CoR Safety Declaration | Montague Farms

1

Transport Company* This field is required.

2

Vehicle Registration* This field is required.

3

Driver Name* This field is required.

4

Arrival* This field is required.

Date

Hour

Minutes

5

Site* This field is required.

6

Team Member's Name* This field is required.

7

I declare that the following information is legally accurate and not misleading:

8

Does the driver have sufficient legal hours to complete the delivery task?

YESNO

9

Fatigue Management* This field is required.

Standard

BFM

AFM

10

Legal hours left

11

Does the driver accept the load/vehicle is within legal mass limits?

YESNO

12

Vehicle WeightsEnter values in KG without decimals

Vehicle Tare

Trailer Tare

Legal GML

Other goods on board

13

Confirm: Total Tare WeightVehicle Tare + Trailer Tare

14

Confirm: PayloadGML - Total Tare - Any other goods (KG)

15

NHVAS Mass

NHVAS #

16

Has the person nominated above undertaken site induction in last 12 months?* This field is required.If YES, ensure you have sighted their induction sticker.

YESNO

17

Ensure the nominated person undertakes site induction prior to proceeding.

Have the person scan this QR Code to complete site induction: