"Cms-7 Contractor Monthly WHS Performance Report Template" - Australia
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1CMS-7 Contractor Monthly WHS Performance Report
Version 1 | March 2014
Purpose: This form is to be provided to the Contract Manager to report incident management statistics, status of implementation of
corrective actions and information on current WHS inspection reports and risk assessments.
This form is to be completed on a monthly basis.
This form is to be completed by the contractor.
Project:.................................................................................
Report for the month of:..............................................................
Contractor:............................................................................
Prepared by:...............................................................................
Contractor Reference No:.....................................................
Date:...........................................................................................
Performance Indicators
Indicator
Current Month
Mthly Average
Total
Number of lost time injuries
Working days lost due to injury
Number of hazard inspections conducted
Number of toolbox talks/consultation meetings
Status of Injured Personnel and/or Property Damage
Date of
Days Lost
Return to Work
Name/Item
Injury/Damage
Incident
Current
Total
Forecast
Actual
Month
WHS Corrective Actions
Status
Nature of Corrective Action
Open
Closed
Comments
Outcomes of WHS audits/inspections
Comments/Outcomes:
.............................................................................................................................................................................................................
.....................................................................................................
Comments on WHS Performance
Contractor: ...........................................................................................................................................................................................
.............................................................................................................................................................................................................
Council Representative: ......................................................................................................................................................................
.............................................................................................................................................................................................................
Contractor Sign off:
Council Representative Sign off:
REGISTERED
Sent to Safety@wagga: __________________
DWS Document No:
__________________
Date Registered:
__________________
Signed: ______________________________
CMS-7 Contractor Monthly WHS Performance Report
Version 1 | March 2014
Purpose: This form is to be provided to the Contract Manager to report incident management statistics, status of implementation of
corrective actions and information on current WHS inspection reports and risk assessments.
This form is to be completed on a monthly basis.
This form is to be completed by the contractor.
Project:.................................................................................
Report for the month of:..............................................................
Contractor:............................................................................
Prepared by:...............................................................................
Contractor Reference No:.....................................................
Date:...........................................................................................
Performance Indicators
Indicator
Current Month
Mthly Average
Total
Number of lost time injuries
Working days lost due to injury
Number of hazard inspections conducted
Number of toolbox talks/consultation meetings
Status of Injured Personnel and/or Property Damage
Date of
Days Lost
Return to Work
Name/Item
Injury/Damage
Incident
Current
Total
Forecast
Actual
Month
WHS Corrective Actions
Status
Nature of Corrective Action
Open
Closed
Comments
Outcomes of WHS audits/inspections
Comments/Outcomes:
.............................................................................................................................................................................................................
.....................................................................................................
Comments on WHS Performance
Contractor: ...........................................................................................................................................................................................
.............................................................................................................................................................................................................
Council Representative: ......................................................................................................................................................................
.............................................................................................................................................................................................................
Contractor Sign off:
Council Representative Sign off:
REGISTERED
Sent to Safety@wagga: __________________
DWS Document No:
__________________
Date Registered:
__________________
Signed: ______________________________
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Most popular documents
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"Vsepr Theory (Molecular Shapes) Chart"
-
DA Form 2062 "Hand Receipt/Annex Number"
-
"Zappos Kid Shoe Size Chart"
-
DD Form 2813
-
DD Form 2977 "Deliberate Risk Assessment Worksheet"
-
AF Form 910 "Enlisted Performance Report (AB Thru Tsgt)"
-
DA Form 31 "Request and Authority for Leave"
-
DD Form 1750 "Packing List"
-
DA Form 3595 "Record Fire Scorecard"
-
DD Form 2923 "Privacy Act Data Cover Sheet"
Popular Articles
- 2020 Tax Deductions for Homeowners 2020 Tax Deductions for Homeowners
- How to Convert Personal Use Property to Business Use? How to Convert Personal Use Property to Business Use?
- How to Rent Your First Apartment? How to Rent Your First Apartment?
- How To Buy a House in the United States? How To Buy a House in the United States?
- 10 Sample Interview Questions 10 Sample Interview Questions
- USCIS Form I-551, Permanent Resident Card USCIS Form I-551, Permanent Resident Card
- Washington State Patrol Inspection Request Form Washington State Patrol Inspection Request Form
- Form MV-4ST, Vehicle Sales and Use Tax Return/Application for Registration Form MV-4ST, Vehicle Sales and Use Tax Return/Application for Registration
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