Contractor Leadership Audit

• Company Name

  Select

• Company Representative

• Role/Title

  Supervisor

  Manager

  Staff/Employee

• Work Location

  Select

• Date

  Date

• Conducted By

Onboarding

• Have the applicable NGM standards/procedures been provided for the Scope-of-Work(s)?

  Yes

  No

  N/A

• Do you how to obtain them?

• Have employee rosters and contact lists for the Scop-of-Work been provided to the NGM end-user(s)?

  Yes

  No

  N/A

• Have all employees been onboarded accordingly? (i.e. MSHA, Convergence, Site Hazards training)

  Yes

  No

  N/A

• Have vehicle/equipment and tools been inspected prior to arrival on NGM site(s)?

  Yes

  No

  N/A

• Who are the NGM contacts for the respective Scope-of-Work(s)?

  Yes

  No

  N/A

• Name of NGM person(s)

Contractor Controls

• Has a Formal Risk Assessment been completed for the Scop-of-Work(s)?

  Yes

  No

  N/A

• How are employees instructed to manage an incident?

  Safe

  At Risk

  N/A

• Who is the NGM site emergency contact?

• Who is the company's emergency contact?

• Has a Safe Work Plan been completed? (if applicable)

  Yes

  No

  N/A

• Are you aware of the NGM Close Call program?

  Yes

  No

  N/A

• How do the employees report a close call?

• If a close call is experienced on site, do you notify anyone from NGM?

  Yes

  No

  N/A

• How is employee training documentation managed? (i.e. task specific, equipment training, MSHA)

  Yes

  No

  N/A

• Where is training documentation stored?

• Is the company compliant in Avetta?

  Yes

  No

  N/A

Notes/Comments

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