akGSHC Alaska Governor's Safety Award of Excellence

Safety Award of Excellence

Alaska Governor's Safety & Health Conference
The Governor’s Safety Award of Excellence is presented to organizations demonstrating distinction in safety and health of their personnel, the environment, assets and reputation that demonstrate and promote superior corporate citizenship. Large and small organizations that have excelled in safety and health are encouraged to apply.

A group may be defined as a company, corporation, government entity, non-profit, or other entity. Groups may submit nominations for smaller business units such as an operating unit, a division, a regional office, a department, etc., or as an organization-wide basis.
Eligibility Criteria
- The highest-ranking officer of the applicant organization is required to certify eligibility on behalf of the organization.
- Organizations must have three years of data to qualify for this award.
- Organizations applying for an award must provide all the relevant information requested in the application.
Companies that perform work regulated by someone other than the department of Alaska Occupational Safety and Health (AKOSH) are encouraged to apply. These may include oversight by those such as MSHA, DOT, US Coast Guard, etc.

Documentation
Except as described above for entities not governed by 29 CFR 1904, Recordkeeping; applications must include 2020, 2021, and 2022 OSHA Form 300 Log of Work-Related Injuries and Illnesses and OSHA’s Form 300A Summary of Work-Related Injuries and Illnesses.

Organizations should obscure all personal information from Form 300 and any submitted injury/illness information included in this application. If they do not possess OSH Logs, they must provide the equivalent injury/illness information as described above.

Violations
Any group submitting a nomination with serious, willful, or repeat violations issued by a State or federal regulatory agency is not eligible for an award in the year the violation was issued or in the year in which there are outstanding violations. This will be verified by AKOSH.

Corporate Citizenship
The State of Alaska will review the application and ensure the submitting organization is a good corporate citizen regarding the environment, legal, and labor activities.

Work Description
Applicants must provide a short description of the work they perform.

NAICS Codes
Organizations must have a Total Recordable Incident Rate (TRIR) no greater than 90% of their NAICS classification and are eligible for the award when the TRIR is no greater than 90% of the published rate for the last three years.

Continued Excellence and/or Continuous Improvement
The application must show three years of excellence in maintaining and/or improving the safety and health of their personnel, the environment, their assets, and the organization’s reputation.

Results may be measured as a reduction in frequency and severity (reduction in lost workday injuries or days, reduced number of recordable injuries, reduction in workers' compensation claim costs, reduced environmental impacts, etc...).

Safety, Risk, and Environment
Applicants must discuss how their safety and/or risk programs have enabled them to be successful and continually improve. Short examples of the program referenced must be submitted with the application (ie: Hazard Identification, Job Hazard Analysis, behavior-based safety, Training Program, etc).

Applicants should provide evidence by at least one example of reduced risk to the employee and/or environment through risk reduction techniques such as through design, engineering out a hazard, use of administrative controls or the use of PPE.

Safety Award of Excellence

For questions, please contact Chris Warner at 907-339-6420
Applicant Information
Name*

First NameLast Name
Affiliation to Company*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.

Safety Award of Excellence

For questions, please contact Chris Warner at 907-339-6420
Safety Performance, Injury/Illness Metrics
This table describes how to calculate the numbers required in the application.

If the organization does not track its rates and is not required to do so per OSHA regulations (usually due to size or industry code), it should submit actual numbers of incidents per manhour.

Injury and Illness Metrics Table*

	2020	2021	2022
Total Work Hours
Average Number of Employees
Number of Recordable Injury & Illness Cases
Number of Days Away/ Restricted/Transfer Cases
Total Recordable Incident Rate (TRIR)
Number of Days Away/ Restricted/Transfer Rate
Severity Rate
EMR
NAICS Rate from BLS
% Above or Below NAICS
Environmental incidents

Injury/Environmental Investigation and Corrective Action

If your organization experienced injuries or environmental incidents, be prepared to provide additional information on the injuries that summarize the type, quantity and severity by year. This includes providing the identified causal factors and the mitigations and corrective actions that were put in place to mitigate future occurrences.

	Date Occurred	Type of Injury/ Incident	Severity	Causes	Corrective Action
1
2
3
4
5

Additional Comments
Safety Improvement Discussion: Briefly describe how your organization demonstrated excellence during all three years. Specifically identify what programs or processes made you successful. Results may be measured as a reduction in frequency and severity (reduction in lost workday injuries or days, reduced number of recordable injuries, reduction in workers compensation claim costs, etc.)*
Pandemic Response: Describe any unique or specific measures your organization put in place to address the COVID-19 pandemic and employee safety, aside from mask usage, social distancing, and working remotely.*
Professional Development: Explain how your organization encourages those employees responsible for health and safety guidance to pursue professional development and increase their skills and knowledge.*
Examples can include: encouraging and allowing participation (during company time) in volunteerism for health and safety related organizations, supporting attendance at conferences (remote or in person) that grant CEUs, encouraging and reimbursing for nationally accredited credentials such as issued by BCSP or other originations, or participation in nationally recognized H&S organizations such as ASSP or ABIH, etc.
Management Commitment: Describe how management provides visible leadership in implementing the safety, environmental and health programs. Describe how these programs fit into the overall organization.*
Employee Commitment: Describe at least three ways employees are involved in the safety and health process.*
Safety Professional/Department Commitment: Describe how your safety professional or department provides visible leadership in managing the organization’s safety programs. Describe how the safety department reports to management on new safety initiatives and emerging issues.*
Health Safety and Environmental Programs / Methods of Risk Control: Describe how the health, safety, environmental and risk programs have enabled success and continuous improvement. Describe at least one example of reduced risk to the employee and/or the environment through risk reduction techniques such as engineering out a hazard.*
Health, Safety and Environmental Focus: Describe the organization's health, safety and environmental focuses.*

The information provided in this nomination is correct to the best of my knowledge.
Signature*

Clear
Date of application completion*

MonthDayYear
Date
The person submitting and signing the nomination attests that all material submitted is correct to the best of their knowledge.
Should be Empty: