This form is for example purposes only. Completing this form alone will not necessarily put you in compliance with the legislation. It is important and necessary that you customize this document to meet the unique circumstances of your work site. Further, it is essential that this document is not only completed, but is used, communicated, and implemented in accordance with the legislation. The Crown, its agents, employees, contractors or content contributors will not be liable to you for any damages, direct or indirect, arising out of your use of this form.