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13 19 09

Application for planned work on or near network

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*Denotes mandatory field

Company representative and company details

Work request details

# All additional charges as per Evoenergy Schedule of Electrical Network Charges.


Applicant declaration

I declare that I and my employees will:

  • Work in accordance with Evoenergy's Electricity Network Safety Management System and all other relevant operational procedures, including the Electrical Safety Rules.
  • Conduct hazard and risk assessments at all work sites and implement requirement controls where required.
  • Report all accidents and incidents.
  • Comply with Evoenergy's Code of Conduct.
  • Ensure that my annual safety and mandatory trade refresher training is maintained.
  • Show any authorisation identification issued to me at Evoenergy's request.
  • I attest that the listed company and employees are sufficiently competent to undertake the work outlined in this request and agree to make employees aware of Evoenergy's Electricity Network Safety Management System, procedures, and any relevant Acts, Regulations, and Guidelines.
  • I accept responsibility for work and actions taken by company employees whilst carrying out work on or near Evoenergy's network whilst employed by the accredited body nominated in this application.
  • I further declare that the above information is true, correct, and current.

Accompanying documentation

Attachment can be an Office document or PDF.


Attachment can be an Office document or PDF.