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  • Engagement of new contractors and self-employed persons

  • ________________________________________________________________

    Data Protection Note: This data may include personal information which is collected and processed by the Occupational Health and Safety Authority (OHSA) to fulfil its investigative, enforcement and regulatory role in accordance with the Health and Safety at Work Act (Chapter 646 of the Laws of Malta) and applicable subsidiary legislation. All personal data shall be processed in accordance with the General Data Protection Regulation (No 2016/679) as well as any other applicable law or guidelines published from time to time and is not shared with any third parties except when necessary and with a justifiable legal basis. To learn more about how OHSA collects, keeps, and processes your private information in compliance with the GDPR, please view OHSA's Data Protection Policy which can be accessed through the following link: https://www.ohsa.mt/data-protection.   

     

    All Sections must be filled prior to submission to OHSA

     

    This form shall be filled by the client or by the client representative. 

  • Date of Submission*
     / /
  • Section A

  • Type of Client*
  • Type of Client/Client Representative*
  • Format: (000) 0000-0000.
  • Date*
     / /
  • Format: (000) 00000000.
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Type of Client*
  • Format: (000) 00000000.
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Type of Client*
  • Format: (000) 00000000.
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Type of Client*
  • Format: (000) 00000000.
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Type of Client*
  • Format: (000) 00000000.
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Type of Client*
  • Format: (000) 00000000.
  • Format: (000) 0000-0000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Type of Client*
  • Format: (000) 00000000.
  • Format: (000) 0000-0000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Type of Client*
  • Format: (000) 00000000.
  • Format: (000) 0000-0000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Type of Client*
  • Format: (000) 00000000.
  • Format: (000) 0000-0000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Client/client representative
  • Section B - Details of the project supervisor for health and safety matters

  • Type of project supervisor?*
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 0000 0000.
  • Format: (000) 0000-0000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Type of project supervisor?*
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 0000 0000.
  • Format: (000) 0000-0000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Type of project supervisor?*
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 0000 0000.
  • Format: (000) 0000-0000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Format: (000) 00000000.
  • Date*
     - -
  • Project Supervisor (i/r/o H&S Matters)*
  • Section C -Type of Project - fill all fields

  • Date of Notification*
     / /
  • Is a planning permission required for these works?*
  • (b) Please indicate all anticipated works involved for the new contractor/self-employed person*
  • Details of the new Contractor(s) or Self-Employed Person(s) 

  • 1) Description of contractor/s chosen?*
  • 2) Description of contractor/s already chosen?*
  • 3) Description of contractor/s already chosen?*
  • 4) Description of contractor/s already chosen?*
  • 5) Description of contractor/s already chosen?*
  • 6) Description of contractor/s already chosen?*
  • 7) Description of contractor/s already chosen?*
  • 8) Description of contractor/s already chosen?*
  • 9) Description of contractor/s already chosen?*
  •  
  • Should be Empty: