TEMPLATE

DOCUMENTARY REQUIREMENTS AND FORMAT IN THE PREPARATION OF

CONSTRUCTION
SAFETY AND HEALTH PROGRAM (CSHP)
For Three Storey and up-( Commercial, Industrial and Government Bid
Projects )
Horizontal and Vertical Construction
I.
Page One
TABLE OF CONTENTS
- Information as to the contents of the documents
submitted.
II.
Page Two
PROJECT DESCRIPTION
- ( See attached Documentary Requirements - II. B )
III.
Page Three and subsequent pages
CONSTRUCTION SAFETY AND HEALTH PROGRAM
a. Introduction /Background :
Cite the Constructors /Owners commitments to comply
with the
Provision of Construction Safety and Health Program (CSHP)
and the Management Policy on Occupational Safety and
Health (OSH) to include the accident prevention and
reporting requirements for the duration of the project.
b. Policy and Composition of Safety and Health Committee
Organization :
Every Construction Activity, the owner/contractor shall
initiate the creation of the Safety and Health Committee,
giving emphasis on the duties and responsibilities of every
member
of
the
Committee.
The
OSH
Committee
membership shall be selected from among the companys
personnel stating their position in the organization.
Companys OSH Policies shall be duly signed and approved
by the highest company official who has the over-all control
of the project and must be duly explained to the workers.
(Please refer to sec. 5 of D.O. 13).
c. Other necessary requirements to be included in the CSHP
based on the projects program of works. Provisions not
related to the program shall be eliminated.
d. The Program shall be prepared and
signed by the duly
trained
Safety
Officer
and
approved
by
the
owner/contractor.
ATTACHMENTS:
Please refer to the Item C of the attached Checklist for Evaluation of
Construction Safety and Health Program (CSHP) per requirements of
D.O.13 series of 1998.

Note: This template also applies to a one storey bldg. other than the residential
building.
The approved CSHP on a specified project will serve as a requisite to start the
project and the issuance of building permits and other issuances related to that
specific project.

TEMPLATE
DOCUMENTARY REQUIREMENTS AND FORMAT IN THE PREPARATION OF
CONSTRUCTION
SAFETY AND HEALTH PROGRAM (CSHP)
FOR Two Storey Below (Construction of Residential Building)
I.
Page One
TABLE OF CONTENTS
Show information as to the contents of the documents
submitted.
II.
Page Two
PROJECT DESCRIPTION
a. Title of the Project
b. Location of the Project
c. Project classification (Vertical-Residential)
d. Project owner/contact no.
e. Name of the Project-in-charge (Engineer/Architect-contact
no.)
f. Estimated no. of workers to be deployed
g. Estimated duration of the project (days/months)
h. Specific/Scope of works to be undertaken
III.
Page Three
SIMPLE CSHP TO CONTAIN THE FOLLOWING BASED ON THE
PROGRAM/SCOPE OF WORK UNDERTAKEN :
a. Introduction-To reflect the Management commitments to
implement the Workplace Safety and Health Policy and to
explain it to the workers.
b. OSH Policy/Program to be implemented must be signed and
approved by the owner and must also be signed by the one
who prepared the said policy/program.
c. The
Construction
Safety
and
Health
Committee
Organization.
Chaired by the owner with emphasis on the duties and
responsibilities of the members.
d. To provide Welfare Facilities (e.g. comfort room, emergency
medicines and treatment room, drinking facilities and other
OSH related facilities).

e. PPEs shouldered by the owner whenever necessary

case of hazardous work areas.

in

ATTACHMENTS:
1. Copy of the Certificate of training of the designated Safety
Officer(BOSH/CST), and a license certificate of an engineer in
charge, if any.
2. Copy of the Certificate of training and ID of First-Aider or
nurse based on the no. of workers deployed (Refer to Rule
1960 of OSHS handbook.
Note: This template is applicable only to a two (2) storey and below residential building.
The approved CSHP on a specified project will serve as a requisite to start the
project and the issuance of building permits and other issuances related to that
specific project.

Republic of the Philippines

DEPARTMENT OF LABOR AND EMPLOYMENT
Regional Office VI

Swan Rose Building, Commission Civil Street, Jaro, Iloilo City

Tel. Nos. (033) 320-8024/ 320-6904/ *Telefax Nos. (033) 509-0400/ 320-8026

October 26, 2011

_________________________
_________________________
_________________________
Sir :
Per Memorandum of Agreement (MOA) dated April 07, 2011 by and among the five
government agencies (DOLE, DPWH, DTI-CMDF/PCAB, DILG and PRC) a Joint
Administrative Order no. 01 Series of 2011 was issued for strict implementation to ensure
the Safety and Health of workers in the Construction Industry.
Anent this, the five Regional Govt. Agencies and Local counterparts have come up with a
Regional Agreements during the one day Orientation on Construction Safety & Health
Program last September 07, 2011 at the Iloilo Business Hotel, Smallville, Mandurriao, Iloilo
City. The activity has earned various outputs coming from regional participants, wherein
they were provided with MOA and pertinent documents prescribed in AOs/Memos. They will
also be provided with templates, checklists on documentary requirements and the regional
agreements when the final version based on AOs and Memos will finally be completed.
Herewith are the final version of documents and regional agreements needed in the
implementation for the preparation, evaluation and approval of the submitted application on
Construction Safety and Health Program in every Construction Project. These documents
are the tools in the approval/disapproval of the submitted Construction Safety and Health
Program (CSHP).
For further information and clarification please feel free to contact us through tel no. 0333206904, and contact with Ms. Salome O. Siaton, TSSD Chief or Engr. John Roy A.
Elevado, Sr. L.E.O., TSSD, DOLE, RO6.
Very truly yours,
CRISPIN D. DANNUG, JR., CESO IV
OIC Regional Director