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ISRI COSE Occupational Awards Entry Form
Please fill out the following information regarding your participation in ISRI Circle of Safety Awards Program.
Deadline: March 31, 2021
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Company Name
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NAICS Code (refer OSHA 300A and definitions on the application)
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Survey Contact (Manager's) Name:
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Email Address:
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Phone Number:
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Number of Establishments Reported (refer to OSHA 300A).
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Total hours worked by all employees (as recorded on OSHA 300A). Do not include vacation, sick leave, holiday pay, or other non-work related time in the calculation.
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Class Category (refer to class categories on the application).
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Annual Maximum Number of Employees (as recorded on OSHA 300A).
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Total number of recordable cases as recorded on OSHA 300 A.
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Total Recordable Incident Rate (TRIR) for 2020 (refer to metrics on the application).
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Experience Modification Rate (EMR) for 2020 refer to definitions on application.
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