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:
*
Please Select
NPCL
MH ELec
PROJECT:
*
DATE:
*
/
Year
/
Month
Day
Date
DAILY CONSTRUCTION ACTIVITIES:
*
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 Miss
Medical Only
Lost Time
Equipment Damage
First Aid
3rd Party
Modified
Property Damage
No Issues to note
TIME:
Hour Minutes
AM
PM
AM/PM Option
NORDIC PCL NOTIFIED?
Yes
No
WHO WAS INVOLVED?
WHAT OCCURRED?
DAILY INSPECTION SECTION
CONDUCTED BY:
TIME:
Hour Minutes
AM
PM
AM/PM Option
AREA/SCOPE OF WORK:
TRADE/SUB CONTRACTORS IN AREA DURING INSPECTION:
1.
2.
3.
HAZARDS IDENTIFIED:
CORRECTIVE ACTION:
CORRECTED BY:
PRINT YOUR NAME:
*
SIGNATURE:
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