Supplier Worker Form

Supplier/Worker

Safety Induction Process

Step 1 of 8

12%

Registration

Please complete the following. Please fill in the contact information for the individual visiting the Rosslyn Rail Hub.

Name(Required)

First Last

ID Number(Required)

Email Address(Required)

Phone(Required)

Car Model(Required)

Car Registration(Required)

Name of Person Visiting / Traxtion Contact(Required)(Required)

First Last

Email Address of Person Visiting / Traxtion Contact(Required)(Required)

Health and Safety Policy

Please read the following. The below procedures are to ensure your safety when entering the Traxtion site:

DO

Following Training Procedure

Always work according to the training and safety procedures provided.

DO

Report Hazards

Immediately report any dangerous conditions to supervisors and health and safety representatives.

DO

Use PPE

In designated areas, wear appropriate personal protective equipment (PPE), such as hard hats, safety shoes, and eye protection..

DO

Keep Walkways Clear

Ensure that walkways and aisles are free from obstructions and properly demarcated.

DO

Secure Tools and Materials

Always secure tools and materials, especially when working at heights or with ladders.

DO

Handle Machines Safely

Only operate machinery if trained and appointed to do so. Ensure all safety devices are in place and operational.

DO

Follow Electrical Safety

Treat all electrical equipment as live and report any unsafe conditions immediately.

DO

Respect Speed Limits

Adhere to speed limits and traffic rules when operating vehicles on company premises.

DO

Maintain Good Housekeeping

Keep work areas clean, return tools to their proper places, and promptly clean up any spillages.

DO

Participate in Emergency Drills

Engage actively in emergency procedures and drills to ensure preparedness.

I have thoroughly read and understand the document and will follow the procedures, instructions, rules, and guidelines as set forth in the above document.(Required)

I agree

DON'T

Don't Enter Restricted Areas

Do not access areas of the workplace where you are not authorised.

DON'T

Don't Ignore Safety Signs

Always heed safety signs and signals, including those for no entry, no smoking, and emergency exits.

DON'T

Don't Bypass Safety Guards

Never remove or bypass safety guards on machinery

DON'T

Don't Work Under Influence

Do not come to work under the influence of alcohol, drugs, or certain medications

DON'T

Don't Leave Machines Unattended

Do not leave machines running unattended or with keys in the ignition.

DON'T

Don't Smoke Outside Designated Areas

Smoking is strictly prohibited outside the designated smoking areas, including the use of e-cigarettes.

DON'T

Don't Ignore Fire Hazards

Never leave flammable materials unattended, and always follow fire safety protocols.

DON'T

Don't Climb Unsafely

Avoid unsafe climbing practices, such as using makeshift scaffolds or working without a harness when required.

I have thoroughly read and understand the document and will follow the procedures, instructions, rules, and guidelines as set forth in the above document.(Required)

I agree

Safety Video

Please watch the following video and answer the questions that follow

By checking this box, you confirm that you have watched and understood the content of this video.(Required)

I agree

Safety Questionnaire

Answer the following question regarding the safety induction process. Please note a 100% pass rate is required before access to the Rail Hub can be granted. You will be allowed to go back and re-answer questions if they are incorrect.

What is the correct PPE?(Required)

Visibility Vest Only

Hard Hat Only

Safety Shoes Only

All of the above

Correct

Incorrect

What colour is the correct demarcated walking ways?(Required)

Red

Yellow

Green

Correct

Incorrect

What are the three points of contact on steps?(Required)

Two feet and one hand on the equipment always

One foot and one hand on the equipment

Two feet and no hand on the equipment

Correct

Incorrect

Visitors and Suppliers can handle any machine on site

True

False

Only if trained and appointed to do so

Correct

Incorrect

What is allowed onsite?

Working under the influence of alcohol

Smoking outside designated areas

Entering restricted areas

Participating in emergency drills

Correct

Incorrect

Indemnity Form

I, the undersigned, hereby indemnify the company and hold it harmless against:

Liability in respect of damage to or loss of my property (or property under my control);
Liability in respect of injury to myself or my death; and
Liability in respect of legal costs and expenses incurred in connection with claims or actions arising out of the foregoing;

whenever, the damage, loss, injury or death referred to in (a) or (b) is due to or arises out of or in connection with the provision of the services in terms of this agreement.

I acknowledge and understand that I will be exposed to the risks and dangers associated with train movements and electrical overheads.
I voluntarily consent to and assume the risk of injury or death which may arise out of the risks ordinarily inherent in the railway environment, or if the injury, or death or risk or loss or damage is occasioned during my transportation in terms of this agreement.
I furthermore waive any claim which I may have in law or otherwise against the company for any loss or damage in respect of my property or in respect of my injury arising out of or in connection with services rendered by the company or any of its subcontractors in terms of this agreement, including but not limited to loss of life, profit, earnings, capacity to earn and/or any other amenities.

By checking this box, you confirm that you have read, understood, and agree to the Terms and Conditions of this indemnity form.(Required)

I agree