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8C Attachment A—Site Safety & Health Plan <br /> Employee Acknowledgment <br /> Employee Name <br /> Project Name Project Location Project Number <br /> Employee Statement of Acknowledgment <br /> I hereby certify that I have read and that I understand the safety and health guidelines contained in Brown <br /> and Caldwell's Site Safety and Health Plan for the above-named project. <br /> Employee Signature Date <br /> In the Case of an Emergency,oantam. <br /> Name Relationship Phone No <br /> 1. <br /> 2. <br /> Name of Site Safety Officer Receiving This Form <br /> Signature of Site Safety Officer Dam <br /> I <br /> BROWN Md CALOWIU Forward completed form to the Health and Safety Director.Place a copy m protect file. 145461m REV IMI <br />