Information
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Site conducted
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Project Name
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Date and time site induction conducted
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Location
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Inductor's Name / Position
Inductee details
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Employer Name
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Employer Phone No.
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Employee Name
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Position of Employment
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General Induction Card Date
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General Induction Card Number
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General Induction Card photo
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I have attended a WMS/Safety Plan/Risk Assessment induction by my employer
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Other Certificates of Competency/Permits (cert number/class)
My signature below confirms that I have been instructed in and understand the following:
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1. Site specific induction carried out by Kerdic Homes
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2. My employer's site specific health & safety plan or work method statements
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3. Worker's obligations under the Workplace Health & Safety Act
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4. Who to contact if there is an emergency, incident or hazard, who is the designated first aid officer and where to access the first aid kit
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5. Report any OH&S event to the Safety Advisor if not available to the Site Supervisor
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6. I am aware of Kerdic Homes' Safety Policy and that it is included in the Project Safety Plan
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7. I have been advised where I can access all relevant legislation, codes of practice and standards at Kerdic Homes (refer to ME:06 Legislation & Other Information if contractor requires detailed information)
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8. I have been advised about the Dispute Resolution Process and understand that if I am not in agreement with the OH&S Dispute Resolution process, that I can request a new Dispute Resolution Process and this process is to be raised and resolved at project induction, this new agreed process will be entered into the Project Safety Plan
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9. I am aware that the National Code of Construction 2015 applies to this project
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10. I have been informed of all common plant and details about how it is to be used
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If supplying plant and equipment: I have completed and forwarded the Plant & Equipment Checklist App-ME:13M and confirm that there have been no changes to the checklist provided.
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I hold the appropriate licenses and qualifications for the work I will undertake on this project.
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I will also follow health and safety instructions as directed by Kerdic Homes and understand I may be denied access to the project if I fail to follow health and safety provisions on site.
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Worker Signature
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I agree with the Dispute Resolution Process (if new process is advised refer to ME:05 item 24)
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In an emergency, please contact:
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Phone No.
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Medical Conditions/Allergies
KERDIC HOMES USE ONLY
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I have sighted the abovementioned General Safety Induction Evidence and licenses and the abovementioned person has been provided with a specific induction for this project which addressed the items required for site inductions in the Project Safety Plan:
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Grant Baillie
Induction
As a Kerdic Homes worker/subcontractor I am aware and have been given the opportunity to raise any issues with the following points:
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I am aware that I am to wear appropriate Personal Protective Equipment relative to the task I am performing and have been given training in its use
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I have been advised who to contact if an incident occurs
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All safety issues should be reported to a Kerdic Homes Representative
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I am aware all rubbish is to be placed in designated areas
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I am aware only licensed scaffolders are to erect/dismantle scaffold over 4 meters and only licensed scaffolders may alter the scaffold.
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If an area is barricaded I must avoid walking through the barricaded area
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Work areas are to be kept clean and tidy at all times
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I must carry my general Induction card (White Card) at all times on site
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I must not be affected by drugs or alcohol anytime whilst working on site
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I will not engage in any activities that will bring Kerdic Homes into disrepute
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Smoking is only permitted in designated areas where there is no risk of fire or damage to house, cigarette butts must be disposed of appropriately
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No fighting or over aggressive behavior will be tolerated
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I will be engaging in high risk activity as stated in Work Health & Safety Regulations 2011, if yes prior to conducting work I will submit a Safe Work Method Statement to Fowler Homes and I will have read, understood and signed SWMS
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Work involving a risk of a person falling more than 2m
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Any work connected with an excavation or demolition
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Work involving structural alterations or repairs
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Work is carried out in or near a confined space
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Work in or near a pier or trench greater than 1.5m
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Work is carried out on or near
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I understand that if I fail to adhere to Kerdic Homes policies and procedures as stated in the WHS management Plan, I will be required to pay costs for any non conformance. The contents of the Kerdic Homes WHS Management plan is accessible online at www.beechwoodhomes.com.au/subcontractors
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I certify that I have undergone Kerdic Homes Subcontractor Induction Training and have been made aware of Site Rules, WHS management Plan and Code of conduct
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Induction given by: