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ALCOA INC. <strong>2007</strong><br />

CONTRACTOR, SUBCONTRACTOR AND CONTRACTED SERVICES 33.055.1<br />

ANNUAL PREQUALIFICATION FORM – SAFETY PAGE 2 OF 7<br />

If “Yes”, please attach examples.<br />

Explain your company’s usual process to eliminate safety hazards<br />

13. At what frequency does your company conduct <strong>and</strong> document safety activities, such as safety<br />

orientations, or safety meetings, or safety inspections?<br />

A. Daily<br />

B. Weekly<br />

C. Monthly<br />

D. Conducts a safety orientation only.<br />

E. None of the above.<br />

Comments:<br />

14. Do the following participate in the investigation of all significant <strong>inc</strong>idents or accidents?<br />

A. Owner or Senior Management.<br />

B. Middle Management.<br />

C. Lead Person.<br />

D. Other.<br />

If “Other” is “Yes”, please specify:<br />

15. Have the following changed for your company in the last 3 years?<br />

A. Ownership.<br />

If “Yes”, please provide details.<br />

B. Insurance Carrier.<br />

If “Yes”, please provide details.<br />

C. Other significant changes which may favorably affect safety.<br />

If “Yes”, please provide details.<br />

16. Check all answers that describe the content of your company’s safety training.<br />

A. Basic safety training complies with all local regulations <strong>and</strong> consensus st<strong>and</strong>ards.<br />

B. Select crafts <strong>and</strong> trades have completed advanced safety training beyond regulatory<br />

requirements.<br />

If “Yes”, please describe specific safety training.<br />

C. Select crew leaders have completed advanced safety training beyond regulatory requirements.<br />

If “Yes”, please describe specific safety training.<br />

17. Documentation of basic safety training exists in the form of:<br />

A. Internal certifications <strong>and</strong> records.<br />

B. External licenses <strong>and</strong> certificates issued by governments, professional organizations, trade<br />

associations or other recognized authority.<br />

This document is the property of Alcoa Inc. <strong>and</strong> must be returned on request. It shall not be reproduced or copied, in whole or in part, or used on behalf of others than Alcoa Inc. or its<br />

subsidiaries, without permission. It is provided solely for the purpose of disclosing Alcoa's approach <strong>and</strong> is not intended to be a recommendation for any recipient other than Alcoa. No<br />

warranties, guarantees or representations, express or implied are made as to the utilities or effectiveness of the methods, processes, products or procedures described or recommended herein.<br />

Rev. 2_<strong>2007</strong>2

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