National AGC Safety Awards

Company
Your Name
Your Title
State
   
     Please report the following from your OSHA Form 300A

 Section (G) “Fatality Information”; Number of Fatalities:

 Section (H) “Cases with Days Away from Work”; Number of Cases:

 Section (I) “Cases with Job Transfer or Restriction”; Number of Cases:

 Section (J) “Other Recordable Cases”; and Number of Cases:

 Employment Information Section for your company work hours. TotalCompany work hours:

                   Total Business
%  Building
%  Industrial
%  Highway
%  Residential
%  Other:

 What role(s), initiatives, or programs would you like to see AGC of DC pursue in safety education or training in the future? 

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