Title Page

  • Workplace

  • Company Name:

  • Contractor’s Name:

  • Conducted on (Date and Time)

  • Prepared by

  • Location

General Information

  • Brief description of work to be performed

General Induction

  • Department Health, Safety and Wellbeing (HSW) Policy

  • Required conduct/behaviour

  • High or extreme risk as identified in the OHS Risk Register related to the works to be undertaken

  • Security access arrangements / Traffic Management Plan

  • Emergency management

  • First aid and amenities

  • Hazardous Substances and Dangerous Goods stored on site

  • Hazard and incident reporting

  • Current Asbestos Management Plan and Division 5 Audit Report

  • Confined Space Entry Permit

Information to be provided by the Contractor

  • Licence details

  • A copy of the current contractors Public Liability Insurance Certificate of Currency (minimum ten million sum insured)

  • A copy of the current Workers Compensation Insurance Certificate of Currency

  • Current Working with Children Check

  • Safe Work Method Statements (SWMS)

  • Personal Protective Equipment (PPE)

Completion

  • Recommendations

  • I have been provided with and understand the information (as indicated above) and will comply with the safety instructions listed in the Safe Work Method Statement (or equivalent).

  • Contractor (Name and Signature)

  • I have provided the contractor with the relevant Department and site-specific information related to the works to be conducted.

  • Workplace Representative (Name and Signature)

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.