Supplementary Form for ISO 50001 and 45001

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Energy Management and H&S Supplementary Form

Company Name*
Number of Employees
Top Management*
Top Management
Energy Management*
Energy Management
Procurement*
Procurement
Change Management*
Change Management
Planning and Continuous Management*
Planning and Continuous Management
Data Analysis*
Data Analysis
Operations*
Operations
Design*
Design
Total*
Total
List the energy types that account for 80% of total energy consumption in your company*
What is your annual energy consumption in terajoules(Tj)?*
List the Significant Energy Uses (SEUs) that have been identified by your organisation*
Will EnMS certification be required for more than one permanent location?*
If yes, please provide details of the sites, including site-specific staff levels, processes and activities, Energy Types, Energy Consumption, SEUs
Do any of the sites requiring EnMS certification generate their own energy onsite?*
If yes, please provide details.
Safety Rep:
Are there any activities covered by your scope which are carried out away from the registration address(es), e.g. depots, warehouses, sites or offices?
- Yes
- No
If yes, please give details:
Please list the key Occupational Health & Safety Legislation / Regulations which apply to your business:
Have you been the subject of any Safety related Prosecutions, Penalties, Insurance Claims or Enforcement Notices in the past 12 Months?
- Yes
- No
Please provide full details:
Have you had any Reportable Injuries in the past 12 Months:
- Yes
- No
Number of Fatalities:
Number of Major Reportable Injuries:
Number of Minor Reportable Injuries:

Supplementary Form for ISO 50001 and 45001

Energy Management and H&S Supplementary Form

Number of Employees

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