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TOPS Award Application
TOPS Project Application 2024
Part 1: Company Demographics & Statistics
Enter SCOAR Logo
Accepted file types: jpg, jpeg, png, gif.
Company Name
(Required)
Company Physical Address
(Required)
Street Address
Address Line 2
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Project Title & Location
(Required)
Project Title
Project Location
Project Description: Add a brief description of the submitted project (approximately 25 words), which can be used at the award ceremonies to introduce your company as the award is received in the box below. Upload a separate page if needed.
(Required)
Upload any necessary files for this section. (Optional)
Max. file size: 64 MB.
Submitted Project Category: Work hours inclusive of all trade contractors (Select only one category per application)
(Required)
Category 1 (under 60k work hours)
Category 2 (60k-250k work hours)
Category 3 (250k-750k work hours)
Category 4 (over 750k work hours)
A. Total Hours Worked
(Required)
2023
2022
2021
B. # Fatalities **
(Required)
2023
2022
2021
C. # Lost Workday Cases
(Required)
2023
2022
2021
D. # Restricted Day Cases
(Required)
2023
2022
2021
E. # Other Recordable Cases
(Required)
2023
2022
2021
F. # Total Recordable Cases (sum of C thru E)
(Required)
2023
2022
2021
Experience Modification Ratio (EMR)
(Required)
2023
2022
2021
North American Standard Industry Classification (NASIC)
(Required)
Upload any necessary files for this section. (Optional)
Max. file size: 64 MB.
Part 2: Project Statistics
Provide the following Statistics for the Submitted Project (Most recent three years): Provide work hours and statistical data for all personnel managed by the applicant Companyinclusive of subcontractors for the applicable years.
Submitted Project Start Date
(Required)
Month
Day
Year
Submited Project Completion Date
(Required)
Month
Day
Year
NOTE: Statistical Data Weighting Factor 80%
Total Hours Managed* (Inclusive of subcontractors)
(Required)
2023
2022
2021
# Fatalities (Inclusive of subcontractors)* Immediate disqualification
(Required)
2023
2022
2021
# Recordable Cases (Inclusive ofsubcontractors)
(Required)
2023
2022
2021
Recordable Incident Rate (TRIR) (Inclusive of subcontractors)
(Required)
2023
2022
2021
# OSHA/MSHACitations*** ( Inclusive of subcontractors)
(Required)
2023
2022
2021
Upload any necessary files (Optional)
Max. file size: 64 MB.
*** Upload documents providing details of each OSHA/MSHA citation. Emphasising why the citation event occurred, contributing factors and actions taken to reduce the potential for future occurrence. (NOTE: MSHA citations will be weighted differently from OSHA citations)
Part 3: Project Questionnaire
Safety Leadership / Responsibilities
1. Describe corporate commitment to safety on the submitted project. Provide examples of corporate/upper management involvement. (150 words maximum. Bulletize responses where possible)
(Required)
2. Did the project utilize a full-time safety professional?*
(Required)
Yes
No
3. Was the client an active partner in the safety of the submitted project? *
(Required)
Yes
No
Safe Execution of the Work
1. Identify the project preplanning activities used:
Pre-Project Risk Assessment/Mitigation Plan
(Required)
Your Personnel Only
Inclusive of all Sub-trades
Daily JSA/Task Planning
(Required)
Your Personnel Only
Inclusive of all Sub-trades
High Hazard Activity Preconstruction Conferences
(Required)
Your Personnel Only
Inclusive of all Sub-trades
Other (provide description below)
(Required)
Your Personnel Only
Inclusive of all Sub-trades
If Other was selected above, please provide details.
2. Identify Safety Engagement Activities used:
Daily JSA/Task Planning
(Required)
Your Personnel Only
Inclusive of all Sub-trades
Project-Wide Safety Meetings
(Required)
Your Personnel Only
Inclusive of all Sub-trades
Flex & Stretch Program
(Required)
Your Personnel Only
Inclusive of all Sub-trades
“Good Catch” Program
(Required)
Your Personnel Only
Inclusive of all Sub-trades
Behavioral Based Processes (Worker Observation)
(Required)
Your Personnel Only
Inclusive of all Sub-trades
Project Celebrations/Luncheons
(Required)
Your Personnel Only
Inclusive of all Sub-trades
Incentive/Reward Program(s)
(Required)
Your Personnel Only
Inclusive of all Sub-trades
Other (provide description below)
(Required)
Your Personnel Only
Inclusive of all Sub-trades
If Other was selected above, please provide details.
(Required)
Provide brief outline of which were successful and least successful and why. (Bulletize responses where possible)
(Required)
Provide brief description of your incentive/reward program and implementation. (Bulletize responses where possible)
(Required)
3. How often were documented safety inspections required?
(Required)
Daily
Weekly
Monthly
4. Documented safety inspections required for:
Corporate Management
(Required)
Your Personnel Only
Inclusive of all Sub-trades
Project Management
(Required)
Your Personnel Only
Inclusive of all Sub-trades
Site Supervision
(Required)
Your Personnel Only
Inclusive of all Sub-trades
Crew Foremen
(Required)
Your Personnel Only
Inclusive of all Sub-trades
Designated Safety Representative
(Required)
Your Personnel Only
Inclusive of all Sub-trades
Designated Safety Representative
1. Did the project track the following incident data?
First Aid Cases
(Required)
Your Personnel Only
Inclusive of all Sub-trades
Property Damage Cases
(Required)
Your Personnel Only
Inclusive of all Sub-trades
Near-hit Incidents
(Required)
Your Personnel Only
Inclusive of all Sub-trades
Vehicle/Mobile Equipment Incidents
(Required)
Your Personnel Only
Inclusive of all Sub-trades
Recordable Cases
(Required)
Your Personnel Only
Inclusive of all Sub-trades
Environmental Incidents
(Required)
Your Personnel Only
Inclusive of all Sub-trades
How were accident/incident cases used/communicated? Frequency?
Project Best Practices
1. Identify unique safety challenges on the submitted project and how they were addressed.
2. Identify three (3) best practices and/or lessons learned for the submitted project.
Vendor/Supplier Recognition
Would you like to nominate your safest project vendor/supplier for recognition?
(Required)
Yes
No
Attach additional documents if necessary. (Optional)
Max. file size: 64 MB.
Checking this box allows the SCOAR Safety Committee to share application information with other SCOAR members.
I agree
Checking this box allows SCOAR to potentially feature your company if selected in press releases as award winners.
I agree
Prepared by
(Required)
Title
(Required)
Email
(Required)
Please enable a valid email address.
Phone
(Required)
Please enter a valid phone number.
Signature
(Required)
Date
(Required)
Month
Day
Year
Corporate Officer / Designate Certification I certify that information contained herein has been verified and is accurate.
Signature
(Required)
Date
(Required)
Month
Day
Year
Name
(Required)
Title
(Required)
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