Access Card Request Form

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Access card application, Vestbase AS
Dokument/document ref.:
Innhold/contents:
VB-S04-SKJ-100v011
Application for access card containing personal/company
details, access matrix, and non-disclosure agreement for
personnel signing out ID cards valid for Vestbase premises
In compliance with international security regulations (the ISPS code) and Norwegian security guidelines
(NOG 091), the company is obliged to stipulate security requirements for all personnel who require
work-related access to the base premises.
Information about the applicant (If completing by hand, please use
block capitals)
Company affiliation:
Vestbase (white)
Lesse (blue)
Name of applicant:
Contact info.:
REPLACEMENT CARD
External (red)
Employee no.:
Mob. tel.:
E-mail:
Pin code required:
Information about the company (If completing by hand, please use block capitals)
Employed by
(company):
Bus. Ent. no.:
Invoicing Address:
Postcode/location
Purchase order no:
The applicant confirms that he/she has read, understood and signed the attached
non-disclosure agreement.
Conditions for application for/issue of access card, Vestbase
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Admittance onto base premises requires a business-related need.
The access card is valid for one person only. Vehicles require their own access permit
(http://www.vestbase.com)
It is not permitted to carry foreign substances, prohibited articles or anything else onto the base that could
put vessels or the port area at risk. This includes weapons, explosives, narcotic drugs/alcohol, etc.
The access card must be worn in plain sight on base premises.
The access card is personal to the individual to whom it is issued and cannot be lent to others. Infringements
may result in the card being confiscated and blocked.
The card holder guarantees that the information provided on the card's date of issue is correct, and that if
any changes to said information arise the issuer will be notified by the card holder's employer or client.
Prevailing HSE rules and other guidelines governing visits to, and movement around, base premises must be
complied with at all times. An HSE course must be passed before an access card can be issued.
All personnel shall comply with instructions issued by the Security Manager, base security personnel, or
employees at Vestbase.
Lost cards must be reported immediately to the company's security representative, who will immediately
pass on this notification to the Security Manager at Vestbase. VB-PFSO@norseagroup.com
________________________
Date/location
___________________________________
Applicant's signature
The completed application must be sent by e-mail to: kort@morebeslag.no
Access card application, Vestbase AS
Dokument/document ref.:
VB-S04-SKJ-100v011
Innhold/contents:
Application for access card containing personal/company
details, access matrix, and non-disclosure agreement for
personnel signing out ID cards valid for Vestbase premises
Practical considerations
Møre Beslag AS (MB) produces and administers access cards on behalf of Vestbase AS.
- Completed and signed applications must be sent to MB.
The applicant must visit the MB office to have his/her picture taken for the card and will receive
log-in information to access the online HSE course.
- The HSE course, which is a mandatory requirement for access to Vestbase, is carried out online.
Please note that the course cannot be taken on MB's premises.
- Your access card will be signed out and can be collected at the main gate at Vestbase.
Any questions, and the signed application, shall be sent to: kort@morebeslag.no
Address: Nordmørsveien 54 ("Nordmørssenteret")
MB
Vestbase
Source: www.visveg.no
Møre Beslag AS is situated in the same premises as the former supplier NordVest
Elektronikk AS.
The completed application must be sent by e-mail to: kort@morebeslag.no
Access card application, Vestbase AS
Dokument/document ref.:
VB-S04-SKJ-100v011
Innhold/contents:
Application for access card containing personal/company
details, access matrix, and non-disclosure agreement for
personnel signing out ID cards valid for Vestbase premises
Non-disclosure agreement
Name of cardholder: ___________________________________
I understand
that after being issued with this ID card, I may become privy during my presence or stay on Vestbase
premises to information or circumstances to which unauthorised persons are not permitted access.
This applies in particular to information procedures or systems linked to security-related work being
carried out, or to be developed, implemented or modified, in accordance with requirements or
guidelines provided in the ISPS code or the NOG 091 guidelines.
I undertake to
maintain absolute confidentiality in dealings with unauthorised persons on all aspects of any securityrelated work to which I may become privy during the course of my work on base premises, and to treat
all such information with due care.
This applies in particular to any knowledge of internal matters regarding security procedures applying to
admittance onto base premises, and to the internal affairs of companies or partners carrying out
activities on base premises.
This duty of non-disclosure does not include the purely technical aspects of the work.
I am aware that:
this duty of non-disclosure, including the restrictions mentioned above, continues to apply after I have
returned the ID card. Section 7 of the Norwegian Marketing Control Act (Markedsføringsloven), covering
trade secrets, and section 294 of the General Civil Penal Code (Straffeloven) also apply. (See extracts
below)
________________________________
_______________________________
Location and date
Signature
Section 28 of the Marketing Control Act (Markedsføringsloven) Trade secrets.
A person who has obtained knowledge of or control over of a trade secret in connection with an
employment or business relationship or a position of trust shall not exploit the secret unlawfully in the
course of trade.
The same applies to any person who has obtained knowledge of or control over a trade secret by means
of someone else's breach of confidentiality or other illegal action.
Section 294 of the General Civil Penal Code (Straffeloven) It is punishable by fines or
imprisonment for a term not exceeding six months for any person to…..3.
unlawfully make use of any business or trade secret of an enterprise which he has obtained knowledge
of or gained control over in the capacity of a technical or mercantile consultant to the enterprise or in
connection with an assignment from it, or unlawfully reveals such a secret for the purpose of enabling
others to make use of it, or who by misleading or inciting aids and abets thereto.
The completed application must be sent by e-mail to: kort@morebeslag.no
Access card application, Vestbase AS
Dokument/document ref.:
VB-S04-SKJ-100v011
Innhold/contents:
Application for access card containing personal/company
details, access matrix, and non-disclosure agreement for
personnel signing out ID cards valid for Vestbase premises
Access matrix
The access matrix must be completed by the manager of the company where the applicant is employed
and then appended to the card application form and non-disclosure agreement when the picture is
taken.
General access control (enter a cross where relevant)
Access
Area
Remarks
The base premises
Employer's building
This includes the main gates, turnstiles and any other
doors providing access to base premises. This
corresponds to the blue sticker which accompanies
vehicle access permits.
Building number and any zones within the building
must be specified.
Building:
__________
Other: __________
Parking
In case a parking space is needed outside base
premises. (To be invoiced in accordance with prevailing
regulations)
Special access control (enter a cross where relevant)
"Restricted area" – quays 6/7
"OCTG storage area"
Access will be needs assessed and a distinction may be
made between access via the turnstiles and/or the
vehicle entrance gate. Responsibility for this rests with
the Security Manager/PFSO.
Fenced-off area located near quays 4/5. This area is
leased by certain operating companies and access is
restricted to employees of these companies and certain
Vestbase employees.
I confirm that the applicant is an employee at ____________________________________ and the
application concerns access to Vestbase as described above.
________________________
Date/location
Contact info:
Tel. no.:
___________________________________
Manager responsible
E-mail:
If you have any questions regarding access to the "restricted area" and/or the "OCTG storage area",
send an e-mail to:
VB-PFSO@norseagroup.com
The completed application must be sent by e-mail to: kort@morebeslag.no
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