Andersen Construction EXHIBIT A Subcontract Safety Exhibits Page 1 of 12 04/10
SITE SPECIFIC SAFETY REQUIREMENTS ACKNOWLEDGEMENT Dear Contractor: This acknowledgement must be signed and returned with your contract documents to obtain a fully executed agreement. The remaining requested and attached documents must be completed and provided to the site supervisor at the work location. One copy of the following documents needs to be submitted preferably two to four weeks prior to mobilization to the site supervisor for this project and updated as necessary. Site Specific Safety Checklist (see attached). Hazard Communication Checklist (see attached) complete and return with a copy of the material safety data sheets for products to be used on site. Site Specific Safety Plan with emergency contact information (see last page for guideline) Proof of current, valid drug and alcohol test for site employees (valid meaning the test result was negative and within the past 6 months or in compliance with the Washington Construction Industry Substance Abuse Program) For Washington State Jobsites You must provide a complete copy of your Accident Prevention Program unless already on file. Job Hazard Analysis / Pre-Task Plans must be submitted on an on-going basis as the work dictates. These must be submitted on the project, to the project superintendent or safety supervisor. Pre-task Plans for your work activities and your lower-tiered subcontractors. I,, certify that I am an authorized representative of and acknowledge that the required safety plans will be completed and provided to the project supervisor prior to this organization mobilizing on site. Contractor Acknowledged by: Project Title Reviewed by: Andersen Construction Site Representative Page 2 of 12 04/10
SITE SAFETY INFORMATION Andersen - Safety & Health Department The Remaining documents provided in Exhibit A (as it applies) must be completed and returned to the Andersen Construction site supervisor for the project under which this contract applies prior to beginning your work. The Subcontractor Site Specific Safety Checklist outlines what safety documentation will be expected, if applicable. This should be your cover sheet for your site specific safety plan. The Hazard Communication Checklist should be completed and returned as part of your site specific safety checklist. The purpose of this checklist is to communicate to Andersen Construction any hazardous chemicals you may be using on the project. As you review your Material Safety Data Sheets for this project note the comments in the checklist above the grouped chemicals. This is especially important when working in occupied facilities and healthcare facilities. o If this contract is for a master agreement for which there is yet to be an assigned project and you use the same chemical products for your work activities, keep a completed copy with your safety documentation that covers mobile and short term projects. Job Hazard Analysis / Pre-Task Plan these forms may be used by any subcontractor or you may use your own provided that the same or similar information is reviewed. JHA s / PTP s should be done at the start of new tasks, changes to a task and whenever a change in personnel occurs. For short duration, low risk tasks a JHA / PTP may suffice for the site safety procedures. This JHA format assists with the requirement to conduct a written PPE Hazard Assessment but may not include all PPE requirements for the task. Site Specific Safety Plan Guideline this serves as a guideline for a site specific safety plan. A template is available upon request. Any work hazards identified on the Subcontractor Site Specific Safety Checklist should be included in the Site Specific Safety Plan with the appropriate hazard corrections, safe work practices and personnel protection methods. A JHA / PTP may or may not suffice, dependent upon the magnitude of the work. Washington Jobsites In accordance with WAC 296-800-140, provide a copy of your Accident Prevention Program. If you are a small contractor that conducts multiple projects for Andersen Construction, one copy to be maintained in our Seattle office will suffice unless notified otherwise. If you have questions regarding Andersen Construction s Safety Requirements contact Kimberly Gamble, Corporate Safety and Health Director at our Portland office. Page 3 of 12 04/10
Andersen Construction Co., Inc. Subcontractor Site-Specific Safety Checklist Andersen - Safety & Health Department Company: Phone No.: Project: Site Supervisor: Contact: Fax No.: Start Date: Phone: This checklist is intended as a guide to assist with site specific safety planning. It may not be inclusive of all of the safety hazards associated with your trade, your scope of work, or the applicable site. Each contractor is responsible for adequate site specific safety planning for their workers, which includes communication with other employers working on the same site. When completing a site specific safety plan for Andersen Construction, refer to the front-end documents provided at bid time, and the exhibit "A" attached to your subcontract for guidance on safety rules that may differ slightly from OSHA. All subcontractors PRIOR TO SITE MOBILIZATION must submit the following items. Payment can be withheld for non-compliance. Your Site Specific Safety Plan see last page of this exhibit for an example listing of what a SSSP should contain. Andersen Construction Hazard Communication Checklist Completed AND copies of all Applicable Material Safety Data Sheets available on site, electronically or a contact person for immediate access. This Site Specific Safety Checklist Job Hazard Analysis / Pre-Task Plans (JHA s/ptp s may be an on-going submittal dependent upon scope & duration. You may use your own or the attached form.) Washington Projects a copy of your complete accident prevention program must be submitted or available on the site. If your scope of work includes any of the below listed activities, a work plan must be submitted to the site superintendent for review. Attached is a job hazard analysis form that may be used, if appropriate, to assist with your safety planning. Check Potential Work Hazards: Fall exposures > 6 feet Excavations > 4 feet Confined Space Entry Electrical Hot Work Welding/Cutting (req. permit/watch) Lock out/tag out activities Multi-level Scaffold Erection Multi-level Scaffold Use Steel Erection Mobile Crane(s) Use Asbestos Impact or Abatement Lead Install Sandblasting Traffic Control Structural Demolition Microbial Abatement Interior Spray Finishes Potential Silica Exposure(s) Welding on Stainless Steel Demo of lead containing paint Rotating Equipment Installation of underground power temporary or permanent Work within 10 of overhead utilities Working in Occupied Buildings Working above Others Dust Control/Containment(s) Critical Crane Lift(s) * Working in Client Classified Sensitive Areas Working in a residential structure built prior to 1978 or a child occupied facility built prior to 1978 Chemical(s) Regulated by OSHA/OR-OSHA/DOSH/ or Listed on Andersen Construction Hazard Chemical Checklist Submit a completed copy of this checklist with your site specific safety plan to the site superintendent prior to mobilizing on site. Completed by: Title / Project Role: Page 4 of 12 04/10
HAZARD COMMUNICATION CHECKLIST Contractor: 1. Attach the material safety data sheets for the chemicals to be used on this project. 2. Evaluate your attached material safety data sheets for the following chemicals; identify your products that contain these chemicals. CHEMICAL PRODUCT Examples where chemical product may be found (not a complete list) PRODUCT CONTAINING SUCH CHEMICAL OR PROCESS CREATING THE EXPOSURE USE OSHA Data Yes / No (Attach) BANNED PRODUCTS FOR NEW CONSTRUCTION DO NOT ALLOW! (except lead for shielding / sealing & only under site specific workplan with personnel exposure data and/or protection methods) Asbestos Mastics; roof & ext wall waterproofing; sheet vinyl; acoustical ceilings & plasters; monokote prior to 1987 Lead* (allowed for shielding) Lead lined sheetrock Benzene (other than gasoline) Styrene; phenols;,n, hexane, hexane Solvent based duct sealants; roofing glues (severe fire hazard) THE FOLLOWING PRODUCTS HAVE SUBSTANCE SPECIFIC OSHA REGULATIONS; MONITORING DATA MUST BE SUMBITTED PRIOR TO USE IF THE USE MAKES THE PRODUCT AIRBORNE OR IT IS USED IN LIQUID FORM Cadmium Metals Methylene Chloride or Paint remover Dichloromethane Ethylene Oxide Anti-freeze Formaldehyde Floor glue Methylenedianiline (MDA) Mfg of polyurethane foam; some glues & epoxies Vinyl Chloride Mfg of pvc Inorganic Arsenic Contaminated soils MBOCA (4,4-Methylene bis (2- chloroaniline)) Mfg of plastics; coating in chemical reactions to "set" glues, plastics, and adhesives Coal tar pitch volatiles (creosote) Contaminated soils; wood preservative; roofing; road paving 1,2-dibromo-3-chloropropane Contaminated soil & groundwater; well water near farms Acrylonitrile used to make plastics, synthetic rubber, and acrylic fibers Thiram Used in agriculture; seed protectant
CHEMICAL PRODUCT Examples where chemical product may be found (not a complete list) 1,3-Butadiene production of synthetic rubber; contaminated water near mfg plant Chromates / Hexavalent Chromates found in paints; Stainless steel; portland cement; electroplating; contaminated Chromium (Chromium VI) * see groundwater note below PRODUCT CONTAINING SUCH CHEMICAL OR PROCESS CREATING THE EXPOSURE USE OSHA Data Yes / No (Attach) THE FOLLOWING PRODUCTS MAY CREATE STRONG ODORS & MAY REQUIRE EMPLOYEE MONITORING & PPE SPECIAL PLANNING & VENTILATION MAY BE REQUIRED! Methyl Methacrylate Concrete waterproofing Heptane, Toluene, Xylene, Methyl Ethyl Ketone, Acetone, Naptha, aliphatic or aromatic hydrocarbons ; Petroleum distillates Paint thinner; lacquer thinner; clear spray sealants; mineral spirits; degreasers Oils & lubricants; camp fuel; shoe polish; degreasers; contaminated soils Stonhard waterproofers & floor coatings Isocyanates ; diisocyanates Spray on polyurethane; industrial uses to protect cement, polyureathane foam; spray paints; surface (methylenebis(phenyl isocyanate) (MDI), coatings; resins toluene diisocyanate (TDI)) Roofing Tars WELDING / TORCH CUTTING ON ANY OF THE FOLLOWING TYPES OF METALS OR METALS COATED / CLEANED WITH THE FOLLOWING PRODUCTS MAY REQUIRE SPECIAL PLANNING & VENTILATION Stainless Steel Nickel, chromium, manganese, Cadmium (electrical panels) Lead Painted / primed steel Chlorinated Solvents Paint removers; Zinc (galvanized metals) q-deck Page 6 of 12 04/10
CHEMICAL PRODUCT Examples where chemical product may be found (not a complete list) PRODUCT CONTAINING SUCH CHEMICAL OR PROCESS CREATING THE EXPOSURE USE OSHA Data Yes / No (Attach) THE CREATION OF ANY SILICA DUST, LEAD DUST, BERYLLIUM DUST OR HEXAVALENT CHROMIUM CONTAINING DUSTS REQUIRES CONTROL AND/OR SPECIAL PLANNING & PERSONAL PROTECTION Grinding, crushing, chipping of concrete or other cementitious products Demolation of painted structures built / painted prior to 1980 Silica - Dry Monokote; sandblasting grit; Black Beauty (creates beryllium dust during sandblasting) Demolition of concrete structures REVIEW OF MSDS FOR ANY PRODUCTS WHICH STATE: PRODUCT CAN CAUSE SENSITIZATION OR ALLERGIC REACTIONS OR HYPERSENSITIVITY (such as isocyanates or epoxies) PRODUCT USE SPRAY APPLIED - YES or NO Non Identified Flammable(s) OTHER PRODUCTS WITH SPECIAL CONCERN If any of the above-identified products specified by the plan documents please identify. Attach any personnel exposure monitoring for any of the hazardous products you will be using on this jobsite. *Potential Hexavalent Chromium containing or producing products: Page 7 of 12 04/10
Ammonium Dichromate; Barium Chromate; Tert-Butyl Chromate; Calcium Chromate; Chromium Trioxide; Chromium (VI) ion; Hexavalent Chromium; Lead Chromate; Potassium Chromate; Potassium Dichromate; Silver Chromate; Sodium Chromate; Sodium Dichromate; Strontium Chromate; Zinc Chromate; Zinc Dichromate Page 8 of 12 04/10
Project Name: Contractor: Crew Supervisor Review: Andersen Superintendent Review: Task: JOB HAZARD ANALYSIS / PRE-TASK PLAN Andersen - Safety & Health Department Start Date: End Date: Review Date: Andersen Safety Review: YES NO YES NO Does this task require special training? If yes verify completion Does this task impact traffic or public? Attach traffic or public control plan Does this task require any chemicals? If yes, review MSDS with crew. Attach copy Does this task require an impact to concrete with potential to contain power? If yes locate, lock out If unknown check with supervisor before proceeding submit locate tickets Was this plan conducted at the worksite? If not it needs to be reviewed at the worksite to ensure site conditions are considered. Does this task require special coordination with other trades? Does this task impact egress routes? If yes coordinate with Andersen and/or facilities Is there any potential impact to client operating facilities? If yes remediate potential impact prior to starting work. Is this a child occupied facility older than 1978? If yes, STOP, contact Safety Office. Do site utilities need to be shut down & locked out? If yes, attach lock out / tag out plan ASBESTOS, LEAD & HAZARDOUS MATERIALS PRE-CHECK FOR DEMOLITION ACTIVITIES YES Has the owner provided a hazardous substances survey? If not STOP! Does this work require an impact to potential asbestos containing material? If yes, contact safety office. Does this work impact any painted substrates that are older than 1978? If yes contact safety office. Are there any lead containing sheetrock, shielding, piping etc. to be impacted? If yes, contact safety office. Has demolition checklist been completed? Checklist must be completed prior to demo proceeding PPE & RISK HAZARD ASSESSMENT * Activities that include the following PPE or risks may require safety planning & training documentation beyond what can be completed in a JHA / Pre-Task Plan Fall exposures > 6 feet Excavations > 4 feet Confined Space Entry Electrical Hot Work Welding/Cutting (req. permit/watch) Lock out/tag out activities Multi-level Scaffold Erection Multi-level Scaffold Use Steel Erection Mobile Crane(s) Use Asbestos Impact or Abatement Lead Install Sandblasting Traffic Control Structural Demolition Microbial Abatement Interior Spray Finishes Potential Silica Exposure(s) Welding on Stainless Steel Demo of lead containing paint Rotating Equipment Installation of underground power temporary or permanent Work within 10 of overhead utilities Working in Occupied Buildings Working above Others Dust Control/Containment(s) Critical Crane Lift(s) * Working in Client Classified Sensitive Areas Working in a residential structure built prior to 1978 or a child occupied facility built prior to 1978 Chemical(s) Regulated by OSHA/OR-OSHA/DOSH/ or Listed on Andersen Construction Hazard Chemical Checklist NO PPE& CONTROLS REQUIRED Hardhat Safety Glasses Welding goggles / helmet Special footwear Safety Goggles / faceshield Hearing Protection Gloves material handling Gloves chemical Gloves electrical Arm cut protection Whole body - Dust, chemical, heat Whole body electrical Leg cut protection Respirators (air purifying p100) Respirators (apr chemical) Respirators supplied air Fall Protection High visibility clothing Barricades soft (caution tape) Barricades solid Danger tape & signage
JOB HAZARD ANALYSIS / PRE-TASK PLAN Andersen - Safety & Health Department Task: WORK TASKS HAZARDS (of work, to workers & other trades) MITIGATION MEASURES The tasks for today have been reviewed in the work area they will be performed and the workers on this crew have been through the required training. Supervisor or Task Lead Signature: CREW NAMES SIGN LEGIBLY 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. Attach a second page if necessary Supervisor or Task Lead Phone: Page 10 of 12 04/10
Site Safety Plan Contents Guideline Site Safety Plans should be the first brush to review the work tasks of a project, the expected hazards associated with the work processes and the process the contractor will take to address the hazards in a timely fashion. Site Safety Plans are not finished until the project is finished as they should include work plans developed as the work develops. A blank site safety plan template is available upon request. Completed copy of Andersen Subcontractor Site Specific Safety Checklist o All identified hazards on the site specific safety checklist must be addressed in writing prior to that work activity commencing. Contractor Name, Address, On-site supervisor and contact information Emergency contact information for contractor in case of injury to personnel o Include after hours emergency contact information for on site supervisor(s) Name of contractor safety & claims representative Outline of drug testing program Listing of employees to work on the project and current drug test information (update as necessary) List of lower tier subcontractors to be utilized on the project & method to be used to ensure the lower tier sub obtains required pass down information and who to review their safety plans Scope of work description Expected hazards associated with scope of work Company policies for associated hazards, i.e. respirators expected to be used so brief outline of policy to ensure employees are properly trained and fit tested) Hazard correction / control measures * (detail most often comes in form of pre-task plan or JHA as project progresses) Company absolutes regarding safety, (i.e. Company ABC requires the use of gloves for all handling of sharp sheet metal at all times.) Company accident, near miss and hazard reporting procedures Subcontractor s methods for inspecting their own work areas and processes, how often and how hazards will be corrected o Schedule of inspections o Who to conduct o How often o Who to ensure correction Verification of employee training for those items that require training o Example list of aerial lift trained employees or forklift trained employees MSDS Inventory for project Completed Andersen Hazard Communication Checklist As the project progresses, special work plans such as a site specific fall protection work plan or crane plan, required work permits such as hot work permits,and Job Hazard Analysis (JHA s) or Pre-Task Plans will be required to be submitted. These become a part of the site safety plan files for each subcontractor. Page 11 of 12 04/10
WASHINGTON JOBSITES In addition to the site safety plan contents listed on the previous page, Subcontractors working on a Washington State Jobsite must provide a copy of their Accident Prevention Program in accordance with Washington State Labor & Industries Department of Occupational Safety & Health (DOSH) Accident Prevention Program Requirements. SAMPLE MINIMUM REQUIREMENTS OFAN APP Company Safety Policy Safety Disciplinary Policy First Aid Training and Emergency Procedures General Safety Rules Ladder Safety Rules Trenching and Excavation (if applicable Motorized Vehicles and Equipment Lockout / Tagout Checklist (if applicable) Hazard Communication Program Hearing Conservation Program Confined Space (if applicable) Responsibilities Basic Rules for Accident Investigation Weekly Safety Meetings Personal Protective Equipment Fall Protection Safety Rules Scaffold Safety Rules (if applicable) Fire Prevention and Protection Welding and Cutting Safety rules (if applicable) Respirator Program (if applicable) Heat Stress (Heat Illness) If you will be bringing a crane to any jobsite within the State of Washington, refer to the Construction Crane Rules under 296-155 to ensure compliance with the required regulations. Page 12 of 12 04/10