1. Main contractor name – LTI# - Date of incident 1 HSE Investigation template and guidance Lost Time and HiPo Incident HSE Incident Investigation guidance notes

2. Main contractor name – LTI# - Date of incident Minor incident investigations 2 For a minor or low potential incident, the only action is to complete the low severity sheet. This is an excel sheet. LTI incident investigations For LTI or HiPo incidents, use the process and template after this slide. HSE Incident Investigation guidance notes

3. Main contractor name – LTI# - Date of incident 3 Notification Kick offInvestigation Reporting draft MSE3 IRC Quality sign off IRC/MDIRCMinutes PIM action close out Process flow for investigations HSE Incident Investigation guidance notes

4. Main contractor name – LTI# - Date of incident 4 Incident Investigation Terms of Reference (ToR) Investigation protocols - Documents to be used to investigation PR 1418 & GU 612 Incident Owner - Name and reference indicator PIM No - XXXXXX Investigation Team Leader - Names, reference indicators, role in investigation Special terms - Special conditions/requirements of the investigation (e.g. joint PDO/contractor) Subject Matter Experts – as required to be discussed during Kick Off meeting Investigation deliverable - The team is responsible for investigating the incident and completing the following: Investigation report, MD/IRC presentation, Tripod (if Applicable), and learning pack. Previous LTI / NAD / Asset Integrity - Previous incident, similar incident, including PIM No from company Immediate Cause – Bring to kick off meeting for agreement Critical Factors – 1. 2. Info to be established before or during Kick Off meeting Investigation Team Members- Names, reference indicators, role in investigation 1.Investigation Team lead Name Reference Ind, Role, attend the scene (yes / no), HII (ICAM) trained (yes / no) 2.Name Reference Ind, Role, attend the scene (yes / no), HII (ICAM) trained (yes / no) 3.Name Reference Ind, Role, attend the scene (yes / no), HII (ICAM) trained (yes / no) If not HII (ICAM) trained the contractor is to provide Incident investigator, level of competency assurance from senior management Evidence repository must be provided electronically on data stick prior to MSE3 IRC HSE Incident Investigation guidance notes

5. Main contractor name – LTI# - Date of incident 5 Incident classification, Critical factors, SME requirements, Tripod Beta requirements, Timelines for reports Timetable to be communicated during kick off meeting * Escalation process milestones for not keeping to the timeline: +3 days over due reminder 1 to Investigation Team Leader, HSE Team Leader and MSE 3 +5 days over due reminder 2 to Investigation team lead, HSE Team leader, MSE 3, MSEM and Director Rolling DaysAction / Task 0 Notification received from MCOH 0-1 Initial Notification, and first Alert 1 Kickoff meeting 10* 1 st Draft of report to MSE 3 representative Review 1 st draft return consolidated feedback 2 nd Draft of report to MSE 3 representative Review of 2 nd draft return consolidated feedback 21Final revision for MSE IRC 23*MSE3 IRC Final report QA / QC letter 30*Director IRC 42MDIRC HSE Incident Investigation guidance notes

6. Main contractor name – LTI# - Date of incident Singular photograph of the incident: (MDIRC only) 6 Main Contractor Name, Incident Type (eg. LTI), date of incident- header on all slides

7. Main contractor name – LTI# - Date of incident 7 Bulleted description key points from the incident (MDIRC only) Main Contractor Name, Incident Type (eg. LTI No), date of incident- header on all slides

8. Main contractor name – LTI# - Date of incident Incident details PDO directorate/dept: (e.g. OSD /OSO/OSO4) Contractor name/number : (subcontractor-contractor-PDO)/CXXXXXX Incident owner: Name / Ref Ind Location : Area / unit - (road/yard/station/rig/hoist/plant etc) Incident date & time: (d/m/yr) / (24 hour clock) – advise if estimated Incident type: Fatal, LTI, high potential, significant incident etc Actual severity rating: Number (1-5) / letter (P, E, A,R) – from RAM Potential risk rating: Letter (A-E), Number (1-5)/letter (P, E, A,R) from RAM Names of any IPs :Names of the injured people (for fatality add marital status with kids age) Description of injury/damage : Worst injuries (fractures, head injury, amputation etc)/damage, body part PIM ID: Number assigned in PIM Immediate cause: Short description of what caused harm Key mgmt system failure : Key Management system failure from conclusion slide including number Previous LTI:Short description of last (LTI/NAD) of the contractor, this applicable to all contracts with PDO and not specified to a specific contract No. 8 Main Contractor Name, Incident Type (eg. LTI No), date of incident- header on all slides

9. Main contractor name – LTI# - Date of incident Description of the incident: 9 Main Contractor Name, Incident Type (eg. LTI), date of incident- header on all slides

10. Main contractor name – LTI# - Date of incident Photographs, diagrams & sketches: 10 Main Contractor Name, Incident Type (eg. LTI), date of incident- header on all slides

11. Main contractor name – LTI# - Date of incident Critical Factors : 1.Critical Factor 1, 2.Critical Factor 2, 3.Critical Factor 3, 11 Main Contractor Name, Incident Type (eg. LTI), date of incident- header on all slides

12. Main contractor name – LTI# - Date of incident Key Causational Factors : 1.Critical factor 1 Causational factor 1: Causational factor 2: Causational factor 3: 2.Critical factor 2 Causational factor 1: Causational factor 2: Causational factor 3: 3.Critical factor 3 Causational factor 1: Causational factor 2: Causational factor 3: 12 Main Contractor Name, Incident Type (eg. LTI), date of incident- header on all slides

13. Main contractor name – LTI# - Date of incident Findings: Immediate causes: 13 Main Contractor Name, Incident Type (eg. LTI), date of incident- header on all slides Immediate Cause Ref N o # ICAM Causation descriptionJustification for causation cited Unsafe actions: Unsafe conditions: Immediate Cause Ref N o # ICAM Causation descriptionJustification for causation cited

14. Main contractor name – LTI# - Date of incident Findings: Underlying causes (human and workplace) : 14 Main Contractor Name, Incident Type (eg. LTI), date of incident- header on all slides IC Ref N o #UC Ref N o #ICAM Causation Description Justification for causation cited

15. Main contractor name – LTI# - Date of incident Findings: Management system failures (MSF) 15 Main Contractor Name, Incident Type (eg. LTI), date of incident- header on all slides UC Ref N o #MSF Ref N o # ICAM Management Failure Description Justification for management system failure cited

16. Main contractor name – LTI# - Date of incident Were life saving rule breaches related to the incident? - Yes / No? Delete which is not applicable Is consequence management in PIM actions Yes / No ? If a contractor broke the rule has the Contract Holder been informed of the action taken? Yes / No ? Who broke them? Names/Ref Inds: ………………………………….…….. Did the life saving rule breach, cause it? - Yes / No? Why……………………………………….. ……………………………………………………………… Was it a violation or error? - Yes / No? Why……………………………………… ……………………………………………………………… ………………………………………………………………. Which rule (s): HR Panel HOD/Project Lead, HSE & independent person from other directorate) Life Saving Rules Main Contractor Name, Incident Type (eg. LTI), date of incident- header on all slides

17. Main contractor name – LTI# - Date of incident PDO Contract management 17 Main Contractor Name, Incident Type (eg. LTI), date of incident- header on all slides Report on the state of the contract management and whether any omissions were causational NoContract management processEvidenced Y/N Causational Y/N Comments 1HEMP signed off by Contract Holder 2Annual HSE plan signed off and tracked by Contract Holder 3Monthly HSE meetings held with Contract Holder and actions recorded 4Tracking register for close out of HSE actions in place 5HSE audits, inspections, site visits conducted as per plan 6HSE competency assured in review of HSE training matrix 7HSE VTCs implemented correctly 8HSE procedural step-outs managed effectively 9Evidence of MOC being effectively managed by Contract Holder 10Evidence of HSE defaults for non compliances

18. Main contractor name – LTI# - Date of incident Immediate actions taken: 18 Main Contractor Name, Incident Type (eg. LTI), date of incident- header on all slides Actions takenDate Action party PDO / contractor Status 1 Review HEMP for appropriateness in regards to the incident, is it used, how is it translated into action, last review date 2 3 4 5

19. Main contractor name – LTI# - Date of incident 19 Remedial actions planned MSF Causation number Target date Contractor action party PDO action party for PIM Action party accepted Yes / No Status Open / Closed 1 2 3 4 5 6 7 Main Contractor Name, Incident Type (eg. LTI), date of incident- header on all slides Remedial actions planned:

20. Main contractor name – LTI# - Date of incident Recommendations for MDIRC/IRC endorsement:. 20 Recommendation N o 01Status Endorsed/Not endorsed Causations No Recommendation Action party Reference Ind. Target date Revised recommendation after IRC review Recommendation N o 02Status Endorsed/Not endorsed Causations No Recommendation Action party Reference Ind. Target date Revised recommendation after IRC review Main Contractor Name, Incident Type (eg. LTI), date of incident- header on all slides

21. Main contractor name – LTI# - Date of incident Incident Review Committee Contractor Commitment Declaration 21 Main Contractor Name, Incident Type (eg. LTI), date of incident- header on all slides I, Mr. …………………………….…………………. CEO, and I, Mr. ………………………………………………. Operations Manager Of the Company: …………………………………. We have signed below to demonstrate to PDO our commitment to personally conduct the necessary follow up to ensure the effective implementation of the agreed actions contained in the IRC endorsed investigation in all our units, and to demonstrate our personal leadership in implementing the necessary consequence management in case of re-occurring of similar incident. Moreover, we will disseminate the learning from this incident to all our workforce and our subcontractors. Mr. …………………… Signature:………………………… Date:………………..

22. Main contractor name – LTI# - Date of incident Date: Incident title What happened? Short description of what happened Your learning from this incident.. (This must solely relate to the people at risk of harm or people at risk of causing the harm) Learning points for them from the investigation Strap line – should be the key (keep short and memorable ) Photo explaining what was done wrong Photo explaining how it should be done right 22 PDO Second Alert

23. Main contractor name – LTI# - Date of incident As a learning from this incident and ensure continual improvement all contract managers must review their HSE HEMP against the questions asked below Confirm the following: 1 2 3 4 5 Management self audit 23 Date: Incident title

24. Main contractor name – LTI# - Date of incident Tripod Tree (include copy of the Tripod tree flow diagram for all 4/5 incidents or High Potential) Investigation reports requiring a Tripod must confirm that the findings and recommendations match the Tripod findings 24 Main Contractor Name, Incident Type (eg. LTI), date of incident- header on all slides

25. Main contractor name – LTI# - Date of incident Directorate or MD IRC Minutes:Date held : 25 Main Contractor Name, Incident Type (eg. LTI), date of incident- header on all slides Item N o ActionAction partyTarget date 1 2 3 4 5 6 7 Directorate/dept: Identity of minute taker: Name/Ref Ind:

26. Main contractor name – LTI# - Date of incident Sequence of events/timeline: 26 Main Contractor Name, Incident Type (eg. LTI), date of incident- header on all slides No.DateTimeDescription of event 1 2 3 4 5 6 7 8

27. Main contractor name – LTI# - Date of incident Supplementary investigation findings : The findings are points to note but were not causational in the incident 1.Non causational findings to the incident but worth to address 2.Emergency response, how effective was it, did it impact on the severity? 3.People, training, age, experience, nationality, medical conditions, disciplinary record etc 4.Equipment, type, serial number, maintenance, inspection, failings, appropriate for use etc 5.Operational management, sub contractor management, supervision, TBTs, SJPs, SWPs, STOP, availability on site etc 6.Relevant environment, workplace conditions, weather, lighting, floor surface, dust, cramped etc 7.Previous relevant incidents/ learning‘s what, where, were they aware of it, were controls introduced add into Kick off 27 Main Contractor Name, Incident Type (eg. LTI), date of incident- header on all slides

28. Main contractor name – LTI# - Date of incident 28 Investigation Team Members- Names, reference indicators, role in investigation NameRef. IndRole Attended the scene Yes / No HII* trained Yes / No Date attended HII training 1Investigation Team Lead 2 3 4 5 6 7 8 9 10 *HII – HSE Incident Investigation

29. Main contractor name – LTI# - Date of incident Investigation timeline compliance 29 Main Contractor Name, Incident Type (eg. LTI), date of incident- header on all slides Item N o Action Deadline (day) AchievedVarianceReasons for variance? 1Notified to Medical team 2Medical team notified MSE31 3 MSE3 provided notification to Director/MD 1 4Notification email issued1 5Kick off meeting held1 6First draft produced10 7Final draft produced21 8MSE3 IRC held23 9Final report produced25 10IRC held30 11MDRIC held42