Title Page
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Site conducted
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Conducted on
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Prepared by
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Location
Section 1: To be completed by Contractor and submitted to IBRA Representative prior to mobilizing to site
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Instructions for Contractors: Section 1 of the Authority to Mobilize (ATM) is a pre-mobilization check that must be completed by all contractors that provide services on Iberdrola Renewables Projects sites or locations. Authority to Mobilize Section 2 IBRA-RP-HSE-FRM-007-Rev00 Contractor Pre-start will be completed on site with the IBRA Representative prior to the commencement of work. Contractors are required to complete Section 1 and submit it, along with all requested information, to their nominated IBRA Representative, for review and approval, prior to commencing any works on site. If you have any questions, you should contact your IBRA Representative for clarification
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Date:
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Contracting Company:
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PO Number:
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IBRA Contract Representative:
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Site/Location:
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Planned duration of works:
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ATM is only valid for this period
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Start date:
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End date:
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1.2 Access Requirements
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Is your company HSE prequalified with IBRA? Please provide evidence
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If not prequalified, attached evidence of required insurances, and tick
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Public Liability - $20M
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Workers Compensation
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List of names of all workers carrying out work attached (if known). Names must be provided before site access is granted. Names can be attached
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Licenses and competencies of all workers have been supplied or attached
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A register of plant and equipment to be used on site is attached?
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A register of chemicals to be used on task is attached, and Safety Data Sheets available?
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Is a Journey Management Plan required for travel to/from site? Please provide if yes
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A preliminary risk assessment (JSEA, SWMS, etc.) relevant to the scope of works has been supplied?
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Will you be engaging any sub-contractors to complete the work? If yes, provide details below
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Vendors who will be engaging sub-contractors to perform work must be HSE prequalified. Contact your IBRA Contract Representative if you are engaging sub-contractors and/or require prequalification
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Sub-Contractor Name:
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Trade/Specialty:
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Note: A site induction is a condition of entry onto all IBRA work sites. Please contact your IBRA Contract Representative for details
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1.3 Work Scope
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Describe works to be carried out:
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(Please attach)
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Will the works involve any of the following High-Risk Activities* (tick all that apply)?
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Electrical work*
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Confined Space Entry
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Removal of Asbestos
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Excavation Work
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Working at Heights
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In or near water where there is a risk of drowning
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Work carried on pressurised gas or fluid systems or chemical, fuel or refrigerant lines
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Tilt-up or pre-cast concrete
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Work carried out in an area/s that may have a contaminated or flammable atmosphere/location
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Demolition
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Lifting Operations
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Contractor Company Representative:
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Phone Number:
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This form, and any attachments, must now be forwarded to your IBRA Contract Representative for review and approval
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IBRA USE ONLY: Authority for Contractor to mobilize to site to be reviewed and signed by IBRA Contract Representative
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Name:
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Position:
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Signature:
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Date:
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* If the contractor is not HSE Prequalified and the scope of work involves any of the High-Risk Activities indicated above, the ATM must be reviewed, and approved by the Head of Function / Project Manager or (approved delegate)
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HSE Review
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Name:
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Date
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Signature
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Head of Projects App
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Name
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Date
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Signature
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*Electrical Work – work on any electrical equipment or installation that operates at a voltage greater than extra-low voltage
