Health and Safety Pre-qualification


HazardCo has been asked to provide prequalification feedback to the standards of Health and Safety. Your answers and supporting documentation will provide an insight into your health and safety performance.  This includes any sub-contractors engaged by any PCBU conducting work.

The following questionnaire is designed to help us review your Health and Safety procedures and to ensure they are effective in addressing your legal duties. You must complete all the questions and where requested, provide suitable evidence to support your answers before you can be an approved provider/supplier.

In some sections, you will need to provide documents in support of your answers. These must not be blank forms.

NOTE: Before you start you must select the "create an account or login" button below so that you can save your progress and return back to this form as and when you need to.


Save & Return

Save your progress and complete this form later. (optional)


Do you have appropriate insurance cover for this work? * 🛈

Contractor Health and Safety Prequal Evaluation

Have your health and safety systems/procedures been reviewed by a recognised third party against the current legislation? * 🛈
Select the third party who has reviewed (prequalled) your Health and Safety : 🛈

Safety Policy and Management

Do you have a Health and Safety Policy that is signed by management? 🛈

Has your Health and Safety Policy has been distributed to all of your workers? *

Health and Safety Procedures

Do you have a documented Health and Safety Procedure (manual or template document)? * 🛈

Safety Records - during last 5 years

Have you had any safety or environmental notices, warnings or prosecutions from an enforcement agency such as WorkSafe, Council, or the Police? * 🛈

Health Monitoring

Do you have a documented procedure or process for Health Monitoring for specific risks? * 🛈

Communication, Engagement and Participation

Do you have a documented procedure for involving workers (including contractors) in health and safety? * 🛈
Are all workers inducted onto your work sites and are these inductions recorded in an induction register? *
The frequency of our health and safety (toolbox) meetings are; * 🛈

Hazard / Risk Identification and Management

Do you have a documented procedure for Hazard Identification and Risk Management? * 🛈
Are site hazards/risks and risk controls displayed using site hazard boards? *
Do you have safe work procedures to identify site or job specific hazards/risk and how to control (eliminate or minimise) these risks to health and safety (eg using a SSSP, Task Analysis (TA), Safe Work Method Statement (SWMS) or Job Safety Analysis (JSA)? * 🛈

Are all workers provided with appropriate PPE for the work being undertaken, is it regularly checked and maintained and are workers trained and competent in its correct use? *

Notifiable Works

Do you have "Notifiable" works associated with your contract? * 🛈

Plant, Machinery & Equipment

Do you have a documented procedure for maintaining plant, machinery and equipment to a schedule and in a safe condition? * 🛈

Safety Training

Do you have a documented procedure or process for training and competency. * 🛈
Have your workers completed some form of basic health and safety training or competency standard eg HazardCo Practical Steps, Site Safe Passport or Construct Safe Tier1? *

Have your workers who do specific hazardous work, received formal training in the safe working practices required e.g. asbestos removal, excavations, scaffolding: ? * 🛈
Are workers who are not yet competent (in a specific task or with a specific tool or substance) supervised by someone who is competent (has relevant training and experience)? * 🛈

Safety Inspections and Safety Reviews

Do you have a documented procedure for doing documented work site safety inspections or reviews? *
Do you conduct regular documented work site safety inspections or reviews? *


Do you have a documented procedure for managing all emergencies including emergencies related to high risk work ? * 🛈

Event Recording, Reporting and Investigation

Do you have a documented procedure for event recording, reporting and investigation ? * 🛈
Do you investigate all events including near miss incidents? *
When applicable do you notify Worksafe NZ of any Notifiable Events? *
Do you inform all workers of the outcome of any event investigations and any remedial action required? *
Do you keep a record of any events (accidents, Incidents or near misses) in an Event Register or similar? *

Hazardous Substances

Do you have a documented procedure for managing hazardous substances? *
Do you have a hazardous substance inventory / register (if relevant)? * 🛈

Do you have copies of Safety Data Sheets for all Hazardous Substances you use and make these available on your work site? * 🛈
Do you have an approved handler for hazardous substances where required (if yes ensure details are on your training register)? * 🛈

Sub Contractors

Do you have a documented procedure or process for the engagement of sub-contractors (PCBU's)? * 🛈
Does each subcontractor (PCBU) you engage have their own active on site health and safety management system? *
Has each subcontractor's (PCBU) competence to work safely been assessed or reviewed (eg they have the skills, systems and procedures to work safely on site)? *

Do you regularly cooperate and consult with all contractors (and others) to ensure you coordinate your activities to minimise risks to health and safety: ? *

Prequal Completed By

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