HSE EVALUATION OF BIDDER

TOTAL E&P INDONESIE

Rev 2014
Diving Support Vessel

Contractor :
Service

DIV/DEP

:
Assesed by team :

Tender No :
Date :

Weighting
factor WFi

Max
score
Zi=3 x
WFi

System to follow up any change in local regulation

Statutory authorisations and permits available (SKT Migas and SKTPM)

Compliance with international standards ( ISO, OSHAS, IMO and OVID )

Established Corporate and Project HSE Organisation

Corporate HSE policy and its socialization
Procedure of HSE communication, program and HSE talk topic index
Implementation of HSE communication program and HSE talk, meeting

2
2
2
2

6
6
6
6

1
2
1
2

2
4
2
4

Current years HSE Objectives Management

Comprehensive and documented contractors HSE MS
HSE 03 - Operational responsibilities
Work Permit procedure & Implementation
Implementation of Work Permit audit and monitoring
Site personnel HSE Roles & responsibilities defined, known, implemented

2
1

6
3

1
1

2
1

2
2
2

6
6
6

2
1
2

4
2
4

Procedure to manage Electrical Safety and evident of implemention

Procedure to manage lifting gear inspection & certification and evident of
implementation
HSE 04 - Risk evaluation and management
HSE Plan including the management of risks
Copies of JRA implementation
Equipment Inspection and certification procedure, program and
implementation
A system & program to test and maintain safety and emergency equipment
and evidence implementation
Worksite housekeeping and industrial hygiene procedure & program
Procedure for managing risks in sea transportation
HSE 05 - Respect for the environment
Environmetal Management Plan (EMP)
Procedure, program of waste management and evidence of implementation

2
2

6
6

2
2

4
4

2
1
2

6
3
6

1
2
2

2
2
4

1
2

3
6

1
2

1
4

1
2

3
6

2
1

2
2

Procedure and implementation to monitor and measure waste and emission

impacts?
HSE 06 - Safeguarding of health
Procedure to manage the occupational risks for health?
Programme for staff medical assessment and follow up?
Procedure for the management of hazardous substances on site & its
implementation
Procedure to monitor housekeeping and hygiene in the living quarters, check
list?
Procedure and evidence implementation to manage PPE on site
Site first aid facilities, sickbay with qualified support personnel?
HSE 07 - Management of sub-contractors and suppliers (SC & S)
Procedure to evaluate HSE perfomance of sub-contractors ?

1
2
2

3
6
6

1
2
2

1
4
4

2
2

6
6

2
2

4
4

2
2

6
6

2
2

4
4

2
2
1

6
6
3

1
1
1

2
2
1

1
2

3
6

1
1

1
2

2
2

6
6

1
2

2
4

HSE EVALUATION

Score Weighted
Xi
score Yi
=Xi x WFi

HSE 01 Respect of Laws and Regulations

HSE 02 Responsibilities of Management Corporate HSE Organisation?

HSE 08 - Competence and training of personnel

HSE Training Matrix for all level
HSE Training program and evidence of implementation last 12 months
HSE 09 - Emergency preparedness
Emergency Respopnse Plan organisation for responding to an emergency
situation (plan and means and emergency scenarios described)
implementation of emergency drill exercises to validate emergency situation
procedures and to train personnel?
Qualified fire-fighting and SAR intervention teams?
HSE 10 - Incident analysis
Procedure & Implementation incident management
Procedure & Implementation anomaly management
A system to set up and follow up the associated corrective action plans
HSE 11 - Audits and inspections
Procedure, program and evidence implementation for internal HSE audits
Documented evidence of associated corrective action plans?
HSE 12 - Performance improvement
Procedure to review and improve HSE performances?

Regular Management review meeting to define improvement targets

and implementation
HSE performance indicators and criteria last 12 months?
Last 12 months incidents statistics

Page 1 of 2

Comments

HSE EVALUATION OF BIDDER

TOTAL E&P INDONESIE
Rev 2014
Diving Support Vessel

Contractor :
Service

DIV/DEP

:
Assesed by team :

Tender No :
Date :

Weighting
factor WFi

Max
score
Zi=3 x
WFi

Legal commitment letter to fulfill HSE training requirement to all personnel in

order to support their operation
Legal commitment letter to provide gualified person reguired for marine
crews as TI regulation and local LABOR regulation

HSE Coordinator/Officer hold AK3Umum with experiece min 3 year working

at the same position ( CV. And Valid certificate of Ak3 Umum Validated by
DEPNAKER)

HSE EVALUATION
List of Must Have Requirement
Legal commitment letter to provide PPE for all project personnel as company
requirement
Legal commitment letter to provide medically fit personnel provent by valid
MCU validated by Hyperkes Doctor (as per SOP 06-601)

Total:
Maximum Score (Z)

Comments

Team Leader:

Approved by:

(
)

(.)

273

Audit result (Y)

165

Percentage SCORE (Y/Z)*100

60.4396

Must Have Requirement (MHR) Score

100

Note:
- WFi = 3 is a Must Have Requirement (MHR),
- MHR Score = 3 mean 100% meet expectation
All legal statement shall be signed by Director or Authorize
Branch Manager and completed with stamp duty

Score Weighted
Xi
score Yi
=Xi x WFi

MHR Score

100

Overall Score

60.44

Page 2 of 2