DBX 2022 Best Practices in Safety Recognition Program

The Builders Exchange of Dayton “Best Practices in Safety” Recognition Program highlights DBX member companies in good standing that have demonstrated a commitment to improving jobsite safety through development, implementation, and enforcement of a formal safety and risk management program.
This program is more than an award program and companies are not in competition with other companies. The program is designed to not only recognize you for your commitment to safety, but to also provide you with an in-depth evaluation of your safety program by an industry professional. Because of the unique nature of this award, you can use it effectively with your clients, insurance company and even OSHA.
Eligibility:
Applicant must be a current Builders Exchange member company in good standing with a documented safety/risk management program including a formal written safety program.
Confidentiality:
The information in Section 1 of this application, and any reference in any part of this application to a specific company, will not be included with the application when the submissions are judged. All information provided on this application will be kept in strict confidence. DBX reserves the right to publish any innovative safety ideas from the submissions 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 strict confidence.
Judging:
Applications will be judged anonymously by an industry panel headed up by nationally renowned OSHA/Workers Compensation Attorney, Gary Auman, of Auman, Mahan and Furry.
Deadline:
Deadline for entries is July 15, 2022. Winners will be announced during Team Building Night on August 11, 2022.
Entry Fee:
There is a $350 entry fee to have your safety plan reviewed by Gary Auman. In return, you will receive a detailed, written critique of the information provided with your application. This evaluation letter is designed specifically to facilitate ongoing safety program improvement for every participating member. The entry fee also includes a complimentary registration to Team Building Night. 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 $350 application fee must be paid by July 31, 2022 or the APPLICATION WILL BE DISQUALIFIED.
More Information:
Questions about the application may be directed to Gary Auman at gwa@amfdayton.com or by calling him at 937-223-6003.

PLEASE NOTE!

This online form does not have a save function that allows you to come back to a partially completed application. We strongly advise that you construct your answers in a separate Word document that you can copy and paste from into this online application. If your application session exceeds 4 hours or if you are navigating multiple internet browser pages during your session, you may be at risk of losing your application. PLEASE save your answers in a separate document so that if you do experience any internet issues, you can still retrieve your answers for submittal.
Instructions:
Please complete the following information about your company. Complete and accurate information will help the judging process and will likewise assist your company in receiving appropriate consideration. DO NOT SUBMIT YOUR ENTIRE COMPANY SAFETY PROGRAM. YOUR APPLICATION WILL BE REJECTED.

Section 1: General Information

Company Name
Contact Name
Address
 
City State Zip
Phone
Email
Please check one:
Small Company (less than 100,000 man hours)
Medium Company (100,001 - 500,000 man hours)
Large Company (more than 500,001 man hours)
Does your Company have a formal written safety program?
What is your:
Experience Modification Rate (EMR):
Lost Time Rate:
Total Recordable Injury Rate (TRIR):
Restricted Duty Rate:

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 do not include anything in your answers that would indicate the identity of your company. The name of your company will not be given when your application is reviewed. DO NOT SUBMIT YOUR ENTIRE SAFETY PROGRAM! YOUR APPLICATION WILL BE REJECTED!
Application Questions:
1. Do you have a Distracted Driving and Distracted Working Policy:
 
If Yes, please describe each policy in detail:
 
2. When and how do you train your new employees and indoctrinate them into your safety program and company 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 comprehensive recordkeeping program. Include ALL records you maintain in connection with safety including injury recordkeeping, training recordkeeping, and disciplinary recordkeeping with regard to safety program violations.
 
4. Please describe how you comply with the OSHA requirement for competent persons on each job site?
 
5. Please describe in detail your safety enforcement program?
 
6. Does your company have a PPE hazard assessment, training, and/or audit program?
 
If yes, please explain the program:
 
7. Do you have a substance abuse program?
 
If yes, please describe it:
 
8. Does your company have a formal Heat and Cold Illness Prevention Program?
 
If so, please describe these programs:
 
9. Do you conduct random job site inspections and safety audits?
 
If yes, who conducts these? How are they conducted, and what do they cover?:
 
10. Does your company have an Emergency Action Plan including first-aid, communication, and evacuation?
 
If yes, how do you communicate this program to your employees in the field and how are they trained on the procedures?:
 

Section 3: For Informational Use and Bonus Questions:

The questions in this section will be used for informational purposes only, and may count as bonus points towards your overall score.
11. Do you feel you do anything innovative in your safety program - anything unique or not typical of industry standard practices? If so, please explain the practice and its benefit to your company.
 
12. What is your greatest risk as a Contractor and how do you mitigate that?
 
All applications will be graded and recognition will be awarded at a Platinum, Gold, Silver, Bronze, or Participant level. Each applicant will be judged anonymously and will receive a letter critiquing their program from Gary Auman. All participants will receive a certificate and those receiving Bronze, Silver, Gold, or Platinum awards will receive recognition during Team Building Night on August 11, 2022.
By checking the box below, you agree that everything submitted in this application is true to the best of your knowledge, and that you agree to pay the $350.00 application fee by the deadline of July 31, 2022:
  I agree
If you have a valid promo code, please enter it below:
   - denotes required fields