Partnership #2 - Renewal Agreement - October 1, 2001

Idaho Construction General Contractor/Construction Manager Partnership Renewal Agreement October 1, 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
  • October 1, 2001
  • SUBJECT: Idaho Construction General Contractor/Construction Manager Partnership Program
    1. Purpose.

      This Instruction provides the background and procedures for a local emphasis partnership program for Idaho General Contractors and Construction Managers.

    2. Scope.

      This Instruction applies to the Boise Area Office.

    3. Cancellation.

      Boise Area Office Instruction CPL 2.1.1, dated July 1, 1996.

    4. References.
      1. Boise Area Office Instruction CPL 2.1.2 Idaho Construction Specialty Trades Partnership Program.
      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 Assistant Secretary, Subject: Guidance to Compliance Officers for Programed 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.
    5. Action.

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

    6. Background.

      On July 1, 1996, the Boise Area Office initiated the Idaho Construction Targeting and Partnership Project for general contractors and construction managers (noted in paragraph C above). The partnership has led to significant improvements in more effective safety and health programs at construction sites managed by the general contractors/construction managers 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, OSHA has observed many contractors who are striving to improve their safety and health programs with the goal of becoming a partner. 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 continuing this partnership program is in the best interest of construction employees, general contractors/construction managers and OSHA.

    7. Goals and Objectives.

      This project promotes contractor partnerships with OSHA under which contractors must adhere to strict requirements for managing site safety and health, and demonstrate this in advance to OSHA through a comprehensive written program and effective site enforcement. The Area Office will also verify that partnership requirements are met and program goals are being attained, by reviewing evidence of regular and effective safety audits, accident investigations and injury/illness data. The project goals are:

      1. To continue to reduce construction worker injuries and illnesses in Idaho through OSHA inspection actions and through development of effective partnerships with qualifying general contractors/construction manger under this program and for qualifying specialty contractors under reference D.1.
      2. To continue to improve employer safety and health programs.
      3. To better utilize 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.
    8. Selection of Partnership Contractors for OSHA Inspection:
      1. Programmed inspections - general. The selection of partnership companies for programmed OSHA inspections will be made from the standard construction planning guide list developed for programmed construction inspections. However, because partnership contractors have committed to conduct regular safety audits to enforce safety and health requirements at the site, the Area Office will conduct fewer programmed inspections among partnership contractors than if they were not making the partnership commitment. While all non-partnership companies that appear on a list will be inspected, only one in every five partner companies will be selected.
      2. Development of programmed inspection lists. The lists will be developed in accordance with OSHA Instruction CPL 2.25I and the construction project information system of the Construction Resource Analysis (CRA) Group at the University of Tennessee. The number of sites selected for a monthly construction planning guide inspection list is usually about 15 per month. This number can be raised or lowered depending upon other priorities and resources.
      3. Selection of sites from the lists. The sites on the construction planning guide list will be arranged to place the non-partnership contractors first, followed by those companies that have entered into a successful partnership with the Boise Area Office. Once an inspection list is opened, all non-partnership sites must be inspected and every fifth (5th) partnership company. The count of partnership companies made to identify every fifth one is a running or continuous count that carries over from list to list.
      4. Scope of programmed partner inspections. Inspections of partner sites will be conducted as a focused inspection as directed in reference D.6, with a review on fall hazards, struck-by hazards, caught by/pinched by hazards, trenching and excavation hazards, and electrical hazards. If the Compliance Safety and Health Officer (CSHO) determines during the walkaround that the number or the nature of hazards found on the project indicates that the safety program is inadequate or is not effectively implemented, the scope of the inspection will be expanded. The CSHO will not be required to review the written programs prior to conducting a focused inspection. A partnership contractor is subject to citations in accordance with the agency's policy as described in reference D.3. However, "Other-than-serious" violations identified and corrected during the inspection and verified as abated by the CSHO, will not be cited.
      5. Complaints, fatalities and catastrophes. Fatalities, catastrophes and formal complaints (signed by a current employee) will be inspected in accordance with reference D.3. This partnership grants no special provision with regard to inspections initiated as the result of a fatality, catastrophic event, or a formal complaint. Non-formal complaints will normally be handled by phone and FAX.
      6. Referrals. The area director or his designee will determine on a case-by-case basis the response to be taken on referrals of satefy and health hazards made by law enforcement, fire departments, emergency response agencies, safety and health professionals, and the media. The Boise Area Office may conduct an on-site inspection in accordance with reference D.3, or it may investigate the matter by requiring that the employer promptly review and respond formally to a description of the hazards provided by OSHA in a phone call and FAXed letter.
      7. Inspection Protocol and Citation policy: Inspections list will be conducted in accordance with guidance provided in OSHA Instructions CPL 2.103, CPL 2.25I, STD 3-1.1 and the Policy Memorandum dated August 22, 1994 (references D.3 to D.6 of this instruction). Nothing in the partnership program exempts the general contractor/construction manager from their obligation to control the site and to promptly remove employees at the site from safety and health hazards. The general contractor/construction manager may be subject to citation in accordance with the agency's multi-employer citation policy outlined in paragraph D.3 of OSHA Instruction CPL 2.103.
    9. 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 the type of construction published by the Bureau of Labor Statistics. The most recent published rate is for CY 1999, and is 3.7 lost workday injuries/illnesses per 100 workers for general building contractors and 3.8 for heavy construction.

        An employer's LWDII rate for the most recently ended calendar year, is calculated as follows1:
        - 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.
    10. Partnership Application and On-Site Evaluation,

      Candidates for a partnership with OSHA will complete a copy of the Self-Evaluation Questionnaire included as Appendix A of this instruction, provide a copy of their current safety and health programs and provide a list of construction sites that will be active during the next 90 days.

      1. Written Safety and Health Programs. The general contractor/construction manager applying for the partnership program must have written safety and health programs, and must provide a copy of these programs with the application.
      2. Self-Evaluation Questionnaire. Appendix A is a self-evaluation questionnaire that employers are to complete to evaluate their safety and health programs. This self-evaluation serves as the partnership program application, and 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. Site Visit. The employer is to provide a list of construction sites that will be active during the next 90 days. OSHA will select a site and conduct an evaluation inspection to determine if the employer's safety and health program is operating effectively and meets the partnership qualifications. The visit will be recorded as a partial scope OSHA inspection.
    11. Requirements for partnership:

      A partnership is a written agreement under which the contractor makes a commitment to maintain an effective comprehensive written safety and health program and conducts regular safety audits to enforce safety and health requirements at the site. In return, the Area Office will provide safety and health program advice and support and will conduct fewer programmed inspections among partnership contractors than if they were not making the partnership commitment.

      NOTE: Nothing in the partnership program exempts the general contractor/construction manager from their obligation to control the site and to promptly remove employees at the site from safety and health hazards. The general contractor/construction manager may be subject to citation in accordance with the agency's multi-employer citation policy outlined in paragraph D.3 of OSHA Instruction CPL 2.103.

      1. Requirement for Written Safety and Health Program: General Contractors must have a written safety and health program. The program will be reviewed by the Boise Area Office staff before the partnership is approved. The evaluation of this program will be in accordance with the guidelines in OSHA Instruction STD 3-1.1, as well as the guidelines listed below. The Self-Evaluation Questionnaire provided as Appendix A is to be prepared and submitted by the general contractor/ construction manager and will be reviewed by the OSHA representative. The OSHA representative will make any appropriate comments or recommendations based upon their document review and a site audit.
      2. Training Requirements for Managers: All job site supervisors and foremen of a partnered general contractor/construction manager will receive the OSHA 10 hour construction course or equivalent training. Equivalent training will vary for each construction activity and for the scope of a supervisor or foreman duties. Training provided in-house will often exceed the scope of the training provided by the OSHA 10-hour course. Equivalent training should include accident prevention training which has been tailored to the scope of the supervisor or foremen duties.
      3. Training Requirements for Employees: 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 general contractor/construction manager. 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.
      4. Site Safety Audits: Site management will conduct an informal site audit daily by focusing on 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. Where serious hazards are noted during the informal site audit, they will be appropriately documented. On at least a weekly basis, a documented inspection of the work site will be conducted by a person competent in the safety and health issues applicable to the job at its current stage of construction.
      5. Subcontractor Enforcement: General contractors/construction managers will establish an effective policy for dealing with non-complying sub-contractors. The general contractor/construction manager will document hazards with videos or still cameras and keep track of date, time, exposed employee name(s), and what they did to get the non-complying sub-contractor to comply and the name(s) of management spoken to. If partnered company deems that OSHA enforcement action against the subcontractor is the only way to ensure future compliance, a management representative from the partnered contractor can make a referral to OSHA. The partnered company must ensure that the employees are removed from the hazard, and the condition is abated prior to allowing the employees to return to work, even when the general contractor/construction manager has elected to notify OSHA.
      6. Subcontractor Safety and Health Requirements: Partnership companies will agree to maintain a copy of the subcontractor's safety and health plan, hazard communication program, and fall protection plan. The general contractor/construction manager can require all subcontractors to follow their programs in lieu of individual subcontractor plans.
      7. Annual Reporting. The partner general contractor/construction manager will complete and provide an annual report to OSHA on or before February 15 each year so that OSHA can evaluate the program and can determine whether the contractor continues to qualify for partnership. Appendix B 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. Partnership Banner. General contractors/construction managers 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.
    12. 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/construction managers administered in accordance with this instruction and subcontractors administered in accordance with reference D.1. Efforts will be made to contact all general contractors/construction managers 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, the Associated General Contractors and the Associated Builders and 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 general contractors/construction managers who have demonstrated excellent commitment to safety and health to participate in this program.
    13. Partnership Agreements and Renewal
      1. Partnership Agreement. Paragraphs I, J and K of this instruction identify 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 C provides a sample copy of the partnership agreement that would be signed by OSHA and the general contractor/construction manager.
      2. Renewal. Partnership agreements will require renewal action every three years. General contractors/ construction managers will be evaluated by OSHA to assure that they continue to meet the partnership requirements identified paragraph K. of this instruction. The Boise Area Director may extend the three year period somewhat if resources to conduct the renewal evaluation are not immediately available at the three year anniversary.
    14. Disqualification:

      As indicated in paragraph I.4., 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 contractor 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.
    15. Recording in OSHA's Integrated Management Information System (IMIS):

      The activities and hours for this program's partnership inspection, evaluation and compliance assistance activities are to be recorded in IMIS using the Local Emphasis Code IDCON.

      1. An OSHA 1 Inspection Report will be completed for on-site evaluation of the partner's safety and health program, and for all subsequent inspections. In most cases the scope of the inspection will be 'partial'. Mark these as a Local Emphasis Program inspection with the code IDCON in block 25C.
      2. Program evaluations, discussions, and paper reviews conducted prior to the site evaluation, and compliance assistance outreach activities, are to be recorded on an OSHA-55 with the LEP code IDCON (or the successor compliance assistance Web-form).
    16. 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 general contractor/construction manager who has 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 _________________________________
1. Appendix A has been appropriately completed?    
2. A current copy of each safety & health program is attached?    
3. A list of active construction sites for the next 90 days is attached? NOTE: The list will contain a project description, estimated date of completion and the dollar amount of the project.    
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 at 1.0 or below?      
2. Is a copy of the insurance document documenting the company's EMR 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?    
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:
  • a) hazard recognition?
  • b) first aid/CPR?
  • c) hazard communication and material safety data sheets?
  • d) fall protection?
  • e) confined space entry?
  • f) safe equipment operation?
  • g) industrial truck operations?
  • h) electrical safety?
  • i) lockout/tagout?
  • j) personal protective equipment?
  • k) trade speciality safety and health?
3. Is there documentation that training is provided? If yes, does it show:
  • a) date?
  • b) signature of person conducting the training?
  • c) qualification of the person conducting the training?
  • d) areas covered?
  • e) 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:
  • a) date?
  • b) signature of person conducting the training?
  • c) qualification of the person conducting the training?
  • d) areas covered?
  • e) 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:
  • o) 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?
  • p) Are copies of the daily to monthly inspections maintained on site?
  • q) Is a copy of the operators and maintenance manual maintained on site for each crane in service?
-Appendix B-
  • 1, Company name submitting this report: ________________
  • 2. This report is for calendar year: ________________
  • 3. Have you had any lost time accidents, property damage YES NO NA exceeding $5,000 or near misses?
  • 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:




























  • 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 reoccurring 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 described in paragraph F 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 general contractor agrees to meet the requirements of paragraph H 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 accordance with paragraph J of this instruction). In addition, the undersigned parties understand that this agreement will require renewal action every three years (in accordance with paragraph J of this instruction). The undersigned general contractor is aware of the disqualification clause specified in paragraph M of this instruction.

General Contractor: Union (if applicable): OSHA Area Director:

______________________ __________________________ ________________________

Date: __________ Expiration date: __________


1For 2002 rates and thereafter: OSHA has replaced the OSHA-200 log effective January 1, 2002 with a revised form OSHA 300 and 300A. Accordingly, when calculating the lwdii rate from injuries and illnesses recorded on the 300 forms, use the total of columns H and I in lieu of columns 2 and 9.

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