Post on 04-Nov-2019
TENANT / CONTRACTOR PROFORMA PACK
This proforma pack contains various proformas for use by Tenants or Contractors, eg. booking of exclusive use of goods lift, application for access cards, hot work permit, etc. This proforma pack is annexed to the following handbooks:
Tenant Reference Handbook
Tenant Works Handbook
Contractor Induction Handbook
Version: V6.0 Date: May 2011
PERMIT TO WORK – HOT WORKS
Contractor Details Company : ___________________________________ Phone No.: ________________ Name : ________________________________ Mob. No.: _________________ Name : ________________________________ Mob. No.: _________________ Hot Work Details Hot Works required : ______________________________________________________________ Equipment used : ______________________________________________________________ Location of works : _______________________________________________________________ Period of works : _______________________________________________________________ Hazards : _______________________________________________________________ Protective gear to be used : _______________________________________________________________ Other precautions needed : _______________________________________________________________ We acknowledge that it is our responsibility to take all necessary OH&S precautions to eliminate the possibility of fire &/or explosion. We also confirm that we have checked and arranged for all relevant smoke/heat detectors to be isolated to avoid false alarms. ________________ __________________________________ ______________ Signature Name Date ________________ __________________________________ ______________ Signature Name Date
Endorsed by (Authorized Tenant Representative eg. Corporate Real Estate) ________________ __________________________________ ______________ Signature Name Date
Received by (Building Management or its Authorized Representatives) ________________ __________________________________ ______________ Signature Name Date
PERMIT TO WORK - CONFINED SPACES Contractor’s Details Company : ________________________________ Phone No.: ________________ Name of Staff : ________________________________ Mob. No.: _________________ Name of Staff : ________________________________ Mob. No.: _________________ Confined Space Work Details Description / Location : ___________________________________________________________ Description of Works : ___________________________________________________________ Hazards (gas, heat, etc) : ___________________________________________________________ Protective gear to be used: :__________________________________________________________ Standby person (name) : ___________________________________________________________ We acknowledge that it is our responsibility to take all necessary OH&S precautions, including having a standby person(s) at all times during the work. ________________ __________________________________ ______________ Signature Name Date ________________ __________________________________ ______________ Signature Name Date
Endorsed by (Authorized Tenant Representative eg. Corporate Real Estate) ________________ __________________________________ ______________ Signature Name Date
Received by (Building Management or its Authorized Representatives) ________________ __________________________________ ______________ Signature Name Date
PERMIT FOR ACCESS TO ROOF
Contractor’s Details Company : ________________________________ Phone No.: ________________ Name of Staff : ________________________________ Mob. No.: _________________ Name of Staff : ________________________________ Mob. No.: _________________ Name of Staff : ________________________________ Mob. No.: _________________ Roof Access Details Location to be accessed : _______________________________________________________________ Period of access : _______________________________________________________________ Reason for access : _______________________________________________________________ Hazards : _______________________________________________________________ Protective gear to be used : _______________________________________________________________ Other precautions needed : _______________________________________________________________ We acknowledge that it is our responsibility to take all necessary OH&S precautions to ensure the safety and well being of all parties. ________________ __________________________________ ______________ Signature Name Date ________________ __________________________________ ______________ Signature Name Date ________________ __________________________________ ______________ Signature Name Date
Endorsed by (Authorized Tenant Representative eg. Corporate Real Estate) ________________ __________________________________ ______________ Signature Name Date
Received by (Building Management or its Authorized Representatives) ________________ __________________________________ ______________ Signature Name Date
PERMIT FOR USE OF BUILDING MAINTENANCE UNIT (BMU) Contractor’s Details Company : ________________________________ Phone No.: ________________ Name of Staff : ________________________________ Mob. No.: _________________ Name of Staff : ________________________________ Mob. No.: _________________ Name of Staff : ________________________________ Mob. No.: _________________ BMU Use Details Purpose of Use : _______________________________________________________________ Period of Use : _______________________________________________________________ Hazards : _______________________________________________________________ Protective gear to be used : _______________________________________________________________ Other precautions needed : _______________________________________________________________ We acknowledge that it is our responsibility to take all necessary OH&S precautions to ensure the safety and well being of all parties, in particular all risks in relation to falls & drops.
We confirm that we have been trained on the use of this BMU and briefed on the site specific conditions relating to this BMU and Building. We also confirm that we are aware of the importance of ensuring that the wall guns of the BMU are securely and properly fixed to the façade pins before proceeding to move the BMU to a different position. ________________ __________________________________ ______________ Signature Name Date ________________ __________________________________ ______________ Signature Name Date ________________ __________________________________ ______________ Signature Name Date
Endorsed by (Authorized Tenant Representative eg. Corporate Real Estate) ________________ __________________________________ ______________ Signature Name Date
Received by (Building Management or its Authorized Representatives) ________________ __________________________________ ______________ Signature Name Date
PERMIT TO WORK ON SITE
Contractor Details
Company : _________________________________________ Phone No.: ___________________ Key on-site Contact : __________________________________ Mobile No.: ___________________ Tenant : _________________________________ Tenant Contact: ______________________________ Work Details
Name of project : ________________________________________________________________ Location of works : ________________________________________________________________ Timing of works : ________________________________________________________________ Description of works : ________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________
Requirements - Contractor has submitted the following:
Detailed Description of the works
Details & Drawings as per Tenant Works Handbook (where relevant)
Certificates of Currency for Insurances Contractor has submitted Safe Method Work Statement (SWMS) or JSA which complies with:
SWMS / JSA is correct ie. relevant to the works to be carried out
Includes description of the works
Identifies individual steps associated with the works
Identifies key plant & equipment to be used
Identifies OH&S and other risks arising from the works
Identifies control measures which will be used to manage the risks
Identifies PPE (personal protective equipment) which will be used
Penned on the SWMS / JSA, name(s) & signature(s) of the persons doing / supervising the work We will commence work on site only upon completing the contractor induction, and agree to abide by all requirements of the induction, building rules & controls stated in our SWMS / JSA. We also understand that building management may withdraw this permit at any time should we fail to comply with any of the above. _____________ ___________________________ _________________ ____________ Signature Name Mobile No. Date _________________________________________________________________________________________ Endorsed by (Authorized Tenant Representative eg. Corporate Real Estate) ________________ __________________________________ ______________ Signature Name Date _________________________________________________________________________________________ Cleared by (Building Management or its Authorized Representatives) ________________ __________________________________ ______________ Signature Name Date
INCIDENT REPORT
Quick Reference: If calling Emergency Services at 000, tell them:
Name & Address of building
Front-desk or other Contact No.
Best place for Emergency Services to arrive on-site Submit this report to Building Management (eg. Cromwell staff, Security / Concierge)
Details of INCIDENT Date & Time of Incident
_____/_____/_________ ; ___________________ am/pm
Description of incident
Details of injuries (if any)
Details of persons involved & witnesses (if any)
Other:
Person Making this Report Name
Contact No. Company Role Initial/Signature
NOTIFICATION OF INTENSIVE GOODS-LIFT USAGE
Tenant / Contractor Details
Tenant / Contractor : ______________________________________________________ Name of Representative : ______________________________________________________ Contact Nos. : ____________________ Goods Lift Booking Details Purpose : _______________________________________________________________ Periods : _______________________________________________________________ Floors accessed : _______________________________________________________________ Details of Mover (if any) : _______________________________________________________________
We agree that we will take all precautions to avoid any damage or harm to all and any of the common area floors, walls, ceiling, fittings and fixtures. We also confirm that we will abide by the Building Management’s requirements in relation to the use of the Goods Lift, including avoiding undue obstructions and inconveniences to other occupants in the building. We also acknowledge that it is our responsibility to take all necessary OH&S precautions to ensure the safety and well-being of all parties. ________________ __________________________________ ______________ Signature Name Date _________________________________________________________________________________________ Endorsed by (Authorized Tenant Representative eg. Corporate Real Estate) ________________ __________________________________ ______________ Signature Name Date _________________________________________________________________________________________ Cleared by (Building Management or its Authorized Representatives) ________________ __________________________________ ______________ Signature Name Date
APPLICATION FOR ISOLATION/IMPAIRMENT OF FIRE SERVICES [Page 1 of 2]
Tenant / Contractor Details Tenant / Contractor : ________________________________________________________________ Name of Representative : _____________________________ Mobile / Tel :______________________
Details of Isolation / Impairment Purpose / work required : ________________________________________________________________ Equipment to be Isolated : _______________________________________________________________ Times of Isolation : _______________________________________________________________ Floors / locations affected : _______________________________________________________________ Precautions needed, if any : _______________________________________________________________
We acknowledge and undertake to abide by Building House Rules, including (where applicable) filling in Fire Isolations logbooks. We will ensure all systems are reinstated to an operational state (including pumps, valves, FIP, EWIS, ASE) by the close of business day, unless we have obtained the Building Management’s prior consent and we have notified the Fire Brigade. We commit to complete & return the “Reinstatement” section below to the Building Management upon reinstating the system, failing which we agree to bear full responsibility & costs should the system fail to operate properly in the event of a fire.
________________ __________________________________ ______________ Signature Name Date _________________________________________________________________________________________ Endorsed by (Authorized Tenant Representative eg. Corporate Real Estate) ________________ __________________________________ ______________ Signature Name Date
Received and Approved by (Building Management or its Authorized Representatives) ________________ __________________________________ ______________ Signature Name Date
REINSTATEMENT OF ISOLATED SYSTEMS: See page 2
Will there be any isolations outside of normal business hours? Yes / No [ If yes, the Building Management is to inform insurers & initial here once done : ____________ ]
Will the building / ASE be isolated from Fire Brigade? Yes / No
Any isolation of sprinkler pumps or valves? Yes / No
APPLICATION FOR ISOLATION/IMPAIRMENT OF FIRE SERVICES [Page 2 of 2]
REINSTATEMENT OF ISOLATED SYSTEMS: We confirm that the FIP, EWIS and ASE (or similar Brigade Isolation Switches) have been returned back to a fully operational state.
________________ __________________________________ ______________ Signature Name Date
Received by (Building Management or its Authorized Representatives) ________________ __________________________________ ______________ Signature Name Date
Fill this IF Sprinkler Pumps or Valves were isolated We confirm that the sprinkler system (including all pumps & valves) has been reinstated to fully operational state and that the sprinkler gate valve is locked open using strap/padlock.
The line has been recharged & pressure is normal. Time_____________ Pressure: _____________KPa
BOOKING OF COMMON AREAS FOR EVENTS Tenant / User Details
Tenant : ______________________________________________________ Name of Representative : ______________________________________________________ Contact Nos. : ____________________ Details of Common Area Booking
Purpose : _______________________________________________________________ Periods : _______________________________________________________________ Floor Area Needed (sq m) : _______________________________________________________________ Details of Contractor (if any) : ______________________________________________________________
We agree to the terms and conditions as follows:
The Building Management reserves the right to disallow this booking without giving any reason; and to revoke any approval granted if it deems that the usage is or has become detrimental to the well-being of the building &/or its tenants.
To comply with all relevant codes and regulatory requirements as well as the Building Management’s requirements, including avoiding obstructions or nuisance to other occupants.
To take all precautions to avoid any damage to all and any of the common area floors, walls, ceiling, fittings and fixtures.
If any fitting out works are involved, to submit details of the proposed works and a Job Safety Assessment to the Building Management and to ensure that the premises is made good to the Building Manager’s satisfaction upon completion.
The Building Management reserves the right to:
o charge a rental fee for this booking o charge cleaning up fees if cleanup is required due arising from the event o charge security fees if additional security is required for the event o charge repair / other costs for damage, injury or other claims arising from the event
________________ __________________________________ ______________ Signature Name Date
Endorsed by (Authorized Tenant Representative eg. Corporate Real Estate) ________________ __________________________________ ______________ Signature Name Date
Received and Approved by (Building Management or its Authorized Representatives) ________________ __________________________________ ______________ Signature Name Date
APPLICATION FOR SECURITY ACCESS CARDS
Company : ___________________________________
Name of Person
Card No. (or Staff Name) of another card with identical access needs (if not available, please detail the floor areas & areas/doors needing access)
Building Mgmt use – Card No. issued
Access Card Received by (signature)
We confirm that we authorize the above person(s) access to our premises. We agree that we will:
Recover and return, as soon as possible, any Access Cards of staff who leave the company
Inform all staff to notify the Building Mgmt immediately upon losing any Access Card
Accept all responsibility for the proper handling of all Access Cards issued to us _________________________________ ___________________________ ____________ Signature (Authorized Representative) Name Date
TENANTS’ AUTHORIZED REPRESENTATIVE & CONTACT LIST (Page 1 of 2)
Tenant : ________________________________________________________ SECTION 1. TENANT’S AUTHORIZED REPRESENTATIVE
AUTHORIZED REPRESENTATIVES FOR TENANCY & GENERAL MATTERS
Name & Designation
Office Phone Direct No.
Mobile Phone No.
Email Address
We confirm that the abovementioned persons are authorized to act and submit requests on our behalf for day-to-day tenancy and general matters, including but not limited to all facilities-related applications to the Building Management. I agree that the Building Management may deem all such requests issued by any of these persons to be with our bona fide authority to act.
________________ ______________________________________ ______________________ Signature / Date Name & Designation Company Stamp [Tenant’s General Manager / Managing Director / CEO / President / Director]
________________ ______________________________________ ______________________ Signature / Date Name & Designation Company Stamp [Tenant’s General Manager / Managing Director / CEO / President / Director]
Continued
TENANTS’ AUTHORIZED REPRESENTATIVE & CONTACT LIST (Page 2 of 2)
SECTION 2. TENANT’S EMERGENCY CONTACTS 2.1 TENANT’S EMERGENCY CONTACT LIST (OFFICE HOURS)
EMERGENCY CONTACTS DURING OFFICE HOURS (At least 2 persons in order of contact priority – first name will be contacted first)
Name & Designation
Office Phone Direct No.
Mobile Phone No.
Email Address
2.2 TENANT’S EMERGENCY CONTACT LIST (AFTER OFFICE HOURS)
EMERGENCY CONTACTS FOR SECURITY BREACH AFTER OFFICE HOURS (At least 3 persons in order of contact priority – first name will be contacted first)
Name & Designation
Office Phone Direct No.
Home Phone No.
Mobile Phone No.
Email Address
EMERGENCY CONTACTS FOR FACILITIES MATTERS AFTER OFFICE HOURS Eg. Power failures, Sprinkler bursts, Fire alarms. (At least 3 persons in order of contact priority – first name will be contacted first) Name & Designation
Office Phone Direct No.
Home Phone No.
Mobile Phone No.
Email Address
We nominate the above-listed staff as the Tenant’s point of communication during emergencies for the times of day & matters listed above. _________________________________ ___________________________ ____________ Signature (Authorized Representative) Name Date
TENANTS’ MOBILITY & OTHERWISE IMPAIRED PERSONS DATA FOR EMERGENCIES Tenant : ________________________________________________________ Location of staff (Floor level, location, etc)
Name of staff
Nature of impairment (to facilitate correct assistance)
Remarks (contact nos, other relevant information)
_________________________________ ___________________________ ____________ Signature (Authorized Representative) Name Date