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Customization Form Page
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COMPANY SPECIFIC DETAILS
Company Legal Name
*
Common Company Name
*
Address
*
Address Line 1
Address Line 2
City
State / Province / Region
Postal Code
Phone
Name of Most Senior Management/Owner of Company
*
First
Last
NOTE: (Most Senior Management/Owner who will be signing the policies)
Upload Company Logo
Click or drag files to this area to upload.
You can upload up to 2 files.
Company Contact Person (for this order)
*
First
Last
Email
*
Phone Number
Industry
Farming
Forestry & Logging
General Services
Manufacturing
Electrical
Plumbing & Heating
Oil & Gas Production
Oil & Gas Service Providers
Property Management
Real Estate
Retail
Seniors Services
Trucking (NSC - Federal)
Trucking (NSC-Provincial)
Trucking (Light Duty)
Details of Products/Services offered
What areas do you serve?
*
Alberta
British Columbia
Canadian Federal
Manitoba
New Brunswick
Newfoundland & Labrador
North West Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Saskatchewan
Yukon
Number of Employees
*
(If applicable)
Number of Drivers (if registered under National Safety Code for vehicles over 4500kgs)
(If applicable)
Number of Subcontractors - enter 0 if you do not use subcontractors
*
(If applicable)
Please Upload a company schematic showing levels in company and employee positions in each level.
Click or drag a file to this area to upload.
SAFETY PROGRAM SPECIFIC
What service(s) do you need a safety program for?
*
COR
SECOR
ISNetworld
Complyworks
DOT (Commercial Transportation)
Avetta (formerly PICS)
Canqual
ContractorChek
Browz
Customer Requested
Other
If Other please enter information (website)
Log In details for Services Above
If COR/SECOR Name Certifying Partner
Original Safety Program was been created on:
*
Your Original Safety Program was been created on:
MM
1
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1
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31
YYYY
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
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2002
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1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
How many revisions have been completed so far - revision #
Privacy Officer Name
*
First
Last
NOTE: This is the person who is responsible to make sure that all of the employees records are kept confidential & locked up.
Which worksites do your company employees work in
Office
Shop
Warehouse
Remote Worksites
Other
Explain other:
NOTE: Is it a home office or public? What is completed in the shop? Do you have a mechanic or use outside service provider?
List Type of Equipment / Machines Used
eg. cats, hoes, buggies, welders, etc.
COR Safety Program Sections
Leadership & Commitment
Health & Safety Policy
Roles & Responsibilities
Discipline Policy
Company Rules
Drug & Alcohol Program (Impairment)
Legislation
Hazard ID, Risk Assessment & Controls
Workplace Inspections
Preventative Maintenance
Job Competency (Orientation & Training)
Personal Protective Equipment (PPE)
Emergency Response
Incident Investigations
Program Administration (Statistics & Recording)
First Aid
WHMIS
Workplace Harassment & Violence
The sections above are required and included in every safety manual except where indicated (There are exceptions eg. owner operator does not need discipline policy)
Safe Work & Best Practices & Procedures. Check all that may apply to your company requirements. (If you have entered ISN, COMPLYWORKS login details you can skip this section)
Asbestos
Audit Performance Review
Behavior Based Safety
Basic Health and Safety Awareness Training - ON
Benzene and Benzene Awareness
Cadmium
Chemical Biological Hazards
Commercial Transportation (NSC)
Concrete Masonry Construction
Confined Space
Cranes, Hoists & Lifting Devices
Demolition
Electrical Safety
Electrical Equip Grounding Assurance
Electrical Utilities
Electrical Utility Proximity Awareness
Emergency Preparedness & Response
Enviro – Erosion And Sediment Control
Enviro – General Waste Management
Enviro – Spill Prevention & Response
Environ – Sustainability
Enviro – Wastewater
Ergonomics/Manual Material Handling
Fall Protection
Fatigue Management Program
Fire Protection
Fit For Duty
Fleet Management
Forestry & Logging
Forklift
Gas Hazards & Equipment
General Health & Safety Requirements
Ground Disturbance
H2S/ Hydrogen Sulfide
Hand & Power Tools
Heat & Cold Stress
Hexavalent Chromium
Hot Work
HS Rep/Committee
Injury Management
Job Competency
Journey Management
Ladder Safety
Lead
Lockout Tagout
Machine Guarding
Management Of Change
Management Review
Mining
Noise (Hearing Protection)
Occupational Health
Oil & Gas
Overhead Power Lines
Powered Mobile Equipment
Radiation Exposure
Respiratory Protection
Rigging
Scaffolds
Short Service Employee Program (SSE)
Subcontractor Management Plan
Silica
Thermal Exposure (Heat & Cold Stress)
Traffic Control
Transportation of Dangerous Goods
Welding Cutting Hot Work
Working Alone
Working Near Water
Vehicle Safety
Other
The sections above may be required and are specific to your company activities and area of operation. These pass requirements for ISNetworld (RAVS) as well as other 3rd party prequalification services.
EMERGENCY RESPONSE - Potential emergencies your employees may face
*
Vehicle Collisions/Accidents
Contact with Electricity (Regular Voltage)
Contact with Electricity (High Voltage)
Fire/Explosion
Workplace Violence
Medical Emergencies
Extreme Temperatures
Severe Weather
Tornado
Hurricane
Flooding
Blizzard
Ice Storm
Accident Involving TDG
Gas Leaks
Animal Attacks
Accident Involving Severe Injury or Fatality
Chemical Spills (small/Interior)
Chemical Spills (large/exterior)
Chemical Fires
Fall from Heights
Confined Space requiring rescue
Other
Explain Other
Emergency Contact #1
*
First
Last
Position
Emergency Contact #2
First
Last
Position
Upload your company logo
Click or drag a file to this area to upload.
Acknowledgement
*
I understand and agree to the following terms:
The purchaser may modified & reproduce copies of the materials for the sole purpose of personalizing their own company safety program and distributing to their company employees ONLY. No products or materials purchased from Safety2Go or Safety Programs.ca may be resold, copied, reproduced, modified, republished, uploaded, posted, transmitted, or distributed in any form or by any means for the purpose of resale or for use by another company. All rights not expressly granted herein are reserved. Any unauthorized use or resale of the materials appearing on this site will violate copyright, trademark and other applicable laws and could result in criminal or civil penalties.
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