DEPA’ WENT OF LABOR AND EMPLOYMENT Regional Office No. VII x** ‘Approval Number 1410/85 -ROT-BFO-27/ To: | DOLORES V. YAP Co: JRY CONSTRUCTION vm Cc 4 IC - onal Director Phone: (02) 255-7724 Date: Oct. 5, 2017 Email: [email protected] cc: Transmited by: ceri: Pex Ema |X| Ml Project Tile REPAIR OF PORT FACILITIES TO INCLUDE BULKHEAD, CENTER ISLAND, STREET LIGHTING, GUARDHOUSES AND VEHICLE GATES, PORT OF TUBIGON Location :TUBIGON, BOHOL Project Owner :PHILIPPINE PORTS AUTHORITY Main/General Contractor's PCAB License No:10943 Date of Validity: JUNE 30, 2018 Appointed Safety Officer: ARTURO GLORIA Appointed First Aider/s: HELSON LOUIE JOSUE OH Nurse N/A OH Physician :N/A Tolal Number of Workers:45 WORKERS Duration of the Project: 300 C.D. Date of Estimated/Completion of the project: AUG. 2018 No. of Sub-contractors: Name of Sub-contractors: PCAB License Date of Validity 14. NONE NONE NONE. 2. NONE, NONE, NONE, (Use Separate Sheet, if necessary for the complete list of subcontractors) This refers to above captioned Construction Safety and Health Program (CSHP) which was submited to this Office on Oct, 5, 2017 in compliance with the requirements of D.0. No. 13 of series of 1998. Based on the evaluation of the requirements submitted by the main/general contractor, said Program Satisfactorily complied with the minimum requirements of D.O. 13 s 1998. In view of the foregoing, the instant CSHP is hereby APPROVED _ for implementation in the abovementioned project. The mair/general contractor shall beresponsible in ensuring its sub-contractors compliance withthe provisions of D.0. 13, specifically on the implementation of a suitable CSH Program designed for the specific work to be done by the sub-contractors. This approvalis without prejudice to comply with the requirements for the submission of the Certificate of Inspection and Testing of ConstructionHeavy Equipment, or its accredited testing organization pursuant to the requirements of Section 10 of D.O. 13, in case said heavy equipment will utiized in the project. Likewise, the approved CSHP shall not be limited to its existing provisions but may include other, ‘Systems and procedures applicable to the project. The CSHP maybe be reviewedby the main contractor form time to time to modify or include appropriate systems and procedures which must be in accordance with the prescribed standards, rules and regulations. Let a copy of this letter be furnished the tendering agency and the appropriate LGU for their respective eee nm 1 Validate at wn dole? com phiéchecContractor: LF Project nam: ** General Requirements RE-EVALUATION SHEET FOR CSHP APPL ONS LEY COYSPOATS OH Do as 4/2077 S50 hfe, foctfa £0 elfekeac’, Crhe fofort, hh Gamo poces STs s ofe. rks ‘A. Requirements for Submission a (a B The a a ee a 2. Two (2) copies of letter of intent stating therein thatthe Safety and Health (SH) Program is being. Submitted for evaluation and aprroval of DOLE “one copy of letter shall accompany the program “the second copy shall be returned to the applicant as proof of receipt of application b. name of authorized contact person with telephone number/s. This shal be used by the evaluator, when necessary to verify certain information concerning the program. «. Two (2) copies of the Safety and Health Program. One copy must be original print. yeram must contain the following: 1, Neme of person who prepared the program, and itis preferred that the person * preferably an accredited safety practtioner with DOLE, 2. Project Description 2. Specific name of project as it may/will appear on project bid documents or as advertised by the project tender. ». Specific location of project, preferably the exact address ofthe project. Project dassification as classified by the project tender. 4. Project owner €@. Name of main contractor. f. Estimated number of workers to be deployed. * consisting of the total number of workers to be directly employed by the contractor-applicant and the estimated number of workers who may not be under the direct supervision ofthe contractor applicant (ex. workers from the subcontractors and other contractors who may simultaneously Undertake the project. g. Estimated start of execution of project h Estimated duration of the project i. Scope of work to be uncertaken. 7] 3. Company Safety Policy written on a company letterhead “must be duly signed by the highest company official or the highest-ranking company representative who has over-all control of the project execution and should include the contractor's general policy ‘towards occupational safety, workers’ welafare and health, and environmental policy. 4. Composition of Safety and Health Committee ‘5. Names of Site Safety and Health Personne! 6. Specific duties and respon: E * Must specify the proposed structure and membership of the safety and health committee. es of the safety officer SPECIFIC PROVISIONS ON THE FOLLOWING (if applicable) 7. Orvsite Safety and Health Promotion and Continuing information Dissemination 8. Accident and Incident Investigation and Reporting. 9, Protection of the general Public within the vicinity of the Construction Site. 10. Environmental Control 11. Guarding of Hazardous Machinery 12. Personal Protective Equipment 413, Handling of Hazardous Substances 14. General Materials Handling and Storage procedures 415. Workers Skills and Certification (for critical occupation) 16. Provisions for transportation facilities for workers in case or emergency. 17. Temporary Fire protection facilities and equipment. 48, First Aid and Health Care Medicines, Equipment and Facilities 419, Workers Welfare Facilities 20. Proposed Hours of Work and Rest Breaks 21, Construction Waste Disposal 22. Testing and Inspection of construction heavy equipment. 23, Disaster and Emergency Preparedness Contingency Plan 24, Standard Operating procedure and Job Hazard Analysis a. Site Clearing . Excavations «.Erection and dismantling of scaffolds and other temporary working platforms. d. Temporary electrical connections/installations.. €@. Use of scaffolds and other temporary working platforms. {. Working at unprotected elevated working platforms or surfaces. &. Use of power tools and equipment h. Gas and electric welding and cutting opreations. |. Working in confined spaces i. Use of internal combustion engines.[Abuse othantoots 1m, Use of mechanize. uting appliances for movement of materials 1n. Use of construction heavy equipment 0, Demolition P. Installation, use and dismantting of hoist and elevators 25, Penalties/Sanctions for violation ofthe provision/s ofthe SH program a. should be specific act b. action to be taken when workers violate provisions under the program C.Attachments 1. Photocopy of Registration Forms and approved by the concerned DOLE Regional Office 2.0.0. 18-8 Registration/PCAB License [71 , Rule 1020 registration 2. Photocopy of invitation to Bid/Project Contract +3. Photocopy of Certificate of Completion on required Training of All designated OSH Personnel a. All appointed First-Aiders must be duly certified by the Philippine National Red Cross and ‘ith valid PNRC LD. on the Standard First Aid Training. b. All appointed Safety Officers must have undergone the construction safety and health course for site safety officers as required by 0.0. 13, 5.1998. [1 caltAppointed nurse must have completed a training from the Occupational Health Nurses Assocation ofthe Philippines (OHNAP). 4. All doctors and dentist assigned atthe project site must have completed the occupational and health course, as prescribed by the BWC and the Pilippine Occupational medicine, orits equivalent. [21 4-certificate of inspection and Testing of Construction Heavy Equipment (CHE) conducted by a DOLE accredited inspection and testing organization. 5. Skills Certificate of Construction Heavy Equipment Operators issued by TESDA 6. Contract with nearby hosptal/clinicin lieu of the required infirmary hospital (i applicable) 7. Construction Contract Documents with the Principa/Client (with billing on OSH implementation) 8. OSH Implementation Cost duly quantified as per .0. 13 section 5 and 17 Total costing must at least contain the itemized cost of the following: a. Site orientation/seminar on all workers, Pre-employment medical check-up Random drug testing [7] a: Table 47 of medicines/ medical facilities (Ce: Potable drinking water {Salaries of health personnel , Training of health personnel NRC taining for first aiders }+ oar traning for nurses + PCOM training for doctors Salaries for full-time safety personnel aries for fulltime safety practitioner if applicable) PE's specifying the number of workers to be provided for each PPE i. TESDA training for skilled workers (heavy equipment operators, installers of scaffolds, electricians, welders, riggers, mason, signallers, et.) C- Testing/inspection of Heavy Equipment rp. Construction Safety Training for Safety Officers ‘n, Safety provisions (safety nets, barricades, debris catchers, safety signages, fre extinguishers) ‘9, Other related Labor Laws and issuances Drug Free Workplace Program Anti-Sexval Harassment Program TB prevention Program HEPA B Prevention Program Je. HIV/AIDS prevention FINDINGS ‘Almost Completed No Contract No DPWH Evaluation Others; please specify RECOMMENDATIONS Project Name: For approval Remarig Forfurther compliance Remarks: Disapproved Remarks: ‘Tvs docaman al be doe desproved shoul thy Evaluated By: tet comply hth lacing requires hin 15 dye fom the dt of ssbmiion Noted by: COM AAS, Ve sfearJRY CONSTRUCTION 254 Menlo St., Corner Donada St., Pasay City Telefax: (02)2557724 October 5, 2017 Cyril L Ticao, DOLE Cebu Dear Sir: We are Submitting our Construction Safety and Health Program for the Project : Repair of Port Facilities to include Bulkhead, Center Island, Street Lighting, Guard Houses and Vehicle Gates, Port of Tubigon, Tubigon Bohol. Thank you. Very truly yours ose fap General ManagerNO FEES REQUIRED FOR THE FILING, EVALAUTION AND AMPROVAL OF CSHP Revised Form.: CSHP.D013-08: Date of Revision: Junet, 2011 Page tof 3 REVISED APPLICATION FORM for Department of Labor and Employment EVALUATION’ APPROVAL OF CONSTRUCTION SAFETY & HEALTH PROGRAM (CSHP) |Legal Basis: Section 5 of Department Order No. 13 s 1998 (Guidelines Goveming Occupational Safety and Health In Construction Industry) ‘Instructions: This form shall be duly accomplished and submitted by the MAIN/GENERAL CONTRACTOR in applying for an approval of a Construction Safety and Health Program intended for specific construction project. Note: A CHECKLIST OF REQUIREMENTS shall be used in receiving the application. ‘Only an application form with a complete requirements and attachments will be processed. Application found with incomplete requirements will be given 15 calendar days to comply. Failure to ‘comply within the prescribed period, the application will be deemed disapproved. ‘A. Company Profile/License/Registration of Main/General Contractor ‘Complete Name of the Company! Complete Address: £| Velasco St. pn, Tagas, ‘Main /General Contractor Daraga, Abay JRY — Genstruction TeLNo: zp ass -7724 FaxNo. Name of Project ManageriGontact Person: | Emel: jryconstroct@yahoo. com mcaeaq &- Wind | Main Contractor PCAB License Main Contractor Total employment 45 No._{o14 3 ‘43 Male_2 Female Date of Validity. ne 30, 2n18 DOLE Registration of Main Contractor ( Pis. attach photo copy of Registration forms received and approved by the concemed DOLE Regional Office) Date Registered/Approved _DOLE-RO 4. per DO 18.02 ( requires yearly renewal) i b._ por Rule 1020, OSHS (one time registration) Arpcil Ul, 2016 ‘Sub-contractors’ Profile/License i No. of | PCAB | Validity | Date of Name of Sub-contractors (If, any) | Scope of Work and | Workers | License | Date DOLE Project Cost | Registration 7 2 3 a 5 | (Use separate sheet, Wnecessary)REVISED APPLICATION FORM for Department of Labor and Employment EVALUATION! APPROVAL OF CONSTRUCTION SAFETY & HEALTH PROGRAM (CSHP) = B. Project Profile/Description Tame of the Project (Please attach copy of Invitation o Bidiother documents indicating name and details of the PIE) Repric of fort Facilities 4o laclede Bulkheod, Center Island ,Strect Lighting: Geardhoose.s ard Vehicle Gates, Port of Tubigon, Tovigen » Bebe! Complete Project Address/Location fort of Tebigon, Tubige”, Boho Name of Project Owner T a . Tel. No: Philippine forts Arthority nan ax No! PMD ~ Bohol Email Project Classification: Date of Estimated StarExecution of ; Estimated No. of Workers to | the project: PHOE -Meclivin A be deployed in the project: Kou, 01% Morty Day Year pees Gg eee Duration of the project (Pls. Total Project Cost_P_23.6M (Workforce of the project to | state the number of calendar days include workers of the sub- contractors) 300 Cal Days Bret Daccrplion of AclviiesNVork Flow (Vou may attach edetonal sheet, necessary) I. Mobilization and Demo bilization I. Repair of | Bulkhead TW. Construct security Fence and Vehicle Cates B. Repair of Center Island T. Repair of Causeway lighting System Date of Revision: June, 2011 Page 2ot 3A Department of labor and Employment APPLICATION FORM for APPROVAL OF CONSTRUCTION SAFETY AND HEALTH PROGRAM 08H Personnel assigned to the project Name of Appointed Safety Officer/a: Name of Appointed First-Aideris: —Acturo CE loricr Helon [oie Me losue. Date of his/her BOSH training: _New. 14, 20f1 Date of First Aig Training: 18 Bosic Life S rng. Ae 4 Se (P's, tach photo copy of Certiteate of Completion onthe | Validity of ID: Sasic OSH Course tor Consructon Site Safety Otters issued Ho BeZOt by DOLE-BWC accredited Safety Training Organizations or (Ps. aach photo copy of Certificate of Fis-Aid Training recognized instiions) | ana Vat Prat Aer ID om PNR ‘ier OH personnel [if more than 60 workers will be deployed in the project) sare oat Name Date of BOSH Training | OF Nurse Nit NIA OH Physician NIA — rr nN | q fe een nih NIA (if Heavy Equipment will be used in the Project) 1 List of Heavy Equipment to be Used in the Project ‘Name of Heavy Equipment Operator/s (To attach photo (Please attach additional sheet, if necessary) ‘copy of skills certification from TESDA) Backhoe fxcayator JOEY V. Guteatop | ~ Profile of the person who prepared the CSH Program for the abovementioned Project: and Signature Educational Background: Boor of uence in Ml Crginerr i al a ‘Work Experience in OSH: Signatule over phinted name COS Toning, Other Qualfations: 0 Gagpinens | HEREBY CERTIFY ON MY HONOR TO THE TRUTHFULNESS OF THE ABOVEMENTIONED INFORMATION. THE COMPANY HEREBY COMMIT TO STRICTLY IMPLEMENT THE ATTACHED CONSTRUCTION SAFETY and HEALTH PROGRAM DESIGNED FOR THE ABOVEMENTIONED PROJECT. Way Signature Over Printed Name Position Goneral planand e Date: ‘Submitted By: Revised Form: CSHP-DO 13-98 Date of Revsion: June1, 2011 Page 30f 3ew JRY CONSTRUCTION 4 209 BRGY. 38 LAKANDULA DRIVE, GOGON, LEGAZPI CITY « Branch Office (Unit 214) 760 Pacifie Regency Tower, P. Ocampo St, Melate, Merile some Tel. No. (02) 255-7726; EmalLAdG: [email protected] CONSTRUCTION SAFETY AND HEALTH PROGRAM Project : REPAIR OF PORT FACILITIES TO INCLUDE BULKHEAD, CENTER ISLAND,STREET LIGHTING, GURADHOUSES AND VEHICLE GATES Location: PORT OF TUBIGON, TUBIGON, BOHOL I. Company Safety Policy 1.1 To provide and maintain a safe and healthful working condition for its workers. 1.2 To develop and maintain a vigorous Safety and Accident Prevention Program to avoid human suffering and financial losses. 1.3 To hold responsible every manager or supervisor who supervises or directs the work manager or supervisor who supervises or directs the work of other in assuring the safety of each employer under his supervision. 1.4 To guide employees in maintaining safe and impose corresponding penalty for violation committed. Il. Construction safety & Health Committee Group The group of Construction Safety & Health Committee will be composed of the following personnel: NAME POSITION Chairman: _Oliver Aligan ____Project Manager Members: _Nilo J. Mirandilla Project Engineer Rafael R. Obusan IL “Material Engineer Helson Louie M. Josue First Aider Fernando Gallardo _ “Foreman Secretary: _Arturo Gloria _ Safety and Health OfficerIll. General Safe Practices Before the start of the construction project, the chairman of the committee will conduct a meeting to all workers for the purpose of orienting, instructing and training them with regards to the Construction. Safety and Health Program under which they will perform and a weekly gang meeting will be held at 7:00 A.M. every Monday of the week. For them to have humane working condition the following shall be provided: TIL1 A bunkhouse shall be constructed for the workers 11.2. A treatment room where they can be treated in case of accident TIL3 A portable toilet and washing facilities. TIL4 A portable water where they can drink safe water. All signs and safety measure shall be installed and posted in prominent position at strategic location and in the language understandable to most of the workers in order to warn them and the public as well for the hazards existing in the construction site. All workers are required to wear their personal protective equipment such as hardhat, gloves, safety shoes, safety belts, lifelines, etc. before starting to their respective assignments. Iv. Penalties and Sanctions If workers found not performing the policies on safety program will be given a warning, restriction for the first offense, suspension for the second and termination of the third offense. Failure to attend the weekly gang meeting would constitute a violation and the proper penalty shall be imposed. v. Disposal of Waste ‘The workplace shall be properly clean; all waste materials shall be disposed ion the proper disposal area after the project has been completely finished. Submitted by. DOLORES V. YAP General Manager