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

CONTRACTOR, SUBCONTRACTOR AND CONTRACTED SERVICES 33.055.1<br />

ANNUAL PREQUALIFICATION FORM – SAFETY PAGE 3 OF 7<br />

If “Yes”, please attach an example or certificate issued by a recognized authority.<br />

18. What percent of the work force has been working in the industry for 1 year or more?<br />

A. 0% - 25%<br />

B. 26% - 50%<br />

C. 51% - 75%<br />

D. 76% - 100%<br />

Comments:<br />

19. Your company has a lead person to crew ratio of:<br />

A. Less than or equal to 1 to 7<br />

B. Between 1 to 8 <strong>and</strong> 1 to 11<br />

C. Between 1 to 12 <strong>and</strong> 1 to 25<br />

D. Greater than 1 to 25<br />

Comments:<br />

20. The criteria used to qualify safety trainers is established by:<br />

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

If “Yes”, please describe:<br />

B. External training <strong>and</strong> certifications from governments, professional organizations, trade associations<br />

or other recognized authority.<br />

If “Yes”, please describe:<br />

21. Safety <strong>and</strong> scheduling coordination meetings with sub<strong>contractor</strong>s are held:<br />

A. Daily<br />

B. Weekly when work is for longer than 1 week.<br />

C. As needed.<br />

D. No Sub<strong>contractor</strong>s are used.<br />

Comments:<br />

22. Indicate all that apply to your company’s substance abuse program.<br />

A. Substance abuse is monitored using r<strong>and</strong>om substance tests.<br />

B. Substance abuse is monitored using substance tests for cause or post <strong>inc</strong>ident.<br />

C. Substance abuse is monitored by crew leaders trained in substance abuse recognition.<br />

Comments:<br />

23. Your company audits <strong>and</strong> documents safety meetings, job safety conditions or job safety performance at<br />

the rate of:<br />

A. Daily<br />

B. Weekly<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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