National Excellence in HSE Awards 2017
AMERICAN CHAMBER OF COMMERCE OF TRINIDAD AND TOBAGO
Address: 62 Maraval Road, Port of Spain; Mailing Address: P.O. Bag 150, Newtown, Port of Spain
Tel: (868) 622-4466/0340/628-2508; Fax: (868) 628-9428; Email: [email protected]
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Outstanding HSE Project
RATIONALE AND GOAL:
This prestigious award seeks to recognize and inspire small and medium-sized entities who are
committed to HSE excellence! The award is intended to encourage the implementation of formal
HSE management systems by recognizing an outstanding project completed or significantly
completed in 2017 that has resulted in significant and sustainable improvement in the
organization’s occupational safety and health or environmental performance or management
program. Projects must relate to occupational health, safety and environmental activities in the
workplace, facility or immediate vicinity of the facility and must achieve specific positive HSE
impacts beyond legal compliance requirements.
NOTE: The main objective of this Awards Scheme is the promotion of the development and
implementation of robust occupational health and safety and environmental management systems
by the applicant companies and to recognize related achievements. Projects and other activities
designed primarily for engaging persons and groups external to the applicant companies may not
meet the criteria for applying.
SELECTION CRITERIA:
Business Profile
Briefly describe the type of business, principal products and/or services, size of workforce,
including number of employees, contractors, and temporary workers and any other relevant
information. The business profile should include evidence that the organization operates as a
financially viable organization.
National Excellence in HSE Awards 2017
AMERICAN CHAMBER OF COMMERCE OF TRINIDAD AND TOBAGO
Address: 62 Maraval Road, Port of Spain; Mailing Address: P.O. Bag 150, Newtown, Port of Spain
Tel: (868) 622-4466/0340/628-2508; Fax: (868) 628-9428; Email: [email protected]
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Section 1: Project Overview:
a. Which of the following main areas is the project in: [ ] Occupational Safety & Health;
[ ] Environmental protection or preservation; [ ] Combination of above – state which categories
Provide a brief description of the project.
National Excellence in HSE Awards 2017
AMERICAN CHAMBER OF COMMERCE OF TRINIDAD AND TOBAGO
Address: 62 Maraval Road, Port of Spain; Mailing Address: P.O. Bag 150, Newtown, Port of Spain
Tel: (868) 622-4466/0340/628-2508; Fax: (868) 628-9428; Email: [email protected]
Section 2: Results
Provide information on the following:
2017 year to date 2016 2015 2014
1. Lost time accidents (LTA):
a. No. of lost time accidents (LTA) i.e. accidents with human injury which resulted in days away from work (not counting the day of the accident) as certified by a registered Medical Doctor.
b. No. of persons injured (for all the LTAs in the respective year).
c. No. of days lost (for all the LTAs in the respective year).
2. No. of cases of work-related ill-health or disease.
a. No. of persons so affected.
3. No. of OSH Agency citations
4. No. of Administrative Orders under the Environmental Management Act Chapter 35:05
5. No. of Notice of Violations under the Environmental Management Act Chapter 35:05
6. Has the company received any accolades for OSH or Environmental performance? Y/N: Indicate type/nature/name of Awards etc.
National Excellence in HSE Awards 2017
AMERICAN CHAMBER OF COMMERCE OF TRINIDAD AND TOBAGO
Address: 62 Maraval Road, Port of Spain; Mailing Address: P.O. Bag 150, Newtown, Port of Spain
Tel: (868) 622-4466/0340/628-2508; Fax: (868) 628-9428; Email: [email protected]
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Section 3: Project Details: a. Provide details on the following:
1. Aims and objectives of project.
2. Brief description of project, from conceptualization of project idea to implementation.
3. Time frame of implementation.
National Excellence in HSE Awards 2017
AMERICAN CHAMBER OF COMMERCE OF TRINIDAD AND TOBAGO
Address: 62 Maraval Road, Port of Spain; Mailing Address: P.O. Bag 150, Newtown, Port of Spain
Tel: (868) 622-4466/0340/628-2508; Fax: (868) 628-9428; Email: [email protected]
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4. People involved: state names and job positions of key personnel involved in the Project,
including the Project Leader.
5. Level of people involvement/engagement.
6. How does this project impact on the HSE performance of your company or relevant entity?
7. What performance indicators are used to assess the success of your project?
National Excellence in HSE Awards 2017
AMERICAN CHAMBER OF COMMERCE OF TRINIDAD AND TOBAGO
Address: 62 Maraval Road, Port of Spain; Mailing Address: P.O. Bag 150, Newtown, Port of Spain
Tel: (868) 622-4466/0340/628-2508; Fax: (868) 628-9428; Email: [email protected]
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8. How can the project or the benefits from this project be sustained for years to come?
9. What resources did this project utilize: financial, personnel, time?
10. How does this project contribute to a Management Systems approach to OSH/E Management?
National Excellence in HSE Awards 2017
AMERICAN CHAMBER OF COMMERCE OF TRINIDAD AND TOBAGO
Address: 62 Maraval Road, Port of Spain; Mailing Address: P.O. Bag 150, Newtown, Port of Spain
Tel: (868) 622-4466/0340/628-2508; Fax: (868) 628-9428; Email: [email protected]
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11. Why in your view is this project outstanding from an OSH/E perspective?
National Excellence in HSE Awards 2017
AMERICAN CHAMBER OF COMMERCE OF TRINIDAD AND TOBAGO
Address: 62 Maraval Road, Port of Spain; Mailing Address: P.O. Bag 150, Newtown, Port of Spain
Tel: (868) 622-4466/0340/628-2508; Fax: (868) 628-9428; Email: [email protected]
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Outstanding HSE Project
APPLICATION FORM
1. Application Organization/Company
Title of Submittal
Name of Organization
Industry Sector:
Energy Manufacturing Services to the Energy Sector
Services to the Non- Energy Sector
Which of the following main areas is the project in?
Occupational Safety & Health
Environmental protection or preservation
Combination of above – state which category
Business Size (according to the number of persons employed):
Small [0 - 49] Medium [50 – 249] Large [250 and greater]
2. Please provide the contact information for the person who should receive all correspondence
Name
Job Title
Phone Fax
APPLICATION VERIFICATION
National Excellence in HSE Awards 2016
As an executive-level official of the organization named above, I verify that:
National Excellence in HSE Awards 2017
AMERICAN CHAMBER OF COMMERCE OF TRINIDAD AND TOBAGO
Address: 62 Maraval Road, Port of Spain; Mailing Address: P.O. Bag 150, Newtown, Port of Spain
Tel: (868) 622-4466/0340/628-2508; Fax: (868) 628-9428; Email: [email protected]
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I have reviewed, and our organization meets, the eligibility requirements of the National Excellence
in HSE Awards 2017
I have reviewed the information submitted for consideration for the Award and to the best of my
knowledge neither any untrue statement nor omission of material fact has been made in our
Submittal Package
As required in the review and Award processes, we agree to meet the requirements of the Awards
including, availability for on-site assessment, transfer copyright, and promoting the sharing of our
submittal through the National Excellence in HSE Awards Scheme and related activities.
Signature of Executive-Level Official Title
Printed Name Date