Wor Cor Pgs 567 Supplier Self Assessment

WORK INSTRUCTION Author: Melanie Moore Quality Manager
HSEQ SUPPLIER / CONTRACTOR SELF Owner: Joanna Oustad Senior Vice President
ASSESSMENT LIGHT Document number: WOR-COR-PGS-567

BU: Corporate [COR] Scope: PGS Group [PGS] Subject: HSEQ
Reviewer(s): Hilmija Draganovic; Joost Bakker; Stein Olav Hagalid; Tony Robertsen; Magnus Christiansen
Related Procedure: PRO-COR-PGS-411
Supplier / Contractor HSEQ Self-Assessment - Questionnaire
Supplier Name
Contact Person
Supplier address
Contact Telephone
Supply Type
Date questionnaire completed
(NB: In cases where “Yes” or “No” is not the precise answer, please provide supporting information)
Section 1: Leadership & Commitment Responses

Questions Yes No Supporting information
1.1 Are senior managers personally involved in the
management of HSEQ?
1.2 Is the company certified according to ISO9001,
OHSAS 18001, ISO 14001, EMAS or other relevant HSEQ
standards? Please specify and attach relevant certificates.
Revision: 1 Effective from: 01/04/2015 Page: 1 of 5

UNCONTROLLED WHEN PRINTED

Section 2: HSEQ Policy and Strategic Objectives Responses

2.1 Does your company have a documented HSEQ
policy? If YES, please attach a copy.
2.2 Does your company have a documented HSEQ
manual? If YES, please attach a copy.
2.3 Who has overall and final responsibility for HSEQ in
your Organization?
2.4 Does your company have a long-term (3-5 years)
HSEQ strategy or improvement plan in place? If YES,
please attach a copy.
Section 3: Organization, Responsibilities, Resources Responses

and Documentation
3.1 Is your organization structured to manage and
communicate HSEQ effectively?
3.2 Does your Organization have HSEQ specialist
resources available?
3.3 Are your company standards aligned with industry
guidelines or recommended practices? If YES, please
specify.
3.4 What arrangements does your company have to
ensure employees and also new employees have
knowledge of your HSEQ policies, practices and company
requirements?
3.5 Does your organization have a competence
management system in place? If YES, please describe the
scope and content of your competence management
system.


3.6 Have managers and supervisors at all levels who will

plan, monitor, oversee and carry out the work received
formal HSEQ training in their responsibilities?
3.7 Do purchasing specifications and/or contracts with
sub-contractors incorporate HSEQ requirements?
3.8 How is sub-contractor HSEQ capability and
performance monitored and evaluated?
3.9 Do you meet regularly with the sub-contractor to
discuss and action any interface situations?
Section 4: Risk Management Responses

4.1 Has applicable legislation, codes of practice and/or
other requirements been identified and complied with?
4.2 Are changes in legislation, codes of practice and/or
other requirements monitored?
4.3 Are the necessary licenses and/or permits for your
activities and locations in place and valid?
4.4 Is Risk assessment undertaken and documented for
all tasks that involve hazard to health, safety, security or
the environment?
4.5 Are mitigation and control measures clearly defined,
documented and implemented?
Section 5: Planning & Procedures Responses

5.1 Do you have a company HSEQ Management System
manual (or Operations Manual with integrated HSEQ
requirements) which describes in detail your company
approved HSEQ working practices relating to your work
activities? If YES, please attach a copy of an index.


5.2 How do you manage changes and assess associated

risks e.g. personnel, equipment, processes, and
documentation?
5.3 Is an emergency response plan that includes
identified potential incidents/accidents/spills in place?
5.4 Does the emergency response plan clearly identify
authorities to be notified in the event of an
incident/accident/spill?
5.5 Are Emergency training and drills that cover
incidents/accidents/spills conducted and documented?
Section 6: Performance Monitoring Responses

6.1 How is health performance monitored and recorded?
6.2 How is environmental performance monitored and
recorded?
6.3 How is quality performance monitored and recorded?
6.4 How is security performance monitored and
recorded?
6.5 How is safety performance monitored and recorded?
6.6 How is social responsibility performance monitored
and recorded?
6.7 How often is HSEQ performance reviewed? By
whom?
6.8 How is logistics performance monitored and reported?
Section 7: HSEQ Auditing, Review and Reporting Responses

7.1 Is a system for reporting incidents, accidents, near
hits/misses and spills in place?
7.2 How and what near miss incidents are reported?


7.3 Do you have a system in place which detects

problems and promptly affects corrective action?
7.4 Do you have a written procedure for HSEQ auditing
and management review? If yes, please attach a copy.
Section 8: Social Responsibility and human rights Responses

8.1 Does your organization have procedures in place to
comply with internationally recognized labour standards
covering any of the following areas:
Minimum wages?
Working hours and vacation?
Disciplinary practices and employment practices?
Working Conditions?
Terms of employment for migrant workers, including
Human trafficking?
8.2 Do you employ child labor (younger than 15 years
old)?
8.3 Do you have a written policy/procedure stating that
you will not employ children below the legal age of
employment?
Section 9: HSEQ Management - Additional Features Responses

9.1 Does your Organization (globally, regionally or locally)
have any HSEQ features or arrangements not described
elsewhere in your response to the questionnaire?


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WORK INSTRUCTION Author: Melanie Moore Quality Manager

ASSESSMENT LIGHT Document number: WOR-COR-PGS-567

Supplier / Contractor HSEQ Self-Assessment - Questionnaire

Date questionnaire completed

Section 1: Leadership & Commitment Responses

Revision: 1 Effective from: 01/04/2015 Page: 1 of 5

ASSESSMENT LIGHT Document number: WOR-COR-PGS-567

Section 2: HSEQ Policy and Strategic Objectives Responses

Section 3: Organization, Responsibilities, Resources Responses

Revision: 1 Effective from: 01/04/2015 Page: 2 of 5

ASSESSMENT LIGHT Document number: WOR-COR-PGS-567

3.6 Have managers and supervisors at all levels who will

Section 4: Risk Management Responses

Section 5: Planning & Procedures Responses

Revision: 1 Effective from: 01/04/2015 Page: 3 of 5

ASSESSMENT LIGHT Document number: WOR-COR-PGS-567

5.2 How do you manage changes and assess associated

Section 6: Performance Monitoring Responses

Section 7: HSEQ Auditing, Review and Reporting Responses

Revision: 1 Effective from: 01/04/2015 Page: 4 of 5

ASSESSMENT LIGHT Document number: WOR-COR-PGS-567

7.3 Do you have a system in place which detects

Section 8: Social Responsibility and human rights Responses

Section 9: HSEQ Management - Additional Features Responses

Revision: 1 Effective from: 01/04/2015 Page: 5 of 5

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