A C C A S A F E T Y E X C E L L E N C E A W A R D
ACCA SAFETY EXCELLENCE AWARD
Invitation T
he Air Conditioning Contractors of America believe that a primary focus of the HVAC industry must be the safety of our member companies’ employees. ACCA is committed to the promotion of safer workplace environments among our members and our industry. Some members do an exemplary job of creating a culture of safety within their organizations. ACCA would like to honor these contractor members for their efforts in safety. ACCA created the Safety Excellence Award (SEA), sponsored by Federated Insurance, as a way to recognize the premier member companies that have made a significant commitment to safety as an integral part of their company’s philosophy. These companies have implemented safety programs designed to protect their employees and the public while reducing their annual workers compensation rates and the costs related to accidents. Any ACCA member may apply for the ACCA Safety Excellence Award regardless of size. The honor associated with receiving this award is priceless. This award has been divided into three categories designed to provide an opportunity for contractors. The categories are: 1-10 employees; 11-50 employees; and More than 50 employees. The ACCA Safety Committee congratulates all applicants who have expressed an interest in this prestigious award by completing the required application and submitting it along with associated documentation. We wish you the best of luck in competing for this award. Sincerely, The members of the ACCA Safety Committee
sponsored by:
ACCA SAFETY EXC EL L ENC E AWAR D
GUIDELINES NAME Award will be referred to as the “ACCA Safety Excellence Award” (ACCA SEA), sponsored by Federated Insurance.
OBJECTIVE The ACCA Safety Excellence Award was created to recognize HVAC contractors who have developed and implemented excellent safety and loss prevention programs, and have consequently achieved excellent safety measures within their company.
AWARD STRUCTURE The ACCA Safety Excellence Award has been divided into 3 award categories based on contractor’s employee size in order to allow for equal competition between contractors of different sizes. ACCA Safety Excellence Award: Category 1: 1-10 employees Category 2: 11-50 employees Category 3: More than 50 employees
QUALIFICATIONS In order to be eligible for consideration of the ACCA Safety Excellence Award in one of the 3 categories, an applicant is required to:
7. Applicants with more than 10 employees must demonstrate that they have an OSHA Incident Rate (OIR) for the prior year that is less than the OSHA National Average Incident Rate published in 2015. 8. Applicant must submit a letter of 250 words or less, stating why they believe that they are deserving of receiving the ACCA Safety Excellence Award, and how they feel it would benefit their company to continue to maintain an excellent safety record.
APPLICATION PROCESS An application for the ACCA Safety Excellence Award may be downloaded from the ACCA website or requested from ACCA. Complete the application and submit it along with the required documentation. All applications become property of ACCA and will not be returned. Applications and information contained in such applications, as well as supporting documents will be viewed only by ACCA personnel, ACCA Safety Committee members, and judges. All information will be kept confidential. Any company-specific information submitted will not be used for any other purpose other than to determine ACCA Safety Excellence Award recipients, and will not be divulged to the public.
APPLICATION DEADLINES Applications must be submitted and received by the ACCA by midnight September 30, 2016.
• Be a member of ACCA in good standing • Meet the specified application criteria
JUDGING
• Submit the required application and documentation
APPLICATION REQUIREMENTS
Judging will be conducted by the ACCA Safety Committee and invited judges. All decisions from the judges will be final. Results are confidential and the selection process will not be shared outside of the judging team. All applicants will be judged individually, based on the quality and compelling story of the submitted letter.
1. Applicant must be a member of ACCA in good standing.
ANNOUNCEMENT
Member companies of the ACCA Safety Committee and those involved in the judging process are not eligible to apply for this award.
2. Applicant must have a designated person or committee charged with the task of overseeing safety related issues and policies within the company.
Recipients will be announced at The IE3 Show 2017, March 20 - 22, 2017, in Nashville, TN.
3. Applicant must have a current printed “Safety Policy” in place and distributed to all employees.
Please submit the completed application form and documentation to ACCA. Mail: ACCA, 2800 South Shirlington Rd., Suite 300, Arlington, VA 22206 E-mail: [email protected]
4. Applicant must conduct regularly scheduled and documented safety meetings for employees. 5. Applicant must have received a Workman’s Compensation experience modification rate of less than 1.0 for the prior year. 6. Applicant must have no unresolved safety related OSHA violations.
SUBMISSION
QUESTIONS Contact ACCA's Director of Government Relations E-mail: [email protected]
ACCA SAFETY EXC EL L ENC E AWAR D
APPL ICATION In order to apply for the ACCA Safety Excellence Award, sponsored by Federated Insurance, please complete and return this questionnaire along with supporting documents as requested below.
Y
N
Does your company have any unresolved safety related OSHA violations?
If yes, please explain: ________________________________________________ ________________________________________________
One award winner will be chosen in each of 3 categories consisting of: ACCA Safety Excellence Award: Category 1: 1-10 employees Category 2: 11-50 employees Category 2: More than 50 employees Please be sure that all documentation is included with the application! Missing documentation will disqualify an application from consideration. Date ___________________________________________ Company Name__________________________________ Contact Person __________________________________ Title ____________________________________________ Address_________________________________________ City ____________________________________________
What was your company’s Workman’s Compensation Experience Modification Rate (EMR) for the 2015 fiscal year? ______________________ (Your EMR or Mod Factor can be obtained by contacting your workers’ compensation insurance carrier) # of Employees as of 01-01-16: _____________________ If you claimed more than 10 employees in the question above, please submit a copy of the 2015 OSHA Form 300A (“Summary of Work-Related Injuries and Illnesses”). If you claimed 10 or less employees and you completed the OSHA Form 300A, you may submit a copy if you wish. If you submitted the 2015 OSHA FORM 300A above, please provide the following information: G. Total number of DEATHS (line G on the OSHA 300A) _____________________
State______________________ Zip Code_____________
H. Total number of CASES with days away from work (line H on the OSHA 300A) _____________________
Phone _________________________________________
I.
Total number of CASES with job transfer/restriction (line I on the OSHA 300A) ______________________
J.
Total number of OTHER RECORDABLE CASES (line J on the OSHA 300A)_______________________
Fax_____________________________________________ Email ___________________________________________ Select One: Y
N
Is your company an ACCA member in good standing?
Y
N
Do you have an individual overseeing safety? Safety Director’s Name: ___________________________________________
Y
N
Does your company have a written Safety Policy in place?
Please submit a copy of your safety policy table of contents or a sampling of a few pages from your policy along with the application as proof of a written policy. Y
N
Does your company conduct regularly scheduled safety meetings for employees?
Samples of your safety meeting sign-in sheets may be submitted as proof, but are not a requirement.
K. Total hours worked by all employees (as entered in your OSHA 300A)__________________ Please calculate your Incidence rate based on the data provided above: Incidence Rate: ( [G+H+I+J] x 200,000 ) / K = __________ Please submit a letter of 250 words or less, stating why you believe that your company deserves the honor of receiving the ACCA Safety Excellence Award in Category 1, 2, or 3; and how you feel it would help your company in maintaining an excellent safety record. I hereby confirm that the information provided is true and correct to the best of my knowledge. Print Name _______________________________________ Signature ________________________________________ Date ____________________________________________
Invitation T
he Air Conditioning Contractors of America believe that a primary focus of the HVAC industry must be the safety of our member companies’ employees. ACCA is committed to the promotion of safer workplace environments among our members and our industry. Some members do an exemplary job of creating a culture of safety within their organizations. ACCA would like to honor these contractor members for their efforts in safety. ACCA created the Safety Excellence Award (SEA), sponsored by Federated Insurance, as a way to recognize the premier member companies that have made a significant commitment to safety as an integral part of their company’s philosophy. These companies have implemented safety programs designed to protect their employees and the public while reducing their annual workers compensation rates and the costs related to accidents. Any ACCA member may apply for the ACCA Safety Excellence Award regardless of size. The honor associated with receiving this award is priceless. This award has been divided into three categories designed to provide an opportunity for contractors. The categories are: 1-10 employees; 11-50 employees; and More than 50 employees. The ACCA Safety Committee congratulates all applicants who have expressed an interest in this prestigious award by completing the required application and submitting it along with associated documentation. We wish you the best of luck in competing for this award. Sincerely, The members of the ACCA Safety Committee
sponsored by:
ACCA SAFETY EXC EL L ENC E AWAR D
GUIDELINES NAME Award will be referred to as the “ACCA Safety Excellence Award” (ACCA SEA), sponsored by Federated Insurance.
OBJECTIVE The ACCA Safety Excellence Award was created to recognize HVAC contractors who have developed and implemented excellent safety and loss prevention programs, and have consequently achieved excellent safety measures within their company.
AWARD STRUCTURE The ACCA Safety Excellence Award has been divided into 3 award categories based on contractor’s employee size in order to allow for equal competition between contractors of different sizes. ACCA Safety Excellence Award: Category 1: 1-10 employees Category 2: 11-50 employees Category 3: More than 50 employees
QUALIFICATIONS In order to be eligible for consideration of the ACCA Safety Excellence Award in one of the 3 categories, an applicant is required to:
7. Applicants with more than 10 employees must demonstrate that they have an OSHA Incident Rate (OIR) for the prior year that is less than the OSHA National Average Incident Rate published in 2015. 8. Applicant must submit a letter of 250 words or less, stating why they believe that they are deserving of receiving the ACCA Safety Excellence Award, and how they feel it would benefit their company to continue to maintain an excellent safety record.
APPLICATION PROCESS An application for the ACCA Safety Excellence Award may be downloaded from the ACCA website or requested from ACCA. Complete the application and submit it along with the required documentation. All applications become property of ACCA and will not be returned. Applications and information contained in such applications, as well as supporting documents will be viewed only by ACCA personnel, ACCA Safety Committee members, and judges. All information will be kept confidential. Any company-specific information submitted will not be used for any other purpose other than to determine ACCA Safety Excellence Award recipients, and will not be divulged to the public.
APPLICATION DEADLINES Applications must be submitted and received by the ACCA by midnight September 30, 2016.
• Be a member of ACCA in good standing • Meet the specified application criteria
JUDGING
• Submit the required application and documentation
APPLICATION REQUIREMENTS
Judging will be conducted by the ACCA Safety Committee and invited judges. All decisions from the judges will be final. Results are confidential and the selection process will not be shared outside of the judging team. All applicants will be judged individually, based on the quality and compelling story of the submitted letter.
1. Applicant must be a member of ACCA in good standing.
ANNOUNCEMENT
Member companies of the ACCA Safety Committee and those involved in the judging process are not eligible to apply for this award.
2. Applicant must have a designated person or committee charged with the task of overseeing safety related issues and policies within the company.
Recipients will be announced at The IE3 Show 2017, March 20 - 22, 2017, in Nashville, TN.
3. Applicant must have a current printed “Safety Policy” in place and distributed to all employees.
Please submit the completed application form and documentation to ACCA. Mail: ACCA, 2800 South Shirlington Rd., Suite 300, Arlington, VA 22206 E-mail: [email protected]
4. Applicant must conduct regularly scheduled and documented safety meetings for employees. 5. Applicant must have received a Workman’s Compensation experience modification rate of less than 1.0 for the prior year. 6. Applicant must have no unresolved safety related OSHA violations.
SUBMISSION
QUESTIONS Contact ACCA's Director of Government Relations E-mail: [email protected]
ACCA SAFETY EXC EL L ENC E AWAR D
APPL ICATION In order to apply for the ACCA Safety Excellence Award, sponsored by Federated Insurance, please complete and return this questionnaire along with supporting documents as requested below.
Y
N
Does your company have any unresolved safety related OSHA violations?
If yes, please explain: ________________________________________________ ________________________________________________
One award winner will be chosen in each of 3 categories consisting of: ACCA Safety Excellence Award: Category 1: 1-10 employees Category 2: 11-50 employees Category 2: More than 50 employees Please be sure that all documentation is included with the application! Missing documentation will disqualify an application from consideration. Date ___________________________________________ Company Name__________________________________ Contact Person __________________________________ Title ____________________________________________ Address_________________________________________ City ____________________________________________
What was your company’s Workman’s Compensation Experience Modification Rate (EMR) for the 2015 fiscal year? ______________________ (Your EMR or Mod Factor can be obtained by contacting your workers’ compensation insurance carrier) # of Employees as of 01-01-16: _____________________ If you claimed more than 10 employees in the question above, please submit a copy of the 2015 OSHA Form 300A (“Summary of Work-Related Injuries and Illnesses”). If you claimed 10 or less employees and you completed the OSHA Form 300A, you may submit a copy if you wish. If you submitted the 2015 OSHA FORM 300A above, please provide the following information: G. Total number of DEATHS (line G on the OSHA 300A) _____________________
State______________________ Zip Code_____________
H. Total number of CASES with days away from work (line H on the OSHA 300A) _____________________
Phone _________________________________________
I.
Total number of CASES with job transfer/restriction (line I on the OSHA 300A) ______________________
J.
Total number of OTHER RECORDABLE CASES (line J on the OSHA 300A)_______________________
Fax_____________________________________________ Email ___________________________________________ Select One: Y
N
Is your company an ACCA member in good standing?
Y
N
Do you have an individual overseeing safety? Safety Director’s Name: ___________________________________________
Y
N
Does your company have a written Safety Policy in place?
Please submit a copy of your safety policy table of contents or a sampling of a few pages from your policy along with the application as proof of a written policy. Y
N
Does your company conduct regularly scheduled safety meetings for employees?
Samples of your safety meeting sign-in sheets may be submitted as proof, but are not a requirement.
K. Total hours worked by all employees (as entered in your OSHA 300A)__________________ Please calculate your Incidence rate based on the data provided above: Incidence Rate: ( [G+H+I+J] x 200,000 ) / K = __________ Please submit a letter of 250 words or less, stating why you believe that your company deserves the honor of receiving the ACCA Safety Excellence Award in Category 1, 2, or 3; and how you feel it would help your company in maintaining an excellent safety record. I hereby confirm that the information provided is true and correct to the best of my knowledge. Print Name _______________________________________ Signature ________________________________________ Date ____________________________________________
