Tripartite Zero (Recordable) Injury Turnaround Award – Canadian Safety Achievement Awards

Signatory Employer Information

Signatory Employer(Required)

Please type the name of your Company in the field above.

Signatory Employer Address(Required)

Street Address City Province Postal Code

This address will be used to ship awards should the nomination be successful.

Agreement Type(Required)

General Presidents Maintenance Agreement (GPMA)

National Maintenance Agreement (NMA)

Turnaround/Outage Information

Turnaround or Outage Name

Event Start Date

Event End Date

Craft Hours & Incident Information

Name of Collective Agreement(Required)

i.e. Project Agreement Covering Syncrude or National Maintenance Agreement for Province of Alberta.

Client and Worksite

Craft Hours Executed

Trades	Hours	Actions

There are no Entries.

Do not include Boilermaker hours from GPMA/NMA Agreements for Alberta and Saskatchewan and GPMA Agreements in Ontario. Only craft hours performed under the GPMA and/or NMA agreements can be submitted. To add additional trades select add row below.

Total Hours

Recordable Safety Incidents (2025 Operations)

Incident	Actions

There are no Entries.

Indicate whether any recordable injuries occurred on the job site during the nomination period. If so, briefly describe each incident, listing each incident on a separate line. Leave blank if there are no incidents to report during this period. Do not include personal identifying information.

Your Contact Information

Your Name(Required)

Your Email(Required)

Your Phone Number(Required)

Your Address(Required)

Street Address City Province Postal Code

General President's Safety Excellence Award

Also nominate this Signatory Employer, Client and Worksite for the General President’s Safety Excellence Award.

Verification

Enter the name, e-mail address and phone number of a Client representative who can verify this information. Be advised that an e-mail will automatically be sent to this person granting them access to this nomination, so they may confirm the information is accurate. Please coordinate and communicate with the chosen person before submitting the nomination. The Employer is responsible for ensuring their nominations are verified before the nomination deadline. Unverified nominations will not be considered.

Verifier Name(Required)

First Last

Verifier Email(Required)

Verifier Phone(Required)

Finalize & Submit Nomination

Signature(Required)

Date(Required)