8/12/2019 04c Supervisor's Commitment

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ATTACHMENT C

JCP

Supervisors Commitment Declaration:

Company Name: Unit: Discipline:

Immediate Supervisors Name: Construction Managers Name Date:

Supervisors are appointed for their skills in the various disciplines, and are best equipped to identify various work

haards and initiate effective control !easures in order to prevent incidents fro! occurrin"# $t is our stron" belief that

Supervisors are the key to incident % accident prevention#

$n order to create a sustained culture of proactive safety awareness on the &ro'ect, thereby leadin" to hi"her levels of

safety e(cellence, it is required that Supervisors apportion special ti!e devoted for Safety alone#

AG!!M!N"

#y accepting t$e position o% Supervisor on t$is Pro&ect and 'ort$y o% per%orming t$e duties and responsi(ilities

o% suc$) I t$e undersigned) understands t$at Sa%ety is a prime condition o% my employment* "$ere%ore) I agree

to underta+e t$e %ollo'ing:

)# $ will uphold, abide by and consistently enforce the site safety and security rules, re"ulations, policies and

procedures#

*# $ will continually !aintain a ero tolerance for unsafe acts and conditions, and consistently identify and

correct unsafe acts and conditions, and initiate appropriate corrective actions whether concernin" !y own

area and crew or so!eone else+s#

## $ will analye work practices in detail for the purpose of issuin" safe work plans and for the establish!ent of$ will analye work practices in detail for the purpose of issuin" safe work plans and for the establish!ent of

safe work practices#safe work practices#

-# $ will pro!ptly correct all safety deviations and infractions observed by !e and or infor!ed to !e by others#

.# $ will actively participate in the /eekly Area Safety Assess!ents and i!!ediately correct all safety

deviations and infractions found#

0# $ will report all near1!iss incidents, and all in'uries i!!ediately and seek i!!ediate !edical treat!ent of

the in'ured 2whether !y own crew or not3 to the nearest !edical facility on site or area#

4# $ will actively involve !yself in the investi"ation of all near1!iss occurrences, all in'uries, incidents%accidentsin !y work area or other areas when called upon to do so#

5# $ will utilie only trained, co!petent and qualified crew who has under"one safety trainin" or received safety

instructions#

6# $ personally "uarantee and accept responsibility and accountability for the safety and health of !y crew and

the area and of other people who are not under !y direct supervision workin" in !y area and $ will !onitor!onitor

e!ployees+ perfor!ance to ensure the use of safe work practices#e!ployees+ perfor!ance to ensure the use of safe work practices#

S$ould I disregard or %ail to a(ide (y t$e a(ove provisions) I understand t$at my services 'ill (e terminated

immediately 'it$ cause and denied access to t$e Pro&ect site*

Name: Signature:

!mployee No*: Date:

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