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Company Injury and Illness Prevention Program Acknowledgement <br /> Employee Acknowledgment and Agreement to Participate in tie Company Injury and Illness Prevention <br /> Program (IIPP). <br /> Every employer is required to provide a safe and healthful workplace. The Company is committed to <br /> fulfilling this requirement. A safe and healthful workplace is one of the highest priorities of the <br /> Company. <br /> Employees have the following obligations- <br /> • Study the policies and rules contained in the company IIPP. <br /> • Discuss workplace situations with your supervisor. <br /> • Attend all company sponsored training and safety meetings. <br /> • Read all posters and warnings. <br /> • Listen to instructions carefully. <br /> • Follow the employee safety rules. <br /> • Participate in accident investi;ations as requested. <br /> • Accept responsibility for the safety of others. <br /> The signatures below,document that the above orientation was completed on the date listed. Both the <br /> employer and the employee accept responsibility for maintain:,ig a safe and healthy work environment. <br /> If you are unclear of any of the polies wiziun the IIPP, please ask your supervisor for clarification. Failure <br /> to follow safety policies and rules is grounds for immediate terminatk-ri. <br /> Employee's Signature ✓` <br /> A I <br /> ee's Printed Name <br /> Trainers Signature <br /> IL <br /> Trainers Printed Name <br /> Date <br /> (Remove and retain this sheet in the Employee's Personnel Fife) <br /> 2 <br />