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Application Form for Construction Heavy Equipment
BWC application form for testing organizations for construction heavy equipments
Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: FM-DOLE-BWC-02.02
Revision No. 00
Date Issued: 10 Dec 2014
Applicant’s Profile for
ACCREDITATION as TESTING ORGANIZATION FOR
CONSTRUCTION HEAVY EQUIPMENT
(validated/updated on _______________________)
A. Company Profile:
Name of Company/Organization:
Official Address:
____________________________________________________________
__________________________________________________________________________
Tel. No. : ____________
Fax No. __________ Email address: ___________________________________
Company Head:_ __________________________________
B. Legal Existence
Number
(Pls. Attach copy of
Registration/License)
Date of
Approval
Position : ______________________________
Validity
REMARKS
1. SEC Registration
2. Business License (Mayor’s
Business Permit)
3. DOLE Registration
(Rule 1020 of the OSHS)
C. Technical Staff
(Pls. Attach Resume,
certificate and contract of
service with the Organization)
Name
Accreditation
No.
Name
License No.
Validity of
Accredit’n.
1. DOLE-BWC Accredited
OSH Consultant
2. DOLE-BWC Accredited
OSH Practitioner/s
3. Technical Staff Licensed
to practice the ff:
a. Mechanical engineering
b. Civil engineering
c. Electrical Engineering
d. Other fields of engineering
4. Licensed Heavy equipment
Operator certified by TESDA
Validity
REMARKS
FM-DOLE-BWC-02.02
Revision No. 00
Date Issued: 10 Dec 2014
D. Other Staff
Name
E. List of Office
Equipment/Facilities
F. List of Testing
Equipment
Position
Employment
Status
Description
Description
Evaluated/Prepared By:
_____________________________
Signature Over Printed Name
Position:___________________
Date: _____________________
_____________________________
Signature Over Printed Name
Position:___________________
Date:______________________
Remarks
