Safety Compliance COVIDSafe Plan

SAFETY COMPLIANCE COVIDSAFE PLAN

This Safety Compliance COVIDSafe Plan ("Plan") is prepared by and between:

WHEREAS

WHEREAS, Company Name: operates the facility described below and seeks to maintain a workplace that minimizes transmission risk of communicable respiratory illness including COVID-19; and

WHEREAS, Plan Preparer: will document specific control measures, responsibilities and monitoring procedures to be implemented at the facility located at:

WHEREAS, the parties agree that adherence to the measures set forth in this Plan is a condition of continued engagement at the facility and is intended to reduce transmission risk and comply with applicable health and safety obligations.

RESPONSIBLE PARTIES

PLAN EFFECTIVE DATES

Plan Effective Date:    Review Date:

SCOPE OF WORK

Describe the scope of safety activities, locations, and personnel covered by this Plan. Include on-site operations, off-site work, and any high-risk tasks.

HAZARD ASSESSMENT

Identify known hazards and populations at greater risk present at the covered locations. Attach or summarize any facility-specific assessment findings below.

CONTROL MEASURES

Select implemented or required control measures and provide details for measures not listed.

Mask use policy for employees and visitors
Entry screening and symptom checks
Physical distancing protocols
Enhanced ventilation assessment and controls
Hand hygiene facilities and supplies
Cleaning and disinfection schedules
Personal protective equipment (PPE) requirements
Remote work or staggered shifts where practicable

TRAINING, COMMUNICATION & RECORDS

Provide training plans, communication methods to staff and visitors, and recordkeeping practices for exposures, training, and cleaning logs.

REPORTING AND INCIDENT MANAGEMENT

Reporting contact for suspected or confirmed cases: Name:   Phone/Email:

Incident response steps, isolation procedures, notification protocols, and return-to-work criteria must be followed as described below.

MONITORING, AUDIT AND REVIEW

Frequency of monitoring and audit:   Next scheduled review:

PAYMENT TERMS

If this Plan is provided under a separate services engagement, the following payment terms apply:

TERM AND TERMINATION

This Plan commences on Start Date: and continues until End Date: unless earlier terminated in accordance with the provisions below.

Either party may terminate this Plan for convenience upon written notice delivered at least days before the intended termination date. Either party may terminate immediately for material breach, including failure to implement required health and safety measures or repeated noncompliance.

CONFIDENTIALITY

Each party shall maintain as confidential all non-public information disclosed in connection with this Plan, including medical, personnel, and exposure records. Confidential information shall not be disclosed except to the extent required by law or necessary to implement this Plan, and then only to persons with a need to know who are bound by confidentiality obligations no less protective than those set forth herein.

GOVERNING LAW

This Plan shall be governed by and construed in accordance with the laws of the state or jurisdiction in which the facility is located. The parties consent to the exclusive jurisdiction of the courts in that jurisdiction for disputes arising from this Plan.

ENTIRE AGREEMENT

This Plan, together with any incorporated appendices, attachments and related engagement documents, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior discussions and agreements. No amendment will be effective unless in writing and signed by authorized representatives of both parties.

CERTIFICATION

The undersigned certify that they are authorized representatives of their respective parties, have read this Plan in full, and will implement and enforce the measures described herein to the extent within their control.

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