Contractors Safety Information Sheet

Houston Business Roundtable 2010 Safety Excellence Award Training • Contractors Safety Information Sheet Presented by: John Bollom

Houston Business Roundtable 2010 Safety Excellence Award Training • Six Sections • Nominated By • Name of Firm • Type of Business • Company Description • OSHA Information • Contact Information 2009 CONTRACTORS SAFETY INFORMATION SHEET

Section 1: Nominated By • Fill out one form for each project site you have been nominated for.

Section 2: Name of Firm • Name of company as you would like to see it on awards. • Contact name needs to be someone that can answer questions.

Section 3: Type of Business • Check the category for which you want to be considered.

Section 4: Company Description • Need a good description of work/service your company performs.

Section 5: OSHA Information Use 2008 OSHA No. 300 logs to provide the following injury/illness data: • Data needed for both: • Nominated worksite. • Total company (All work in the US)

Section 6: Contact Information SUBMITTED BY: ____________________________Title ______________________________ PHONE NUMBER: _____________________ E-MAIL:________________________________ Please return this form along with your HBR Safety Awards Initial Evaluation Form and the attachments checked off on the last page of that form to the Houston Business Roundtable, 8031 Airport Blvd., Suite 118 Houston, Texas\ 77061 by 4:00 p.m. on Monday, February 1, 2010 • Contact name needs to be someone that can answer questions. • Make certain contact information is correct.

Houston Business Roundtable 2010 Safety Excellence Award Training • Safety Awards Initial Evaluation Form

Houston Business Roundtable 2010 Safety Excellence Award Training 2009 Safety Awards Initial Evaluation Form Consist of a five page document

Safety Awards Initial Evaluation Form • Five Sections • General Information • Safety, Health & Environmental Performance • Safety, Health & Environmental Management • Safety, Health & Environmental Programs/Procedures • Information Submittal

Section 1: General Information • Once again double check contact information.

Section 2: Safety, Health & Environmental Performance

Section 3: Safety, Health & Environmental Management

Section 4: Safety, Health & Environmental Programs/Procedures

Section 5: Information Submittal • Provide copies of checked items applicable to your company’s work.

Section 5: Information Submittal

Section 5: Information Submittal • Need name and title of Company Officer responsible for accuracy of this document.

Overview • Fill out Contractor Information Sheet for each project site that nominated you. • Complete the Safety Awards Initial Form. • Need copies of checked items applicable to your company’s work either: • Electronic Copies (Disk) • Hard Copies • NO EMAILS! (Will not be accepted)

Overview Continued • If submitting a disk make sure: • Content is organized. • Can open all material with a common program. • Need hard copies of Information Sheet and Initial Evaluation Form with the disk.

Overview Continued • Please submit all Information by: • Hand delivering or, • Mailing to: • Houston Business Roundtable 8031 Airport Blvd. Suite 118 Houston Texas, 77061By: 4:00 PM Monday Feb 1, 2010 NO EXCEPTIONS!

Houston Business Roundtable 2010 Safety Excellence Award Training

Contractors Safety Information Sheet