CONTRACTOR HEALTH AND SAFETY MANAGEMENT PLAN TEMPLATE
1. CONTACT DETAILS
Location of Works:
Timing of Works (approximate): Start Date: / / End Date: / /
2. STATEMENT OF RESPONSIBILITIES FOR HEALTH & SAFETY
(will also include the WH&S Committee members and the appointed WH&S Representatives)
Name Position held Safety responsibilities Contact number
3. EMERGENCY CONTACT DETAILS
Contact Name Position Contact number
4. SCOPE AND ACTIVITY DETAILS
(type of construction work to be performed)
List of Major Activities
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5. SITE SPECIFIC RISKS
List the risk specific to this job.
List of site specific High Risk Activities
6. SITE SAFETY RULES
List any site safety rules that will be imposed on the site and outlining how you will ensure that all employees and
subcontractors are informed of the rules.
7. SAFE WORK METHOD STATEMENT
Complete the following section below outlining how you will ensure that all employees and subcontractors understand
the Safe Work Method Statements and attach copies of these documents.
8. FIRST AID AND INJURY MANAGEMENT
A first aid program for contractors is outlined in the CQUniversity Contractor Safety Guidelines. Please describe
below any additional first aid needs for this contract or attach the Accident Response Plan for the job.
9. PUBLIC SAFETY STRATEGIES
List and describe safety strategies that will be taken to ensure that any site hazards do not impact on others including
members of the general public, hazards could include:- falling objects, equipment, tools, rocks hitting people during
construction and controls may include erection of a barricade or hoarding, closing of adjoining areas.
10. EMERGENCY PROCEDUES
Identify specific emergency procedures or equipment required for the contract or attach the Accident Response Plan
for the job.
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11. INCIDENT REPORTING AND INVESTIGATION
Describe how incidents will be reported and investigated during the contract.
12. SPECIALISED WORK OR LICENSING
List any special licences required for the contract.
13. TRAINING AND INDUCTION REQUIREMENTS
Training and inductions for contractors are to be completed in accordance with the CQUniversity Contractor Safety
Guidelines. List any relevant communication or training methods used during the works in relation to safety. i.e. the
risk of exposure to biological hazards, infection control, use of Personal Protective Equipment, blood and body
substance exposure, weekly toolbox meetings or specific safe procedure training.
14. CHEMICAL MANAGEMENT
Complete the attached Chemical Register listing all chemicals to be used.
15. SAFETY MONITORING
List any ongoing inspections, hazard management or incident reporting or investigation processes to be used during
the works, if relevant.
16. PLANT PROVIDED FOR COMMON USE
On the ‘Plant and Equipment Register’ attached list any items of common plant provided by the Principle Contractor
for use by any person at the workplace. Describe below the process you will be adopting to ensure the item of plant
is appropriately maintained and is safe for use.
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17. SUBCONTRACTOR MANAGEMENT
Complete the attached Subcontractor List detailing the subcontractors to be used and the details of the subcontractor
Sub Contractor Authorised Date of Local
Sub Contractor Name Description of Work
Representative Name Induction
18. SIGN OFF
This Safety Management Plan and any attachments incorporate all the safety requirements outlined in the contract.
Signature: Date: / /
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CONTRACTOR CHEMICAL REGISTER
To be completed by the contractor.
Note: MSDS to be made available by the contractor for all chemicals listed.
Product Name Hazard Controls Required Location Quantity
Contractor signature: Date:
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CONTRACTOR PLANT AND EQUIPMENT REGISTER
Registration Purpose Inspection Date and
Type Inspected by
Include: Design, Design No., Item, Item No. (Use on Site) Frequency
Contractor signature: Date:
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