The document provides a questionnaire for contractors to assess their health, safety, security and environmental (HSSE) management systems and capabilities. It includes questions on commitment from top management, risk management processes, management of change, incident learning, and compliance plans. Contractors will complete the questionnaire and any gaps found during review will be classified. Scoring will evaluate the contractor's HSSE system and management's commitment and accountability for HSSE aspects. A follow-up discussion may be needed to further understand the contractor's HSSE system and address any gaps.

1. Contractor Capability Assessment
IOGP Processes
By: HSSE Team
EMPOWERING SAFETY TO THE FRONTLINE
Copyright of Meinhardt ID CONFIDENTIAL

2. General Process EMPOWERING SAFETY TO THE FRONTLINE
June 2023
When completing the questionnaire, the contractor should
include all associated contractor activities and relevant
support functions not only for a specific contract (supported
with attached documents for each section)
Questionnaire for contractor HSE capability assessment
Date: Location:
24-Jan-23 Jakarta
1.1 Commitment and
accountability to HSE
aspects
1.1 Commitment and
accountability to HSE
aspects
1.1 Commitment and
accountability to HSE
aspects
1.1 Commitment and
accountability to HSE
aspects
1.1 Commitment and
accountability to HSE
aspects
1.1 Commitment and
accountability to HSE
aspects
1.1 Commitment and
accountability to HSE
aspects
1.1 Commitment and
accountability to HSE
aspects
1.1 Commitment and
accountability to HSE
aspects
1.1 Commitment and
accountability to HSE
aspects
Top Level Management, Managers, HSSE & Site Supervisor accountable for the
oversight and coordination of HSSE activities as per HSSE-MS.
e) Is there a code of conduct in place to establish behavioural, ethical and
compliance obligations for employees? If yes, please provide a copy. (E1.4)
f) 1) What communication and engagement mechanisms are established?
(E1.6)
f) 2) How is responsibility assigned for prompt, appropriate and engaging
communication to those involved in delivering HSE performance? (P1)
a) 1. How are managers personally involved in HSE aspects? (E1.2)
a) 2. What is the responsibility of managers in this respect? (P1)
b) How do managers ensure commitment from the workforce to perform
activities in accordance with company policies, standards and objectives, and in
compliance with external requirements? (E1.3)
c) How does the contractor ensure learning from internal and external sources
and promote continuous risk reduction and performance improvement? (E1.8)
d) Provide evidence of accountability and commitment at all levels of the
organization. (E1.5)
g) 2) Who in your organization is accountable for the oversight and co-
ordination of activities within the scope of their part of the HSE-MS? (P1)
Company name:
Completed by : Fitri N. Muhasibi
PT. Heksagon Tiwikrama
Element 1: Commitment and accountability
Written response
g) 1) Provide evidence to show that the HSE-MS is in place across the
organization, with priorities established, authorities and
accountabilities assigned, and resources allocated. (E1.1)
Yes, as per attached
Yes, as per attached
Being able to demonstrate the context of the organisation to collect and support
internal and external requirements and ensure business to properly align its risk
management strategy with its overall risk appetite and risk tolerance in order
support continous improvement, risk reduction and to gain a competitive edge
without compromising business continuity
1. Establish an active workplace safety and health
2. Fully support and committed to eliminating hazards, protecting workers, and
continuously improving workplace safety and health.
3. Provide sufficient resources to implement and maintain the safety and health
program. 4.
Visibly demonstrate and communicate their safety and health commitment to
workers and others
5. Value employee input and feedback.
6. Do regular inspection & audit
7. Involve in safety meeting
8. Set safety goals and hold everyone accountable.
1. Management’s responsibility is to set goals and target, and to track or monitor
performance and success of these goals. Safety goals and targets are established
during management review meetings
2. Heads of Departments (PM, Prod Manager, HSSE Manager etc) sets their
departmental objectives and monitor for compliance.
3. Durector as top persons on the organization is responsible to overseeing the
development of safety goals as well as implementing them
1.As top persons on the organization of HSSE management
2.Regularly involve on the HSSE events as speaker or observer (e.g workshop/
training, briefing, induction, safety meeting, and MR meeting)
3.Do the inspections on HSSE implementation at premises and project site
4.Involve on the HSSE events conducted by clientele
5.As representative on the LCSC (Local Contractor Safety Council) ID
by involving and couraging in safety events and agenda
Formal Communication (email, project meeting etc), mid-formal communication
(Project WAG, Ms. Teams Message etc), display/ interface communication (buletin,
poster etc)
Validated by : Meinhardt
Yes, as per attached
Contractor will be given questionnaire that covers the information required to
assess the extent to which HSE and its management are organized by the
contractor
1
2

3. General Process EMPOWERING SAFETY TO THE FRONTLINE
June 2023
The submissions assessed by a scoring mechanism in the evaluation
process, such as that provided in HSE capability assessment: overview
and scoring system
Findings
(fill in below):
Select type of finding (hold marker on
field to see definitions):
Company HSE-MS does not
include identification, assessment
and treatment of HSE risk
considering
all potentially affected parties,
including external stakeholders. A
culture
of risk awareness that supports
decision-making at each level of
the organization does not exist.
Company HSE-MS makes
reference to the need
to conduct HSE risk assessment
but has no techniques to perform
identification, assessment and
treatment of risk considering all
potentially affected parties,
including external stakeholders. A
culture of risk awareness that
supports decision- making at each
level of the organization is not
established.
Company HSE-MS includes
techniques for the assessment of
task based and specific HSE
subject risk identification,
assessment and treatment of HSE
risk considering
all potentially affected parties,
including external stakeholders. A
culture
of risk awareness that supports
decision-making at each level of
the organization is established.
“Acceptable” together with
recognition of positive impacts
and the optimization of benefits
that the business activity may
provide. These could include the
development of people, local
capacity building, environmental
conservation opportunities and
infrastructure.
- No LFI included within the HIRADC
which likelihood measrurement is
questionable
- No Master Hazard Register that covers
all API's scope of work
- Company HIRADC available, evidence
of socialization available, but frontliner
still not aware of it
YELLOW
Unacceptable (D) Poor (C) Acceptable (B) Excellent (A)
Normal 3 C
Element 5: Risk assessment and control
5.1 - Risk assessment and control: a) 1) What processes and methods does your company have in place to manage risks to an
acceptable level for the scope of your activities? (E5.1)
a) 2) How does your company ensure no operation is performed without a specific risk assessment? (E5.1)
a) 3) How does your company monitor that all control and mitigation measures are in place before performing any operation? (E5.1)
b) 1) How are conflicting interests dealt with, within your risk management process? (P5)
b) 2) Is there commitment to review and improve risk management and associated processes periodically, and in response to an event or
change in circumstances? (P5)
c) Provide evidence of documentation and communication of the risk management processes for significant risks, including risk acceptance
approval at appropriate levels of the organization, scheduled reviews and updating of risk registers. (E5.2)
d) How do you manage changes and assess associated risks, e.g. temporary/permanent changes that affect the organization, activities,
assets, operations, products, plans or procedures? (E5.3)
e) How are vulnerabilities and non-conformances recognized, including deviations from operating procedures or weak signals that provide
indications of potentially increasing risk? (E5.4)
f) How is learning from incidents, events, non-conformities and good practices from internal and external sources incorporated into risk
assessments and their review? (M5)
g) Has your company established risk control and regulatory compliance plans to manage ‘normal’ conditions, allowing the organization to
manage HSE risks locally while maintaining full compliance with relevant requirements and legislation? If yes, please specify which areas of
risk, context or requirements. (P7)
Contractors
self
evaluation
Gaps found
during document
review
Classification
type of finding
Weight
Scoring
3

4. General Process EMPOWERING SAFETY TO THE FRONTLINE
June 2023
A follow-up discussion with the contractor’s management may be needed.
This checklist is provided to give auditors some guidance on desired
outcomes, or
objective evidence that should be seen from audits on various topics. It is by
no
means complete and is provided as guidance for use by an auditor if desired.
The
text used is based on IOGP 510, Operating Management System Framework
and
therefore refers to, for example, “OMS”. However, this guidance focuses on
HSE.
Gen.
Man.
HSE/HR/
Tec/Proc
man.
Saf.
del.
A X X 1,1
Please explain briefly how the management is committed and accountable to HSE aspects
With HSE we mean health and working environment, safety, security, environment and social responsibility
(emphasise first time with General manager)
- Does your company have appointed owners to ensure their part of the managment system is reviewed and
continuously improved, including updates to reflect learning from incidents and audits?
- How are strategies and clear objectives that drive the organization to achieve high levels of performance shared?
• How do you reinforce the importance of a strong culture, recognizing teamwork and valuing individual behaviours?
• Are all outcomes—good or bad— embraced as opportunities to learn and improve?
• Do you develop ‘constant vigilance’ to be acutely aware of things that could go wrong and facing up to these
risks?
• Do you communicate clearly that procedural short cuts or rule-bending are not tolerated?
EVIDENCE:
- Leaders demonstrate ownership through direct involvement in, and application of, system processes,
and by constantly mandating the workforce’s adherence to the OMS. Accountability based on well-
defined authority levels, acceptance of decision making and a clear understanding of job responsibilities.
Element 1: Commitment and accountability to HSE aspects
OGP423 - Checklist
Self
evaluation
Compliance
(Y/N)
Spes focus
(Y/N)
Questions to:
Item
no
Questions
Finding
(a finding is a documentet non-conformity with reference to an observation)
4

5. General Process EMPOWERING SAFETY TO THE FRONTLINE
June 2023
Gaps that found during the audit visit must be listed
along with the required action from contractors.
5
Action taken by
contractor to close
the gaps

6. Benefits & Challenges EMPOWERING SAFETY TO THE FRONTLINE
June 2023
BENEFITS CHALLENGES
The process is risk-based which applies both to
contractors and suppliers (available Full
Questionnaire and Short Questionnaire depends on
the risk faced)
New approach of process which require contractors
in re-banding program need times for adjustment
Guidance available and explained for the expected
outcome from contractors
More than 200 Questions which has to be filled
Has more complete questionnaires than previous
Greenbanding Process with new elements to
assess:
- Customer and Stakeholders
- Risk Assessment that more detailed and complex
in Security, Health, and Social
Scoring could be adjusted depend on the market
condition

7. The Process So Far EMPOWERING SAFETY TO THE FRONTLINE
June 2023
0 10 20 30 40 50 60 70 80 90
Makro
Heksagon Tiwikrama
Citra Karsa Dinamika
Anugerah Petro Indonesia
Usaha Engineering Services
Mitra Purnama Engineering
Full Questionnaire
Days
Haven’t submit any
document since given
questionnaire (March
2023)
Haven’t submit any document
since Audit Visit (March 2023)
Done and proceed to C-HSSE Plan
Wait for document after Audit
No submission more
than 2 months
0 20 40 60 80 100
Visualindo
Dapoer Creative Indonesia
Panca Jaya Setia
Himawan Putra Corporation
Multi Sistim Komunikasi
Short Questionnaire

8. EMPOWERING SAFETY TO THE FRONTLINE