MB Electrical- EllisDon Form F

MB Electrical- EllisDon Form F

EllisDon SUBCONTRACTOR WEEKLY SUMMARY – FORM F
Please complete this form and submit it with your weekly documentation.
Company Name
Project Name
Date Submitted

MonthDayYear
Date
Week Ending

MonthDayYear
Date
Days on the Project
Check and submit the following:
Submissions
# Pre-Job Hazard Assessments
# Orientations Conducted
# Total Personnel on Site (including management, staff & workers)
Person hours worked this week (average # of personnel daily x 40 hours)
Name (s) of First Aiders
Names of Supervisors (Foreperson) on Site:
Hold Ctrl to select multiple names
Additional Information Reports must be submitted to EllisDon within 24 hours
Disciplinary Actions:
Warnings
Suspensions
Incidents:
Lost Time
Medical Treatment
Restricted Work
First Aid
Near Miss
Damage
List of all "Sub" Sub contractors
1.
2.
3.
Comments
Form Completed By
Email
example@example.com
Should be Empty: