Title Page
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Site conducted
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Host employer:
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Request / issue date:
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Consultant name:
PPE Issue details
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Candidate Name:
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Start date:
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PPE Required / Issued
- Jacket
- Shirt
- Boots
- Work Pants
- Polar Fleece
- Hard Hat
- Eye Wear
- Wet Weather gear
- Other
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Details / type:
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Size:
- XS
- S
- M
- L
- XL
- XXL
- XXXL
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Number issued:
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Details / type:
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Size
- 8
- 8.5
- 9
- 9.5
- 10
- 10.5
- 11
- 11.5
- 12
- 12.5
- 13
- 13.5
- Other
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Number issued:
-
Details / type:
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undefined
- 34
- 36
- 38
- 40
- 42
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Number issued:
-
Add more items
-
PPE Required / Issued
- Jacket
- Shirt
- Boots
- Work Pants
- Polar Fleece
- Hard Hat
- Eye Wear
- Wet Weather gear
- Other
-
Details / type:
-
Size:
- XS
- S
- M
- L
- XL
- XXL
- XXXL
-
Number issued:
-
Details / type:
-
Size
- 8
- 8.5
- 9
- 9.5
- 10
- 10.5
- 11
- 11.5
- 12
- 12.5
- 13
- 13.5
- Other
-
Number issued:
-
Details / type:
-
Size
- 34
- 36
- 38
- 40
- 42
-
Number issued:
-
Add more items
-
PPE Required / Issued
- Jacket
- Shirt
- Boots
- Work Pants
- Polar Fleece
- Hard Hat
- Eye Wear
- Wet Weather gear
- Other
-
Details / type:
-
Size:
- XS
- S
- M
- L
- XL
- XXL
- XXXL
-
Number issued:
-
Details / type:
-
Size
- 8
- 8.5
- 9
- 9.5
- 10
- 10.5
- 11
- 11.5
- 12
- 12.5
- 13
- 13.5
- Other
-
Number issued:
-
Details / type:
-
Size
- 34
- 36
- 38
- 40
- 42
-
Number issued:
-
Other items supplied:
- Safety glasses
- Gloves
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Other requirements:
Candidate declaration
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I have received the listed items of PPE from Searson Buck
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By signing this document I understand that if I should leave employment within 3 months of the commencement date, Searson Buck will deduct an amount equal to the cost of the PPE from my final wages, unless another arrangement can be made with Searson Buck.
the replacement of any lost or misused items of PPE will be my responsibility and if these replacement items are supplied by Searson Buck, I agree to a deduction from my pay of the replacement cost. -
Candidate Signature
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Consultant Signature
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Total Price:
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Date
