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Home My WebLink About891598.tiff � POLICIES AND PROCEDURES Section SAFETY AND INSURANC • E Subject Table of Contents COLORADO Date 10/2/89 Page 1 TABLE OF CONTENTS Page RISK MANAGEMENT: PRACTICES AND PROCEDURES 3 CAPP COVERAGES 6 EXTENSION OF PROPERTY COVERAGE BEYOND NORMAL COVERAGES . . . 8 EXTENSIONS OF LIABILITY COVERAGE 10 COVERAGES - - EXCLUDED 11 POLICY LIMITS, COVERAGES, RETENTIONS 12 v0 RESPONSIBILITY & AUTHORITY FOR LOSS CONTROL, LOSS PREVENTION & INSURANCE PROGRAMMING 13 SAFETY & LOSS PREVENTION PROCEDURES 15 ACCIDENT & CLAIM REPORTING 16 PROCEDURES FOR REPORTING ACCIDENTS & LOSSES 17 CONTRACT & LEASE REQUIREMENTS 18 PROCEDURE FOR SECURING INSURANCE 19 ALLOCATION OF INSURANCE COSTS 20 REPORTS TO BE FILED WITH DIRECTOR OF FINANCE AND ADMINISTRATION 21 RECORDS TO BE KEPT BY THE DIRECTOR OF FINANCE AND ADMINISTRATION 22 SAFETY MANUAL: INTRODUCTION 23 SAFETY PROGRAM STATEMENT 24 g9I5°9S POLICIES AND PROCEDURES I� af� 110 I section SAFETY AND INSURANCE Subject Table of Contents COLORADO Date 10/2/89 Page 2 Page MANAGEMENT PARTICIPATION 26 SAFETY PROGRAM RESPONSIBILITIES 30 SAFETY PROGRAM METHODS 34 OCCUPATIONAL ILLNESS & INJURY CONTROL 39 RECORDKEEPING 42 FLEET SAFETY 43 EMERGENCY PROCEDURES 45 GENERAL SAFETY RULES 48 Q EXHIBITS : 1 - Personal Injury/Accident Reporting System 49 2 - Job Safety Analysis 50 3 - Safety Check List 51 4 - Fire Inspection Check List 52 5 - Supervisor's Investigation Report 54 6 - Vehicle/Property Damage Reporting System 56 7 - Accident and Damage Report 57 8 - State of Colorado Report of Motor Vehicle Accident 58 9 - Road Test 60 10 - Employer's First Report of Accident or Occupational Disease 61 Q POLICIES AND PROCEDURES en s Section SAFETY AND INSURANCE IlkSubject Risk Management COLORADO Date 10/2/89 Page 3 PRACTICES AND PROCEDURES A. PURPOSE: This policy statement establishes uniform procedures for handling County of Weld liability, property, fidelity, and worker's compensation exposures. B. DIRECTOR OF FINANCE AND ADMINISTRATION: The Director of Finance and Administration has the responsibility for the County's risk and insurance management. He shall identify and treat all exposures which could result in financial loss to the County. C. BUDGET: The Insurance IGS Fund budget has been established to allow payment for property, casualty, fidelity, and worker's compensation insurance premiums, claims and losses, personnel costs , equipment purchase and other expenses. Jj D. INSURANCE COVERAGES: The following policies shall be observed in determining amounts of insurance and bonds: 1. Effective July 1, 1986 Weld County, in accordance with a resolution adopted May 21, 1986, agreed to join Colorado Counties Casualty and Property Pool (CAPP) under the authority of Article XIV, Section 18(2) (a) of the Colorado Constitution, and Sections 24-10-115 . 5, 29-13-102, and 29-1-20 et seq. , CRS, 1973. The insurance pool shall provide all property, liability and fidelity coverage for the county as outlined under the CAPP Coverage Section of this manual beginning on page 3 . 2. Employee Fidelity Bond: An employee fidelity bond shall be secured for all County employees as required by the Laws of the State of Colorado, the Charter, ordinance or regulations of the County of Weld, or upon recommendation of the Director of Finance and Administration or the County Attorney's Office. 3. Worker's Compensation Insurance: Worker's Compensation shall be provided under the County's self-insurance permit with excess insurance limits as recommended by the Director of Finance and Administration. C POLICIES AND PROCEDURES (! t 1� � Poi Section SAFETY AND INSURANCE • WIIIDc Subject Risk Management COLORADO Date 10/2/89 • Page 4 4. Unemployment insurance shall be paid under the federal and state option of the reimbursement method. The cost shall be paid out of the self-insurance program. 5. Other Insurance: Other insurance such as boiler, medical malpractice or any type of coverage deemed necessary by the County shall be placed into affect. The policy limits of such coverages shall be determined by the Director of Finance and Administration and placed through CAPP. E. RESPONSIBILITY: Department heads shall report to the Director of Finance and Administration the following changes in property under their supervision: 1. Changes in Building Use: All changes in the use or occupancy of buildings shall be reported. Strict observance of this requirement is necessary since building use bears directly on insurance rates and public liability status. 2. Razed Buildings: All razed buildings or buildings sold shall he reported immediately to the Director of Finance and Administration in order that insurance on such buildings can be cancelled. 3. Changes in Equipment: In order to provide a complete record for the insurance of equipment, department heads shall file a report with the Director of Finance and Administration covering the disposal and procurement of all insurable equipment. 4. Property Losses: Property losses occurring from fire or other causes which may be recovered from an insurance company shall be immediately reported in writing to the Director of Finance and Administration. 5. Duties of the Director of Finance and Administration: Changes and adjustments in insurance policies necessitated by reports from the department heads shall be made by the Director of Finance and Administration. POLICIES AND PROCEDURES ii IF Section SAFETY AND INSURANCE .Lyme Subject Risk Management COLORADO Date 10/2/89 Page 5 t RISK MANAGEMENT Board of County Commissioners I Safety Officer I Dir.of Finance and Director of Personnel —— Admin. Asst.Director of Personne Overall Responsibility for Risk Personnel Tech. Management for Weld County Responsible for the design,man- agement and direction of safety and loss prevention.Processing —7 and maintenance of claims. CI I Weld County Safety Committee I Elected Officials and I Advisory body recommending Department Heads L- policy and procedures affecting IResponsible for providing a the Weld County Safety Pro- safe working environment for gram. Monitors compliance, employees investigates problems and reccomends training. • II-Chairperson Supervisors I I-Vice-chair. I-Secretary Responsible to insure safe 1-Member for each County actions for employees and safe . department operations of machines and equipment and safe training. WELLNESS TRAINING INVESTIGATIONS INSPECTIONS SUBCOMMITTEE SUBCOMMITTEE SUBCOMMITTEE SUBCOMMITTEE Review accident investigation Advisory role and steering provides advice and direction reports.investigates accidents Conducts walk through committee for Weld County s for Safety training for Weld to insure that proper proce- inspections of all County Wellness Program dures are followed.Reccom- 'acilities.Identifies hazards and County mends new procedures, follows up to insure they are identifies problem areas and corrected. deficiencies. POLICIES AND PROCEDURES Atilt( '�, _Section SAFETY AND INSURANCE r Subject Rack Management COLORADO Date 10/7/89 Page 6 CAPP COVERAGES The pool coverages have been structured around the protection provided public entities under the Colorado Governmental Immunity Statutes . In the recent Colorado Supreme Court decision of Lee v. Colorado Department of Health, Case No. 835A414, the court strongly upheld the provisions of the immunity act as currently written. This gives credence to the pool's approach of limiting coverage for state tort liability claims in Colorado Courts to only those where immunity is not a defense. Consequently, it is important to note when reviewing the coverages outlined on the following pages, that for state tort liability claims these are limited according to the Colorado Governmental Immunity Act. If the Colorado Supreme Court overruled the limitation on judgments outlined in the immunity act, it would be the individual Counties responsibility to (� make payments or judgments in excess of 150,000 each person/400,000 each incident. . It is the pool's opinion that any decision overriding or changing the limitation on judgments would not be retroactive but would apply only to future decisions . The following coverages are being provided for federal action or suits brought in states other than Colorado: 1. Property Including: A. Buildings B. Contents C. Contractors' Equipment and Miscellaneous Property Floaters D. Fine Arts E. Class - (Includes Stained Glass and Vandalism) F. Valuable Papers G. Electronic Data. Processing Equipment H. EDP Extra Expense I. Extra Expense J. Owners Interest in New Construction K. Miscellaneous Unnamed Locations - $500,000 r� r POLICIES AND PROCEDURES aa( ` Section SAFETY AND INSURANCE • Subject Risk Management COLORADO Date 10/2/89 Page 7 2. General Liability Including but not Limited to (Claims-Made Form) : A. Premises B. Products Liability/Completed Operations C. Blanket Contractual D. Personal Injury E. Law Enforcement Professional Liability F. Worldwide Coverage G. Liquor Legal Liability H. Care, Custody and Control I. Teachers Professional Liability J. Punitive Damages (silent in form) K. Cemetery Liability L. Broadcasters, Publishers and Advertisers Liability M. Medical Payments (Premises) ^ N. Watercraft (Limited to Boats under 26 Feet) i(✓1 0. Employee Benefit Liability P. Non-Owned Aircraft and Watercraft Q. Incidental Medical Malpractice 3 . Errors and Omissions (Claims Made Form) : A. Elected and Appointed Officials B. Employees and Volunteers as Named Insured 4. Crime Coverages Including: A. Employee Dishonesty Coverage - $150,000 Each Loss B. Monies and Securities - $150,000 Each Loss 5. Auto Liability Including (This is a Claims Made Form) : A. Personal Injury Protection (Statutory Benefits) B. Medical Payments C. Owned and Non-Owned 6. Automobile Physical Damage POLICIES AND PROCEDURES A a 1 Section SAFETY AND INSURANCE • 11111111k Subject Risk Management Cie) COLORADO Date 10/2/89 Page 8 EXTENSION OF PROPERTY COVERAGE BEYOND NORMAL COVERAGES On the building coverages the Protected Self Insurance Plan includes all the normal coverages of fire, lightning, windstorm, hail, explosion, riot and riot attending a strike, civil commotion, aviation damage, smoke damage, vehicle damage and vandalism. In addition the following broadening of property coverage is included: 1. Losses on 100% Replacement Cost Basis without depreciation. (ACV if the building is not replaced within two years. ) 2. "All Risk" to include flood and earthquake coverage (with a $1,000,000 annual aggregate applying separately to each) . 3 . "All Risk" to include water damage from rising water, backing-up (e) of sewers, and wind driven rain and damage by surface water, waves , tidal wave, or spray from any of the foregoing. 4. Collapse of buildings or parts thereof extended to all risk of loss except normal settling, normal shrinkage, or normal expansion in foundations , walls, floors, or ceilings . • 5. Automatic protection for newly acquired properties including contents and owned builder's risk up to $500,000. 6. No Coinsurance Clause or requirement. 7 . No calculations of individual location rates. 8. Replacement to extend to any additional cost for rebuilding or repairing to meet ordinance requirements. 9. Cost of demolishing portions of building which are required to be removed because of damage by an insured hazard. 10. Loss by freezing whether buildings are occupied or vacant. 11. Loss to statuary, marble, glass, fences , structures whether on or off the premises. 12. Loss by animals or birds. CO) POLICIES AND PROCEDURES �� •IDS Section cflFmv Bran TMCURAwrr 'Wilk Subject RicU M,n,onmont COLORADO Date lo/9/Rq Page 9 13. Comprehensive automobile coverage and collision coverage automatic whether declared or not. 14. Robbery, Burglary and Theft of all property, including money and securities. 15. Care, Custody and Control Coverage. 16. Property in transit wherever located. C O POLICIES AND PROCEDURES fl `gm Section SAFETY AND INSURANCE Subject Risk Management COLORADO Date 10/2/89 Page 10 EXTENSIONS OF LIABILITY COVERAGE All of the usual Comprehensive General and Automobile Liability coverages are included. In addition the following broader protection is provided. 1. Personal Injury - Bodily Injury, Mental Injury, Mental Anguish, Shock, Sickness, Disease, Disability, False Arrest, False Imprisonment, False Eviction, Detention, Wrongful Eviction, Malicious Prosecution, Discrimination, Invasion of Right of Privacy, Libel, Slander or Humiliation, Defamation of Character, Disparagement of Property, Piracy and any Infringement of Copyright or of Property, Erroneous Service of Civil Papers, Violation of Civil Rights, and Assault and Battery. 2. Insurance includes Blanket Contractual Liability includes all written and oral contracts. 3. Insurance will cover any owned automobiles or buses automatically on acquisition. 4. Insurance will cover any special event sponsored by the County. 5 . Broad form named insured includes all employees and volunteers while acting within the scope of their duties as such. 6. Advertisers' Liability. 7. Law Enforcement Professional Liability. 8 . EMT's and Paramedics Professional Liability. 9. Public Officials Liability. r' 4 •'''r1 POLICIES AND PROCEDURES Section SAFETY AND INSURANCE Subject Risk Management COLORADO Date 10/2/89 Page 11 COVERAGES - EXCLUDED 1. Personally Owned Automobiles 2. Property Losses of a Degenerative Nature - (Wear and Tear, Deterioration) 3. War Risk and Nuclear Damage 4. Sexual Misconduct 5. The first $500 of each Property, Auto Physical Damage and Crime loss 6. Medical Malpractice Insurance other than Incidental Medical © 7. Pollution (Including Sudden and Accidental) and Asbestos 8. Employees and Trustees Accidental Death and Dismemberment 9. Workers' Compensation 10. Athletic Participation for Schools 11. Personal Surety Bonds Required by Law 12. Pension and Welfare Fiduciary Responsibility Insurance 13. Foreign Exposures 14. Failure to provide Utilities 15. Eminent Domain and Inverse Condemnation 16. Time element coverages other than extra expense 17. Boiler and Machinery 18. Aircraft 19. Hospital and Clinic Malpractice O POLICIES AND PROCEDURES ` f�4 � � Section SAFETY AND INSURANCE , IIiD c Subject Risk Management COLORADO Date 10/2/89 Page 12 POLICY LIMITS, COVERAGES, RETENTIONS PROPERTY: $ 50,000,000 Each Occurrence (Includes EDP, Inland Marine, "All Risk" Basis with Sublimits Auto Physical Damage) of $1,000,000 Each Occurrence/ Aggregate Applying Separately to Flood and Earthquake GENERAL LIABILITY: Bodily Injury/Property Damage: $ 150,000 Each Person $ 400,000 Each Claim AUTOMOBILE LIABILITY: Bodily Injury/Property Damage: $ 150,000 Each Person $ 400,000 Each Claim ERRORS AND OMISSIONS: $ 150,000 Each Person Q $ 400,000 Each Claim/Aggregate CRIME COVERAGES: Monies & Securities (Inside) : $ 150,000 Each Loss Monies & Securities (Outside) : $ 150,000 Each Loss Employee Fidelity: $ 150,000 Each Loss EXCESS LIABILITY (FEDERAL AND OUT OF STATE ONLY) $ 850,000 Each Person excess $150,000 each person $ 600,000 Each Claim excess $400,000 each claim RETENTIONS: Specific: Property $ 150,000 Each Loss 3rd Party Liability $ 150,000 Each Claim Crime $ 150,000 Each Loss Combined Retention $ 150,000 Each Loss Aggregate (Loss Fund) $ 3,400,000 Annually MAINTENANCE DEDUCTIBLE: $ 500 Applying only to Property, Auto Physical Damage & Crime Losses . Each individual County will be responsible for losses within the maintenance deductible. POLICIES AND PROCEDURES j� to 104 Section SAFETY AND INSURANCE Cinat Subject Risk Management COLORADO Date 10/2/89 Page 13 RESPONSIBILITY AND AUTHORITY FOR LOSS CONTROL LOSS PREVENTION AND INSURANCE PROGRAMMING A. The purpose of this procedural statement is to state the responsibilities and authority of the Director of Finance and Administration and other departments of the County and its agencies with respect to implementing the County's program on property and liability loss control. B. Resnonsibiliti.es of the Director of Finance and Administration: The Director of Finance and Administration is expected to: 1. identify risk exposure areas, and make recommendations to the Board of County Commissioners as to whether to insure, self- insure or budget for these risks, or to use some combination of these methods. It is also his responsibility to recommend changes in current County policy with respect to loss prevention, self- insurance and insurance coverages when appropriate; 2. maintain perpetual inventories on the insurable values of all property, including buildings, contents, equipment, vehicles and supplies; 3. together with the County Attorney be informed of proposed changes in the liability status of municipalities in the State of Colorado and provide loss controls necessary to avoid any large liability losses ; 4. review municipal and state ordinances and appropriate federal manuals to determine when insurance and bonds are required, permitted, or desirable at the discretion of the community; 5. together with the Director of Personnel supervise and encourage all loss prevention activities and cooperate with department heads to establish a working safety program; and 6. make periodic reports to the County Commissioners with respect to the current status of the insurance and loss prevention programs . O POLICIES AND PROCEDURES Ef ti411 Section SAFETY AND INSURANCE Subject Risk Management WII'Dc Date 10/2/89 Page 14 COLORADO C. Responsibilities of Other Personnel : 1. Department heads shall cooperate with the Director of Finance and Administration in his investigation of loss exposures and claims and in the operation of an effective safety and loss prevention program. They shall also review all contract forms with the County Attorney and Director of Finance and Administration before signing them so that any increase or decrease in the County's contractual liability can be properly identified and controlled. 2. The County Attorney's Office shall review all contract forms entered into by the County to identify and reduce any contractual liability being assumed by the County and attempt to transfer such liabilities. 3. The County Attorney's Office shall further notify the Director of Finance and Administration of changes in the State statutes and �1 common law which affect municipal liability. 4. The County Attorney shall also provide assistance to the insurer in the investigation and settlement of claims against the County from both employees and the public. 5. The County Attorney shall also provide legal assistance in the examination of insurance and bond contracts entered into by the County. • POLICIES AND PROCEDURES a lit 4ip, j' J ( . Section SAFETY AND INSURANCE 1111Illik Subject Risk Management COLORADO Date 10/2/89 Page 15 SAFETY AND LOSS PREVENTION PROCEDURES The Director of Personnel shall design and manage a workable safety and loss prevention program with the cooperation of all County department heads and their designated safety representatives. The purpose of this program is to reduce accidents causing injuries to County employees and the public and to reduce the frequency and severity of all property losses. The program will consist of making periodic inspections of facilities, investigating the causes of accidents and property losses, developing training programs for employees, and communicating safety literature to all departments. Department heads will then be expected to have such literature posted. The Director of Personnel shall make maximum use of the expert services of insurers' brokers and departmental safety directors whenever possible to develop better safety and loss prevention procedures. O O POLICIES AND PROCEDURES ji V( f' p \ _ Section SAFETY AND INSURANCE WII'Dc Subject Risk Management COLORADO Date 10/2/89 Page 16 ACCIDENT AND CLAIM REPORTING Prompt reporting of losses helps expedite claims handling, reduces loss of time for personnel and results in cost savings through settlement of justifiable claims. Therefore, all accidents resulting in bodily injury to any person whether or not employed by the County, and all incidents resulting in property damage, destruction or illegal taking of County property, shall be reported to the Director of Personnel as outlined in the Safety Manual. Claims against insurance companies or persons damaging County property will be filed by the Director of Finance and Administration and the County Attorney's Office. V Ca) POLICIES AND PROCEDURES j� f, 'LP..., Section SAFETY AND INSURANCE AnneSubject Risk Management COLORADO Date 10/2/89 Page 17 PROCEDURES FOR REPORTING ACCIDENTS AND LOSSES It is important that accidents and losses be reported promptly and in accordance with prescribed procedures. The maintenance of a favorable public image, the protection of the County's interests, the reduction in time lost for personnel and equipment, and the savings realized through prompt settlements, are significant benefits which may be realized. Supervisory personnel at all levels should require adherence to these principles. All accidents must be reported within 24 hours of the department's knowledge. A First Report of Accident MUST be received by the Personnel Office within 24 hours of knowledge of the accident. Departments filing late reports shall n be fined $100 per day. • POLICIES AND PROCEDURES ` I Section SAFETY AND INSURANCE • 11111€ Subject Risk Management COLORADO Date 10/2/89 Page 18 CONTRACT AND LEASE REOUIREMENTS All contracts entered into by the County will have to meet the insurance and indemnification requirements for all County contracts . Short form contracts , professional agreements and leases should be discussed on an individual basis with the Director of Finance and Administration or the County Attorney so appropriate insurance requirements may be added into these agreements . O U POLICIES AND PROCEDURES ,x `401 1) ai Section SAFETY AND INSURANCE Subject Risk Management COLORADO Date 10/2/89 Page 19 PROCEDURE FOR SECURING INSURANCE The County of Weld shall maintain an insurance program specifically designed to meet the needs of the County and be changed based on need.. A. All department or division heads are to make recommendations as to coverage which would best protect their particular operation. B. All reports and records received from the different departments will be reviewed and the insurance program will be revised to meet the changing requirements. C. The Director of Finance and Administration will consult with the County Attorney's Office for their recommendations concerning the County's liabilities. D. The Director of Finance and Administration will make recommendations to the County Commissioners as to the proper and adequate insurance coverages. E. After approval by the Board of County Commissioners of the acquisition of insurance, the insurance shall be obtained through the Colorado Counties, Inc. Casualty and Property Pool. POLICIES AND PROCEDURES ittri 4 Tel Section SAFETY AND INSURANCE • L/1 Subject Risk Management COLORADO Date 10/2/89 Page 20 ALLOCATION OF INSURANCE COSTS A. Where County operations or divisions have their own revenue sources or are a legal entity to themselves, insurance costs should be attributed to such operations or divisions and will be charged specifically to those operations or divisions. B. When premium breakdown is not determinable, liability insurance, Worker's Compensation and property insurance costs shall be allocated accordingly to each department based on payroll and loss experience. Blanket fidelity bond premiums shall be allocated by the number of employees in each department. Property insurance costs are allocated according to the specific properties used and operated by each of the divisions or departments. Allocation of insurance costs shall be in accordance with FMC 74-4. U C. Unemployment insurance cost for Human Resources and Social Services shall be charged back as the County is billed. Road and Bridge shall be charged an annual amount for unemployment costs of seasonal employees. D. Human Resources and Social Services shall be charged the manual rate for worker's compensation based upon the state fund rates. E. The deductibles from CAPP of $500 shall be billed to the department incurring the loss. Worker's Compensation losses shall have a $100 deductible charged to the department with the loss . F. Departments with specialized policies for their programs, such as clinical malpractice, headstart student accident, etc. , will be charged directly for the insurance. Q POLICIES AND PROCEDURES Section SAFETY AND INSURANCE clinkSubject Risk Management COLORADO Date 10/2/89 Page 21 REPORTS TO BE FILED WITH DIRECTOR OF FINANCE AND ADMINISTRATION A. All claims reports. B. Copies of authorizations for the acquisitions or disposal of property. C. Minutes of all legislative meetings, safety meetings and all other board meetings in which insurance or loss prevention is discussed. D. Inspection reports when the building inspector or Fire Department inspects County premises. E. All other reports, proceedings and memoranda which have to do with the County's Risk Management Program. O POLICIES AND PROCEDURES Section SAFETY AND INSURANCE Subject Risk Management • COLORADO Date 10/2/89 Page 22 RECORDS TO BE KEPT BY DIRECTOR OF FINANCE AND ADMINISTRATION A. An inventory of current locations, descriptions and insurable values of all property owned or leased by the County. B. An insurance register, outlining all coverages in force and including premiums , policy numbers, servicing agents, terms of coverage and expiration dates. C. Premium payment and allocation records. D. Claims filed and pending. E. Loss records subdivided into property, liability and other liability claims paid by the insurer under existing insurance policies. F. Claim recoveries received from third parties who have damaged County property or is reimbursing for County wages paid. POLICIES AND PROCEDURES •tp[t. } Section SAFETY AND INSURANCE Gil Ilk Subject Safety Manual COLORADO Date 10/2/89 Page 23 INTRODUCTION The Weld County Safety Program represents a practical commitment to safety. It sets forth philosophy and policy goals, organizational authority, safety program directives, and methods of prevention. The full implementation of the safety program is required of all employees at every level of the organization. The responsibilities outlined in the program are the minimum and should in no way be construed to limit individual initiative to implement more comprehensive procedures in an effort to reduce losses. The success of the safety program is highly dependent upon the cooperation of all employees . A successful safety program will benefit all employees, their families, taxpayers, and members of our community. • POLICIES AND PROCEDURES • i' \ .1•4 Section SAFETY AND INSURANCE ( Subject Safety Manual 'IN/ COLORADO Date 10/2/89 Page 24 SAFETY PROGRAM STATEMENT 1.1 PURPOSE - The Board of County Commissioners believes the safety of our employees is a vital consideration in the operation of our shops , offices, vehicles and facilities. Maintenance of safe and healthful working conditions and the development of safe operating procedures including the organization and execution of a continuing accident prevention program is the responsibility of management at all levels . 1.1.1 Weld County will implement and administer an all-encompassing safety program. In all of our assignments , the health and safety of all will be the first consideration. Department heads and supervisory personnel at all levels of the County work force are directed to make safety a matter of continuing concern, equal in importance to all other operational considerations. The County goal is to ensure maximum use of ( each tax dollar available. 1. 2 CONCEPT - Within the operational activities of any endeavor, there may be exposure to personal injury or property damage that may be unintentionally hidden. Reviews of contemplated operations will include consideration of errors or improper actions which could occur. Accidents are unplanned events. Proper planning and training can eliminate many accidents. Most accidents are preventable. The purpose of a safety program is to initiate such pre-planning as is necessary to minimize unsafe acts, contain environmental hazards and control unsafe conditions. 1.2.1 Continual emphasis on safety aspects , the refinement of work procedures, and safe working conditions has been shown to reduce significantly potential injuries, property damage, and work interruption. Every elected official, management official, and employee is charged with the responsibility of supporting and cooperating with the safety program outlined in this document. All employees are expected, as a condition of employment, to adopt the concept that the safe way to perform a task is the most efficient and the only acceptable way to perform it. Safety adherence and performance will be considered as an important measure of supervisory and employee performance evaluation. () POLICIES AND PROCEDURES -) ai h Section SAFETY AND INSURANCE • Subject Safety Manual COLORADO Date 10/2/89 Page 25 1.2.2 Safe practices on the part of employees shall be a part of all operations, and supervisors at all levels shall have the main responsibility for safety in each of their areas of supervisory responsibility. 1.2.3 The Director of Personnel shall have the overall responsibility for safety measures within Weld County government and is hereby designated as the Safety Officer for Weld County, Colorado. 1.2.4 The Road and Bridge Safety Manual shall be the safety manual for Weld County employees of the Road and Bridge Department; all such employees are instructed to read it and follow the terms therein to the best of their ability in the light of good safety practices. 1.2.5 Other departments may develop their own safety manuals. With the approval of the Safety Officer, they shall become the safety manuals for their respective departments . Q POLICIES AND PROCEDURES AS'? ' j Section SAFETY AND INSURANCE Subject Safety Manual COLORADO Date 10/2/89 Page 26 MANAGEMENT PARTICIPATION 2.1 IMPLEMENTATION OF PROGRAM - Management's commitment to safety can only be realized by active management involvement in the safety program. Individual responsibilities in the effective implementation of the safety program are outlined in Chapter 3. With the adoption of this program, each department will set forth its goals and objectives in striving toward reducing losses due to preventable accidents. 2.1.1 While numerous accidents may not be deemed preventable, the extent of the frequency or severity of personal injury or property damage may be mitigated by safety program measures . The most effective accident prevention measures are those which have been formulated at each level of organization, thoroughly discussed and coordinated by all concerned, and supported by top management. The organization of a safety committee within the County facilitates the maximum exchange of ideas between supervisory personnel and greatly enhances the immediate definition of policies covering hazards, problem areas, and promotion of a safety program. 2.2 SAFETY COMMITTEE - A County safety committee will be formed to function as an advisory body to develop and recommend to the County Commissioners matters of policy and procedure affecting the administration of the County safety program. The Safety Officer will be assigned as a permanent member. 2.2.1 Each major department listed below will appoint a primary and alternate member. Membership will be selected by the department head with the alternate member to serve during the primary member's absence. Regularly scheduled meetings will be held on a bi-monthly basis, or as often as deemed necessary to obtain desired results. Each committee member will serve a minimum of one year, with appointments staggered to maintain continuity. Attendance will be mandatory. Accounting/Purchasing Health Department Ambulance Human Resources Assessor Library Buildings & Grounds Office of the Board Clerk & Recorder Personnel/Payroll . POLICIES AND PROCEDURES t(' �� Section SAFETY AND INSURANCE Subject Safety Manual COLORADO Date 10/2/89 Page 27 Communications Pest & Weeds County Attorney Planning & Zoning Data Processing Sheriff District Attorney Social Services Engineering Treasurer Extension Veterans 2.2.2 The Safety Committee will take an active part in the following specific functions: A. Formulate committee operating rules. B. Develop monthly activity themes, safety awards and related programs. C. Promote the adoption and use of general safety rules. D. Establish a schedule for departmental and general surveys. E. Establish procedures for handling safety recommendations and suggestions. F. Review and analyze the injury and accident reports and make appropriate recommendations to preclude future accidents or injuries. G. Provide and maintain a suitably located bulletin board on which safety information only will be posted and changed at monthly intervals. H. Assist with the promotion of safety training activities for employees. I. Review and make recommendations on disciplinary procedures to be implemented for safety policy notations . J. Recommend incentive awards for departments and/or employees to the Commissioners. K. Serve as the Advisory Committee for the Wellness program in Weld County. POLICIES AND PROCEDURES 1� la Section SAFETY AND INSURANCE • WI`IPc Subject Safety Manual COLORADO Date 10/2/89 Page 28 2.2.3 A member of the Committee will be appointed as secretary and shall record and maintain complete minutes of all committee meetings in accordance with the following: Date I. Call to order II. Roll call III. Approval of minutes • IV. Old Business V. New Business VI. Adjournment Signature of Secretary 2.2.4 The Safety Committee will meet the second Tuesday of every other month at 9:00 a.m. unless it falls on a holiday or is otherwise changed by proper advance notification. The agenda r` will be as follows: U A. Chairman calls meeting to order. B. Secretary calls roll and lists members present and absent. NOTE: A member who must be absent should notify the Secretary in advance. The alternate member should attend in member's absence. C. Introduce visitors or new members. D. Read previous minutes. 1. Corrections or discussion. 2. Approval of minutes. E. Discuss all unfinished business. 1. Report on matters held over. 2. List all recommendations not acted on since last meeting. F. New Business. 1. Review of sub-committee reports . 2. Review of injury and accident reports. 3. Other pertinent topics. G. Review training features. r' , POLICIES AND PROCEDURES Ef i,1 j' 141/(1.01, t, Section SAFETY AND INSURANCE C) , Subject Safety Manual COLORADO Date 10/2/89 Page 29 H. Announcements. 1. Assignments. 2. Date and time of next meeting. 3. Other. I. Adjournment. 2.2.5 Officers will be elected and will perform duties as follows: A. CHAIRPERSON 1. Conduct the meetings. 2. Follow-up on any pending items of business or recommendations made during the meeting. B. VICE CHAIRPERSON 1. Assume the duties in absence of the Chairperson. C. SECRETARY 1. Arrange for meeting place. 2. Notify members of meeting. 3. Arrange agenda. 4. Prepare minutes of meetings . 5. Distribute minutes. 6. Report status of recommendations. 7. Assume duties of chairperson in absence of Chairperson and Vice Chairperson. C. MEMBERS 1. Report unsafe conditions. 2. Attend all safety meetings. 3. Contribute ideas and suggestions for improvement of unsafe conditions. 4. Encourage others to work safely. 5. Make inspections. 6. Serve as liaisons between Committee and all County officials, department heads and employees. C POLICIES AND PROCEDURES Va iy j� +� Section SAFETY AND INSURANCE • 1111€ UbCt Safety Manual COLORADO Date 10/2/89 Page 30 SAFETY PROGRAM RESPONSIBILITIES 3.1 Each County employee will be fully responsible for implementing the. provisions of this program as it pertains to the operations under their jurisdiction. The responsibilities listed below are minimum, and will in no way be construed to limit individual initiative to implement more comprehensive procedures to reduce losses and enhance safety programs. 3. 2 SAFETY OFFICER - The Safety Officer will be fully responsible for the direction and administration of the program. Duties include: A. Establish and administer the safety program. B. Develop within County personnel a strong safety attitude and a clear understanding of their duties and responsibilities to include Q� assisting in safety training. C. Participate actively in the County safety committee. D. Review serious and disabling accidents personally to satisfy himself that accident cases are being investigated and proper corrective action is being recommended for the prevention of a reoccurrence. E. Consult directly with all management personnel and employees on safety matters and provide all the guidance necessary to assure effective administration. • F. Make follow-up investigations when required to ensure that unsafe conditions or practices identified by the safety committee or the department heads have been properly corrected. G. Inform the Commissioners and department heads about the status of matters affecting the safety program. H. Develop and maintain an effective driver training and selection program for all drivers of County equipment. I. Periodically evaluate compliance with the program within departments by making inspections of facilities for hazardous �\ conditions and practices. l� (f POLICIES AND PROCEDURES r;:t.Hiiic:a Section SAFETY AND INSURANCE . t�� SUbjeCt Safety Manual COLORADO Date 10/2/89 Page 31 • J. Take action to budget all necessary safety equipment. 3.3 ELECTED OFFICIALS AND DEPARTMENT HEADS - Each Elected Official and department head has the full responsibility and authority for maintaining a safe and healthful working condition within his/her jurisdiction. Each department head is responsible for providing the type of work environment, work procedures, and service to the public that will promote, to the highest extent possible, the safety of County employees and the general public. Therefore, each Elected Official and department head will: A. Develop and actively support a departmental safety program that will effectively reduce and control accidents. B. Develop in conjunction with the Safety Officer, practical safety 1 rules and regulations pertinent to the activities conducted by the �• department. C. Establish and maintain a system of job safety analysis and monthly safety inspections. (See Exhibits 2 and 3) . D. Provide for adequate job training and continuing safety instruction to all employees in the department. Hold each subordinate supervisor fully accountable for an explanation of the preventable injuries, collisions, and liability incurred by a departmental employee. E. Take corrective action for any unsafe condition that is observed which could adversely affect the safety of an employee or the general public. F. Review all disciplinary action taken on employees who have violated safety policy. G. Ensure that all drivers of County equipment attend the driver training and selection program developed by the Safety Officer. H. Coordinate compliance with safety and fire codes . I. Recommend purchases of safety equipment to the Safety Officer, and maintain existing safety equipment. POLICIES AND PROCEDURES , fie 1 Section SAFETY AND INSURANCE • hiDeSubject Safety Manual J COLORADO Date 10/2/89 Page 32 J. Provide resources and direction to supervisors for safety training. K. Insure that MSDS's (Material Safety Data Sheets) are available to employees and that proper handling is done on hazardous chemicals. 3.4 SUPERVISORY PERSONNEL - A supervisor has the responsibility for the safe actions of his/her employees and the safe operation of machines and equipment within his/her operational area. The full potential of an effective safety program will only be accomplished when supervisors are active and held accountable in all phases of the program. The supervisor's ability to maintain a safe working environment for his/her subordinates will be considered in the supervisor's overall evaluation. Supervisors at all levels will be responsible for the following: A. Aggressively enforce the safety procedures that apply to the work they supervise. LOD B. Provide adequate basic job training and safety instruction to all employees under their jurisdiction. C. Be fully accountable for preventable injuries, collisions, and liabilities caused by their employees. D. Ensure that all management policies herein are fully implemented for maximum efficiency of each job. E. Provide continuing safety instruction while issuing daily work assignments to focus attention upon potential hazards, changes in work conditions or procedures. F. Ensure all employees are instructed in, and understand the use and need for, protective equipment for specific hazardous jobs . G. Continually observe and evaluate work conditions and work procedures to detect and correct unsafe conditions and practices . H. Promptly investigate and document all accidents and make certain that the recommended corrective actions are completed. (See Exhibit 5) . I. Impose appropriate disciplinary action when warranted. �' \ J . Ensure the necessary safety equipment and protective devices for U POLICIES AND PROCEDURES j� Section SAFETY AND INSURANCE `vim. 111 Subject Safety Manual COLORADO Date 10/2/89 Page 33 each job are available, used, and maintained properly. 3.5 EMPLOYEES - Each employee is required, as a condition of employment, to develop and exercise safe work habits in the course of their work to prevent injuries to themselves, their fellow workers , and conserve material and equipment resources. Each employee will: A. Promptly report to his/her supervisor all accidents and injuries occurring within the course of his/her employment. B. Cooperate with and assist in investigation of accidents to identify correctable cause and to prevent reoccurrence. C. Promptly report to his/her supervisor all unsafe actions, practices, or conditions observed. D. Become familiar with and observe approved safe work procedures `�s during the course of his/her work activities. E. Keep work areas clean and orderly at all times. F. Avoid engaging in any horseplay and avoid distracting others . G. Obey all safety rules and follow published work instructions. H. Wear required protective equipment when working in hazardous operation areas. I. Wear shirts at all times. J. Wear seat belts when operating any County vehicle or when operating a personal vehicle on County business, unless personal safety dictates otherwise. C POLICIES AND PROCEDURES J fie • �iS k '�py� 1 S2CtlOf1 SAFETY AND INSURANCE Subject Safety Manual COLORADO Date 10/2/89 Page 34 SAFETY PROGRAM METHODS 4.1 Each of the following safety methods share an important part in the overall safety program. Omission of any part will mean that even minimum accident prevention cannot be obtained. 4.2 SAFETY INSPECTIONS - Safety inspections will be conducted on a formal basis, at least monthly, by each department head or his/her representative. (See Exhibit 3, 4, and 4a) . Informal inspections should be made during the month to include a written report, to assure that hazards are kept at a minimum and safe work practices are enforced. Formal inspections will be made on a regular basis (at least once per year) of all County facilities. 4.2.1 Emphasis should be placed upon condition of facilities, equipment, and machines as well as implementation of the COS overall program such as: A. Good housekeeping. B. Use of prescribed protective equipment. C. Compliance with published department work rules. D. Qualification of drivers and condition of vehicles. E. Proper storage of flammable liquids and maintenance of fire fighting equipment. F. Proper guarding of open pits, ditches, tanks, etc. G. Proper maintenance of electrical equipment, power tools, and hand tools. H. Administrative compliance with this manual and other pertinent directives. I. Compliance with the Hazardous Communication Standard (OSHA) . • 4.3 JOB SAFETY TRAINING - No supervisor will assume that a newly hired, O newly assigned, or reassigned employee clearly knows all the job safety POLICIES AND PROCEDURES 011 Section SAFETY AND INSURANCE GaleSubject Safety Manual COLORADO Date 10/2/89 Page 35 procedures. The employee must be trained. It is the direct supervisor's responsibility to properly train all subordinates. 4.3.1 Training must be accomplished on a continuing basis . Therefore, the older employee must be re-trained through a series of follow-up instructions and/or training periods. 4.3.2 The Training Sub-Committee of the Safety Committee will provide specific training efforts in identified areas. 4.4 ACCIDENT INVESTIGATION AND REPORTING - Investigation of any accident is an invaluable tool in controlling losses. Each accident must be considered a total loss unless its true cause is objectively determined and all contributing deficiencies are corrected. Investigation, recording, and corrective follow-up of each accident can be time consuming, but are important if the cause is to be successfully Oeliminated. (See Exhibit 5) . 4.4.1 The Investigations Sub-Committee of the Weld County Safety Committee will prepare monthly summaries of accidents and injuries to be submitted to all departments through the Safety Committee Minutes. The Safety Committee will use this information to make recommendations to departments for corrective action. 4.4.2 Vehicle Accidents: Each accident involving a County vehicle will be investigated by the supervisor of the person involved and reported on an "Accident and Damage Report" . (Exhibit 7) . A. Employee completes the Accident and Damage Report and submits to his supervisor within 24 hours after occurrence. If injury is involved, immediately call the Personnel Department. B. When damage exceeds $250, employee also completes the State FRA Report (Exhibit 8 and 8a) , and submits to his supervisor within 24 hours after occurrence. If damage exceeds $1,000 call the Personnel Department within one day. C. Supervisor reviews reports with employee and completes the "Supervisor's Investigation Report" . The supervisor then submits the reports to the department head with POLICIES AND PROCEDURES jA ' Section SAFETY AND INSURANCE • Subject Safety Manual • COLORADO Date 10/2/89 Page 36 recommendation for disciplinary action when necessary. D. Department head reviews reports with the supervisor and enforces disciplinary actions. E. Department head obtains two written estimates of damage. The department head sends the Accident and Damage Report (along with estimates for repair) to the Personnel • Department. These reports must be submitted to Personnel within four days of occurrence. The Supervisor's Investigation Report is submitted to the Personnel Department. F. The Personnel Department submits the "Accident and Damage Report" to our insurance adjusters, with copies to the Safety Officer and County Attorney when appropriate. 1/44 G. After the insurance carrier has completed their investigation, they will contact either the Personnel Department or the department directly involved. At this time they will give approval to have the repairs made and the appropriate estimate that should be followed. H. It is the responsibility of the department head to assure that: 1. the vehicle is taken to the proper place for repairs; 2. repairs are made properly and vehicle is in acceptable condition after repairs are made; and 3. all bills for repair of the vehicle are submitted to the Personnel Department. 4.4.2 Personal Iniury Accidents: Every on the job personal injury or accident will be investigated by the supervisor of the person involved as soon as possible after it has occurred. A. Employee completes the Worker's Compensation Form (Exhibit 10) and submits it to his supervisor immediately. j 1 , 4 POLICIES AND PROCEDURES Et j� Section SAFETY AND INSURANCE • °Wi`k Subject Safety Manual COLORADO Date 10/2/89 Page 37 ti B. The supervisor reviews the report with the employee and completes the "Supervisor's Investigation Report" . The supervisor then submits the reports to the department head with recommendation for disciplinary action when necessary. C. The department head reviews the reports with the supervisor and enforces disciplinary action when • necessary. D. The department head then forwards reports to the Safety Officer. The report should include signatures from the employee involved, the immediate supervisor, the Sub- Committee representative, and the department head. 4. 5 SAFETY DISCIPLINE - Corrective action will be taken when any person: .‘O A. Violates policies which are directly associated with saving lives or preventing injuries. B. Causes injury to himself or others. C. Destroys or damages equipment. D. Violates safe work rules. E. Disregards traffic regulations. F. Demonstrates an attitude of indifference or 4defiance. 4.5.1 When a violation occurs, other than accident, the respective department head will tike whatever disciplinary action is required. 4.5. 2 In the event of a vehicle accident, department h ads will impose disciplinary action (when required) , anti submit report of that action with the Accident & Damage R. port, as well as to the Safety Officer. 4.5.3 The Department Head may fine the employee up to $l(i0 if the employee is at fault, or for any employee in4'olved in an accident without wearing a seatbelt. POLICIES AND PROCEDURES � , i' ��! ' Section SAFETY AND INSURANCE Vin , Subject Safety Manual • V COLORADO \Date 10/2/89 Page 38 4.5.4 Disciplinary actions resulting from vehicle accidents will be monitored by the Safety Officer, and in cases where little or no action is taken, the department head will be required to justify, upon query, his actions to the Board of County Commissioners. A. When any disciplinary action is taken resulting in a restitution or suspension without pay, the monies received will be forwarded to the Office of Finance & Administration for deposit into the IGS - Insurance Fund. 4.6 Each accident will result in the department being assessed $100. O POLICIES AND PROCEDURES 4i js i17Fel Section SAFETY AND INSURANCE • 911111k Subject Safety Manual COLORADO Date 10/2/89 Page 39 OCCUPATIONAL ILLNESS AND INJURY CONTROL 5.1 In addition to the methods cited in Section 4, there are several steps which may be taken to reduce the possibility of occupational illness and injuries. 5.5.1 Physical Examinations will be required in accordance with the Personnel Policies Manual. 5. 2 FIRST-AID TREATMENT FOR SICK OR INJURED EMPLOYEES - Significantinjuries or illness shall be reported and the supervisor will send the injured employee to seek first aid or medical treatment from the designated county medical facility. Q 5.2.1 The Engineering Department will develop and maintain a list of doctors in small towns and clinics in the County for use in emergencies. Radio procedures will be established so that injuries to employees in remote areas of the County can be handled as efficiently as possible. 5.2.2 If the employee has seen a doctor and he considers the employee capable of returning to regular work, the employee will be allowed to do so. If the employee is considered to be incapable of full job performance, the employee may have job duties reassigned that can be performed properly and safely. The employee will be required to have the Weld County Medical Work Release form completed and signed by his/her doctor. 5.2.3 The family of an employee who is severely ill or injured shall be notified promptly by the department head. 5.2.4 The Safety Officer shall be notified immediately by the department head of all disabling and probable disabling injuries. 5.2.5 The Board of County Commissioners will be notified immediately of all deaths. 5 . 3 EMERGENCY MEDICAL TREATMENT - In the event of a serious injury requiring immediate medical treatment, first-aid will be administered as necessary and an ambulance called. The facility nearest the accident scene shall POLICIES AND PROCEDURES •� lei Section SAFETY AND INSURANCE oSubject Safety Manual COLORADO Date 10/2/89 Page 40 be used. 5 .4 INTERACTION OF MEDICATION - An employee taking strong or multiple medication which causes dizziness, blackouts, drowsiness, double vision, impaired judgment or other abnormal reactions will not attempt or be allowed to work until the effects of the medication have dissipated. If multiple medication affects the individual's ability to act and perform normally, the individual will be required to consult with his physician. 5.5 INTOXICATION OF EMPLOYEES - An employee reporting to work who is obviously under the influence of alcohol or drugs will be suspended immediately until a thorough investigation is completed by his supervisor. Upon evaluation of the facts and confirmation of work rule violations, the employee may be dismissed in accordance with personnel policies. _. 5.6 EMPLOYMENT DURING ABSENCE FROM DUTIES - An employee who is absent from (\••�� his duties because of illness or injury, whether his status is disability leave, accident compensation time, or leave-without-pay, shall not work outside his County employment. 5.7 PERSONAL PROTECTIVE EOUIPMENT - Designation and use of protective equipment for all jobs which have an inherent injury potential will be specified by the supervisor involved. Detailed specifications for the design, purchase, and use of all protective equipment will he coordinated by supervisors. Employees will be fully accountable for the use of specialized protective equipment provided by the employer. Protective Eauioment Hazard Hard Hat Falling objects, electrical conductor, etc. Goggles/face shields Flying debris , welding sparks Ear plugs Prolonged exposure to noise exceeding sound tolerance levels. Gas masks/self-contained Toxic or abnormal atmosphere breathing apparatus conditions. • • , POLICIES AND PROCEDURES sp aE Section SAFETY AND INSURANCE • Subject Safety Manual Date 10/2/89 Page 41 COLORADO g Protective clothing: gloves, Lacerations, abrasions, bumps, aprons, leggings, shoes & full suits heat, nails and melted metals. Reflective/bright vest Working around traffic. 5.7.1 When the use of personal protective equipment has been specified for hazardous work, its use will be mandatory. • Supervisors will be held accountable for employees allowed to work without compliance. 5.8 PROPER DRESS FOR WORK - Employees will wear clothing suitable to the job performed. For example: around machinery, hot or injurious substances, sunburn, or other harmful agents, employees with long hair will wear a cap or net. In toxic atmospheres employees will be clean shaven so the mask contacts the face. Employees working in hazardous O areas will not wear tennis shoes, loafers, platforms or sandles, and are encouraged to wear safety-toe shoes on jobs where there is a hazard from dropping equipment or materials. Employees will wear shoes and shirts at all times. When mowing lawns employees will not wear tennis shoes. 5. 9 HARD HATS REOUIRED - The wearing of safety hard hats will be mandatory for Road and Bridge Department employees. Hard hats are not required while in a vehicle or equipment with a closed cab; however, they are required to be on when out of the vehicle or cab. 5.9.1 Hard hats will be furnished by the County. 5.9.2 Failure of any employee to comply with this directive could result in disciplinary action in accordance with the County personnel procedures. POLICIES AND PROCEDURES , E f. Section SAFETY AND INSURANCE Subject Safety Manual COLORADO Date in/2/89 Page 42 RECORDKEEPING 6. 1 EMPLOYEE FILES - A file will be kept by the Personnel Department on each County employee. All matters pertaining to accidents , medical exams , or disciplinary actions will be sent to the Personnel Department. 6 .2 SAFETY COMMITTEE MEETING MINUTES - Copies of minutes will be kept by the committee chairman, the Safety Officer, and department representatives. 6. 3 INSPECTIONS - All department heads are responsible for inspection reports on their areas. In addition, the Inspections Sub-Committee of the Safety Committee will conduct walk through inspections of all work areas on a regular, scheduled basis. 6.4 Accident reports will be maintained by the Personnel Department. C , POLICIES AND PROCEDURES Section SAFETY AND INSURANCE Wilic Subject Safety Manual COLORADO Date 10/2/89 Page 43 FLEET SAFETY 7.1 DRIVER SELECTION - Driver selection is done by the department supervisor, Personnel Director, and the Safety Officer. 7.1.1 County vehicle driver qualifications: A. A valid Colorado driver's license of the proper class. B. A clean traffic record. C. Passing of an eye test. D. Successfully passing of a road test administered by the supervisor or a qualified operator. (See Exhibit 9) . E. Understands that seat belts are to be used while operating County vehicles . F. Successfully completes the County's defensive driving course. 7. 2 PREVENTIVE MAINTENANCE - Operators of County vehicles will perform checks before and after the operation of a vehicle. Checks include tires, gas, oil, radiator, windshield (wiper and washer) , brakes (hand and foot) , and all safety equipment. The Equipment Services Manager will maintain records on all vehicles to ensure identification of required maintenance. Fire extinguishers will be provided and mounted in all County vehicles by the Equipment Services Manager, and will be checked out during the regularly scheduled preventive maintenance inspection. 7. 3 REPAIR OF VEHICLES INVOLVED IN AN ACCIDENT: The following procedure must be followed in order to get a vehicle involved in an accident repaired. (This procedure includes windshield repair, also. ) : 1. When an accident occurs a department representative should notify Personnel at 356-4000, extension 4234 immediately. 2. The driver and department must submit an accident report to Personnel within one (1) work day. POLICIES AND PROCEDURES Section SAFETY AND INSURANCE Subject Safety Manual COLORADO Date 10/2/89 Page 44 3. If a County owned vehicle needs repair, it is the driver's department responsibility to get at least three repair estimates. A department representative will contact at least three vendors provided by the Controller and either get their repair estimates directly, or have the repair estimates sent to Personnel. Be sure and advise the vendors that the work will be billed to Weld County, P.O. Box 758, Greeley, Colorado 80632, ATTN: Personnel. 4. When all three estimates are received by Personnel a determination will be made as to who will do the repair work. 5. Once the vendor has been determined, if the vehicle is operable the driver's department will be notified and should drive the vehicle to the vendor. If the vehicle must be towed, contact the Controller to arrange towing with either ARA or a private provider. 6. Once the vehicle is repaired it shall be the driver's department responsibility to pick-up the vehicle and inspect the vehicles repair work. If work is complete, the vehicle can be put back into use. ARA Fleet Services are not responsible or involved in the insurance repair work on vehicles. The only contact that they will have is if they want to submit an estimate on the work. POLICIES AND PROCEDURES j• 0 Section SAFETY AND INSURANCE 111lik Subject Safety Manual COLORADO Date 10/2/89 Page 45 EMERGENCY PROCEDURES 8.1 In cases of fire pull "Red Fire Alarm" located in various parts of the building. 8.1.1 Call operator for assistance in reporting to Fire Department or Sheriff's Department of a bomb or fire situation. 8.1.2 Notify Buildings & Grounds for assistance in fire situations . 8.1.3 Exit from the building will be in accordance with Emergency Evacuation Plan as posted in each office and in the hallways . 8.1.4 All County buildings are required to develop, post and train Uall building occupants in their emergency evacuation plan. A copy of each plan will be approved and maintained in the Personnel Department. 8.2 BOMB THREATS: When a bomb threat or report is made, attempt to get as much information as possible. The following questions should be asked: A. Where is the bomb? B. When is it to go off? C. Name of person reporting. D. Telephone number of person reporting. E. Who set the bomb? F. Listen for background noises. , 8.2.1 If possible, try to get another employee on the line to monitor the call. This will allow one person to take action while the other gathers information. Try to write down exact wording of caller. Be sure to note the time of the call. 8.2.2 The following notifications should be made as quickly as .4 possible: POLICIES AND PROCEDURES ` ` fit may. ? 0Nes Section SAFETY AND INSURANCE • W ' Subject Safety Manual • C COLORADO Date 10/2/89 Page 46 A. Department Head (if possible) B. Sheriff's Office C. Security (if during their working hours) D. Maintenance E. Communications Center 1. The following advisement will be made by the Communications Center over the public address system: "A bomb threat has been received for this building. Anyone desiring to leave may do so at this time. " F. The Personnel Office Ii 8.2.3 Upon notification, each person should visually check their work area. If anything unusual or out of the ordinary is observed, DO NOT TOUCH it. Notify your department head. A search command center will be established in the Communications Center of the County Complex Building. 8.2.4 The Command Center will be manned by a County Commissioner (if available) , the ranking officer of the Sheriff's Office, and any other department head wishing information. All information and press releases will be made through the personnel of the Command Center. 8.2. 5 The Command Center should be notified of any findings . Employees will be allowed to exit the building, if they wish, during the building search. The Communications Center must be manned during this time. If Communications Center employees wish to leave the building, the Director will operate the Center. Mandatory evacuation orders may be made by any County Commissioner during this time. 8.2.6 If an explosive device is located, the building will be evacuated immediately upon orders of the Sheriff or the ranking deputy present, according to building fire evacuation plans. The Communications Center will only be evacuated if the device is so located as to cause damage inside the POLICIES AND PROCEDURES "r" a �' � Section SAFETY AND INSURANCE Subject Safety Manual COLORADO Date 10/2/89 Page 47 immediate area. The Communications Center will institute their procedures for emergency operation outside the building, if evacuation is ordered. REMEMBER: Do not touch anything which is unusual in your area. Report anything which you cannot account for in your department. If you find or see an explosive device, leave the area quickly and close all doors behind you. NOTE: This procedure is written for the entire Complex. Each Department may initiate specific procedures inside that department to elaborate on specific assignments. The Sheriff's Office is available to assist with these procedures on request. 0 C POLICIES AND PROCEDURES fig jA .� Section SAFETY AND INSURANCE • Subject Safety Manual COLORADO Date 10/2/89 Page 48 GENERAL SAFETY RULES 9.1 PROTECTIVE CLOTHING OR EOUIPMENT - Wear special protective clothing when specified, such as: gloves, body protection, face protection, safety shoes, safety glasses, hard hats, etc. 9.2 HOUSEKEEPING - Keep equipment, tools, materials and work areas clean and orderly. 9.3 MACHINE GUARDING - Be sure that all drives, transmissions, and revolving parts are guarded. 9.4 MOVEMENT - Walk, never run. Use handrails on stairs. Be cautious when approaching swinging doors, corners, congested areas . 9.5 LIFTING - When lifting bend the knees or get help with heavy loads. `+I 9.6 "HORSEPLAY" - An act in jest can end in disaster. 9.7 FIRE AND EMERGENCY PROCEDURES - Know what to do, what action to take , where to go. 9 .8 REPORT ALL INJURIES - Report all injuries to your supervisor. 9. 9 HAND TOOLS - Regularly check the condition of all hand tools. 9 . 10 PORTABLE POWER TOOLS - All portable power tools must be grounded or double insulated. 9.11 SMOKING - Obey all smoking regulations. 9. 12 SEAT BELTS - All drivers will wear seat belts while operating County vehicles or when operating personal vehicles on County business . Drivers will be responsible to insure that all passengers in the vehicle have fastened their seat belts while the vehicle is in motion. POLICIES AND PROCEDURES tit' a �� ' { Section SAFETY AND INSURANCE ' .•' Subject Safety Manual -- Exhibit 1 , ilk1 . Date 10/2/89 Page 49 COLORADO PERSONAL INJURY/ACCIDENT REPORTING • SYSTEM Employee Injury or Accident First report of injury/accident investi- gation completed by Supervisor. I CETA report County Reports (*) reviewed by (*) reviewed by Exec. Dir. Department Head County Personnel Department) 3 copies of 1st report of injury. Copies of 1st report of injury/accident Workman's Comp. investigation report. Carrier Safety • Director Monthly Report. Board of County Commissioner • • • * Disciplinary action may be taken if necessary. POLICIES AND PROCEDURES :NH*, Section SAFETY AND INSURANCE Subject Safety Manual -- Exhibit 2 COLORADO Date 10/2/39 Page 50 • DEPARTMENT EMPLOYEE DATE • JOB SAFETY ANALYSIS Basic Job Steps . Potential Hazards I Safe Job Procedure ;Break the job down into its basic steps. j What are the hazards for each Job Step. I How should job be done. . I • - • Q POLICIES AND PROCEDURES. j� � Section SAFETY AND INSURANCE ti`..1; Subject Safety Manual -- Exhibit 3 COLORADO Date 1o/2/89 Page 51 SAFETY CHECK LIST LOCATION DATE INSPECTED BY TIME AM PM EXTERIER INSPECTION YES NO N/A REMARKS Parking lot pavement in good condition _ _ Bumper guards in good condition _ _ --- Ample drains for water removal ' _ _ --- Visible parking.and markings _ _ All curbs in good condition ENTRANCE AREA Ramps, where necessary, and in good repair — — — Stairs in good repair Handrails, where necessary Doorways wide enough for wheelchairs Lighting adequate Non-slip surfaces at all entrances INTERIOR All hallways free of storage Hallways mopped one-half at a time, with employees using ropes and stanchion. All floors free of small objects Approved ladders and stools provided as necessary. Hallway and stairway railings secure _ _ --- All stairway treads and nosings in good condition. All fixture wiring arranged to avoid tripping hazards. Shower and lavatory floors checked each shift. Kitchen and lunchroom floors checked each shift. C POLICIES AND PROCEDURES st 1"11P A Section SAFETY AND INSURANCE J Subject Safety Manual -- Exhibit 4 COLORADO Date 10/2/89 Page 52 FIRE INSPECTION CHECK LIST LOCATION DATE INSPECTOR TIME START COMPLETED 1. Sprinklers YES NO a. Sprinkler valves accessible & locked open. N/A b. No leaks, corrosion, or other defects noted. c. All sprinkler heads unobstructed. d. Caps in place on the fire department pumper connection. e. Monthly alarm & valve test. 2. Fire Alarms , a. Fire alarm boxes accessible. b. All alarm boxes tested monthly. _ c. Alarm horns/bells audible in all areas.d. Alarms connected to fire/answering service. e. Automatic heat/smoke detectors properly placed & free of covers, etc. 3. Fire Doors a. Doors in good operating condition. b. Doors-unobstructed. c. Doors kept closed. d. Doors adequate in width for easy movement _e. Electric door closers in operating condition. _ f. Fuse links not used to hold doors opens. _ 4. Fire Extinguishers & Hose Stations a. All employees familiar with location & opera- tion of extinguishers. b. All extinguishers unobstructed. _ c. Proper extinguisher location. d. All unapproved/obsolete extinguishers removed. _ e. Weekly visual and monthly recorded inspections _ of extinguishers with annual servicing. f. Cabinet doors on hose stations operate properly.• g. Hose in good condition & nozzles in place. h. All hoses re-hung annually. _ 5. Catastrophe Planning a. Sounth the building fire alarm/call fire dept.b. Evacuate building. _ c. Close the door to the affected area. d. Notify staff. e. Search building/close all doors to affected area. 6. Smoking • a. Safety type ash trays. b. Smoking regulations enforced. c. NO SMOKING signs d. Safety-typeposted. -i metal waste baskets used in smoking areas. POLICIES AND PROCEDURES Section SAFETY AND INSURANCE Subject Safety Manual -- Exhibit 4a COLORADO Date 10/2/89 Page 53 FIRE INSPECTION CHECK LIST • YES NO N/A 7. Heating and Cobking Equipment Heating a. Annual inspection of equip. _ b. All repairs made by certified person. _ c. Only trained personnel operating equip. _ e. Combustion safeguards in accordance with state & local codes. f. Combustible storage kept out of boiler & furnace room. Cooking a. Annual inspection of equipment. b. Fixed extinguishing system serviced (semi-annually). _ c. Manual &,.automatic shut-offs checked. d. Vapor globes on lights in hood. e. Ducts over cooking equip. cleaned. — f. Filters over cooking equip. cleaned. B. Electrical Hazards a. All wiring completed by licensed electrician. _ b. All equipment "UL" listed. _ c. All electrical equipment grounded. _ d. All spiced cords removed. e. Proper size fuses in use. f. Extension cords prohibited. _ g. All light cords in the open. _ h. Annual inspection of all cords, outlets & switches _ General a. Combustibles kept away from heaters. b. Combustibles not stored in boiler room. _ c. Waste materials stored in proper containers. _ d. Waste materials emptied on each shift. Other Hazards'- Suggestions a. Lint cleaned from laundry dryer daily. _ b. Lint cleaned from laundry room overhead pipes. _ c. Battery powered emergency lights tested monthly. d. Written record of battery testing. _ e. Emergency generator tested weekly - k hr. test. f. One fire drill per month. _ g. Fire drill records up to date. 0 POLICIES AND PROCEDURES I. ` , j' ' Section SAFETY AND INSURANCE • Subject Safety Manual -- Exhibit 5 W�`PD Date 10/2/89 COLORADO Page 54 • SUPERVISOR'S INVESTIGATION REPORT Gallagher Bassett Insurance Service The unsafe acts of persons and the unsafe conditions that cause accidents can be corrected only when they are known specifically. It is your responsibility to find them and name them and to state the remedy for them in this report. COMPANY DEPARTMENT Weld County LOCATION OF ACCIDENT DATE S HOUR OF ACCIDENT NAME OF INJURED PERSON DEPT. NUMBER INJURED'S JOB OR POSITION DESCRIBE THE INJURY • *DESCRIBE THE ACCIDENT (State what the injured was doing and the circumstances leading to the accident. Attach extra sheets if needed) • • • • • *UNSAFE CONDITION (Describe as oily floor, poor light, lack of guards on belts and gears, broken step, etc. Attach extra sheets if needed) *UNSAFE ACT — Unsafe work procedure (Described as removed guard, adjusted moving machine, or a specific item of substandard procedure, lack of planned safety, etc. Attach extra sheets if needed) • *REMEDY (As a supervisor, what action have you taken or do your propose taking to prevent a repeat accident. Attach extra sheets if needed) • Employee Date Immediate Supervisor Date Safety Committee Member Date Department Head/Elected Official Date * See the Instructions on the reverse side. POLICIES AND PROCEDURES A11 Section SAFETY AND INSURANCE C' Subject Safety Manual -- Exhibit 5a .. Date 10/2/89 PageCOLORADO 55 When answering Describe the Accident, Unsafe condition, Unsafe act, and Remedy questions, please ask the following questions: 1. Why, what, where, when, who, and how? 2. Did any of the following affect this accident and how; Equipment Material People Selection Selection Selection Arrangement Placed Placement Use of Handling Training Maintenance of Process Leadership 3. Complete and return to Personnel within 48 hours after accident. 4. Type or write legibly with black pen that will photocopy well. 5. Do not settle for the obvious; be sure to get the base cause of the accident. (See questions I and 2) 6. Signature blanks are to be signed by the person indicated. Signatures only -- no initials. 7. Department Head is to review before signing to be sure counseling and other appropriate action has been taken. 8. Attach extra sheets if required to achieve an adequate report. • NOTE: Worker's Compensation First Report of Accident form is to be filed within 24 hours after the accident. This is different than the Supervisor's Investigation form. MOST ACCIDENTS ARE PREVENTABLE AND SO ARE THE LOST DOLLARS AND PRODUCTION HOURS FOR YOUR DEPARTMENT. G POLICIES AND PROCEDURES t 140 ' € .'''a1 Section SAFETY AND INSURANCE Subject Safety Manual -- Exhibit 6 COLORADO Date 10/2/89 Page 56 VEHICLE/PROPERTY DAMAGE REPORTING SYSTEM Accident or Property Damage Employee completes Accident/Damage report and State FRA (if cost exceeds $200) . Immediate Supervisor Reviews reports and recommends what action should be taken Department Head Department Head reviews and signs report. (*) State FRA (must complete within 10 Personnel days of accident) . Department Copies of Accident/Damage Report to all the following: State Safety County Safety Department Director Attorney Committee of Revenue *Disciplinary action may be taken if necessary. POLICIES AND PROCEDURES - Section Safety and Insurance ClinkSubject Safety Manual -- Exhibit 7 COLORADO Date 1012/89 Page 57 • WELD COUNTY ORIGINAL COPY Personnel Der artcrent ACCIDENT AND DAMAGE REPORT DATE AND HOUR OF ACCIDENT • LOCATION OF ACCIDENT TYPE OF VEHICLE LICENSE NO. COUNTY NO. POLICE CALLED: _ YES _ NO SUMMONS ISSUED: _ PERSONAL INJURIES: _ YES NO IF YES, GIVE NAME AND EXTENT: SUPERVISOR'S SIGNATURE DEPT DATE EMPLOYEE AND OTHER OWNERS OF DAMAGED PROPERTY NAME ADDRESS I PHONE EXT. OF DAMAGE I EST. AMOUNT � I 1 I I I I 1f i I WITNESS TO ACCIDENT OR DAMAGE NAME. ADDRESS I PHONE I REMARKS I � I STATEMENT OF COUNTY EMPLOYEE OR OTHERS INVOLVED: I DRAW DIAGRAM-SHOW VEHICLES-SHOW NORTH: SIGNATURE OF EMPLOYEE OR OTHER I *** STATUS ON REPAIR OF COINIY VEHICLE *** Is this vehicle going to be repaired? If vehicle is to be•repaired please submit three estimates to the Personnel Department within fourteen days of accident. /Th If vehicle is not going 4 to be repaired, please explain; s4-visor's Siirurr O POLICIES AND PROCEDURES 0 ►i , Section SAFETY AND INSURANCE Vil Subject Safety Manual -- Exhibit 8 le . COLORADO Date 10/2/89 • Page ss • • CONFIDENTIAL STATE OF COLORADO REPORT OF MOTOR VEHICLE ACCIDENT I 1 T,I a. I" I EPORT u"N.loud'a••swe.PJvnr,elowd In RoachPNIEN.Iy.lIPR Iww TWIST,CFI A] HE<ORU TVPE] NOT OPEN TO PUBLIC Inn"r,. S.+W IA anV✓wniri T He u•Browny..e,G.rr AI.J.,ulxl HAVING"NU PAUL I INSUR INSPECTION AND ANNE"DOES NUT CHANGE E FINANCIAL RESPONSIBILITY ACT FILING IILOUIHEMENTS yin ,IEx CANNOT BE USED AT Iu,.,o resin)'say cams xxu.n,.pn ul rnr„IIm..w FRA ANY TRIA L ' DEPARTMENT OF REVENUE ANSWER FULLY EACHMOTOR QUESTION TO AVOID • MAIL TO: COAL R`iG VEHICLE DIVISIONON LLOWINI OCCID SUPPLEMENTARY IHOWHE GM L Dannr.rCelpr.EA IBO]0<ON FOLLOWING ACCIDENT REPORT cm STING THIS x e r x r H VEHICLE O,vI Iry PESTLE INNSS,'CIO AY{ IIENTLN LUI°HAIw DATE ACCIDENT INVOLVED'I OTNECLEI.iOU s u OBJECTII ANIMAL I. tlICYCLEII OTNFNI LOCATION A.I.. ,. r - AmGExr VEHICLE DRIVER AND OWNER INFORMATION ISNOW OWNER AS DRIVER IF VEHICLE WASPARKED, ,^I I YOU- 01 DIVER5.Ms,NAME.MIONLEINITIAL.LAS,NAME STALL,AOUAL55 --- I WERE DRIVING CITY STATE G.PCUUE LA, IRIVEAZLIUENSE NN. STATE KILLED LI VEHICLE S 1_ NJUREDII NUMBER LICENSE PLATE —, DN AMA N OF a in- "IY YEAR VA IHI ryCII 1 DIL OWNERSFIRST NAME.M.L.LAST NAME STREET ADDRESS ruin: STATE GIP Col VEHICLE DRIVER HANO OWNER INFORMATIDL ISNOW OWNER AS DRIVER IF VEHICLE WAS PARKEUI _ —__� OTHER D2 .,LAs.Ixsr NxM„NIMBLE.NITIAI.,LxsT NAME iaerr.3pntsT-- I�S�u• CITY zIAtL GIPLL, E u Al SRIVEx's LIE.MSS NU. IST KILLED I,1 DRIVING II ,E INJURED El I VEHICLE LILETAAPLA,EMDI YEAR IS I ATE I SPPROB,OAMAOE I•Esl]RNDLJMA OFMHIC,LE I MNDEI. vFAH I NUMBER oEsc)IRE AMA T 2 02 DWND .INSTNAML.MI..LASTNAME STHEEIAUNRESS LNY STA•F TIP CIIoLI F MORE TITAN TWO VEHICLES WERE INVOLVED.OESCV IRE T HE OTHER VEHICLE SON ON THE RE VERSE SITE OP THIS FORM �1 USE ADDITIONAL FORMS IF NEEDED J OTNFq PROFAO• A.rm.Iro.' N".0,Ill mwml,Hnx.,.NUA I I IIAMa,.I II.,...INS,.., -- INFER. .A•Ai.r.Sr N.. AOE AND OPIi1IE55 NATION P N.A.`M•"L lxnAMIN,'l OBJECT DAMAGE()III..u of LIAl F_ DAMAGE) _�DEJECT DAMAGED_. __ __ WAS A POLICY OF LIABI LIT V INSURANCE,COVERING THE VEHICLE YOU WERE DRIVING IN EFFECT AT TIME or ACCIDENT, YES.-1 NO II PLACE YOUR LIABILITY POLICY IN PHONY OF YOU BEFORE COMPLETING THE BLANKS BELOW ' I, IF YOU FAIL TO GIVE FULL INFORMATION.IT WIL L BE ASSUMED INA i MOLE WERE NOT INSURED. ' N NAME OF INSURANCE COMPANY 5• NOT AGENCY,THAT ISSUEDPOLICY — -_-_-_.__ --__ U R HOME OFFICE ADDRESS _______ ___ A NTT.. N AGENCY THAT , C SOLO POLICY _—AINTREE,' E ,,.Lap. POLICY NO POLICY PERIOD "QM mc :^—_..— ,._n'_,_TO—mane. AA. NAB— POLICY XOLCE0. —__ REV JR, PN DI COLORADO FILL IN RUT DO NOT DETACH FRA • J NAME CF COMPANY WHICH ISSUED YOUR INSURANCE POLICY TO COVER LIABILITY FOR DAMAGE OR INJURY TO OTHERS___-- HOME OFFICE ADDRESS_ —_ • AGENCY THAT SOLDPOLICY— ADDRESS— POLICY NO. _POLICY PERIOD FROM rA.� �TO v • DATE OF '••' /// ACCIDENT IN OR NEAR _ ,COLURppp MARE OF OF YOUR mu.e. Pa, ,..v 'T-' "'" IOEN9FICAnON VEHICLE NOT _,,,____ UwrvtN __ . . ._..__AVUIILS5_.. ____.__ /I NA ME OF PULICrHULUEP_ _,.,,rl•H,I -.-, POLICIES AND PROCEDURES idif1 j� & Section SAFETY AND INSURANCE 444 174. III k Subject Safety Manual -- Exhibit 8a COLORADO Date 10/2/89 Page 59 CHICLE B RIVER AND OWNER INFORMATION!SHOW OWNER AS DRIVER IF VEHICLE WAS PARKEDI 1 OTHER D3I01V[RSFIR,TNAm[.M,SDLEHNITA..LASTDAME STREET ADONL„ I PERSON c•r. STATE P I WpseI cnec LSO ,I R, a wlvu suc[nzc N Iz, TL�KILLEV O DRIVING INJURED 0 VEHICLE CCanoeoI�`E:IEEAR StIAte RO B.DAMAGE Paw rE op HIULe OEL 'TEAR NUMBER YEAR a nIS PP cE acs❑NND C,mw IMn OA 3 03IoWN,..„Fins,Nam:.M.I.LASTNAVE RES ADORE„ E1CODtI VEHICLE DRIVER AND OWNER INFORMATION I SHOW OWNER AS DRIVER IF VEHICLE WAS PARKED) 1 OTHER 04! " INCH s.•ws.NAME.MIDBLC INI,IAL,LAST"Mm' s,BF.'AMM.LA. PERSON WAS STATE ZIP CODE M :71 •RIVER,LICENSE N eINJURD [1 VEHICLE G EOF.I I rum INJURED❑ me RarsHolY APPROX.DAmw Aw .wAv reWlaE IN oFL SEAR NUMBER DEscwmE DAMAGEmv Mn[IS cE IVES❑K NO I[Im I 4 04IOWNER.,,IRSTNAME.M.I.LA„NAME „REE,aDBRE„ EIPEDDEI oLE ME u a PEOESTEIATVU WI. noolEsz LI,v <Iw,r N.M<N'soa,L INITIAL.LAST NZ PLooc IMc KlueoLl•I D A ' oTS,EI STREET ADD ess urn nwsr N.mc.msmrelNMl.L.LAST NAME 'INJURED_R D R A EXU RIVEHr NMI A. SIP CODE I AWEIKILLED Ii /I • T PEoc,NR•anp I [ ICLE o. _ INJURED(TJ V R V .IRar NAME.MIDDLE INIr I.L.LAST Nonni W E STREET AooLLs, CITY s..,e zln eaoE I^r IKILLED INJURED El0 DID A LAW ENFORCEMENT OFFICER INVESTIGATE AT SCENE OF ACCIDENT? YES I I NO EI IMgTN..PARS.ShwIII,CityPOIISI fPI NAME OF INVESTIGATING OFFICER IEPAHTMENT.__ WAS A*TRAFFIC VIOLATION SUMMONS ISSUED)VETO NO Ti ISSUED Tn _ _"IOLATION:__. • ISSUED TI+ VIDI ATION. DESCRIOE WHAT HAPPENED REFER TO VEHICLES Hv NU'.1TER EXPLAIN WHAT CAUSED ACCIDENT • I 1 CFR TI F Y THAT THE STATEMENTS ON BOTH SIDES OF THIS REPORT AIRE TRUE 10 Till REST OF MY KNOWLEDGE ANn RELIEF JJJ SIGN HFRF+— '— '.a' .o.n.o.. MA IL R n.D.p.NnmIDIR.nnu.,Moor% IIE.O ENion'Pin.n,HIRHFPmibE III WIC6thAPNIn. WANT.Cam.nnASTER 11 OR RHINO THIS REPORT TO MOTOR VEHICLE UIRISION OFFICES.MODEST OM ARE.RENTER.COLORADO- DO NOT WRITE D[IOW TNI,LINE NiAIL TO'.DEPARTMENT OF REVENUE .e.VII on N.Vaan es Amami EP^.ALL[o ED,v MOTOR VEHICLEDIVISION WAS IN EFFECT monomer FINANCIAL RESPONSIBILITY SECTION IRO An,Ern An. O.T.N.CO ROOM POW?'Or OD PmnynnlANnuny m .n on . .rREE.h..PL nw.n IF•UoO MOCICI l . umnwm CORM you m pompano*Rh m.gem Opel,. .EA. EO 2 Our palmy lnr m<n.mp P>,EERln.emir I tS IEm..rn.operator taunt Ran EOI IOOl.tom.owner Pl IER u.nID.In.OIM Hi llis.E Ji m, C 3.OPIPPI,Ep RPS.E.IF m.E.Sn el the P2I..EUH don nO,.pply to a.op.nI5 of OF FINN.Inver.,m ..CA inR.n,. \ Tnl I an Automobile ILbrI,l E IIn..e.unw.sm.Colorado Motor yard..;room's!R.WPR.IenMv An DIOM.N crow of uSFo.530.000 noels.Inlury End 05.001)Amory o.mge I REmARRS ...a e.I DATE Rv POLICIES AND PROCEDURES ./i" 't Section SAFETY AND INSURANCE 4Y 0 Subject Safety Manual -- Exhibit 9 COLORADO Date 10/2/89 pale 60 ROAD TEST Driver's Name Date Code Location License No. Always Occasionally Never AIMS HIGH IN STEERING Drives in center of lane Selects proper speed Avoids tailgating Reduces speed if necessary Steers smoothly 'GETS THE BIG PICTURE Looks right & left at intersections Looks behind before pulling from curb Check sides and rear Anticipates others actions KEEPS EYES MOVING Checks mirror regularly Yields to pedestrians Avoids being boxed in Avoids hard stops or turns MAKES SURE THEY SEE HIM Signals and takes proper lane for turning Taps horn to.alert others Makes eye contact Signals before pulling from curb LEAVES HIMSELF AN OUT Maintains safe following distance Avoids blind spots Is alert to parked cars Allows adequate room to pass • PRE-TRIP Visual Inspection Fastens seat belts ttarts engine,.checks instruments Adjusts mirrors REMARDS: POLICIES AND PROCEDURES -11 mPoi Section SAFETY AND INSURANCE • Subject Safety Manual -- Exhibit 10 COLORADO Date 10/2/89 Page 61 t R85 COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT DIVISION OF LABOR WORKERS'COMPENSATION SECTION EMPLOYER'S FIRST REPORT OF INJURY eu ions ce.inNuo nema••ao•Y•a on OSN.rom.No?Of -aupplomonnq a•cam a occuesieni Irwin 'lease read instructions on reverse side before completing this form DO NOT 055151 WRITE in 1. Name of Employer Weld C.oanmvuwM vrorucrav von.a . Phone THIS COLUMN 2. Mailing address P.O. Box 758 Greelev, CO 80671 INa.Sues,. 101,✓To-NI Iciusnl ISuul mpg 3. Location if different from mailing addra•e s" 4. Nature of businese 5. Number of employees 6. Name of injurer' Soc Sec.N- 6.11 wd*n Muni eGapuroME 7. Home addrNe. _ .Phone inn a Senn Icrl ISien um B.Age_9. Binh date 10. Sex_11. Marital Status_12. 14o.of dependents_ ACCIDENT TINt 13. Na of hours worked per day_Days worked per week_Hourly wage S_Weekly wage S 14. Value of meals received weekly as wages S Value of rent received S Tips 5 sasuwSa: Insurance 5 Commissions 5 Piece Work S_Overtime S [ \ 15. (a) How long employed by company) lb) employee occupation sLNnCE coNPAw (c) Job assigned when Injured/exposed 16. Place of accident/exposure motsm.', IGh or Tom,. imv.,n OCCUPATION (See Instructions on reverse aide) 17. What was employee doing when injurer'? &OUNCE Be specific.II using tools or equipment name them and tell how they were being used. Pool os Boor 18. How did the accident occur? Describe fully the events which resulted in the injury/occupationalillness.Tell what happened and how it hap- NAmNt pened.Give lull details on all factors which led or contributed to the accidenUexposure.Use separate sheet if additional space is needed. TYPE 19. Name the object or substance which directly affected the employee For example,the machine or thing he struck against or which struck him;the vapor or poisons he inhaled or swallowed;the chemical or radiation which irritated his skin;or in the case of strains,hernia etc_the thing he was liking,pulling.etc. we savcaerY 20. Describe the injury/illness in detail and indicate the pan of the body elected cowpir For example, amputation of right index finger at second joint; Iracture of ribs:lead poisoning; derm— atitis of left hand etc(Medical description) 21. (a) Date of injury (b)Time (c) Working shift From_as lo_arstort P.m. 22.When did employer or his representative first know of injury or illness? 23.(a) Was employee able to continue to work after the injury? Yes_ No_ If no,date left work (b) has employee returned to work? (c) If so,give dam, (d) II not.probable length of disability (e) Did injury/illness force employee to transfer to a different assignment? 24. Did injury/illness result in death?_ If so,give date of death PLEASE TURN TO OTHER SIDE C THE FOLLOWING INFORMATION IS TO E BE COMPLETED BY THE INSURANCE CARRIER BEFORE County Workers' Compensation Yoo 1lLED WITH THE DIVISION OF LABOR Name olInsurance Company c/o Fred.S.James b Co. , Address P0R 6174 Denver. CO R0?0R Policy No. 'Carriers No. I No luslor Code IBIocO Lo 3.95• 3 C.•,006 FSJ POLICIES AND PROCEDURES �`" �► jA Section SAFETY AND INSURANCE Subject Safety Manual -- Exhibit 10a 0 COLORADO Date 10/2/89 Page 62 25. D.d the injury result from any of the hallowing: (a) Failure to use safety devices? No_Yes_ (ci Failure to obey safety rules? No_Yes_ (b) Intoxication of employees? No_Yes_ (dl Other(Explain) No Yes_ 26. Dale of last job-related mluryfillnesa 27. In case of Silicosis or Asbestosis.has employee,while in your employ,been injuriously exposed on at least 60 separate days? 26. Name and address of spouse or other dependent. 29. Name and address of physician 30. Name and address of hospital 31. Names and addresses of witnesses' 32. Date of report 33. Prepared by.(Signature, 34.Till. Designated Physician (#29 above) crif YES NO Physician's Telephone U Cost Center Code Class Code INSTRUCTIONS I.All injuries no matter how trivial,must be reported to your insurance company. 2.All injuries or occupational diseases which result in lost time from work in excess of three shifts or calendar days or in perma- nent physical impairment,must be reported to the division on this form within ten days alter notice or knowledge of the injury or disease.Fatalities must be reported immediately. 3. Forms should be typed or printed legibly. 4.All questions must be answered completely to meet requirements of the Colorado Workmen's Compensation Act and to con- _ form to the OSHA requirements for Form No.101. NOTE: Question 27 to be filled out in cases of Silicosis or Asbestosis. 5.This form will be the only acceptable form after April 1,1986. Instructions for Question 16 It accident/exposure occurred on employers premises give address of plant or establishment in which it occured.If it occured outside emcloyees crem,ses at an identifiable address give that address II it occurred on a public highway or at any other place wiien cannot be identified by number and street please provide place references locating the place of accident or exposure as accurately asLel possible. oc ia','.as Hello