Partnership #156 - Renewal Agreement - June 18, 2001

Idaho Construction Specialty Trades Partnership Renewal Agreement
June 18, 2001

U.S. Department of Labor Occupational Safety and Health Administration
1150 North Curtis Rd, Suite 201
Boise, Idaho 83706

Telephone: (208) 321-2960 or 1-800-482-1370
Fax: (208) 321-2966

June 18, 2001

SUBJECT: Idaho Construction Specialty Trades Partnership Program

  1. Scope:

    This Instruction applies to the Boise Area Office.

  2. References:
    1. Boise Area Office Instruction CPL 2.1.1 Idaho Construction Targeting and Partnership Project.
    2. OSHA Instruction CPL 2.102 Procedures for Experimental Programs.
    3. OSHA Instruction CPL 2.103 Field Inspection Reference Manual (FIRM).
    4. OSHA Instruction CPL 2.25I Scheduling system for Programmed Inspections, paragraph B.1.a(2(b)4.
    5. OSHA Instruction STD 3-1.1 Citation Policy Regarding 29 CFR 1926.20, 29 CFR 1926.21 and Related General Safety and Health Provisions, Appendix A.
    6. Policy Memorandum dated August 22, 1994 for Regional Administrators from James W. Stanley, Deputy Regional Administrator, Subject: Guidance to Compliance Officers for Programmed Construction Inspection, Construction Safety Referral Inspections, and Construction Fatality or Complaint Inspections (FOCUSED Inspections).
    7. OSHA's Safety and Health Program Management Guidelines published in the Federal Register dated January 26, 1989.
    8. ANSI A10.38-1991 Safety and Health Program Guidelines.
  3. Action:

    The Boise Area Office will carry out the project following the procedures described in this instruction.

  4. Background:

    On July 1, 1996, the Boise Area Office initiated the Idaho Construction Targeting and Partnership Project (noted as reference B.1 above). The partnership has led to significantly more effective safety and health programs at construction sites managed by the general contractors who partnered with OSHA. An important aspect of the contractor's safety and health program under the partnership has been the worksite audits they conduct, in which they identify violations of OSHA workplace standards at the site and get them corrected. The Idaho construction contractor partnership program has been a popular one and has served to highlight both employers' ability and willingness to effectively manage workplace safety and health, and OSHA's willingness to support that effort. In addition to improvements in the partnered contractors' programs and those of their subcontractors, additional employers are working hard to meet the qualification requirements. The diligence and hard work of the partnered contractors, and the overall positive response from the construction industry, are believed to have contributed directly to the significant reduction in Idaho construction injuries and fatalities over the last several years. The fatality rate over the last five years has been cut in half, and the total worker's compensation cases filed over the past 5 years has been reduced by 10 percentage points. And, from July 31, 1999 to May 8, 2001, the construction industry in the State of Idaho did not experience any construction related fatalities.

    OSHA, as well as the partnered general contractor construction managers feel that expanding the partnership program to specialty trade subcontractors will result in an even safer workplace for the Idaho construction industry. Specialty trade subcontractors (also called special trade contractors) are construction contractors who perform specialty construction work, usually on subcontract from the general contractor. Among the specialty trades are excavation, concrete work, structural steel erection, carpentry, roofing, electrical work, painting, plumbing, heating/air-conditioning, masonry and plastering. The specialty trades have the highest lost-workday case rates in the construction industry, and the rates for most of the individual special trades are one and a half to two times higher that the overall private sector rate.

  5. Goals and Objectives:

    This project promotes specialty trade subcontractor partnerships with OSHA under which the specialty trade subcontractors must adhere to strict requirements for managing site safety and health. The Boise Area Office will verify that partnership requirements are met and program goals are being attained by conducting a site audit, and reviewing the company's safety and health programs. During the site audit, OSHA will verify that regular and effective safety audits are being conducted and that accidents are being investigated by the partner company, and will review the company's injury/illness records. The project goals are:

    1. To reduce construction worker injuries and illnesses in Idaho through OSHA inspection actions and through development of effective partnerships with qualifying specialty trade subcontractors.
    2. To improve employer safety and health programs.
    3. To better utilize the Boise Area Office resources by using a partnership tool to reduce the need for some on-site visits, while still achieving worker safety and health.
    4. Provide maximum leverage of inspection resources by promoting more active employer action and responsibility in safety and health management.
  6. Inspection Scheduling/Targeting Strategy:
    1. The selection of construction sites for programmed inspections will be in accordance with reference B.4.
    2. Inspection list will be in accordance with reference B.3.
    3. Inspections of partner specialty trade subcontractors in good standing will be carried out as described in G., below.
    4. Any inspections that are initiated as the result of an employee complaint, or of a workplace fatality or catastrophe, will be scheduled and conducted in accordance with reference B.3.
  7. Requirements for partnership:

    The partnership calls for a written agreement under which the specialty trade subcontractor makes a commitment to maintain an effective comprehensive safety and health program, to provide safety and health training to foremen and employees, and to conduct regular safety audits to enforce safety and health requirements at those portions of the site where the partnering specialty trade subcontractor has employees working. In return, when the Boise Area Office conducts a programmed inspection at a construction site where a partner company is working, that partner company will receive a "focused" inspection, rather than a traditional comprehensive inspection. That is, when the OSHA Compliance Officer conducting a programmed compliance inspection is notified by site management for the specialty trade subcontractor that they are a partnered company in good standing, the Compliance Officer will briefly review the following areas of special construction focus for each partner specialty trade subcontractor: Fall hazards, struck-by hazards, caught-by/pinched-by hazards, trenching and excavation hazards and electrical hazards. The Compliance Officer will only conduct a comprehensive enforcement inspection of the partner subcontractor if a Serious hazard is observed in one of the focused areas. A partner subcontractor may be subject to citation in accordance with the agency's policy as outlined in reference B.3. However, any "Other Than Serious" violations for partnered subcontractors that are immediately corrected during the inspection will not be cited.

    Nothing in the partnership exempts the specialty trade subcontractor from meeting the obligation to provide a safe and healthful workplace for its employees at the site and to promptly remove employees who are at risk from safety and health hazards. A partner subcontractor is subject to citations in accordance with the agency's policy in accordance with reference B.3.

    1. General Eligibility.
      1. Business age. The company must have been in business for three or more years.
      2. Insurance Mod Rate. In general, the company's most recent industrial insurance experience modification rate factor must be 1.0 or less. A copy of the most recent mod rate notice must be provided when applying to the partnership program.
      3. Exception. Companies with a mod rate that exceeds 1.0 will be considered if the modification is being driven by a single loss greater than $5,000 which occurred in the last four years, and, the company's most recent calendar year lost work day injury/illness (LWDII) rate at or below the most current rate for construction special trade contractors published by the Bureau of Labor Statistics. The most recent published rate is for CY 1999, and is 4.4 lost workday injuries/illnesses per 100 workers.

        An employer's LWDII rate for the most recently ended calendar year, is calculated as follows:
        - Review the appropriate OSHA-200 log to assure that the entries in columns 2 and 9 correctly include all the injuries/illnesses that involve days away from work or days of restricted work activity.
        - Add columns 2 and 9 to obtain the total number of lost workday injuries and illnesses.
        - Calculate the total number of hours worked during the calendar year by all employees (omitting paid hours that are not hours worked, such as sick and vacation hours).

        lwdii rate = total of columns 2 & 9 multiplied by 200,000
        the number of hours worked.

        Note: multiplying by 200,000-the full-time equivalent workhours of 100 workers, is necessary to produce a rate of injuries/illness per 100 workers.

      4. OSHA Citation History. OSHA will review the employer's citation history in both Federal OSHA states and in State Plan states (e.g., Oregon and Washington). Employers who have received an OSHA citation classified as "Willful" or Failure-to-Abate" which became a final order within the last three years, are not eligible for the partnership. Employers who have received a "Repeat" violation or a "High-Gravity Serious" violation in the same period may apply, but may be deemed ineligible at the discretion of the Boise Area Director, following his office's review of the nature of the violation. Those employers may re-apply three years after the final order date of such a violation.
    2. Safety and Health Programs and Self-Evaluation Questionnaire. Specialty trade subcontractors applying for the partnership program must have written safety and health programs. Appendix A is a self-evaluation questionnaire that employers are to complete to evaluate their safety and health programs. Since this self-evaluation serves as the partnership program application, employers should complete the document, certify that the information is true and correct to the best of the employer's knowledge, and provide it to OSHA.

      The employer may, at his discretion, have his safety and health programs and the self-evaluation questionnaire reviewed in advance by another party such as a safety consultant, employer association or insurance carrier. This will not affect the level of OSHA's review.

    3. Letter of Recommendation. The specialty trade subcontractor must be recommended for the program by either a general contractor or construction manager participating in the Construction Partnership Project, or by a Voluntary Protection Program (VPP) employer for whom the applicant has conducted contract construction work in the preceding 12 months. The recommendation is to be based on the Construction Partner or VPP employer's knowledge of the applicant's safety and health management and a review of the applicant's self-evaluation questionnaire. The specialty trade subcontractor may also be recommended by a safety consultant, trade association or worker's compensation group that is knowledgeable of the applicant's site management of safety and health. Appendix B to this instruction provides a prototype letter of recommendation.
    4. Supervisor Training. All job site supervisors and foremen of a partner specialty trade subcontractor will receive the OSHA 10-hour construction course or equivalent training. Equivalent training should include accident prevention training as well as hazard recognition training which has been tailored to the operations of the specialty/subcontractor. Equivalent training provided in-house may exceed the scope of the training provided by the OSHA 10-hour course.
    5. Employee Training. Employees will be trained in hazard recognition, OSHA standards, company safety policies and employee rights and responsibilities under the OSH Act of 1970. The guidance for this training will be the OSH Act, OSHA regulations, OSHA Pamphlet 3021 - "Employee Workplace Rights," and any other training material/guidelines deemed appropriate by the subcontractor. The goal of this training is to ensure that employees and employers work together to reduce workplace hazards. In addition, 25% of the non-management employees should complete the OSHA 10-hour construction course or be provided equivalent training as discussed above under Supervisory Training.
    6. Worksite Safety and Health Audits. Specialty trade subcontractors will perform safety and health audits daily. Safety and health audits will address at a minimum the following areas: fall hazards, struck-by hazards, caught in/between hazards, electrical hazards, and trenching and excavation hazards. They will also include other areas of high hazard when appropriate, such as but not limited to confined spaces and chemical hazards. The subcontractor must document that an audit has been conducted, and must document the audit results for identification of violations of safety and health standards, and action taken.
    7. Hazards under Other's Control. Specialty trade subcontractors will establish a program for reporting hazards at multi-employer sites to the creating employer or the controlling employer. These are hazards created by or controlled by others, which the partner subcontractor cannot correct himself or where he wants to provide written notice of the hazards to the creating employer or the controlling employer to reduce the likelihood of reoccurrence. Partner subcontractors will remove their employees from risk by instructing them how they may work without exposing themselves to the safety and health hazard, or, if necessary, stop work altogether. In cases where the creating employer or the controlling employer does not take prompt corrective action, the partner subcontractor is encouraged to call OSHA and report the hazardous condition.
    8. Partnership Banner. Specialty trade subcontractors who partner with OSHA may display a sign or banner at their construction sites advertising their partnership. They may also advertise the partnership on company letterhead or on information sheets submitted with bid proposals.
    9. Annual Reporting. The partner specialty trade subcontractor will complete and provide an annual report on or before February 15 each year so that OSHA can evaluate the program and can determine whether the subcontractor continues to qualify for partnership. Appendix C is the format for the report. Partner companies must review report topics in advance, to be sure that they are maintaining the information needed for year-end reporting.
  8. Outreach:

    The Boise Area Office will carry out various outreach activities to introduce this project and to promote comprehensive employer safety and health programs through cooperative partnerships with general contractors administered in accordance with reference B.1 and specialty/subcontractors administered in accordance with this instruction. Efforts will be made to contact all specialty/subcontractors that may qualify. These activities may include:

    1. Speeches by Boise Area Office staff to the construction industry on the merits of this program.
    2. A press release to the Idaho Construction News.
    3. Enlisting the support and help of various organizations to promote the awareness of the project. Such organizations shall include, but not be limited to, The Idaho Construction News and the Association of General Contractors.
    4. Providing safety and health resources/guidance at the Boise Area Office level to assist employers in the development of effective safety and health programs.
    5. Seeking the support of several partner general contractors/construction managers to offer their support concerning this project.
    6. Seeking qualified specialty trade subcontractors who have demonstrated excellent commitment to safety and health to participate in this pilot program.
    1. Partnership Agreements and Renewal

      Paragraph G. of this instruction identifies the eligibility and program requirements for the partnership, including the requirement for the applicant's safety and health program self-evaluation, and the requirement for an annual report. Appendix D provides a sample copy of the partnership agreement that would be signed by OSHA and the specialty trade subcontractor.

      Partnership agreements will require renewal action every three years. Specialty trade subcontractors will be evaluated by OSHA to assure that they continue to meet the partnership requirements identified paragraph G. of this instruction.

    2. Disqualification:

      As indicated in paragraph G.1.d., OSHA will review applicant's violation history with OSHA and with State programs (e.g., Oregon-OSHA and Washington's WISHA) and may disqualify applicants in advance. In addition, citations received by a partner subcontractor subsequent to partnership may result in termination of the partnership agreement:

      • a "Willful" or "Failure-to-Abate" citation received subsequent to partnership will always result in termination of the partnership agreement.
      • a "Repeat" violation may result in termination of the partnership, agreement depending on the circumstances of the repeat violation.
      • an OSHA inspection resulting in numerous violations or in high gravity "Serious" violations may also result in termination of the partnership agreement.
  9. Recording in OSHA's Integrated Management Information System (IMIS):

    An OSHA 1 Inspection Report will be completed for on-site evaluation of the partner's safety and health program, and for subsequent inspections. Mark this as a Local Emphasis Program inspection with the code IDCONSUB in block 25C. For a program evaluation conducted prior to the site evaluation, complete an OSHA-55 with the same LEP code (or complete the compliance assistance Web form, when it becomes available).

  10. Evaluation of the Project:

    By March 15 of each year that this project remains active, an evaluation of the project shall be conducted by the Boise Area Office.

    NOTE: If the project is determined to be ineffective after the above evaluation it will be discontinued. In this case, the specialty/subcontractors who have entered into a partnership with OSHA will be formally notified in writing.

//original signed//
Ryan E. Kuehmichel
Area Director


//original signed//
Richard S. Terrill
Regional Administrator


Auditor Name ______________________________ Date _______________

Company Name _____________________________ Tel. # _____________

Physical Address ___________________________ FAX # ______________

City _______________________________ State ______ Zip ____________

Mailing Address ____________________________________________

City _______________________________ State ______ Zip ____________

Submitted by _____________________ Title _______ Tel. # ___________

Type of Contractor ____________________________ SIC ______________



1. Have you had a willful citation within the last three years?
If yes, you may not apply at this time.


2. Have you had a repeat citation within the last three years?
If yes you may apply; however, please attach a brief statement explaining why this repeat citation should not prevent you from applying.


3. Have you been in business for three or more years?
If no, you may not apply at this time.


1. Does management participate in the safety program?


2. Does management set objectives for safety?


3. Does management budget for and provide necessary funds?


4. Does management require feedback on safety program?
NOTE: Management that does not participate in their safety program, has a hands-off approach, or leaves safety to the safety coordinator or supervisory personnel fails to meet the minimum acceptable level for management commitment.


1. Does a policy exist?


2. Is the policy in writing?


3. Has the policy been explained to all employees?

4. Do all employees know the policy?      
5. Does the policy set boundaries for the safety and health program?      
6. Does the policy emphasize management's approach to safety?      
7. Is the policy signed by the owner or the president of the company?      

8. Does the policy authorize employees to participate in the company's safety and health program?
NOTE: If no policy exists the company fails to meet the minimum acceptable level for management policy statement on safety.

1. Is the responsibility for safety defined for all levels of the company?      
2. Is it in writing and made a part of the safety and health manual?      

3. Do operating supervisors have key responsibilities for safety incorporated in their job descriptions?
NOTE: If the only person who has responsibility for the results of safety program is the safety coordinator, if the operating supervisors look to the safety coordinator to perform all safety activities, or the responsibility for safety has not been defined within the firm the company fails to meet the minimum acceptable level for responsibility for safety.

1. Is the EMR is at 1.0 or below?      
2. Is a copy of the insurance document documenting the company's EMR is attached?      
1. Does the contractor have a site specific safety budget established?      

2. Is the budget based on planned activities for the specific project?
NOTE: In order to satisfy this element, the company must allocate funding to ensure that personal protective equipment is provided and that equipment is maintained and used in a safe manner.

1. Are safety goals and objectives set to be achieved through the safety program (based on needs or problems)?      
2. Are the goals and objectives published?      
3. Has a strategy been developed to accomplish the safety program goals?      
4. Does the safety program require feedback from those responsible for achieving safety results?      
5. Are results discussed at least annually?      
6. Are audits conducted to measure the performance of the goals?      
7. Are long term and short term goals considered in the safety program?      
1. Are meetings held by management with supervisors where safety is on the agenda?      
2. Does management give an overview of safety activities?      
3. Is information given to supervisors on safety?      
4. Do supervisors give a status report on job site safety activities?      
5. Are serious accidents and near misses reviewed in these meetings?      
1. Is pre-job safety planning required at the bid stage?      
2. Is pre-job safety planning required prior to mobilization for every job?      
3. Is a check list used by the supervisor to assure that safety requirements for the job site are considered?      
4. Is necessary equipment provided?      
5. Are job supervisors trained in pre-job safety and health planning?      
1. Is an employee participation program in place?      
2. Are employees encouraged to participate in activities?      
3. Are employees required to participate in: tool box talks, hazard recognition/ reporting, site inspections, new hire & formal safety training?      
4. Are employees encouraged to participate in safety rule development/revision and accident investigations?      
5. Is there an employee suggestion/comment program in place?      
1. Is a formal orientation program in effect for all new or transferred employees?      
2. Are records maintained showing: date, person conducting orientation, areas covered, and signature of the employee and the person conducting the training?      
3. Does the new hire orientation include training on: safety and health rules, hazard communication, possible safety and health hazard exposure on the job, emergency reporting procedures, and personal protective equipment?      
4. During the new hire orientation, is the company's disciplinary policy for violating safety and health rules clearly communicated?      
5. Is management concern for safe job performance communicated?      
1. Are the safety rules published?      
2. Does management make all employees aware of the safety rules?      
3. Are copies of the rules posted at the work site?      
4. Are the safety rules concise and easy to understand?      
5. Are rules enforced equally among all employees?      
6. Are rules updated on a regular basis?      
7. Are safety rules reviewed on annual basis for possible updating?      
1. Does management conduct a work force safety training needs assessment?      

2. Is formal safety and health training provided (when required) in the areas such as, but not limited to:

  1. hazard recognition?
  2. first aid/CPR?
  3. hazard communication and material safety data sheets?
  4. fall protection?
  5. confined space entry?
  6. safe equipment operation?
  7. industrial truck operations?
  8. electrical safety?
  9. lockout/tagout?
  10. personal protective equipment?
  11. trade speciality safety and health?

3. Is there documentation that training is provided?
If yes, does it show:

  1. date?
  2. signature of person conducting the training?
  3. qualification of the person conducting the training?
  4. areas covered?
  5. signature of the employee?
4. Is employee training comprehension/understanding of training verified and documented?      
1. Are meetings held at least weekly?      
2. Are these meetings conducted by a supervisor?      
3. Are records kept showing attendance and topics presented?      
4. Do employees participate in the meetings?      
5. Are employees asked to present safety topics at the meetings?      
1. Are job site inspections conducted daily?      
2. Are these inspections conducted by a site supervisor?      
3. During these inspections are critical safety items identified and checked?      
4. Are safety and health deficiencies documented?      
5. When possible, are safety and health deficiencies corrected immediately?      
6. When safety and health deficiencies are not corrected immediately, are interim controls initiated to ensure no employee exposure to the hazard?      
1. Does the company provide supervisory training?      
2. Are all levels of supervisors trained?      
3. Are supervisors trained in first aid/CPR?      
4. Are supervisors trained in hazard recognition?      
5. Are supervisors trained in emergency reporting procedures?      
6. Do supervisors receive the OSHA 10 hour or 30 hour construction course?      
7. Are supervisors (when required) trained in respiratory protection?      
8. Are supervisors (when required) trained in confined space entry?      
9. Are supervisors (when required) trained in scaffold safety?      
10. Are supervisors (when required) trained in ladder safety?      
11. Are supervisors (when required) trained in trench and excavation safety?      
12. Are supervisors (when required) trained in monitoring the atmosphere for toxic, flammable mixtures, and/or oxygen levels?      
13. Are supervisors (when required) trained in fall protection requirements?      

14. Is there documentation that training is provided?
If yes, does it show:

  1. date?
  2. signature of person conducting the training?
  3. qualification of the person conducting the training?
  4. areas covered?
  5. signature of the employee?
1. Are all accidents and near misses immediately investigated?      
2. Are reports completed on all accidents and near misses?      
3. Does the owner, president or other corporate officer review the accident investigation report?      
4. Does management try to determine the cause of the accident?      

5. Does the accident investigation focus on what deficiency in the company's safety and health program may have allowed this accident to occur, i.e., management commitment, hazard identification/determination, hazard elimination/control, emergency response planning, first aid/medical, or training?

NOTE: Simply stating it was an unsafe act by the employee or unsafe condition does not meet the requirements for this element. If it is an unsafe condition, what element of your program allowed it to exist or be created? If it is an unsafe act, why did the employee perform this unsafe act. Was he or she not trained, or was it employee misconduct? If it was employee misconduct, what disciplinary actions were taken?

6. Is there a follow-up system in place to assure corrective action has been taken to prevent another similar accident?      
7. Is the information learned from an accident shared with all other job sites to help prevent further accidents?      
1. Does the company conduct an analysis to determine the PPE requirements?      
2. Is the employee informed on what PPE is required?      
3. Are employees trained in the use and maintenance of the PPE?      
4. Does the company provide the PPE?      
5. Has the employee been made aware of disciplinary consequences for not using the required PPE?      
1. Does the company have a policy regarding drug or alcohol abuse?      
2. Are supervisors trained in the hazards of drugs and alcohol on the job?      
3. Is drug testing conducted for pre-hire, post accident, and cause?      

1. Does the company (when required) maintain an OSHA 200 log of injuries and illnesses?
NOTE: Use OSHA Forms 300 and 300A beginning with calendar year 2002


2. Does the company maintain an OSHA 101 or equivalent workers compensation form for the first report of the injury?
NOTE: Use OSHA Form 301 or equivalent beginning with calendar year 2002

3. Does the company maintain accident investigations?      
4. Does the company maintain records of the hazards noted during self inspections?      
5. Does the company maintain copies of written reports they have made on multi- employer job sites concerning hazards that were not created by your company?      
6. Were the reports above forwarded to the creating and controlling employers?      

7. Are cranes used on the construction site?
If yes, are the following records must be maintained for each crane on site:

  1. Is a copy documenting a thorough annual inspection by either a competent person or a person recognized by the U.S. Department of Labor maintained on site?
  2. Are copies of the daily to monthly inspections maintained on site?
  3. Is a copy of the operators and maintenance manual maintained on site for each crane in service?

PO BOX 5555
Anywhere, Idaho 83000
(208) 555-5555


Area Director - Boise Area Office
U.S. Department of Labor - OSHA
1150 N. Curtis Road - Suite 201
Boise, ID 83706-1234

RE: Letter of Recommendation for XYZ Steel Erectors

Dear Sir:

I have personally reviewed the attached self evaluation conducted by the above referenced company. They have worked as a speciality/subcontractor for our company in the past. I have found them to be a well managed company that is responsive to safety and health concerns. Without reservation, I recommend the above referenced company for partnership under the speciality/subcontractor partnership program.


IAM Management


1. Company name submitting this report: _____________________

2. This report is for calendar year: _____________________

3. Have you had any lost time accidents, property damage exceeding $5,000 or near misses? YES NO NA

4. List the name of the company(s) involved in these incidents:

5. If your answer to question number 3 is yes, have you attached a copy of each accident investigation? YES NO NA

6. Transfer the previous year's summary totals from your OSHA 200 log to the following table:

1 2 3 4 5 6 7 8 9 10 11 12 13

HOURS WORKED IN PREVIOUS YEAR: _____________________

7. Insurance Experience Modification Rate: _____________________

8. Number of sites audited during the previous year: _____________________

9. Number of audits conducted during the previous year: _____________________

10. Number of violations found by your audits during the previous year: _____________________

11. Number of subcontractors who worked for you during the previous year: _____________________

12. Top three reoccuring violations corrected during the previous year:

13. Non-compliance letters were issued to the following contractors during the previous year:

14. Warning were given to the following contractors during the previous year:

15. The following contractors were shut down due to safety and health violation during the previous year:

16. The following contractors were removed from the site for safety and health violations during the previous year:









The undersigned parties mutually agree to the goals and objectives of this instruction. We are committed to employee safety and health through the proper implementation of this agreement. The undersigned parties agree to operate within the scope of this instruction. The undersigned specialty/sub contractor agrees to meet the requirements of this instruction to qualify for a partnership.

The undersigned parties understand that this agreement can be canceled by either party by written notice. In addition, the undersigned parties understand that this agreement will require renewal action every three years. The undersigned general contractor is aware of the disqualification clause specified in this instruction.






Union (if applicable):





OSHA Area Director:





Date: __________ Expiration date: __________

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