Scaffold hand over certificate

The scaffold hand over certificate releases the scaffold(s) to the client. The scaffold(s) have
been inspected by the client and has been erected to the clients requirements. All scaffolds
have been erected as per the requirements of the Best Practice Guidelines for Scaffolding in
New Zealand. The client undertakes to control the use, and users of the scaffold structure(s)
while under their control as required by the Health and Safety Act and Regulations.
Scaffold hand over certificate
Client:
Location:
Description:
Comments:
Special conditions:

Authorised Foreman /
Client
(Please print clearly)
Scaffolding
Representative
(Please print clearly)

Signature

Date

Signature

Date

Note: Scaffolding over 5.0m or more is notifiable work and the erection/dismantling
or alterations including the movement of planks, can only be carried out under the
supervision of a Scaffolder holding a current Certificate of Competency.
Scaffold Notifiable
Yes
No
Levels planked
Ladder, stair access bays

Working levels with double hand

rails
Scaffold ties

Screening

Levels with kickboards

Scaffold Register

Yes

Light duty
225Kg per bay

Useable lifts per bay

4

Medium duty
450Kg per bay

Useable lifts per bay

2

Heavy duty
675Kg per bay

Useable lifts per bay

1

Special duty

Useable lifts per bay

Scaffolding and Rigging New Zealand (SARNZ), 2009.

Limitations

No