Contractor Safety Rating Form Initial Evaluation Presented by: James Bergeron Houston Business Roundtable 2010 Safety Excellence Award Training

Contractor Safety Rating Form Initial Evaluation  Nine Sections  Fatalities  OSHA Incident Rate for Lost Work Day Cases  OSHA Incident Rate for Total Recordable Injuries and Illnesses  Documented Safety Policies/Procedures

 Nine Sections  Accident/Incident Investigation Procedure  Self Audit Program  Orientation and Training Program  Best Practice(s)  Year to Year Improvement Contractor Safety Rating Form Initial Evaluation

 Score of up to 200 Points.  This weighs heavily on the over all scoring. Section 1: Fatalities 1. Fatalities - If there are no fatalities for the year, enter 10 in the score box. If there are any fatalities enter 0 in the score box. Multiply score by the weighted value to obtain performance index. _____ Score x 20 = _____ Score Subtotal

 Score of up to 150 Points. Section 2: OSHA Lost Workday Cases 2. OSHA Incidence Rate for Lost Workday (days away from work) Cases - take the most recent year’s rate. Select the corresponding score from the table below and enter that number in the score box. Multiply score by the weighted value to obtain performance index. LCWRScore – – – – _____ Score x 15 = _____ 1.26 – 1.54 Score Subtotal 1.56 – – – Over 2.50

 Score of up to 150 Points. Section 3: OSHA TRR

 Score of up to 80 Points. Section 4: Documented Safety Policies/Procedures

Section 5: Accident/Incident Procedures  Score of up to 80 Points.

Section 6: Safety Audit Program  Score of up to 80 Points.

Section 7: Orientation and Training Program  Score of up to 80 Points.

Section 8: Best Practice(s)  Score of up to 40 Points.

Section 9: Year to Year Improvement  Score of up to 40 Points.

Total Points  All subtotal values or added together for a maximum Total Performance Index of 900.

Contractor Safety Rating Form Initial Evaluation Houston Business Roundtable 2010 Safety Excellence Award Training