CONTRACTOR DAILY STATISTICS AND INSPECTION REPORT

NORDIC
CONTRACTOR DAILY STATISICS AND INSPECTION REPORT
It is the responsibility of the Contractor to submit this Daily Report by 9:00am the following work day. Failure to submit Daily Reports in a timely manner may result in delayed progress payment(s
CONTRACTOR NAME: *
PROJECT: *
DAILY CONSTRUCTION ACTIVITIES
DATE*

YearMonthDay
Date
ENTER YOUR COMPANIES DAILY ACTIVITES HERE:*
TOTAL # OF WORKERS ONSITE*
TOTAL NUMBER HOURS WORKED*
TIER SUB/TRADE COMPANY NAME
TOTAL # OF WORKERS ONSITE FOR TIER SUB/TRADE COMPANY
TOTAL NUMBER HOURS WORKED FOR TIER SUB/TRADE COMPANY
INCIDENT REPORTING SECTION
TYPE OF INCIDENT*

Near MissMedical OnlyLost TimeEquipment DamageFirst Aid3rd PartyModifiedProperty DamageNo Issues to note
Time
Nordic PCL notified

YesNo
Who was involved
What occurred
DAILY INSPECTION
CONDUCTED BY
TIME
AREA/SCOPE OF WORK
TRADE/SUB CONTRACTORS IN AREA DURING INSPECTION
1.
2.
3.
HAZARDS IDENTIFIED
HAZARDS IDENTIFIED
CORRECTIVE ACTIONS
CORRECTED BY
PRINT YOUR NAME*
SIGNATURE*
Should be Empty:

NORDIC