University of Guelph Environmental Health & Safety Form
July 2018
Confined Space Multiple Contractor Co-ordination Letter
(1)
Name
Title
Employer (Contractor)
Address
(2)
Name
Title
Employer (Contractor)
Address
(3)
Name
Title
Employer (Contractor)
Address
(4)
Name
Title
Employer (Contractor)
Address
Date:
Re: Multi-Employer Co-ordination Document for Entry/Work in Confined Spaces:________________________
Where the workers of more than one employer are to perform work in the same confined space or related work with
respect to the same confined space, and before any worker enters the confined space or begins related work with
respect to the confined space, the University of Guelph as the lead employer is required by Ontario Regulation
632/05, Confined Spaces made under the Occupational Health and Safety Act of Ontario, to prepare a co-ordination
document to ensure that the duties imposed on employers by the regulation are performed in a way that protects the
health and safety of all workers who perform work in the confined space or related work with respect to the confined
space. As a matter of general information, this co-ordination document is intended to ensure that employers of
workers working in a confined space are aware of potential or existing hazards that may be introduced by one or the
other employer, and that there is communication between the employers in order to ensure worker safety. Also, the
intent is to reduce duplication with respect to requirements such as the hazard assessment, plan, entry permit and
procedures to follow in the event of an emergency but the document does not allow for sharing of responsibilities for
general training, personal protective equipment and records.
Attached, please find the following documents regarding confined space(s) # _______________________________:
• hazard assessment plan entry permits procedures to follow in the event of an emergency; these documents
will be available and reviewed with all entrants and other related personnel prior to entry into the confined space.
__________________ __________________ (Name and Department of University’s Confined Space Supervisor)
__________________ __________________ (Date and Signature of University’s Confined Space Supervisor)
-----------------------------------------------------------------------------------------------------------------------------------------------------------
CONTRACTED EMPLOYER(S) ACKNOWLEDGEMENT
We the undersigned:
have read and will comply with the requirements of Ontario Regulation 632/05;
have read and will comply with the requirements of the University of Guelph Confined Spaces Management
Program. We have received documentation regarding the hazard assessment, written plan, plan-specific training
(as appropriate), entry permit and procedures to follow in the event of an emergency;
have provided written evidence that all workers who are required to perform entry/work in the confined space or
related work with respect to the same confined space have received appropriate training and instruction in
accordance with the University of Guelph Confined Spaces Program.
Employer Name/Title of Employer
Representative
Signature/Date of Employer
Representative
1
2
3
4
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University of Guelph Environmental Health & Safety Form
July 2018
Confined Space Single Contractor Co-ordination Letter
Name
Title
Employer (Maintenance Contractor)
Address
Date:
Re:
Provision of Documents and Acknowledgement of Compliance for Single Contractor Entry/Work in
Confined Spaces:_________________________________________________________________________
Before any worker enters/works in a confined space or performs related work with respect to the same confined
space, the University of Guelph as the lead employer is required by Ontario Regulation 632/05, Confined Spaces
made under the Occupational Health and Safety Act of Ontario and its Confined Spaces Management Program, to
provide documents to ensure that the duties imposed on employers by the regulation are performed in a way that
protects the health and safety of any worker who performs work in the confined space or related work with respect to
the confined space..
Attached, please find the following documents regarding confined space(s) # _______________________________:
• hazard assessment plan entry permit procedures to follow in the event of an emergency; these documents
will be available and reviewed with all entrants and other related personnel prior to entry into the confined space.
__________________ __________________ (Name and Department of University’s Confined Space Supervisor)
__________________ __________________ (Date and Signature of University’s Confined Space Supervisor)
-------------------------------------------------------------------------------------------------------------------------------------------
CONTRACTED EMPLOYER ACKNOWLEDGEMENT
(Maintenance Contractor Company Name) has read and will comply with the requirements of Ontario Regulation
632/05.
(Maintenance Contractor Company Name) has read and will comply with the requirements of the University of
Guelph Confined Spaces Management Program. We have received documentation regarding the hazard
assessment, written plan, plan-specific training (as appropriate), entry permit and procedures to follow in the event of
an emergency.
(Maintenance Contractor Company Name) has provided written evidence that all workers who are required to
perform entry/work in the confined space or related work with respect to the same confined space have received
appropriate training and instruction in accordance with the University of Guelph Confined Spaces Program.
_________________________________________ (Maintenance Contractor Company Name)
_________________________________________ (Name and Title of Maintenance Contractor Representative)
_________________________________________ (Date and Signature of Maintenance Contractor Representative
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signature
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signature
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