Safety Provide your safety statistics in the table below. Include a copy of your company’s OSHA 300 log, an EMR confirmation letter and a description of OSHA citations, if applicable, with your submission. Current Previous Before Last Year Year Experience Modification Rate (EMR) Number of Days Away from Work Number of Medical Attention Cases Only Total Recordable Injury Rate (TRIR*) Total Lost Workday Injury Rate (LWIR*) Number of Fatalities Hours Worked OSHA Citations *Injury Rate Formula = # of Injuries x 200,000 ÷ Hours Worked Indicate if any of the following are included in your safety program? A copy company’s of your safety program must be available for review upon award of contract. YES NO YES NO Written Safety Program Excavation Program ☐ ☐ ☐ ☐ New Hire Orientation Fall Protection Program ☐ ☐ ☐ ☐ Foreman Training Scaffold Program ☐ ☐ ☐ ☐ Supervision Training Lock Out Tag Out Program ☐ ☐ ☐ ☐ Pre-Job Safety Hazard Analysis Hand Tool Program ☐ ☐ ☐ ☐ Tool Box Talks Construction Crane Program ☐ ☐ ☐ ☐ Accident Investigation PPE Program ☐ ☐ ☐ ☐ Daily Task Safety Analysis Confined Space ☐ ☐ ☐ ☐ Process List any third-party review programs (ISNetworld, PICS, PEC, etc.) in which your company participates. Provide a certificate of your status for each program. Project Controls Does your company use a software application to develop project schedules? If so, list the software name:___ Indicate the number of schedulers your company employs:_ Indicate if your schedules are cost-loaded: Yes No Indicate if your schedules are man-hour-loaded: Yes No Quality
Safety Provide your company’s safety statistics in the table below. Include a copy of your OSHA 300 log, an EMR confirmation letter and a description of OSHA citations, if applicable, with your submission. Current Year Previous Year Before Last Experience Modification Rate (EMR) Number of Days Away from Work Number of Medical Attention Cases Only Total Recordable Injury Rate (TRIR*) Total Lost Workday Injury Rate (LWIR*) Number of Fatalities Hours Worked OSHA Citations *Injury Rate Formula = # of Injuries x 200,000 ÷ Hours Worked Indicate if any of the following are included in your company’s safety program? A copy of your safety program must be available for review upon award of contract. YES NO YES NO Written Safety Program ☐ ☐ Excavation Program ☐ ☐ New Hire Orientation ☐ ☐ Fall Protection Program ☐ ☐ Foreman Training ☐ ☐ Scaffold Program ☐ ☐ Supervision Training ☐ ☐ Lock Out Tag Out Program ☐ ☐ Pre-Job Safety Hazard Analysis ☐ ☐ Hand Tool Program ☐ ☐ Tool Box Talks ☐ ☐ Construction Crane Program ☐ ☐ Accident Investigation ☐ ☐ PPE Program ☐ ☐ Daily Task Safety Analysis Process ☐ ☐ Confined Space ☐ ☐ List any third-party review programs (ISNetworld, PICS, PEC, etc.) in which your company participates. Provide a certificate of your status for each program. Project Controls Does your company use a software application to develop project schedules? If so, list the software name:___ Indicate the number of schedulers your company employs:_ Indicate if your schedules are cost-loaded: Yes No Indicate if your schedules are man-hour-loaded: Yes No Quality
gic_sub-vendor_profile_form_blank.docx