ND Paper Contractor Safety Qualification Form

"*" indicates required fields

General Company Information

All contractors planning to perform work onsite an ND Paper mill are required to fill out this form.

This form also includes our Personal Protective Equipment (PPE) Policy.
Name*
Address*
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Mill/site(s) where service/material will be rendered/supplied*
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Drop files here or
Accepted file types: pdf, doc, docx, Max. file size: 50 MB.

    Contractor Safety Record

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    Drop files here or
    Accepted file types: pdf, doc, docx, Max. file size: 50 MB.

      Contractor Safety Questions - Current Year

      Contractors MUST complete this section: please report accurately the requested information below for year-to-date current year. If you are not a contractor, please indicate "N/A" in all lines. If your company has greater than 10 employees then please upload the previous 3 years of OSHA 300 logs.

      Contractor Safety Questions - Prior Year

      Contractors MUST complete this section: please report accurately the requested information below for prior year. If you are not a contractor, please indicate "N/A" in all lines.

      Contractor Safety Questions - 2 Years Prior

      Contractors MUST complete this section: please report accurately the requested information below for 2 years prior. If you are not a contractor, please indicate "N/A" in all lines.

      Consultant and Engineer Safety Questions - Current Year

      Consultants and Engineers MUST complete this section: please report accurately the below requested information for year-to-date current year. If you are not a consultant/engineer, please indicate "N/A" in all lines.

      Consultant and Engineer Safety Questions - Prior Year

      Consultants and Engineers MUST complete this section: please report accurately the below requested information for year-to-date current year. If you are not a consultant/engineer, please indicate "N/A" in all lines.

      Consultant and Engineer Safety Questions - 2 Years Prior

      Consultants and Engineers MUST complete this section: please report accurately the below requested information for year-to-date current year. If you are not a consultant/engineer, please indicate "N/A" in all lines.
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      Safety Reporting

      How often are incident reports or accident summaries sent to the following? Please note that the immediate reporting of accidents onsite any ND Paper facility is required.
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      ND Paper (only for accidents onsite)
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      Company President
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      Field Supervision

      Policies and Procedures

      Do you have the following policies and procedures?
      Accident/Incident Reporting Procedure*
      Confined Space Entry Program*
      Employee Assistance Program (EAP)*
      First Aid Procedures*
      Hazard Communication Training*
      Incident Review Program*
      Personal Protective Equipment Policy*
      Process Safety Management Policy*
      Respiratory Protection Policy*
      Substance Abuse Program*
      Zero Energy Program*
      Most Current NFPA-70E*
      Drop files here or
      Accepted file types: pdf, doc, docx, Max. file size: 50 MB.
        Drop files here or
        Accepted file types: pdf, doc, docx, Max. file size: 50 MB.
          Drop files here or
          Accepted file types: pdf, doc, docx, png, jpg, jpeg, Max. file size: 50 MB.

            ND Paper Contractor Safety, Environmental and Security Policy

            ND Paper PPE Policy & Safety, Environmental & Security Policy Acknowledgement

            I certify understanding and will comply by the ND Paper PPE Policy when performing work on ND Paper site(s).*

            ND Paper Contractor Safety Qualification Form

            Certification of Accuracy
            As a representative of the company, I confirm the foregoing information is complete and accurate. I understand it is our organization's responsibility to ensure that all of our employees, subcontractors, vendors, service representatives, etc., working in any ND Paper facility or location have read, understand, and are held accountable for following all of ND Paper's Environmental, Health & Safety (EHS) Requirements. A copy of "ND Paper Contractor Safety, Environmental and Security Policy" has been provided to us. By checking "Yes" below, I acknowledge understanding and acceptance.*
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