CONCURRENCE FORM




NO FEES REQUIRED FOR THE FILING AND EVALUATION OF CSHP


Name of OH Date of BOSH training Certificate / ID

NO FEES REQUIRED FOR THE FILING AND EVALUATION OF CSHP

Name of Subcontractors(If, any) Scope of Work and Project Cost Number of workers PCAB LICENSE VALIDITY Date Date of DOLE Registration

NO FEES REQUIRED FOR THE FILING AND EVALUATION OF CSHP

















NO FEES REQUIRED FOR THE FILING AND EVALUATION OF CSHP




Name of Appointed Safety Officer Date Issued of COSH Certificate Certificate of Completion




Name of Appointed First-Aider Date Issued of First-Aid Training Certificate Validity



NO FEES REQUIRED FOR THE FILING AND EVALUATION OF CSHP




Name of Heavy Equipment Operator Heavy Equipment to be used in the project Inspection Certificate of Construction Heavy Equipment Skills certification from TESDA







NO FEES REQUIRED FOR THE FILING AND EVALUATION OF CSHP


 Profile of the person who prepared the CSH Program for the abovementioned Project








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NO FEES REQUIRED FOR THE FILING AND EVALUATION OF CSHP