The Basics
Name*
First*
Last*
Please enter First name and Last name.
Email*
Please enter valid email.
Company Name*
Please enter Company Name.
What type of contractor are you?*
Select Trade
Plumbing
Electrical
Mechanical
Roofing
Fireproofing
Drywall
Flooring
Painting
Wall Panels
Acoustical
EIFs
GCs
Other
This field is required.
How many employees do you have?
<50
51-100
101-200
200+
What percentage of your work is performed by subs?
0-5%
5-10%
10-20%
20-50%
>50%
In which geographic areas has your company completed the most projects in the last 5 years?
West
Midwest
Southeast
Southwest
Northeast
Western Canada
Central Canada
Atlantic Canada
What is your approx annual revenue?
<$1M
$1-$3M
$3M-$5M
$5M-$10M
$10-$20M
$20M+
Approximate annual spend for workers compensation insurance?
<$100K
$100-$200K
$200-$400K
$400-$600K
$600-$1M
$1M+
What is your company's current EMR?
Experience Modification Rating (EMR) is a metric used by insurance providers to understand the risk of a potential company they might insure.
Don't know
1.0+
1-.90
.90-.80
.80-.70
.70-.60
.60-.50
Program Management
Does your company have a formal written health & safety policy?
Yes
No
How often is your health & safety policy reviewed by ownership/management?
Never
As Needed
Annually
Quarterly
Monthly
Do you require all your employees to read & acknowledge your health & safety policy when they are hired?
Yes
No
Do you require all your employees to periodically review your health & safety policies?
Yes
No
How many dedicated health & safety people do you have?
None
1-3
3-5
5-10
10+
Training Management
Have you established basic training requirements for each position at your company?
Yes
No
Do you require all new workers to take an orientation training when they are hired?
Yes
No
How often do you offer training to workers on an ongoing basis?
Never
Occasionally
Regularly
Constantly
Do you have an established system to track worker training & certifications?
Yes
No
How do you currently track worker training & certifications?
Paper
Spreadsheets
A Combination of Paper & Spreadsheets
An App
What styles of training do you use to deliver material to workers? Check all that apply
Hands-On
Instructor-Led
Online
Hybrid
How many dedicated personnel training staff?
0
1-3
3-5
5-10
10+
Project Planning
How often do you create a formal safety plan for projects?
Never
Sometimes
Often
Always
Do you require workers to review & acknowledge the safety plan for a project prior to starting work?
Yes
No
How often during a project is the safety plan reviewed or changed?
Never
When Requested By GC/Customer
When Scope Of Work Changes
During Work
How often do workers perform task hazard analysis?
Never
Occassionally
Often
Always
How often are jobsite safety inspections performed?
Never
Occassionally
Often
Always
Who within you organization typically performs jobsite safety inspections? Check all that apply
Foremen
Superintendants
Safety Personnel
Third Party
How are jobsite safety inspections documented?
Not Documented
Paper
An App
How often are safety issues uncovered during an inspection?
Never
Occassionally
Often
Always
How often are corrective action(s) documented?
Never
Occassionally
Often
Always
How often are corrective actions reviewed to ensure completion?
Never
Occassionally
Often
Always
How often do crews perform toolbox talk safety meetings?
Never
Occassionally
Often
Always
How are toolbox talks documented?
Not Documented
Paper
An App
What source(s) do you use toolbox talk material? Check all that apply
Internet
Trade Associations
Purchased From Vendor
Write Our Own
How often do workers conduct vehicle safety inspections?
Never
Occassionally
Often
Always
How are vehicle safety inspections documented?
Not Documented
Paper
An App
Incident Response & Reporting
How often are near misses reported?
Never
Occassionally
Often
Always
How often are formal investigations into incidents or near misses conducted?
Never
Occassionally
Often
Always
In the case of incidents/injuries how are they reported to management? Check all that apply
Phone
Email
An App
How often are incidents/injuries formally investigated for contributing factors?
Never
Occassionally
Often
Always
Is your company required to submit OSHA 300 each year?
Don't Know
Yes
No
How often does your company submit your OSHA 300 log on time?
Never
Occassionally
Often
Always
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