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Subcontractor/Vendor Safety Program Evaluation & Pre-Qualification Application

Home > Workplace Safety > Subcontractor/Vendor Safety Program Evaluation & Pre-Qualification Application

Thank you for your interest in working with Thompson Electric, Inc. If you have worked for us in the past, you will still need to submit this application for consideration of your renewal as a subcontractor of Thompson Electric, Inc. If you utilize any second- or third-tier subcontractors, they will also need to submit this form for review and approval. Failure to do so could result in removal of their presence from our work sites.

The content of this application will be considered confidential and used solely to determine your firm’s qualifications. No purchase order and/or contract will be issued without an approved Safety Program Evaluation. Failure to complete this application in its entirety will result in your company’s name being removed from our list of approved providers.

Please Note:

  • Incomplete EH&S applications will not be processed.
  • You may not save your information and come back to the application at a later time. Please double check that you have the required information (below) ready before starting the application.
  • The person completing this application is preferably the company Safety Director, but can also be completed by another member of your Safety Department or by Management.

Before You Proceed: Check Required Information

This form will require the following information and supporting documentation:

  • Workers’ Compensation EMR - We require independent verification of your EMR.
    Please attach a copy of:

    • The endorsement page from your policy listing your EMR,
    • A copy of the EMR Report from the Ohio BWC (this can be downloaded from their website), and/or
    • Have your insurance carrier or broker provide this information on their letterhead.
  • Safety Performance - If your company is required to follow OSHA Recordkeeping Requirements, please provide your organization’s injury and illness data for the last three years.
  • Fines/Citations/Legal Actions (+ supporting documentation)
  • Third-Party Contractor Safety Evaluation Programs - If you are a registered contractor under IS Networld, Avetta, Vero or any other third-party contractor safety program evaluation, you will be required to list your account number and provide a copy of your Safety Improvement Plan (if registered with Vero).
  • Subcontractors - All Tiered Subcontractors must have completed this paperwork and have been approved by the TEI Safety Department.
  • Drug & Alcohol Testing - You will be required to provide information about your organization’s drug and alcohol program, if applicable.
  • Safety Staff Information (+ resumes or CVs)
  • Health & Safety Program (+ supporting documentation) - If your organization has a written safety program or manual, please attach a copy of the “Table of Contents” page.
  • Accident/Incident Reporting, Investigation & Injury Management - You will be required to provide information about your organization’s process for immediate reporting, investigating and follow-up of incidents, near misses, equipment damage and occupational injuries.
  • Workforce, Health & Safety Training (+ supporting documentation)
    • Site Safety Audit Form
    • Pre-Job Analysis Form
    • New Hire Orientation or SSE Employee process
    • Most recent copy of a documented employee safety training session
  • Other Supporting Documentation
    • COVID-19 Response Written Policy

 

Questions about the required information and documentation? Please contact administration at (330) 686-2300 ext. 3046.

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