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Doc: OSH Award 2017 Application Form Page 1 of 25

M S O S H MALAYSIAN SOCIETY FOR OCCUPATIONAL SAFETY AND HEALTH

PART A PAGE NO. 1 - 13 PART A PAGE NO. 1 - 13

INTRODUCTION

The annual occupational safety and health performance awards are intended to give due recognition to all

organizations/companies which have achieved commendable safety and health records and/or have shown

improvement in occupational safety and health processes through sound safety and health management systems.

The MSOSH Occupational Safety and Health Awards provide the opportunity to give employees, management and

public the chance to hear about your company’s success story on safety and health performance which can be an

example to inspire other organizations.

All organizations are strongly encouraged to participate in the 2017 Occupational Safety & Health Award. This exercise

will provide the Society the opportunity to identify areas where the Society can provide assistance to the respective

companies/organizations in the development of a long term safety and health management systems to benefit the

employees in particular and the organization at large.

Each successful applicant will receive the award at the presentation ceremony, which will be held at a leading hotel,

and presented by the Guest of Honors on the auspicious night.

BUSINESS GROUPING

For the 2017 Occupational Safety and Health Awards, MSOSH has categorized organizations into ten (10) business

groupings. This will enable participants to compete fairly within their own grouping and they are as follows:

1. 1. The Petroleum, Gas, Petrochemical & Allied Sectors

2. 2. The Electronics and Electrical Sectors

3. 3. The Manufacturing & Chemical Sectors

4. 4. The Utilities Sectors

5. 5. The Construction & Engineering Construction Sectors

6. 6. The Agricultural Sectors(Fishery/Forestry/Plantation)

7. 7. The Services Sectors(Hospitality/Banks/Theme Parks, etc)

8. 8. The Logistics and Transportation Sectors

9. 9. The Educational Sectors

10. 10. Public Sectors &Statutory Bodies

USE OF AWARD LOGO.

The award winning company eligibility to use the Award’s logo for publicity purposes within the winning year until the

announcement of the next award winners or until the printed letterhead is used up.

MSOSH OCCUPATIONAL SAFETY AND

HEALTH AWARD 2017




TERMS AND CONDITIONS :

1) The application for the award is open to All MSOSH Corporate Members and Non-Members.

Deadline for the submission of application form and requested documents is Monday, 26th

January 2018.

2) No submission will be entertained after the deadline.

Those who need additional time for submission can submit a written appeal enclosing a NON REFUNDABLE

appeal fee of RM550-00 for each site by Monday, 29th

January 2018.

Extended deadline for successful appeal cases is on Monday, 6th

February 2018 (upon receipt of appeal fees).

3) The administration and auditing fees:

Award Category Member Non-Member

Additional East

M’sia

Number of

Auditors

a) Platinum RM5,000-00 RM6,000-00 RM1,500-00 3 persons

b) Grand and Gold Merit RM3,000-00 RM4,000-00 RM1,000-00 2 persons

c) Gold, Silver and Bronze RM2,000-00 RM3,000-00 RM500-00 1 person

d) Additional Fee for Offshore Facilities RM3,000-00 RM4,000-00

MSOSH seeks your understanding and cooperation for an additional fee audit offshore facilities, the

expenses of which were paid for our auditors to undergo the mandatory Basic Offshore Safety & E

mergency Training (BOSET), Special Training for H2S, medical checkup fees and additional travelling

days required to audit offshore facilities.

e) RM1,100-00 fee for member per site and RM2,000 fee for non- member per site for an

organization requesting for a written REPORT.

No written reports will be issued by the Auditors after the audit. Findings will be presented orally at the closing

meeting at the end of the site audit. However, an organization can still request for a written report within

two (2) weeks from the date of site audit. A written report will be submitted to the auditee within one (1) month

following the request date. The content of the report will cover the issues discussed during the closing meeting.

f) All fees should be made payable to:

“Malaysian Society for Occupational Safety and Health”

CIMB Bank Berhad, Section 52, Petaling Jaya, Selangor.

Account No : 8002324462

4) All requested documents SHALL be attached.

ALL APPLICANTS are encouraged to submit to MSOSH soft copy via CD.

The MSOSH auditors has the right to assume unavailability of required documents should the requested documents are not

attached. Points will not be given if any required document is not attached.

5) Documents shall be relevant and applicable to the site being audited. Eg: Do Not send HQ documents to represent the site

unless it is being implemented at site. As much as possible, the documents should be from the site to be audited. Every site

must submit a complete and independent set of documents.

6) The document contents shall be orderly arranged and clearly identified in accordance with the OSH Management System

Evaluation Criteria.

7) Applicant needs to ensure adequate preparation in terms of manpower, site documentation, personal protective equipment,

etc and are ready during the site audit. Applicant need to ensure site personnel are aware of the audit dates and relevant

preparation are made prior to the audit

8) The MSOSH auditors has the right to disqualify entries which contain false information / declaration.

9) Companies, including their contractors that have fatalities in the competition period shall not apply for Grand & Gold Merit

Award.

10) Companies which are unable to attach any document along with this application because it is against their company’s policy

SHALL NOT participate.




11) The assessment period:

a) 1 January 2016 to 31 December 2017 (TWO year period) for Platinum and Grand Only

b) 1 January 2017 to 31 December 2017 (ONE year period) for Gold Merit, Gold, Silver and Bronze Award.

12) All documents will be treated with the strictest confidence and can only be viewed by the Auditors.

13) Participating companies may collect their documents from MSOSH office within 3 months after the Award Presentation

failing which MSOSH reserves the right to dispose the documents in an appropriate manner.

14) MSOSH Award Committee, which is independent from the auditors, will make the decision and the decision is final. Any

appeal will NOT be entertained.

15) Construction & Engineering Construction Sectors: if the progress is below 20% or above 90% the organization is not eligible

to participate.

16) MSOSH HAS THE RIGHT TO HOLD OR NOT TO AWARD ANY PARTICIPATING ORGANIZATION WITH THE AWARD

APPLIED/ELIGIBLE IF ANY MAJOR OR SERIOUS ACCIDENT/INCIDENT OCCURS OUTSIDE THE AUDIT PERIOD IN THE

CURRENT YEAR (BEFORE OR DURING THE AWARD PRESENTATION DAY)

CRITERIA AND CATEGORIES OF AWARDS

The 2017 Occupational Safety and Health Awards are based on the participating companie's safety and health management

performance. There will be six categories of awards, namely, Platinum, Grand, Gold Merit, Gold, Silver and Bronze. The

performance levels for the categories are as described below:

a) Platinum = Ultimate OSH Performance

b) Grand = Superior OSH Performance

c) Gold Merit = Excellent OSH Performance

d) Gold (Class I & II) = Very Good OSH Performance

e) Silver = Good OSH Performance

f) Bronze = Satisfactory OSH Performance

The qualification required to participate in the stated categories is listed

below:

1. MSOSH PLATINUM AWARD

1.1

No limit to the number of employees.

1.2 Companies which have won three (3) Grand Awards since 2003 qualify to apply for Platinum Award.

1.3 No worksite fatalities for 5 consecutive years including the year of participation.

1.4 The company shall participate in the current OSH Award Competition.

1.5 Participants are subject to document audit, site audits and Platinum audit checklist.

Note: The Organization which applies for the Platinum Award but does not qualify for the applied category will be granted

any other category, as decided by the Award Technical Committee.




2. MSOSH GRAND AWARD

2.1 MSOSH GRAND AWARD (minimum 50 employees)

2.1.1

Minimum 50 employees.

2.1.2 Achieved No Lost Time Injury (LTI) for assessment period of 2 years i.e. from 1 January 2016 to 31 December

2017. No Worksite Fatality for 2 consecutive years.

Achieved No property damage exceeding RM 1 million for assessment period of 2 years i.e. from 1 January

2016 to 31 December 2017.

2.1.3 Documentation Audit score shall be at least 90%.

2.1.4 Site audit to verify the OSH implementation & the physical condition of the worksite will be conducted by min.

2 MSOSH auditors. Auditors will again validate related documents & also interview Staff/Contractors at site to

determine their level of OSH competency & awareness.

2.1.5 Site audit score shall be at least 90%

2.1.6 Workplace Assessment score shall be at least 90%

2.1.7 MSOSH auditors may conduct second site audit to verify the nomination and the result of the first audit, if

deemed necessary.

2.1.8 Company should have won at least one (1) Gold Award since 2003. (Please submit documented evidence).

2.2 MSOSH GRAND AWARD (Less than 50 employees)

2.2.1

Less than 50 employees.

2.2.2 Achieved No Lost Time Injury (LTI) for assessment period of 2 years i.e. from 1 January 2016 to 31 December

2017 and No Worksite Fatality for 5 consecutive years.

Achieved No property damage exceeding RM 1 million for assessment period of 2 years i.e. from 1 January


2.2.3 Documentation Audit score shall be at least 90%.

2.2.4 Site audit to verify the OSH implementation & the physical condition of the worksite will be conducted by min.

2 MSOSH Auditors. Auditors will again validate related documents & also interview staff/contractors at site to

determine their level of OSH competency & awareness.

2.2.5 Site audit score shall be at least 90%.



deemed necessary.

2.2.8 Company should have won at least one (1) Gold Award since 2003 (Submit documented evidence)

Note: The Organization which applies for the Grand Award but does not win the applied category will be granted

any other category, as decided by the MSOSH Award Committee.

3. MSOSH GOLD MERIT AWARD

3.1

MSOSH GOLD MERIT AWARD (minimum 50 employees)

3.1.1 Minimum 50 employees.

3.1.2 Achieved No Lost Time Injury (LTI) for assessment period of 1 year i.e. from 1 January 2017 to 31 December

2017 and No Worksite Fatality for 1 year.

Achieved No property damage exceeding RM 1 million for assessment period of 1 year i.e. from 1 January


3.1.3 Documentation audit score shall be at least 85%.




3.1.4 Site audit to verify the OSH implementation and the physical condition of the worksite will be conducted by

min. 2 MSOSH Auditors. Auditors will again validate related documents & also interview staff/contractors at site

to determine their level of OSH competency and awareness.



3.1.7 MSOSH Auditors may conduct second site audit to verify the nomination and the result of the first audit, if

deemed necessary.

3.1.8 Company should have won at least one (1) Gold Award since 2003 (Submit documented evidence)

3.2 MSOSH GOLD MERIT AWARD (Less than 50 employees)

3.2.1 Less than 50 employees.

3.2.2 Achieved No Lost Time Injury (LTI) for assessment period of 1 year i.e. from 1 January 2017 to 31 December

2017 and No Worksite Fatality for 5 years.

Achieved No property damage exceeding RM 1 million for assessment period of 1 year i.e. from 1 January


3.2.3 Documentation audit score shall be at least 85%.

3.2.4 Site audit to verify the OSH implementation and the physical condition of the worksite will be conducted by

min. 2 MSOSH auditors. Auditors will again validate related documents & also interview staff/contractors at site

to determine their level of OSH competency and awareness.




deemed necessary.

3.2.8 Company should have won at least one (1) Gold Award since 2003(Submit documented evidence)

4. MSOSH GOLD AWARD (Class I)

4.1 No limit to the number of employees

4.2 Documentation audit score shall be at least 78%.

4.3 Site audit to verify the OSH implementation and the physical condition of the worksite will be conducted by 1 MSOSH

Auditor. Auditor will again validate OSH related documents and also interview staff/contractors at site to determine

their level of OSH competency.

4.4 Site audit score shall be at least 78%.

4.5 Workplace Assessment score shall be at least 78%

5. MSOSH GOLD AWARD (Class II)

5.1 No limit to the number of employees


5.3 Site audit to verify the OSH implementation & the physical condition of the worksite will be conducted by 1 MSOSH


their level of OSH competency.



6. MSOSH SILVER AWARD

6.1

No limit to the number of employees

6.2 Documentation Audit score shall be at least 50%.

6.3 Site Audit to verify the OSH implementation and the physical condition of the worksite will be conducted by 1 MSOSH

Auditor. Auditor will again validate OSH related documents and also interview staff/Contractors at site to determine

their level of OSH competency






9. DEFINITIONS

9.1 Lost Time Injury/Illness (LTI) cases. These include:

9.1.1 Fatality

Death resulting from a work injury or occupational illnesses within 1 year.

9.1.2 Permanent Total Disability

Work injury which incapacitates an employee permanently and results in termination of employment on medical

grounds.

9.1.3 Permanent Partial Disability

Work injury which results in complete loss, or permanent impairment of functions of parts of the body.

9.1.4 Lost Time Injury

Work injury other than permanent partial disability which renders the injured person temporarily unable to perform

a regular job after the next cycle shift on which the injury was received. Eg: 1 full day MC is already considered an

LTI.

9.1.5 Lost Time Illness

Illnesses due to the work that renders the person temporarily or permanently unable to perform a regular job after

the next cycle shift on which the illness was established. Subsequent MC due to the same illness shall also be

counted. Occupational Health Doctor's (OHD) advice is needed before any case can be considered to be work

related.

9.1.6 In all the above cases, LTI of permanent and temporary contractor's or vendor's at worksite shall also be included.

9.2 LTI Statistics

Numbers of LTI incident in one year. LTI means Lost Time Injury or Lost Time Illness

9.3 LTI Frequency Rate (FR)

LTI frequency rate is the number of lost time injuries/illnesses per 1,000,000 exposure hours worked (based on “Notification

of Accident, Dangerous Occurrence, Occupational Poisoning and Occupational Disease” (NADOPOD) Regulations 2004 –

Form JKKP 8) during the year, and is calculated as follows:

No. of LTI CASES

LTI FR = --------------------------------------- X 1,000,000MAN HOURS

TOTAL MAN HOURS WORKED

7. MSOSH BRONZE AWARD

7.1 No limit to the number of employees.


7.3 Site audit to verify the OSH implementation and the physical condition of the worksite will be conducted by 1 MSOSH


their level of OSH competency



8. MSOSH CERTIFICATE OF PARTICIPATION

8.1 Organizations that do not qualify under any one of the categories above will

be awarded with MSOSH OSH Award Certificate of Participation




9.4 Total Man Hours Worked (TMHW)

Number of Employees & Contractors employed in one year multiplied by Number of Hours worked in a day multiplied by

Number of Days worked in a Year

TMHW = Number Employee & Contractors X Number Hours/day X Number Days/Year

Note: TMHW shall include the total Man Hours Worked by the Permanent & Contractual Staff and Permanent & Temporary

Contractors.

9.5 LTI Severity Rate (SR)

LTI Severity rate is the number of working days lost (i.e: no. of MC days) per 1,000,000 exposure hours worked (based on

“Notification of Accident, Dangerous Occurrence, Occupational Poisoning and Occupational Disease” (NADOPOD)

Regulations 2004 – Form JKKP 8) during the year, and is calculated as follows:

No. of LTI Days

LTI SR = ------------------------------------------- X 1,000,000 MANHOURS

TOTAL MAN HOURS WORKED

10. EMPLOYEE

Includes permanent/contract staff and permanent & temporary contractors

(Temporary = less than (3)three months).

11. APPLICATION FORM

Organizations applying for the awards should complete the enclosed application form and questionnaire and return

them together with requested documents and the application fee not later than Mon , 26th

January 2018. 29?

12. MSOSH AUDITORS

1. Department of Occupational Safety and Health (DOSH),

2. Social Security Organization (SOCSO),

3. Malaysian Society for Occupational Safety and Health (MSOSH),

4. Federation of Malaysian Manufacturers (FMM),

5. National Institute of Occupational Safety and Health (NIOSH),

6. SIRIM Berhad.

7. Malaysian Employer Federation (MEF),

8. Other selected resources.




13. MSOSH AWARD COMITTEEE

Minimum Three (3) Independent MSOSH Members appointed by the Management Committee

14. MSOSH OSH AWARDS PRESENTATION CEREMONY

Participants are encouraged to buy the table to support the Society.

“SUSTAINABLE OSH CULTURE”

FAKHRUL ANWAR BIN AHMAD AFFANDI

ORGANISING CHAIRMAN

MSOSH OSH AWARDS 2017




Please send this completed form together with payment and required documents to:

CHAIRMAN

MSOSH OSH Awards 2017

4th

Floor,Wisma PERKESO, Jalan Selangor 46050 Petaling Jaya, Selangor.

Tel: 03-79561763 / 79588396

A. PARTICULARS OF COMPANY/ORGANIZATION

1. Name of Company :

SOCSO code no. :

Postal Address :

:

Tel No. : Fax No :

2. Name of site to be

audited

:

Postal Address of site :

(Please attach route map)

Site Contact person :

Designation :

E-mail :

Tel No. : Fax No:

H/p No. :

3. Business Sectors

Petroleum, Gas, Petrochemical and Allied

Sectors Agricultural Sectors (Fishery/Forestry/Plantation)

Electronics and Electrical Sectors

Services Sectors (Hospitality/Banks/Theme Parks,

etc)

Manufacturing & Chemical Sectors Logistics and Transportations

Utilities Sectors Educational Sectors

Construction & Engineering Construction

Sectors (Project Progress = ______%)

*refer to term and condition no.15 page 3

Public Sectors & Statutory Bodies

APPLICATION FORM (PART A) MSOSH OCCUPATIONAL SAFETY AND HEALTH AWARD 2017




4. Number of Employees ( Incl.

Contract Employees & Permanent

Contractors)

: More than 1000

501 - 1000

301 - 500

101 - 300

50 - 100

Less than 50

Please Mark √ Where applicable.

B. PARTICULARS OF CHIEF EXECUTIVE OFFICER & PERSON SUBMITTING THE ENTRY FORM

1. Application submitted by

Name:

Position:

E-mail:

Tel No:

Signature & stamp

Fax No:

2.

Contact Person:

Position:

E-mail

Tel No.

Fax:

H/p No.

3. Name of Chief Executive Officer/ Managing Director / General Manager

Name:

Designation:

Signature & stamp




C. CATEGORY OF AWARDS

Based on the company's 2016 (for Platinum, Grand and Gold Merit Awards only) and/or 2017 (for Gold and

other awards) OSH performance and based on the Award criteria stated on the front page, tick the category

applied for: (Note that new participations CAN ONLY apply for Gold, Silver and Bronze Category)

PLATINUM GRAND GOLD MERIT

GOLD SILVER BRONZE

Note:

Applicants for Platinum Award have to provide documented evidence of winning the MSOSH Grand Award three

times since 2003. Grand & Gold Merit award applicants should include evidence of having won gold awards

before.

D. APPLICATION FEE

Category Award Member

Non-

Member

Additional

East M’sia

a) Platinum RM5,000 RM6,000 RM1,500

b) Grand and Gold Merit RM3,000 RM4,000 RM1,000

c) Gold, Silver and Bronze RM2,000 RM3,000 RM500

d) Additional Fee for Offshore Facilities RM3,000 RM4,000

e) Written REPORT per site (optional) RM1,100

TOTAL RM

Cheque No:

Payment should be made payable to : “Malaysian Society for Occupational Safety and Health”

Account No.: 8002324462 CIMB Bank Berhad, Section 52, Petaling Jaya, Selangor.




E. FIRST TIME PARTICIPANT:

YES

NO

(Please indicate latest year & award

received)

Year :

Award Received :

F. OTHERS:

GPS coordinate of the site to be audited

Recommended site for accommodation

Need Government Security clearance/ WorkPermit

Recommended nearest airpot (if app

CIDB, GREEN CARD / BOSIET

Recommended nearest airport (if applicable) : ___________________

Other logistics advice :

________________________________________________________________________________________________________________

G. OSH MANAGEMENT SYSTEM

Yes No

(1) The Company has established and implemented a recognized OSH Management

System (eg:OHSAS18001, MS 1722, ISRS, BS 8800, Responsible Care Program, OIMS,

HSE MS, etc)

(2) The complete cycle (policy, organizing, planning, implementation and evaluation &

action for improvement) of OSH Management System has been fully implemented.

(3) Others certification from Certification Bodies (RSPO/MSPO)

*Please attach

a) Copy of the company's OSH management system manual table of content

b) The name of the OSH management system the company is subscribing

c) Certification body's certificate if the OSH management system is certified by any certification

body.




H. OSH PERFORMANCE MEASUREMENT

Please provide the following information

1. 2017 OSH Performance:

a) Total man-hours worked accumulated in 2017: ______________________________________________

(Refer to item 9.4 page 7 on the front)

b) Average number of Staff & Permanent Contractors employed in 2017: ___________________________

c) Number of dangerous occurrence/s: _______________________________________________________

d) Total no of fatalities : _______________________________________________________________

e) Total no. of LTI cases in 2017: __________________________________________________________

f) Total no. of days away from work in 2017: _________________________________________________

g) Latest LTI was on __________________________________________________(date)

h) LTI frequency rate: ____________________________________________________________________

(Refer to item 9.3 page 7 on the front for calculation)

i) LTI severity rate: _____________________________________________________________________

(Refer to item 9.5 page 7 on the front for calculation)

2. 2016 OSH Performance (Applicable for Platinum and Grand Award applicants only):

a) Total man-hours worked accumulated in 2016:______________________________________________

(Refer to item 9.4 page 7 on the front)

b) Average number of staff & contractors employed in 2016: ____________________________________

c) Total Fatality : _______________________________________________________________________

d) Last fatality date : _____________________________________________________________________

e) Last LTI was on __________________________________________________ (date)

f) Last dangerous occurrence was on __________________________________ (date)

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