By signing this document, I hereby confirm that I have read, understood, and accepted the Gate Dredging & Contracting's Safety Management System (SMS), and agree to abide by these.

Name of employee:


Employee Signature
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.