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Title Page
Company name
Company representative
Assessment started on
Assessment concluded at
Assessment done by:
Location
Assessment Overview
This assessment is performed to verify the implementation of HSE measures on the ground. It is partly based on the requirements of the Contractors SHE file submitted prior to start of work.Scoring 0: Not assessed 1: No valid documentation or requirement, not present or expired. 2: Documentation exists but is not implemented and updated 3 : Docs are valid , requirements are implemented but are substandard 4:Docs are valid, requirements are implemented , meet a minimum standard 5 Docs are valid ,requirements are implemented, meets standard, used for continuous improvement
HSE management Compliance
Substandard Behaviour or conditions Observed
Substandard condition/ Behaviour
What is the potential Risk Level
Has the issue been resolved?
Legal Documents:
Letter of Good Standing
Public Liability Insurance (Min R10M)
Contractor Appointment letter (Principal- and Contractors)
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.