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ECCO Equipment Corporation <br />Safety Meeting Attendance and injury Report <br />This form records your attendance at this safety meeting., In addition, since ECCO desires that <br />employees immediately report alt work-related injuries to their supervisors, this form is <br />documentation that no such injury has gone unreported. <br />Your signature on this form indicates that: <br />o You have attended and understand the content of the safety meeting,, and <br />o <br />You have not suffered a work-related injury that has not yet been reported. <br />If you have an injury that has not been reported, please report it t <br />signing this form., Failure to report a work"related injury may delay or even prevent you from <br />o your supervisor now, before <br />receiving your legally entitled workers' compensation' benefits <br />Ifyou need medical treatment, even after r <br />W <br />r working. hours, you are required to see a <br />company aesignatea medical provider, unless you have previously filed a wriften notice that <br />roviderL <br />you have chosen your own p <br />Safety Topic: <br />Meeting.conducted by: <br />Additional subjects discussed: <br />8NS <br />Attendees <br />ilk <br />ate: <br />D IM'Or <br />(Employees: please print and sign your nam' e below)-. <br />y <br />8) a <br />10j <br />11} <br />7 2) <br />13} <br />r <br />rice <br />F <br />I <br />