Idaho Construction General Contractor/Construction Manager Partnership Renewal Agreement
October 1, 2001

APPENDIX A
GENERAL CONTRACTOR/CONSTRUCTION MANAGER
SELF EVALUATION AND APPLICATION/RENEWAL
APPLICATION REQUIREMENTS YES NO
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.
PRE-QUALIFICATION REQUIREMENTS: YES NO NA
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.
MANAGEMENT COMMITMENT: YES NO NA
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.
MANAGEMENT POLICY STATEMENT ON SAFETY: YES NO NA
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.
RESPONSIBILITY FOR SAFETY DEFINED: YES NO NA
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.
EXPERIENCE MODIFICATION RATE (EMR): YES NO NA
1. Is the EMR at 1.0 or below?
2. Is a copy of the insurance document documenting the company's EMR attached?
SAFETY BUDGET: YES NO NA
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.
SAFETY PROGRAM GOAL SETTING: YES NO NA
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?
MANAGEMENT SUPERVISORY MEETINGS: YES NO NA
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?
PRE-PLANNING FOR JOB-SITE SAFETY: YES NO NA
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?
EMPLOYEE PARTICIPATION: YES NO NA
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?
NEW HIRE ORIENTATION: YES NO NA
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?
SAFETY RULES: YES NO NA
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?
EMPLOYEE SAFETY TRAINING: YES NO NA
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?
SAFETY TOOL BOX MEETINGS: YES NO NA
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?
INSPECTIONS: YES NO NA
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?
SUPERVISORY TRAINING: YES NO NA
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?
ACCIDENT INVESTIGATION: YES NO NA
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?
PERSONAL PROTECTIVE EQUIPMENT (PPE): YES NO NA
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?
SUBSTANCE ABUSE POLICY: YES NO NA
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?
RECORD KEEPING: YES NO NA
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-
ANNUAL REPORT
FOR
IDAHO GENERAL CONTRACTOR/CONSTRUCTION MANAGER PARTNERSHIP PROJECT
DUE BY 15 FEBRUARY EACH YEAR

OSHA 200 LOG

1

2

3

4

5

6

7

8

9

10

11

12

13

 

 

 

 

 

 

 

 

 

 

 

 

 

______________________________________________
Signature
_______________
Date
APPENDIX C
PARTNERSHIP AGREEMENT BETWEEN THE UNDERSIGNED
GENERAL CONTRACTOR/CONSTRUCTION MANAGER AND OSHA

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.