# Form 01 — Site Coverage Profile

**Complete at benchmark enrolment. Update before, or no later than five business days after, a material change in project boundary, workforce coverage, reporting owner, or source system.**

## A. Identification and project classification

| Field | Required entry |
|---|---|
| Benchmark site ID | Assigned by Site Safety UAE; do not create a new ID locally. |
| Project/site name | Private operational name. This is never published in the benchmark. |
| Parent organisation reference | Private pseudonymous reference supplied by Site Safety UAE. |
| Emirate / authority jurisdiction | Select the applicable emirate and, where relevant, free-zone or authority jurisdiction. |
| Project type | Building; civil/infrastructure; industrial; fit-out/MEP; other (describe). |
| Project phase at enrolment | Mobilisation; substructure/groundworks; superstructure; MEP/fit-out; commissioning/handover; mixed. |
| Site active start date | `YYYY-MM-DD`. |
| Expected reporting end date | `YYYY-MM-DD`, if known. |
| Appointed site data owner | Role, business email, and telephone. Retained privately; not sent to the public dataset. |
| HSE data certifier | Name, role, business email, and telephone. Retained privately; not sent to the public dataset. |

## B. Coverage statement — the benchmark population

Complete every row. Use a separate row for each group that is either included or excluded. Do not attach an employee list.

| Workforce group reference | Relationship | Included in benchmark? | Incident records captured for same group? | Worker-hour source | Reason for exclusion or limitation | Effective from | Effective to / ongoing |
|---|---|---|---|---|---|---|---|
| Example format only: `DIR-01` | Direct employee | Yes / No | Yes / No | Time-and-attendance export | If no, state why | `YYYY-MM-DD` | `YYYY-MM-DD` / Ongoing |
| `LAB-01` | Labour-supply worker | Yes / No | Yes / No | Certified supplier return | If no, state why | `YYYY-MM-DD` | `YYYY-MM-DD` / Ongoing |
| `SUB-01` | Subcontractor worker | Yes / No | Yes / No | Certified subcontractor return | If no, state why | `YYYY-MM-DD` | `YYYY-MM-DD` / Ongoing |
| `SITE-ADMIN-01` | Site office / management | Yes / No | Yes / No | Timesheet export | If no, state why | `YYYY-MM-DD` | `YYYY-MM-DD` / Ongoing |
| `OTHER-01` | Other (describe) | Yes / No | Yes / No | State source | If no, state why | `YYYY-MM-DD` | `YYYY-MM-DD` / Ongoing |

### Required coverage declaration

Tick or initial every statement.

- [ ] Every group marked **included** is included in both the worker-hour register and the site’s benchmark incident capture.
- [ ] Every group marked **excluded** is excluded from both the worker-hour register and benchmark incident rates.
- [ ] The workforce groups are mutually exclusive. No person’s hour will be reported twice through direct, labour-supply, and subcontractor records.
- [ ] The project boundary is limited to this physical site and its declared related work areas.
- [ ] No employee names, numbers, national IDs, photographs, medical records, or incident narratives will be placed in benchmark templates.

## C. Worker-hour source map

| Workforce group reference | System/source name | Source type | Extract/report name | Responsible source owner | Normal availability date | Reconciliation method |
|---|---|---|---|---|---|---|
| `DIR-01` | Enter private source name | Time and attendance / payroll / timesheet / certified subcontractor return / controlled manual summary | Private report or document reference | Role only | Day of following month | Compare with workforce count, access record, or supervisor confirmation |

## D. Incident-coverage reconciliation

| Question | Required response |
|---|---|
| What system or controlled register is the source of incident cases for this site? | State private system/register reference. |
| Does it capture every workforce group marked “included” above? | Yes / No. If no, the group cannot enter the primary benchmark rate. |
| Who verifies that a zero-incident month is genuine? | HSE data certifier name and role. |
| Which case classes are captured? | Fatal occupational injury; lost-time injury; restricted work; medical treatment; first aid; occupational illness; near miss; other. |
| How are late-reported cases handled? | State correction route and expected reporting period. |

## E. Material-change log

Record a new line whenever scope, source, boundary, or reporting responsibility changes. Submit this update with the next monthly pack.

| Change ID | Effective date | What changed | Affected workforce groups | Effect on worker-hours or incident coverage | Approved by | Benchmark administrator notified on |
|---|---|---|---|---|---|---|
| `CHG-001` | `YYYY-MM-DD` | Describe | `DIR-01`, etc. | Explain | Role/name | `YYYY-MM-DD` |

## F. Authorisation

I confirm that this profile defines the same workforce population for worker-hour and incident reporting. I will report material changes, preserve supporting source records, and avoid submitting personal data in this benchmark pack.

| Data owner name and role | HSE data certifier name and role | Date | Signature or controlled electronic approval reference |
|---|---|---|---|
|  |  | `YYYY-MM-DD` |  |