MRCA Elite Safety Award Contractor Program

Program Application

Eligibility:
Applicants must be current Midwest Roofing Contractors Association members with a documented safety/risk management program including a formal written safety program.
Confidentiality:
The information in Section 1, and any reference in any part of this application to a specific company, will not be included when the application is judged. All information provided on this application will be kept in strict confidence. MRCA reserves the right to publish any innovative safety ideas from the entries for the good of the industry. However, any company-specific information regarding accident or injury statistics, or any other information identified by the applicant as proprietary, will be kept in confidence by MRCA Legal Counsel as applying to the specific company.
Judging:
Applications will be judged by nationally renowned OSHA/Workers Compensation Attorney, Gary Auman, of the Legal Firm of Auman, Mahan and Furry.
Deadline:
Deadline for entries is August 1st. Winners will be announced at the MRCA Conference and Expo that will be held November 20th-22nd at the Overland Park Convention Center in Overland Park, KS.
Entry Fee:
There is a $500 entry fee to have your safety plan reviewed by MRCA Legal Counsel. You will receive a detailed written critique of the information provided in your application in addition to your award. This evaluation letter is designed specifically to facilitate ongoing safety program improvement for every participating member. You can submit payment online via credit card at the end of this application or you can choose "send payment by mail" and send in payment via check. Applications with outstanding fees will not be submitted for judging.
The $500 application fee must be paid by August 1, 2019 or the APPLICATION WILL BE DISQUALIFIED.
More Information:
Requests for clarification on application questions may be directed to Gary Auman at gwa@amfdayton.com or by calling him at 937-223-6003.

PLEASE NOTE

:Once the online application is started, it must be completed in the same session. Partial applications can not be returned to in a separate session. If session time is a concern, it is recommended that you prepare your answers in advance, and then copy and paste them into the answer fields. You can preview the questions below, and then start a separate session to complete your application later. You can also request a list of questions via email by contacting Morgan Arwood at marwood@mrca.org.
Instructions:
Please complete the following information about your company in order to apply for the MRCA Elite Safety Award. Complete and accurate information will help Legal Counsel in making a determination of your award level, and will likewise assist your company in receiving appropriate consideration.

Section 1: General Information

Company Information

Company
Address
 
City
State Zip
Phone

Applicant Contact Information

First Name
Last Name
Title
E-mail

Section 2: Company Safety Program

Please provide an answer to each question. Please make your responses as complete as possible. All individual questions must be answered directly and specifically.
Please note the following two items:
1. Your application will be judged on the answers that you provide in this application form. If an answer is not provided for a question, then that questions will be scored 0 points.
2. Please do not include anything in your answers that would indicate the identity of your company. The information that you provided in Section 1 will not be included with your application when it is judged. The name of your company will not be given to the judges when your application is reviewed.

Application Questions:

1. Do you have a Distracted Driving/Distracted Working Policy:
 
If you answered yes, please describe your Policy or Program:
 
2. Please describe when and how do you train your new employees and indoctrinate them into your safety program and expectations? Please provide a list of the topics you cover with them during this orientation and describe your orientation program. Also include information on how you continually ensure the level of safety knowledge your employees have every day.
 
3. Please describe your company’s fall protection program. If you use more than one method of fall protection, please describe all methods. Also describe your training protocol for fall protection including general and site-specific/daily inspection and training.
 
4. Do you conduct random job site inspections and safety audits?
 
If you answered yes, please describe who conducts these, how they are conducted, and what they cover.
 
5. Please describe how you comply with the OSHA Requirement for competent persons on each job site.
 
6. Please describe in detail your safety enforcement program.
 
7. Please describe in detail your drug and alcohol-free workplace program.
 
8. If you use a torch on any project for any purpose, are your torch applicators CERTA certified, or trained using an in-house torch applicator safety program?
 
9. Does your company have a PPE hazard assessment, training, and/or audit program?
 
If yes, please explain the program:
 
Upon completion of this application, you should be directed to a confirmation screen stating that your application has been received, and you should also receive a confirmation email. If you do not see these confirmations, then your application was not successfully sent.
By checking the box below, you agree that you understand these confirmation steps, and you agree to pay the $500.00 application fee by the deadline of August 1, 2019:
  I agree
Thank you for participating in the Midwest Roofing Contractors Association's Elite Safety Awards program. All applicants will receive a completely customized and confidential evaluation of their program responses from nationally renowned attorney, Gary Auman. This evaluation letter is designed specifically to facilitate ongoing safety program improvement for every participating member. Recognition awards will be presented at the MRCA Conference and Expo on November 20th-22nd at the Overland Park Convention Center in Overland Park, KS.
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