EXPLANATION: Here's an example of an Outside Contractor Entry Notification form based on a model used successfully by the largest pulp and paper mill in North America, Bowater Inc. As with any model form, you'll need to make revisions depending on what kind of industry you're in and what contractor processes you use. For example, remove Item 8 if you don't have orientation sessions for your contractors.

ABC COMPANY

OUTSIDE CONTRACTOR ENTRY NOTIFICATION

INSTRUCTIONS: The ABC Company supervisor responsible for a particular contractor must complete and sign this document for each contractor and subcontractor performing work at the ABC Company plant facility. A separate copy of the completed document will be inserted into the Current Contractor Binders kept in the ABC Company reception area and the safety office on the second floor. The safety manager is also responsible for updating this form as necessary.

GENERAL

1. Date: _______________________________________________________________

2. ABC Company Contact Person: ___________________________________________

3. Department: _________________________________________________________

CONTRACTOR INFORMATION

4. Contractor's Name: ____________________________________________________

5. Contractor's Supervisor (Contact Person): __________________________________

6. Number of Workers Who Will Be On Site: ___________________________________

7. Has the Contractor Met All of ABC Company's Safety Requirements?

8. Has Each Worker Completed ABC Company's Safety Orientation?

9. If any worker has not received orientation, explain and list date orientation is to be provided:

______________________________________________________________________

______________________________________________________________________

10. Will Contractor Be Using Any Subcontractors?

11. If subcontractors are to be used, list their names, supervisors and number of workers to be used:

WORK INVOLVED

12. Starting Date of Work: _________________________________________________

13. End Date of Work: ____________________________________________________

14. Hours of Work (specify A.M. or P.M.): ______________________________________

15. Location of Work: _____________________________________________________

16. Equipment to Be Used: _________________________________________________

17. Brief Description of Work: _______________________________________________

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