Safety Spotlight Recognition

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

Employee Information

• Employee Name:

• Job Title:

• Picture of recognized employee.

  Media

• Job Site:

• Address:

• Name of Supervisor:

Recognition Presented by

• Name:

• Signature:

  Sign

Observation

• Describe how the employee demonstrated safety excellence: