2017 Safety Excellence Award Program

The Missouri Association of Manufacturers (MAM) Safety Excellence Awards Program was developed to stimulate interest in accident prevention,
maintain safe and healthful work environments, and share best practice examples. The goal of the program is to recognize manufacturing companies
and individuals that are making significant contributions to safety, health and/or environmental compliance.

BENEFITS
Benchmarking: The process of applying for the MAM Safety Excellence Awards provides an opportunity for your company to evaluate and
benchmark your safety program’s past, present and future direction as you strive to achieve and maintain a culture of safety in your workplace.
Prestige: Award winners can use the MAM Safety Excellence Award to promote their organizations’ continued commitment to safety in internal
communications, marketing materials and websites.
Morale: Winning organizations may use the award as an opportunity to acknowledge the accomplishments of their employees and show
appreciation for a job done well.

ELIGIBILITY
The MAM Safety Excellence Awards program is for any manufacturer with a facility in the state of Missouri and individuals with experience leading
safety, health and/or environmental projects, programs and initiatives for manufacturers.
Divisions of corporations may apply individually, if the division: operates in a separate location/facility from corporate/parent company; has a distinct
line of business identity; and is evaluated apart from corporate for safety and loss control (i.e., independent procedures and safety programs).
Data submitted for the awards program must be site-specific and for Missouri facilities only.
Applicants may not have had any OSHA violations within the past five (5) years.
Award recipients must be present at the Mid-America Safety, Health & Environmental Conference & Expo on Thursday, May 4 at the Radisson Hotel
Branson to receive the award. Failure to appear will result in forfeiture of the award.

DEADLINE
There is no limit to the number of nominations a manufacturer may submit for the Safety Excellence Award program. Each nomination must be for a
different project or individual achievement. The achievements for which individual leaders are nominated should be separate and distinct from
projects that are being nominated in other Safety Excellence Award categories. If needed, a MAM Safety Excellence Awards Committee member
may contact applicants to confirm and verify information prior to the judging process.
The deadline for application is March 31, 5 p.m. CST. Please email applications and supporting documents to Vicky@MissouriManufacturers.org.
Late or incomplete nominations will not be accepted. Award recipients will be notified mid-April.

JUDGING
Award criteria will consist of data common to all awards and factors that may be unique or specific to a given award category. Each application will
be reviewed and scored by an expert panel of judges, comprising of safety experts from the manufacturing industry and/or governmental agencies.
The applicant(s) receiving the highest scores will be designated as MAM Safety Excellence Award recipients. Nominees must meet all eligibility
requirements and criterion for the award category for which they are applying.
Companies with current or former representatives serving on the MAM Safety Advisory Board or Safety Excellence Award Committee may submit
nominations for the Safety Excellence Awards program.

HOW WE USE THE INFORMATION YOU PROVIDE

All information provided on the MAM Safety Excellence Award application is considered private and confidential and will be used by MAM and the
Safety Excellence Award Committee for award evaluation only. MAM may reference the information in preparing project summaries, program
descriptions or profiles of winners, but inclusion of any information that may be considered confidential or proprietary will be subject to the approval
of the winning manufacturers and individuals. MAM reserves the right to announce winners through various forms of media, including press releases,
emails, website content and social media posts.

AWARD DESCRIPTIONS
Horizon Individual or Corporate, Multi-site or Single-site
This award recognizes a young manufacturer and/or safety professional, in business or in his/her position for less than five (5) years, who is making
significant and quantifiable contributions to safety, health and/or environmental compliance. Applicants will demonstrate a strong understanding of
safety processes and procedures, a hands-on passion for the work, a record of commitment to training and professional development, and ambition
to excel in the industry. Applicants will demonstrate resourcefulness and a strong commitment to safety awareness, providing evidence of consistent
advancement and growth throughout the past few years.
Safety Innovation Award Corporate, Multi-site or Single-site
This award recognizes a manufacturer that best demonstrates how innovation within the organization has been developed and applied to create
significant safety, health and/or environmental improvements and operational effectiveness. The innovation may include a new or improved safety
product or process that demonstrates significant improvement over past products or methodologies. Applicants must provide evidence of improved
safety performance and ratings.
Most Improved Corporate, Multi-site or Single-site
This award recognizes a manufacturer that demonstrates the greatest, sustained improvement of safety efforts in the past three (3) years over
previous years, which have led to measurable reductions in work-related injuries and illnesses, as verified by workers’ compensation loss run reports
and annual worker hours. Applicant must provide evidence of the implementation of programs, products, processes and procedures that have
resulted in a marked improvement in safety, as well as an explanation of the capital (workforce, monies, other resources) that has been devoted to
improving safety.
Safety Champion of the Year Individual (self or joint nomination)
This award recognizes an individual who has gone above and beyond his/her scope of work or responsibility to demonstrate his/her commitment to
the organization's safety culture, which may include participation on a task force, committee, team or panel. This individual promotes a safety culture
and uses techniques that strive for the prevention of accidents that may cause serious injuries or fatalities. The applicant implements innovative work
practices that enhance the organization’s safety and health program awareness and/or develops risk-reduction methods and promotes managerial
action to lessen human and material resource loss. Applicant will have established and/or maintained high standards of occupational safety, health
and/or environmental activities and achievements, which may include development of policies, plans or processes that positively affect the health
and safety culture of the organization.
Safety Professional of the Year Individual (self or joint nomination)
Applicants for this award will demonstrate the greatest breadth and depth of safety leadership and management skills, and successful
implementation of a clear, well-communicated safety strategy. Applicants will provide evidence of critical thinking, innovative practices, and improved
safety performance and ratings. Award recipient will have promoted safety culture and values by engaging with employees to ensure strategy is
effectively communicated across the organization and understood at all levels. Applicants must understand drivers for change within an organization
and implement innovative practices to identify and manage risks to safety objectives.
 Supports training and development to help deliver safety objectives.
 Serves as the voice of safety, advocating and dealing with the multitude of regulatory agencies at the local, regional and state levels and in
influencing organization policy.
 Excellence in field of expertise, promotes best practices with a long history of proven safety leadership.
 Commitment to innovation, research and development.
 Facilitates accountability and improvement through evaluation and monitoring.
Safety Manufacturing Company of the Year Corporate, Multi-site or Single-site
This award recognizes a manufacturer for outstanding safety, health and environmental program achievement. The company must have
implemented a program that contributed towards the establishment of a safe and healthful environment by having built a culture that demonstrates
commitment to continuous improvement of safety, health and environmental standards and will move the manufacturer toward the goal of zero loss
of human and material resources. The selected organization’s program may serve as an example to other manufacturers across Missouri.
 Committed to safety, health and environmental protocols within the workplace including: systematic management of occupational health and
safety; injury management (including return-to-work programs); and systematic identification, assessment and control strategies for hazards.
 Demonstrates best practice approaches and achievements in safety, health and environmental management, which may include:
- improved efficiencies and ability to identify and abate unsafe conditions and practices;
- elimination of or reduction in hazards and/or exposures, accidents, injuries or fatalities;
- leadership in fostering timely and safe return to work;
- solutions to a specific safety management problem or significant safety program improvement; increased safety knowledge, skills or
awareness within the workforce through program communication;
- implementation of effective safety and health resourcing strategies.
 Develops and creates a safety culture inclusive of all employees and activities in consultation with relevant workplace parties (e.g. employees,
management, unions, etc.) and, where appropriate, with outside organizations.
 Demonstrates how approach to safety training and development has improved employee satisfaction, safely optimized productivity and quality,
and increased workforce engagement in the cycle of improvement, recognizing individuals, teams or divisions for contributions.
 Provides evidence of improved safety performance, ratings and claims data.
 Responsibility for health and well-being of employees is beyond statutory duties of care, including qualification and trainings offered.
 Describes how the organization is assessing and addressing both the current and future safety needs of its workforce.
 Describes the broader impact of program across other facilities, and how it impacts industry and workplace safety culture across Missouri.
Leader of the Pack Single-site only
Manufacturer must have been a member of MAM, in good standing, for at least one year at the time of application. Manufacturer must be designated VPP, SHARP or equivalent.

This award recognizes a manufacturer who is a member in good standing of the Missouri Association of Manufacturers (MAM) that exhibits a
proactive approach to safety improvements and risk reduction. The manufacturer will have management’s commitment, employee participation,
safety training, and the successful development and implementation of innovative safety programs and practices. Applicants will demonstrate
progress in worksite hazard identification and control, with creative solutions to industry-related challenges, supplementing or enhancing best-
practice standards. Applicants will also be responsible and pro-active in the utilization of local resources (educational institutions, natural resources,
goods/services, etc.) and demonstrates environmental stewardship.
2017 Safety Excellence Award Program
All information provided on this award application is considered private and confidential and will be used by MAM and the Safety Excellence Award Committee for award evaluation only.

Application must be completed in its entirety and submitted by March 31, 2017, 5 p.m. CST
Company name:
Contact name: Title:
Phone: E-mail:
Corporate address:
Street Suite # City State Zip

Facility address:
Street Suite # City State Zip

Number of facilities: __________ Additional locations (cities):

NAICS: BLS rate:
Awards and certifications:  VPP  SHARP  OHSAS 18001  ISO 14001  Other:

AWARD CATEGORIES
Select one award category per application. MAM Safety Excellence Award Committee reserves the right to change the award category for any application.
 Safety Innovation Award (Corporate, Multi-site or Single-site)  Horizon Award (Individual –or– Corporate, Multi-site or Single-site)
 Most Improved (Corporate, Multi-site or Single-site)  Safety Champion of the Year (Individual)
 Safety Manufacturing Company of the Year (Corporate, Multi-site or Single-site)  Safety Professional of the Year (Individual)
 Leader of the Pack (Corporate, Multi-site or Single-site)

COMPANY DATA
Data represents (select one):  Corporate (all facilities)  Multi-site (two or more facilities)  Single-site (one facility)
Number of employees: Full-time __________ Part-time __________ Percentage of temporary employees: __________ %
Employees per shift: 1st __________ 2nd __________ 3rd __________
2014 2015 2016
Total hours worked (calendar year)
Number of recordable nonfatal work-related injuries and illnesses
Number of days away from work cases
Number of job transfer or restricted work activity cases
Experience Modification
How many days/hours since last lost time injury? ______________________
Tracked hazards to resolution:  Yes  No Example:
Written safety manual available:  Yes  No If yes, include a copy of Table of Contents with application.
Employee safety training provided:  Yes  No Bilingual training provided:  Yes  No
Employee safety celebration program  Yes  No If yes, describe program.

Program Summary – Attach a separate sheet(s) to include the following:

 A description of your company’s safety program (i.e. development, administration, training, etc.)
 Any unique safety activities or plant safety innovations for your company.
Application checklist:
 Completed 2017 MAM Safety Excellence Award Application Form.
 Completed and signed OSHA 300A forms for calendar years 2014, 2015 and 2016.
 Copy of company’s written safety manual table of contents, if applicable.
 Program Summary
 For an individual award (champion, professional or horizon), include a brief bio for the individual and a one-page explanation for why he/she
deserves the award.

___________________________________________________ ____________ MAM Office Use Only

Contact’s Signature Date Date rec’d: __________
Rec’d by: __________
Due March 31, 2017 to: Vicky@MissouriManufacturers.org. Committee: ______________