Contractors Safety Information Sheet

Presented by:

Houston Business Roundtable2013 Safety Excellence Award Training

Houston Business Roundtable2013 Safety Excellence Award Training

Six Sections Nominated By

Name of Firm

Type of Business

Company Description

OSHA Information

Contact Information

Nominated by: ABC Chemicals

*Note: If your firm has received several nominations, copy this form and complete one for each project site

Fill out one form for each project site you have been nominated for.

Section 1: Nominated By

Name of your firm exactly as you wish it published on any brochures, plaques, etc.:

Contact Name: Title:

Address City/State/Zip

Phone: Fax: e-mail:

Name of company as you would like to see it on awards.

Contact name needs to be someone that can answer questions.

Section 2: Name of Firm

Check the category for which you want to be considered.

Section 3: Type of Business

Company Description (Type of work/service your company does)____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Need a good description of work/service your company performs.

Section 4: Company Description

Data needed for both:

• Nominated worksite.

• Total company (All work in the US)

Section 5: OSHA Information

Contact name needs to be someone that can answer questions.

Make certain contact information is correct.

Section 6: Contact Information

Safety Awards Initial Evaluation Form

Houston Business Roundtable2013 Safety Excellence Award Training

Houston Business Roundtable2013 Safety Excellence Award Training

Consist of a four page document

Safety Awards Initial Evaluation Form

Six Sections General Information Safety, Health & Environmental Performance Safety, Health & Environmental Management Safety, Health & Environmental

Programs/Procedures Safety, Health & Environmental Training Information Submittal

Section 1: General Information

GENERAL INFORMATION1.Company Name: Telephone:       Fax:    

Street Address:     Mailing Address:      

 

Web site:   

Contact Person:     e-mail:   

Telephone:   Fax:   

2. Parent Company Name:

Once again double check contact information.

Section 2: Safety, Health & Environmental Performance

Section 2: Safety, Health & Environmental Performance

Section 2: Safety, Health & Environmental Performance

Section 3: Safety, Health & Environmental Management

Section 4: Safety, Health & Environmental Programs/Procedures

Section 4: Safety, Health & Environmental Programs/Procedures

Section 4: Safety, Health & Environmental Programs/Procedures

Section 4: Safety, Health & Environmental Programs/Procedures

Section 4: Safety, Health & Environmental Programs/Procedures

Section 4: Safety, Health & Environmental Programs/Procedures

Section 4: Safety, Health & Environmental Programs/Procedures

Section 4: Safety, Health & Environmental Programs/Procedures

Section 4: Safety, Health & Environmental Programs/Procedures

Section 4: Safety, Health & Environmental Programs/Procedures

Section 5: Safety, Health & Environmental Training

Section 6: Information Submittal

Provide copies of checked items applicable to your company’s work.

Section 5: Information Submittal

• Need name and title of Company Officer responsible for accuracy of this document.

*****Don’t forget to include your company’s actual Best Practice

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/Zip Drive)• Hard Copies• NO EMAILS OR FAXES! (Will not be accepted)

Overview Continued

If submitting a disk/zip drive 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, 77061

By: 4:00 PM Monday, February 4, 2013 NO EXCEPTIONS!

• Keep in mind that the information submitted is the ONLY information the Audit Team Leader has to use to evaluate your company.

• If a program is not there, it’s a zero.• If Best Practices is missing, it’s a zero. • Make sure you don’t have any missing

information.

Overview Conclusion

Houston Business Roundtable2013 Safety Excellence Award Training