CONTRACTOR CHECK LIST

SECTION 1: Contractor Details:

• Task Being completed:

• Contractor/Company completing the work:

• Machinery or equipment involved:

• Confirmation the task to be completed is not a HIGH RISK activity requiring a permit to work?

  Yes

  No

  N/A

• Name of person(s) completing works:

• Lead contractor telephone number:

• Duration of work: Start date/Time:

  Date

• Duration of work: End date/Time:

  Date

• Site

  Select

SECTION 2: Contractor checks (to be completed by Issuer)

• Has the contractor provided a suitable method statement for the work to be completed?

  Yes

  No

  N/A

• Has the contractor provided a suitable Risk Assessment for the work to be completed, covering all aspects of work?

  Yes

  No

  N/A

• Has the contractor provided evidence of competencies for all staff involved in the work to be completed?

  Yes

  No

  N/A

• Has the contractor provided certificates to confirm all work equipment being used is in a safe condition for use?

  Yes

  No

  N/A

SECTION 3: Induction and PPE

• Have all contractor staff involved in the work completed a site induction within the last 12 months?

  Yes

  No

  N/A

• Do all contractor staff have suitable PPE for the work to be completed?

  Yes

  No

  N/A

SECTION 4: Interaction with the operation:

• With the work being completed by the contractor effect any part of the business operationally, including the need for the fire detection systems to be isolated?

  Yes

  No

  N/A

• Will the business operation effect any of the contractors work being completed?

  Yes

  No

  N/A

SECTION 5:

• Any additional comments:

SECTION 6: Confirmation Works can commence:

• Signed on behalf of PKF

  Sign

• Date

  Date

• Signed by lead contractor:

  Sign

• Date

  Date

SECTION 7: Confirmation work has been completed, area inspected, and the area is safe for use:

• Signed on behalf of PKF

  Sign

• Date

  Date

• Signed by lead contractor:

  Sign

• Date

  Date