Title Page
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Site conducted
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Workplace
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Company Name:
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Contractor’s Name:
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Conducted on (Date and Time)
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Prepared by
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Location
General Information
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Brief description of work to be performed
General Induction
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Summary of School WHS policy
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Expected Behaviour/Interaction with Students
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Parking and Unloading arrangements
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Evacuation and Lockdown Procedures
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First Aid and Accident Reporting
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Toilet Facilities
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Hazard Reporting
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Smoking, Drugs and Alcohol
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Confined Space Entry Permit
Information to be provided by the Contractor
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Licence details
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A copy of the current contractors Public Liability Insurance Certificate of Currency (minimum ten million sum insured)
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A copy of the current Workers Compensation Insurance Certificate of Currency
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Current Working with Children Check (Blue Card)
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Safe Work Method Statements (SWMS)
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Personal Protective Equipment (PPE)
Completion
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AUTHORITY
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I have been provided with and understand the information (as indicated above) and will comply with all instructions:
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Contractor (Name and Signature)
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I have provided the contractor with the relevant Department and site-specific information related to the works to be conducted.
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School Representative (Name and Signature)
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Select date