EMPLOYEE SAFETY WAIVER

Company Name: [YOUR COMPANY NAME]
Employee Name: Allene Tillman
Date: October 29, 2078
Job Title: Construction Site Foreman

1. Purpose of the Waiver

This Employee Safety Waiver outlines the potential risks associated with work in hazardous environments, specifically construction sites, and clarifies the employee’s responsibilities regarding safety practices.

2. Acknowledgment of Workplace Hazards

By signing this waiver, the employee acknowledges understanding and awareness of the following:

• Potential Hazards: Includes exposure to heavy machinery, hazardous materials, heights, sharp objects, electrical equipment, and loud noises.

• Physical Risks: Includes the potential for injuries such as cuts, fractures, burns, strains, or hearing damage associated with work in construction zones.

3. Employee Responsibilities

The employee agrees to:

• Follow All Safety Protocols: Adhere to BuildWell Construction's safety guidelines, including the use of personal protective equipment (PPE), safe operation of machinery, and adherence to posted warnings and signage.

• Attend Safety Training: Participate in all required safety training sessions provided by BuildWell Construction, including monthly safety briefings and equipment handling workshops.

• Report Unsafe Conditions: Immediately report any unsafe conditions, incidents, or injuries to the site supervisor or the designated safety officer, using BuildWell’s safety reporting form.

• Use Safety Equipment Correctly: Properly utilize all PPE provided, such as helmets, goggles, gloves, steel-toe boots, and ear protection.

4. Employer Responsibilities

BuildWell Construction agrees to:

• Provide Safety Training: Ensure employees are trained in hazard recognition and safe practices.

• Supply Necessary PPE: Provide and maintain all necessary personal protective equipment, including high-visibility vests, helmets, and ear protection.

• Maintain a Safe Environment: Take reasonable measures to minimize potential hazards in the work environment, including regular site inspections and maintenance.

5. Limitation of Liability

By signing this waiver, the employee understands that:

• Assumption of Risk: They are voluntarily assuming the risks associated with working on a construction site.

• Release of Liability: BuildWell Construction, Inc. will not be held liable for injuries or accidents that occur as a result of the employee's failure to follow safety protocols or use PPE properly, except in cases of gross negligence or willful misconduct by the employer.

6. Employee Consent and Signature

By signing below, the employee acknowledges that they:

• Have read and understand this Employee Safety Waiver.

• Accept the risks and responsibilities associated with working in hazardous environments.

• Agree to adhere to all safety protocols and instructions provided by BuildWell Construction.

Allene Tillman
Date: October 29, 2078

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