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Application For Construction Safety and Health Program (CSHP)

This document is an application for a Construction Safety and Health Program for a project called "I SCAN MARIKINA" located at 6 J.P LAUREL ST. COR. CHESTNUT ST. NEW MARIKINA, SUBD. MARIKINA. The project will last 90 calendar days starting on January 16, 2023 and is estimated to cost 2,200,000. There will be 9 workers. The contractor, BASELINE CONSTRUCTION CORPORATION, and project owner, I-SCAN DIAGNOSTIC CENTER, commit to complying with occupational safety and health standards and implementing a Construction Safety and Health Program for the project.

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ALVIN GATUS
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196 views

Application For Construction Safety and Health Program (CSHP)

This document is an application for a Construction Safety and Health Program for a project called "I SCAN MARIKINA" located at 6 J.P LAUREL ST. COR. CHESTNUT ST. NEW MARIKINA, SUBD. MARIKINA. The project will last 90 calendar days starting on January 16, 2023 and is estimated to cost 2,200,000. There will be 9 workers. The contractor, BASELINE CONSTRUCTION CORPORATION, and project owner, I-SCAN DIAGNOSTIC CENTER, commit to complying with occupational safety and health standards and implementing a Construction Safety and Health Program for the project.

Uploaded by

ALVIN GATUS
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Form Reference No: PM-NCR-03.08-F-03.

R01
Regional Office: DOLE-NCR
Application No: ________

Application for
CONSTRUCTION SAFETY AND HEALTH PROGRAM (CSHP)
(Intended only for residential project/s (2 storey and below) or minor repair works with 15 workers or less or with
project cost of less than Php3,000,000.00.)

Project Name: I SCAN MARIKINA


Project Complete Address/Location: 6 J.P LAUREL ST. COR. CHESTNUT ST. NEW MARIKINA, SUBD. MARIKINA.

Project Duration: 90 CALENDAR DAYS Project Start: JANUARY 16, 2023 Completion Date: APRIL 16,2023
(No. of Calendar days) (Date of estimated start) (Date of project completion)
Estimated Project Cost: 2,200,000.00 Number of Workers: 9
Name of Contractor (if any):BASELINE CONSTRUCTION CORPORATION
Contractor’s Address: UNIT 305 TOYAMA BUILDING TIMOG AVE. QUEZON CITY
Fax No.:412-17-96
PCAB License No 35431 Date of Validity: MAY 18, 2023 Email address:bcc.safety.alvingatus@gmail.com

Name of Project Owner: : I-SCAN DIAGNOSTIC CENTER. Fax No.:_____________________


a. Project Owner Address: 6 J.P LAUREL ST. COR. CHESTNUT ST. NEW MARIKINA,
SUBD. MARIKINA.

Accomplished by: RODERICK S.WEE


Signature over Printed Name
of
OWNER / CONTRACTOR
**********************************************************************
COMMITMENT TO COMPLY on OSH

I/We RODERICK S.WEE AND I SCAN DIAGNOSTIC CENTER


(Name of Contractor’s Authorized Official and/or Project Owner)

do hereby commit and bind ourself to comply with the applicable provisions of the
Occupational Safety and Health Standards (OSHS) and Department Order No.13 series
of 1998 – Guidelines Governing Occupational Safety and Health in the Construction
Industry. I/We hereby commit to implement a suitable Construction Safety and Health
Program designed for the abovementioned project. I/We also acknowledge my/our
responsibilities to provide the appropriate Personal Protective Equipment (PPE) and job
safety and health instructions and training to all our workers during the duration of the
project.

I SCAN DIAGNOSTIC CENTER RODERICK S.WEE


PROJECT OWNER CONTRACTOR
Signature Over Printed Name Signature Over Printed Name
(NOTE: NO FEES REQUIRED FOR APPLICATION, PROCESSING AND APPROVAL OF CSHP)

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