Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Executive Summary

Description of Project or Contract

  • Include project name, number, full list of attendees and positions, Business unit, Auditor name.

  • Audit start date

  • Audit end date

Audit Executive Summary

  • Points of Merit

  • These are where the project or contract have been innovative in their application of the Safety Essentials and are displaying leading practice backed with evidence as records.

  • Non Conformances

  • This is where the project or contract does not comply with the requirements of the Safety Essentials

  • Area of Concern

  • The project has implemented the requirements of the safety essentials to some extent, but have not consistently applied them in practice or there is no evidence to support the implementation in some cases.

  • Opportunity for Improvement

  • Areas discussed in the audit where improvement opportunities have been identified, but otherwise the project is compliant

  • Audit prepared by

  • Signed:

  • Audit findings accepted by:

  • Signed:

Previous Audit Verification

  • When was the previous audit held?

  • Select date

  • Is this audit in Cintellate? Reference AUD number

  • Have actions been raised against all NCR'S, AOC and OFI's?

  • Will the actions raised effectively address the NCR'S, AOC or OFI'S?

  • Have all the actions been addressed?

  • If No, select this switch<br>

  • Record the actions not addressed and why (include action number from Cintellate)

General Desktop Review

  • Scoring for Desktop review section.

  • Questions are yes/no answers and then the whole section is then ranked on a 0 to 3 score with the following applicable guidelines.
    3 = Fully Compliant (COMP)
    2 = Partially Compliant - Opportunity for improvement (OFI)
    1 = Minimal Compliance - Area or Concern (AOC)
    0 = Not Compliant - Non Conformance Report (NCR)

General Questions - Desktop component

  • Where there are work activities within the scope of works that have Safety Essentials identified as relevant, please tick the relevant Essentials below.

  • Working in and around live traffic

  • Electrical work

  • Working at Height

  • Working in and around mobile plant

  • Working with temporary works

  • Mechanical lifting

  • Working with live services

Risk Management

  • Are all applicable Safety Essentials in Active Risk Manager (ARM)?<br>

  • Has the Project/Contract held a risk workshop in the previous 3 months?

  • Is this recorded in Cintellate?

  • If Yes select switch.

  • Record Cintellate review number

  • Have the Safety Essential Risks in ARM been Assessed/Reassessed in the last 3 months?

  • Do all Risks have an Owner?

  • Are all fields in ARM completed, including the justification fields, current and target risks and all treatment plans?

  • Do all treatment plans have a list of responses that are customized to the project's requirements?

  • Are there any overdue Risk Treatment Plans?

  • Is there evidence of Task Observations conducted to verify risk treatment plans are implemented and effective?

  • Overall result for Risk Management.

Communication

  • Are the applicable Safety Essentials posters displayed in lunch rooms or applicable notice boards?

  • Are applicable Safety Essentials included in the site induction?

  • Are applicable Safety Essentials included in the packs provided to potential contractors so that these can be addressed in their tender?

  • Are there records to demonstrate that the Safety Essentials have been communicated to all workers, management and sub contractors? Examples are meeting minutes, toolbox records, training records, safety foundations training (employees), pre-start records.

  • Are there records of pre-start meetings in Cintellate, including references to permits and SOPs, for work involving the Safety Essentials?<br>

  • Have all Employees signed the Safety Essential Booklet Personal Commitment page?

  • Overall result for communication

Work activity documentation

  • Have the project developed Work Activity documentation (eg:SOP's or SHEWMS) for all Work Activities involving the Safety Essentials?

  • Do the SOP's (or equivalent) for work involving the Safety Essentials document the supervisory requirements?

  • Do the documents have above the line controls for Critical Risks?

  • If No turn this switch on

  • Do the Safe Work Documents cover training and competency requirements (referenced to national competences where applicable)' PPE (specific types) and Equipment to be used?

  • Do contractor evaluations include a check of the work activity documentation to ensure that above the line controls are in place and the Safety Essential requirements included?

  • Does the work Activity documentation describe the PPE requirements accurately and fully?

  • Is there a process in place to identify and manage other activities impacted by the work, including adjacent work areas (interface management processes such as authority to work, work authority notice)?

  • Overall result for work activity documentation

Training

  • Are induction records (including safety essentials) available for all workers on the project?

  • Are there records of verification of Competency for the work activities being undertaken?

  • Do applicable workers hold the required licenses and or certification required by the Safety Essentials?

  • Have workers been trained in the LCPL processes relevant to the applicable safety essentials? ( refer to the competency reference guide on Our Way)

  • Are training and competency records up to date?

  • Is a training matrix available for the site? Including contractors?

  • Overall result for Training

Permit to Work - Desktop component

  • Has the project implemented Essential- Permit to Work process on Our Way?

  • If different from the Services Division Essentials: "Permit to Work" process, does the project specific process comply with the Services Division requirements.

  • Is the project using the multi purpose work permit tool from Our Way or an alternative tool approved by The Divisional Business Partner?

  • Is there a Permit to Work register in place and up to date?

  • Are permits reviewed and issued by trained Permit issuers prior to the work going ahead? Approved National Competency - see competency guide on Our Way.

  • Is the permit holder trained? (National competency)

  • Does the permit issuer have at least a basic level competency in the activities on the permit? Eg: working at height training, electricians license?

  • Are permits retained with work order records or otherwise stored so as to be readily accessible? Record how records are managed.

  • Do the permits adequately define the scope and location of works?

  • Does the permit reference the applicable SOP or equivalent?

  • Do the SOP's clearly identify when a permit is required?

  • Do the permits clearly define start and end times and last no longer than one shift?

  • Are Permits closed, reviewed and re-issued when personnel changes occur?

  • Does the permit identify the person doing the work and the competent supervisor?

  • Do records show that the permits have been signed by the permit issuer, the permit holder, all workers and then closed off by the issuer on completion of works

  • Overall result for Permit to work

  • Overall result for General Section

Task Observation at worksite

  • Scoring
    Questions are ranked on a 0 to 3 score with the following applicable guidelines.
    3 = Fully Compliant (COM)
    2 = Partially Compliant - Opportunity for improvement (OFI)
    1 = Minimal Compliance - Area or Concern (AOC)
    0 = Not Compliant - Non Conformance Report (NCR)

  • Work Activity Observed

  • Work Activity
  • Record work activity details, names of work crew and supervisor, work order number and location. Reference SOP number or photograph it. Take photos as required for each question.

  • Are the work team wearing and using appropriate PPE?

  • Are all members of the work team inducted?

  • Are permits available at the work site?

  • Are there records of a pre-start meeting that references the SOP (or equivalent) and that all people on the work team signed?

  • Does the documentation have above the line controls recorded?

  • Is the SOP or other safe work documentation at the work site?

  • Are the above the line controls in place?

  • Have the work team completed a Dynamic Risk Assessment such as a Take 5 or job start card?

  • Have the additional hazards or changed conditions been recorded?

  • Have all identified additional hazards been controlled above the line?

  • Are the work team trained and deemed competent in the Work Activity? Is there evidence such as licenses, tickets?

  • Are appropriate rescue arrangements in place and understood by the work crew?

  • Do behaviors and activities of the work crew ensure there is no potential for risk to any person?

  • The next section focusses on the Safety Essentials being Audited as part of the work activities being viewed.

Essential Specific Questions

  • Turn this switch on if Working in and Around Traffic is being audited<br>

Working in and around Live Traffic - Desktop

  • Has the project implemented and communicated the process "Essential- working in and around live traffic" from Our Way

  • Are traffic management plans (or traffic control plans) in place that are compliant with the requirements of AS1742.3 or NZ CoPTTM?

  • Have the traffic management plans (or traffic control plans) been approved by a competent person such as a traffic engineer or equivalent?

  • Is there a documented approval process for TCP's that are generated electronically? (Within control room software)

  • Have these been recently reviewed? (Within 2 years of after a change)

  • Are records of reviews maintained? (record how and where)

  • Do the traffic control plans reflect current conditions , ie traffic expected to travel at faster than posted speeds, or slower?

  • Are there requirements in place to use Attenuators (TMA) as a preferred control for work in live traffic?

  • Have requests to relevant authorities including client, local traffic authorities, and police as required been made as part of the permit for road closures, or speed reductions?

  • Are work team supervisors responsible for traffic management trained and competent? (Records of National Competency - refer competency guidelines on Our Way)

  • Turn this switch on if there is a work activity being observed that involves this Safety Essential.

Working in and around live traffic - Task observation

  • Record the Work Activity being observed, the work order number and the supervisor and team members names.

  • Is the work being done under a traffic control plan with at least one of the following above the line controls in place? Road closure, use of automatics or remote controlled traffic signals, with physical barriers in place?

  • If No is there a signed exception in place?

  • Have the control measures been incorporated into relevant work activity documentation?

  • Is the highest level of control that is reasonably practical in place?

  • Are there requirements in the documentation to ensure all workers around traffic are trained and deemed competent to wirk with live traffic risks and controls?

  • Do the traffic control plans identify the necessary controls to separate people from traffic, such as physical barriers and minimum separation distances?

  • Has a pre start been signed by all workers that references the TCP and Safe Work Documentation?

  • Are attenuators used as the preferred above the line control wherever reasonably practicable?

  • Are all areas under traffic management clearly signposted to prevent unauthorized access?

  • Is the traffic control implemented as per the TCP or equivalent?

  • Does the TCP include authorization from the relevant authorities as required?

  • Observe behaviors and actions and note any that put people at risk

  • Turn this switch on if Electrical Work is being audited.<br>

Electrical Work -Desktop

  • Has the project implemented and communicated the process "Essential - Electrical Work" from Our Way

  • Has the project implemented and communicated the process "isolate Hazardous Energy"from Our Way

  • Has the requirement for no live work been included in work activity documentation for all work involving electrical equipment?

  • Has the project documented and implemented a process for conducting fault finding on live equipment that is compliant with relevant Australian standards and Electrical Legislation?

  • Is the above process referenced on the work activity documentation?

  • Has all Work Activity Documentation included the competency requirements for the work, specifically? (exact competence levels and licenses documented)

  • Have electrical isolation permits been included on the project permit register?

  • Does the work activity documentation include a requirement for all electrical isolations to be undertaken with an isolation permit?

  • Has the project included test for dead requirements in the SOP or a specific separate process referenced in the SOP?

  • Have fixed earth leakage protection devices been regularly inspected as per statutory requirements?

  • Has the project implemented and communicated the process "Test and Tag Electrical Equipment" from Our Way

  • Is the a Test and Tag register in place and current?

  • Has the testing and tagging been conducted by approved and qualified personnel?

  • Are certificates of safety compliance provided to clients when work is completed on electrical installations?

  • Has the project implemented a process for use of temporary distribution boards?

Electrical Transmission and Distribution Networks. additional requirements.

  • Has a process been implemented for isolation of HV electrical apparatus?

  • Has the requirement for HV apparatus to be isolated, proved to be de-energized, earthed and short circuited been included in Work Activity Documentation?

  • Have HV and Electrical live work permits been included on the project/site permit register?

  • Have safe approach distances been documented in work activity documentation?

  • Has the requirement for insulating sticks, barriers, earths and other engineered electrical equipment been implemented and documented in the work activity documentation?

  • Is all HV switching been completed by people licensed and certified under the relevant regulatory body's requirements?

  • Has a process for using and entry into HV compounds work permit been established

  • Are the HV compound Permits included on the site permit register?

  • Turn this switch on if there is a work activity being observed that involves this Safety Essential.

Electrical work - Task Observation

  • Record the Work Activity being observed, the work order number and the supervisor and team members names.

  • Is the work being done with at least one of the following controls in place? Isolation or disconnection, using an alternative energy source, with fixed or portable RCD's on power and lighting circuits and using insulated tools.

  • If it is not, is the work being done to an approved exception?

  • Is the highest level of control that is reasonably practical in place?

  • Have the control measures been incorporated into relevant work activity documentation?

  • Are all isolation points on electrical plant identified and clearly and legibly labelled?

  • Are switchboard circuits and isolation points documented in circuit diagrams accessible at the work site?

  • Do mains and distribution boards have a legend or circuit diagram in the cabinet?

  • Is the work being done under an electrical isolation permit.

  • Has a test for. Dead been conducted before work?

  • Are all circuits protected with earth leakage? (except where this compromises public safety.)

  • Are isolations locked out with personal locks and identification tags?

  • Where teams are involved are there master locks and individual locks in place for all electrical isolations?

  • Do the tags include contact details of the person they belong to? Name, company, phone number?

  • Is all equipment being maintained compliant to Australia/New Zealand Wiring Rules AS/NZS3000 and AS/NZS3012?

  • Has all electrical equipment and plant been inspected, tested and tagged by a qualified electrician before bring brought to site?

  • Does the Electrical Supervisor have the appropriate competency for the work?

  • Where required is there an LV rescue kit in place and deployed by a competent, trained person?

  • Is all portable electrical equipment that is to be used tagged with a current test and tag, conducted by approved and qualified personnel?

  • If any Temporary Electrical Works are being completed turn this switch on.

Temporary Electrical Works

  • Are all temporary distribution boards of robust design, mounted securely and constructed from materials able to withstand mechanical damage?

  • Are the distribution boards locked?

  • Are all temporary distribution boards waterproof?

  • During minor works, have all electrical leads been secured off the ground by insulated hooks and or lead stands?

  • If any HV work is being observed, turn this on.

Electrical Work - HV Task Observation

  • Has performing work under isolated and earthed conditions been considered for works required to be undertaken by live-HV workers? If this cant be down, why not?

  • Are all elevated work platforms used near live electrical apparatus insulated to a voltage equal to or greater than the operating voltage of the apparatus?

  • Have safe approach distances been established for working in the vicinity of electrical apparatus?

  • Are barriers in place to ensure that safe approach distances are not breached by anything other than approved equipment?

  • Is the worker wearing appropriately related HV gloves and using a mat when testing for dead?

  • When live work is to be undertaken, are workers fully insulated from Earth and other conductors?

  • Are appropriate permits in place and at the work location as required by the network operator and the relevant legislation (as documented in the SOP)?

  • Where HV switching is being completed, are documented switching sequences in place and being undertaken by a competent licensed HV operators?

  • Where entry to zone substations is required, are people trained and deemed competent and are permits approved.

  • Turn this switch on if Working at Height is being audited<br>

Working at Height - Desktop

  • Note: where EWP is used this also refers to scissor lifts, mobile EWP, boom lifts, cherry pickets, etc.

  • Has the project implemented and communicated the process "Essential - Working at Height" from Our Way

  • Are working at height permits specified for all work where there is a risk of fall from height and no compliant fixed edge protection is in place?

  • Have rescue plans for the work activities been developed by a competent person?

  • Has the frequency for rehearsing emergency rescue plans been determined?

  • Is there evidence of rescue arrangements being practiced?

Elevated Work Platforms

  • Have the project implemented the requirements of Manage Elevated Work Platforms from Our Way

  • Have Plant Risk Assessments been conducted on all site EWP's and records available?

  • Are pre-start inspections completed and recorded for all EWP's before use?

Scaffolding

  • Has the project implemented the erect scaffold process on Our Way?

Fall protection equipment

  • Has all restraint equipment been included on the project fall protection equipment register?

  • Have all anchor points been clearly identified on drawings/plans?

  • Have all anchor points and static lines been certified by a qualified and competent engineer in the preceding 12 months. Are records and certificates available and SWL marked/tagged on the equipment?

  • Is there a process in place for inspection and testing of harnesses and fall arrest equipment if used? AS 1891

  • Turn this switch on if there is a work activity being observed that involves this Safety Essential.

Working at Height -Task Observation

  • Is the work being done with at least one of the following controls in place?<br>Work at ground level<br>From a solid or permanent structure<br>With compliant fixed edge protection, from an EWP, scaffolding, or platform ladders.<br>

  • If not is there an approved exception in place?

  • Is the highest level of control that is reasonably practical in place?

  • Have the control measures been incorporated into relevant work activity documentation?

  • Is a work at height permit available at the work site? (If required)

  • Are rescue kits or arrangements in place?

  • Has the rescue plan been communicated to all workers including contractors?

  • Are all items that have the potential to fall attached to a lanyard to prevent them from falling?

  • Is the work area set up to exclude the possibility of a person walking underneath the work zone?

  • Has any equipment and plant being used been subject to a pre-start inspection?

  • Have the harnesses and fall prevention lanyards inspected according to the Australian Standard (if used)? Current tags attached?

  • Is the work team supervisor trained and competed in work at height?

  • Have all anchor points been inspected and tagged defining the SWL?

  • Are all scaffolds erected on site by competent scaffolders to approved drawings and erection plans?

  • Have all scaffolds >4m been inspected and issued with certificates prior to handover?

  • Has a scafftags system been implemented foe al scaffolds >4m?

  • Have scaffolds been regularly inspected during the works period, ie start of shift?

  • Are works in accordance with the work activity documentation?

  • Turn this switch on if Working in and around Mobile Plant is being audited.

Working in and around mobile plant - Desktop

  • Has the project implemented the Essential - "working in and around mobile plant" process on our way?

  • Are there documented plant or vehicle management plans in place?

  • Are light and heavy vehicles separated wherever possible?

  • Are there arrangements in place to prevent vehicles and plant from being started when the driver is out of the vehicle or plant?

  • Are there Mobile plant risk assessments available for all plant items?<br>

  • Have all plant operators undertaken a Verification of Competency?

  • Are light vehicles fitted with flashing lights and equipped with first aid kits and fire extinguishers?

  • Are arrangements in place that ensure that people cannot interact with mobile plant? (Describe these)

  • Turn this switch on if there is a work activity being observed that involves this Safety Essential.

Working in and around mobile plant - Task Observation

  • Is the work being done with at least one of the following controls in place?<br>In an area that has been designed to prevent interaction between plant and equipment<br>What plant that has clear vision and adheres to current design standards<br>With physical barriers in place or with the use of proximity detection technology, reversing cameras, warning devices.

  • If not is there an approved exception in place?

  • Is the highest level of control that is reasonably practical in place?

  • Have the control measures been incorporated into relevant work activity documentation?

  • Are there arrangements in place to physically prevent people and moving plant interactions?

  • Has a pre start check been completed on the plant at site?

  • Did the pre start check refer to the plant risk assessment? Is the plant 100% fit for use?

  • Is a plant risk assessment available for all plant on the site?

  • Have the requirements of the TCP or TMP been communicated and implemented? Are people are following the requirements?

  • Has the Traffic control documentation (TCP/TMP) been referenced in the work activity documentation?

  • Has a pre start been signed by all workers and include the work activity documentation and TCP/TMP?

  • Are there reliable communications in place between operators (plant to plant) and people on the ground?

  • Are physical barriers used to protect workers and or members of the public from mobile plant interactions?

  • Where the above is not reasonably practicable are one or more of the following in place? <br>Delineation and exclusion zones,<br>Engineering detection systems, <br>Requirements for speed reduction<br>an Authority to work procedure with increased supervision of the work area and interfaces.

  • Where practicable are light and heavy vehicles separated?

  • Where not practicable has a risk assessment been conducted to identify risks and associated controls

  • Is work activity documentation in place for operational emergency response including breakdowns, refueling, tyre changing etc?

  • Turn this switch on if Working with Temporary Works is being audited.<br>

Working with Temporary Works - Desktop

  • Has the project implemented the "Essential - working with temporary work" process on Our Way.

  • Have structural support systems, including scaffolding 4m or greater been erected and approved by personnel who hold a scaffold license? (High risk work)

  • Are there appropriate processes in place to manage temporary cables and distribution boards?

  • Turn this switch on if there is a work activity being observed that involves this Safety Essential.

Working with Temporary Works - Task Observation

  • Is the work being done with at least one of the following controls in place?<br>Using a scaffold or work platform instead of working on a ladder?<br>Using prefabricated panels or modular elements rather than for work and poured concrete?<br>Using physical barriers to restrict entry and protect temporary supports against plant or vehicle collision?<br>Using additional structural support?<br>

  • If not is there an approved exception in place?

  • Is the highest level of control that is reasonably practical in place?

  • Have the control measures been incorporated into relevant work activity documentation?

  • Have temporary support systems been checked prior to loading? Evidence required.

  • Has an approved scaff-tag system been used for scaffold over 4m?

  • Have scaffolds over 4 m high been inspected and approved by a licensed and competent person?

  • Is there a copy of relevant TCP/PMP/VMP included in work activity documentation where this is potential for interaction with traffic, plant or light vehicles?

  • Are all structural elements of the temporary support system physically protected (solid barriers) from potential sources of damage from collision?

  • Have these control measures been regularly inspected to ensure their effectiveness?

  • Turn this switch on if Mechanical Lifting is being audited

Mechanical Lifting - Desktop

  • Has the project implemented the Essential - Mechanical Lifting process on Our Way?

  • Does the project ensure all crane operators, including contractors, have been trained and hold appropriate licenses? (High Risk Work)

  • Is there a lift plan template available for use for high risk lifts?

  • Has all lifting equipment had a risk assessment completed and is a copy of this available with the equipment?

  • Does all lifting equipment have a load limiter fitted?

  • Is the Safe Working Limit (SWL) marked on all lifting equipment?

  • Are all ropes, slings and lifting equipment subject to periodic review and test as required by Australian standards?

  • Turn this switch on if there is a work activity being observed that involves this Safety Essential.

Mechanical Lifting - Task Observation

  • Is the load to be lifted less than 85% of the safe working load?

  • Is the work being done with all the following controls in place. With plant that has clear vision, using physical barriers to provide separation between lifting operations and pedestrians or traffic, using automatic isolation mechanisms, with ROPS in place.

  • If not is there an approved exception for the activity?

  • Is the work being done with the highest level of control that is reasonably practicable in place?

  • Have the control measures been incorporated into relevant work activity documentation?

  • Are isolation mechanisms in place for all lifting equipment to prevent limiting out of radius and load limits in accordance with the applicable Australian Standards (eg: AS1418 for Cranes)?

  • Has a risk assessment been completed by a competent person and a copy available with the equipment?

  • Has a lift plan or SOP been developed by a competent person that documents the required equipment and safe method to lift?

  • Is the area around and below the lift area sufficiently barricaded to prevent access?

  • Has all lifting equipment been marked with the SWL?

  • Have all items of lifting equipment been inspected prior to use? All tags in date of calibration?

  • Is the operator of the equipment trained and deemed competent?

  • Is there a qualified dogger or rigger in the work team?

  • Does the work activity documentation include a requirement for the outriggers to be packed and supported as per manufacturers instructions.

  • High risk lifts include: Any lift where the lifting device will be operating at > 75% of its Safe Working load in accordance with load charts, Multiple Crane Lifts, where specifically identified by the project as high risk lift.

  • Is a lift plan in place and approved by a competent person for high risk lifts?

  • Prior to commencing lifting have the detailed lift sequences been documented and communicated to the team?

  • Has a certified geotechnical engineer assessed the ground conditions and advised on appropriate ground protection to ensure suitable support of outriggers

  • Has the accuracy of crane weight load indicators been verified using a calibrated test weight prior to any high risk lift?

  • Turn this switch on if Working with Live Services is being audited.

Working with Live Services - Desktop

  • Has the project implemented the "Essentials -working with live services" process on Our Way?

  • Has the project documented a process for using an energy isolation work permit? Includes Electrical , Mechanical, Hydraulic, Gas, Communications etc?

  • Has the project documented a process for using an excavation/penetration work permit?

  • Has the project documented a process for using a Working in the Vicinity of Overhead power lines work permit?

  • Have working in the appropriate permits been included in the site permit register?

  • Turn this switch on if there is a work activity being observed that involves this Safety Essential.

Working with live services - Task Observation

  • Have all services (underground, embedded, concealed,and above ground) been identified on specific services drawing?

  • Is the work being done with at least one of the following controls in place? By relocating the work activities, or the services away from the work, by using non destructive pot holing to locate underground services, by de-energizing and isolating services, with barricading and exclusion zones in place, by re-routing plant travel routs to avoid overhead lines or by fitting the plant with voltage détente tours with automatic shutdown height and slew restrictions.

  • If not, is there a signed exception in place?

  • Is the work being done with the highest level of control that is reasonably practicable in place?

  • Have the control measures been incorporated into relevant work activity documentation?

  • Have live services been relocated or de-energised and isolated before work in the vicinity?

  • Is there visible signage in place to identify the type and location or services?

  • Does the isolation permit cover all types of energy such as gas, water, communications, mechanical and electrical?

  • If excavating, Was Dial before you dig consulted as well as positively identifying the services before excavation

  • If in the vicinity of overhead power, has visible warning signage, tape, flags etc been used to ensure visibility of the service?

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.