Purpose and Application of these Terms and Conditions Conflicts of Interest 1. 14. These Terms and Conditions define how WorkSafe New Zealand (WorkSafe) and your business will conduct the Self-Assessment phase of the Safety Star Rating Scheme (SSRS) pilot (Pilot) together. They must be agreed by your business for you to participate in the Pilot. Agreement is 1 acknowledged when an authorised representative of the business completes and signs the section at the end of this document and returns a copy to the the SSRS programme team (SSRS Team). We each will use our best endeavours to avoid any actual, potential or perceived conflicts of interest. As needed, we will disclose any conflicts to each other and, where necessary, work together to manage them. Membership of other workplace health and safety incentive programmes 15. Participation in the Pilot does not affect any membership you may have of any other workplace health and safety incentive programme (for example, ACC’s AEP3, WSMP4 and WSD5 or any ISO6 health and safety programme). You agree to notify us if your membership status in such a programme changes while you are participating in the Pilot. 2. Because it is a Pilot, there may be circumstances where it is necessary to amend these Terms and Conditions. WorkSafe will discuss any proposed changes with you and seek your agreement to the changes being implemented. 3. The Terms and Conditions are not intended to provide guidance on procedural detail such as how assessments will be undertaken or what information businesses need to provide the Pilot Assessors (Assessors). Such information is available on WorkSafe’s website: WorkSafe’s regulatory responsibilities http://www.business.govt.nz/worksafe/about/what-we-do/the-safetystar-rating-scheme Health and safety issues at the Business 16. While participating in the Pilot your business remains open to WorkSafe’s normal Inspectorate activities. 17. During your participation in the Pilot, the SSRS Team may be made aware of a health and safety issue (hazard, practice, behaviour or risk) at your business. Such issues will be considered on a case by case basis taking into account all known circumstances including their nature and seriousness. The SSRS Team will notify you of its concerns, give you reasonable opportunity to provide feedback or take action, and clearly communicate to you any decision made and any implications for your ongoing participation in the pilot. How we will work together 4. We will work collaboratively with each other, interacting in a professional, open and honest manner. 5. Where either of us has an issue or concern, we will raise it with one another as early as possible by phone or email, giving the information needed to effectively consider, manage or respond to the matter. Self-Assessment Report Costs 6. There is no fee for participating in the Pilot. We will each be responsible for our respective costs arising from your participation 18. Following completion of the Self-Assessment, you will receive a SelfAssessment Report from the SSRS Team. This will include guidance or other information. Information collection and management 7. The open sharing of information about your business is critical to the success of the Pilot. You agree, therefore, that WorkSafe may collect and use your Self-Assessment information to further the objectives of the Pilot, which include: supporting improvements to health and safety at your workplace(s); improving the design and delivery of and evaluating the Pilot; and sharing learnings, best practice and case studies. 8. WorkSafe will use due care in collecting, storing and using all information about your business including any personal information obtained. Information that WorkSafe holds is subject to the Official Information Act 1982 and Privacy Act 1993. Normal access to confidential information2 may be restricted due to legal professional privilege, commercial sensitivity, or for other reasons requiring the information to be protected from disclosure. 9. The SSRS Team will obtain your agreement before referring to your participation in the Pilot by name in any publicly-focussed communications, publications, statements, and promotions. Such reference is likely to be rare (if it occurs at all). 10. Unless there is a good reason not to, the SSRS Team will anonymise any personal information collected and included in any report to ensure that individuals are not identified. Second assessments 19. Given the time and resource commitments of the Pilot, we ask that you only undertake one Self-Assessment. The Pilot Standards 20. The Government has not made a decision on the future of the proposed SSRS. Accordingly: a. Participation in the Pilot will not confer any ‘Safety Star Rating’ status; and b. You may not make any communications, marketing or promotion to the effect that you are a member of the SSRS, or in any way been successfully assessed, rated or approved under the SSRS or the Pilot, or have been found to be operating at any particular level of health and safety performance as a result of any assessment of your business undertaken through the Pilot. Agreement to Terms and Conditions For and on behalf of the business: Insert name of business 11. WorkSafe owns all records, notes, reports and other documentation created by it for the Pilot. It also owns the Intellectual Property rights in the Scheme and the Pilot Standards (the Standards). 12. WorkSafe encourages you to use and share relevant Pilot documentation within your business. You may not, however, amend, redact or alter the contents of any Pilot assessment report provided to you. I agree to these Terms and Conditions. 13. By signing these Terms and Conditions, you also agree to participate in our Pilot evaluation. Subject to any legislative or other overriding requirements, your responses will be kept confidential or anonymised. __________________________________________________ Signature I authorise to participate in the Self-Assessment phase of the Safety Star Rating Scheme pilot. Name: ______________________________________ Position: ______________________________________ Date: ______________________________________ 1 ‘Authorised representative’ is the Chief Executive (CE) of the business, or other person with delegated authority from the CE or Executive of the business to act for and on behalf of the business in respect its participation in the Safety Star Rating Scheme (SSRS) pilot. 2 ‘Confidential Information’ is information that: (a) is by its nature confidential; or (b) is marked by either Party as 'confidential', 'in confidence', 'restricted' or 'commercial in confidence'; or (c) is provided by either Party or a third party 'in confidence'; or (d) either Party knows or ought to know is confidential; or (e) is of a sensitive nature or commercially sensitive to either Party. WORKSAFE NZ-29762888 3 4 5 6 Accredited Employer Programme Workplace Safety Management Practices Workplace Safety Discounts The International Organisation for Standardisation 1