence Policy (see section 22 of the Handbook)
*
Yes
No
Service Provider is familiar with the Drug and Alcohol Policy (see section 23 of the Handbook)
*
Yes
No
Service Provider is familiar with the No Smoking Policy (see section 24 of the Handbook)
*
Yes
No
I agree to abide by the Instructions and Procedures set out in the South Bunbury Marketplace Instructions and Procedures Handbook; all health and safety legislative requirements and/or any other direction by Management in relation to the health and safety of the site generally.
*
Yes
Thank you!
