<p> FORM H</p><p>APPOINTMENT OF A PRINICPAL CONTRACTOR FOR “CONSTRUCTION WORK”</p><p>Developer / Client’s Details</p><p>Name of Developer / Client: </p><p>Address:</p><p>Head Office within Abu Dhabi Emirate: Telephone No.: E-mail Address: </p><p>Fax No.: P.O. Box:</p><p>Registration Number: </p><p>Classification Code: </p><p>Authorized Contact Person: </p><p>Authorized Contact Person Position: </p><p>Telephone No.: E-mail Address: </p><p>Address of Authorized Person: Fax No. : P.O. Box :</p><p>Development / Project Details</p><p>Project Name: </p><p>Project Address: </p><p>Coordinates: Northing: Easting: </p><p>Location Map (Required): Location Map(s) of Development / Project Attached. </p><p>Brief Description of Project: </p><p>Residential / Housing Power, Water, Sewerage, Commercial Buildings Telecommunications, other Infrastructure Primary Construction Type: Industrial / Heavy Engineering Demolition / Disassembly Works Road, Bridge and Tunnel Other:______</p><p>Proposed Project Duration: Start Date: / / Finish Date: / / </p><p>Version 2.0 Page 1 of 5 FORM H</p><p>APPOINTMENT OF A PRINICPAL CONTRACTOR FOR “CONSTRUCTION WORK”</p><p>Principal Contractor Details</p><p>Name of Principal Contractor: </p><p>Registration Number: </p><p>Classification Code: </p><p>Grade: </p><p>Address:</p><p>Head Office within Abu Dhabi Emirate: Telephone No.: E-mail Address: </p><p>Fax No.: P.O. Box:</p><p>Authorized Contact Person: </p><p>Authorized Contact Person Position: </p><p>Telephone No.: E-mail Address: </p><p>Address of Authorized Person: Fax No. : P.O. Box :</p><p>Declaration of Developer / Client</p><p>I declare that all information provided in this document is true, correct and complete.</p><p>Signature of the Official Authorized Stamp : Contact Person:</p><p>Date : _____/_____/_____</p><p>Declaration of Principal Contractor</p><p>I declare that all information provided in this document is true, correct and complete.</p><p>Signature of the Official Authorized Stamp : Contact Person:</p><p>Date : _____/_____/_____</p><p>Version 2.0 Page 2 of 5 FORM H</p><p>APPOINTMENT OF A PRINICPAL CONTRACTOR FOR “CONSTRUCTION WORK”</p><p>Official Use</p><p>EHS – CMP  Attached </p><p>Approval of EHS - CMP: </p><p> Reviewed and Approved</p><p> Not Approved, reasons / amendments required:</p><p>______</p><p>______</p><p>______</p><p>EHS - Demolition / Decommission Plan (if required)  Attached </p><p>Approval of EHS - Demolition / Decommission Plan: </p><p> Reviewed and Approved</p><p> Not Approved, reasons / amendments required:</p><p>______</p><p>______</p><p>______</p><p>Building and Construction Entered into Database by: Regulatory Authority Stamp</p><p>Name:</p><p>Signature:</p><p>Date: _____ / _____ / _____</p><p>Reviewed by:</p><p>Name:</p><p>Signature:</p><p>Date: _____ / _____ / _____</p><p>Version 2.0 Page 3 of 5 FORM H</p><p>APPOINTMENT OF A PRINICPAL CONTRACTOR FOR “CONSTRUCTION WORK”</p><p>Instructions for Completing this Form:</p><p>Who must initiate this process? Why must this form be submitted?</p><p>This form is to be Lodgment of this form advises the AD EHSMS submitted to the Building Competent Authority and the Building and and Construction SRA by Construction Sector Regulatory of: the Developer / Client of  the location and types of high risk all projects that include: construction projects;  project timeframes and duration;  “Construction Work” with a duration of 30  who the developer / client of the workplace; days or more, or and  “Construction Work” with a duration of less  who is in control of the workplace – the than 30 days and the Building and principal contractor. Construction SRA understands that the project involves sufficient hazards and risks to require the appointment of a principal contractor.</p><p>This form must be completed and approved before “Construction Work” is to begin on site.</p><p>What type of construction work requires a Who must be given this form? Principal Contractor?</p><p>Construction Work includes: Under AD EHSMS RF Element 4 – Management (a) work to erect, construct, extend, alter, of Contractors, the Developer / Client must convert, fit-out, commission, renovate, ensure this form is completed and is submitted to repair, refurbish, disassemble, demolish the AD EHSMS Building and Construction Sector and/or decommission a structure / building / Regulatory Authority before construction work services infrastructure, or part of a commences. structure / building / services infrastructure; or The assigned Principal Contractors must be given (b) work connected with site preparation, a copy of the complete form before “Construction earthworks, land reclamation, excavation, Work” is to begin on site. piling, provision of services infrastructure or landscaping for works mentioned in paragraph (a); or Who must complete this form? (c) the assembly or installation of prefabricated The Developer / Client must ensure this form is components to form a structure / building / completed and is submitted to the AD EHSMS services infrastructure, or part of a Building and Construction Sector Regulatory structure / building / services infrastructure Authority for work mentioned in paragraph (a); or (d) the disassembly of prefabricated components for work mentioned in paragraph (a) that, immediately before the disassembly, formed a structure / building / services infrastructure or part of a structure / building / services infrastructure; and (e) Construction Work is deemed complete when control, operation and possession of Version 2.0 Page 4 of 5 FORM H</p><p>APPOINTMENT OF A PRINICPAL CONTRACTOR FOR “CONSTRUCTION WORK”</p><p> the workplace is officially returned to the developer / client through the contractual arrangement process.</p><p>Version 2.0 Page 5 of 5</p>