Contractor Reporting

Contractor Reporting Form

Please enter your full name:

Please enter your phone number:

Please enter your email address:

Please select the month for which you are reporting for:

Select the Contract you are reporting for:

Enter the total number of hours worked by workers at the project site this month, according to your records:

Male: Female:

Enter the total number of workers who worked at the project site this month, according to your records:

Male: Female:

Any update to the OHS Management Plan?:

Yes No

Attach OHSMP updates or changes (Supported file types: pdf, doc & docx):

Attach the Safety Officer's Monthly Report (Supported file types: pdf, doc & docx):

Attach the other Safety Documents (Supported file types: pdf, doc & docx):

Leading Indicators

	Number	Rate (per 40 hours)	Positive	% Positive
Training
Enter how many people were INDUCTED this month
Enter how many people were COMPETENCY ASSESSED this month
Enter how many people received NEW SKILL TRAINING this month
Enter how many people received OHS training this month
Enter how many people received HIV/AIDS training this month
Enter how many people received GBV/VAC training this month
Health Checks
Site health and safety audits
Safety briefings
Drug checks
Alcohol checks
HIV checks
Risk Identification
Near misses
Stop work actions
Traffic management inspections
Completed investigations
New risks identified
Suggestions for improvement identified
Total

Lagging Indicators

	Number	Injury rate (per thousand hours)
Fatal injuries
Notifiable injuries or incidents
Lost time injuries or illnesses
Medically treated injuries or illnesses
First aid injuries
Injury with no treatment
Traffic accidents involving project vehicles equipment
Accidents involving non-project vehicles or property
Environmental incident
Escape of a substance into the atmosphere
Utility or service strike
Damage to public property or equipment
Damage to contractors equipment
Worker leaving site due to safety concerns
Staff on reduced alternate duties
Total fatalities and injuries
Overall Total

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