Provided by
(Client Name)
(Client Address)
(Applies to all Company locations)
Risk Department
TITLE
EMPLOYEE ISSUE/PURCHASE
OF PERSONAL PROTECTIVE
EQUIPMENT
EMPLOYEE ISSUE/PURCHASE OF PERSONAL PROTECTIVE EQUIPMENT
TABLE OF CONTENTS
1. PURPOSE ............................................................................................................... 3
2. ISSUANCE ............................................................................................................... 3
3. PURCHASE ............................................................................................................. 3
4. ISSUANCE AND PURCHASE ................................................................................. 4
5. ENCLOSURES ........................................................................................................ 5
Acknowledgement of Company-Issued Equipment ......................................................... 6
Purchase/Deduction Authorization .................................................................................. 7
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EMPLOYEE ISSUE/PURCHASE OF PERSONAL PROTECTIVE EQUIPMENT
1.
PURPOSE
1.1. This procedure provides guidance on the requirement for issuing personal
protective equipment (PPE) and provides a standard method whereby
employees may purchase protective equipment at their own expense through
payroll deductions, with the benefit of any discounts provided through the
company.
2.
ISSUANCE
2.1. Issue/Deduction Authorization For Company-Provided Safety Equipment,
unless not authorized by contractual requirements, should be completed as an
issuance record and authorization to deduct the price of the listed safety
equipment that the employee failed to return from the employee’s termination
pay. The issuance may be replaced if non-company equipment is purchased.
2.2. All (Client Company) personnel conducting field activities will be issued an
initial hard hat and safety glasses. Additional protective equipment may be
issued if his/her job scope will entail additional hazards that require additional
protective equipment (ie – harness, lanyards, face shield, etc).
2.3. Issuance of company PPE will be documented at the time of issuance. The
person receiving the equipment will validate the issue by signing the
“Acknowledgement of Company-Issued Equipment” form (Enclosure 1).
2.4. Upon leaving employment, the recipient of the protective equipment will be
responsible for returning these items. If the items are lost or no longer able to
be utilized for reason other than normal wear and tear, the cost of replacement
will be deducted from the employee’s final pay.
3.
PURCHASE
3.1. The Safety Coordinator (or representative) will publish information (descriptions
and price lists) for purchase by (Client Company) employees only. Limited
personal protective equipment will be made available for voluntary purchase by
(Client Company) employees at their own expense, through the payroll
deduction plan.
3.2. The “Purchase/Deduction Authorization” form (Enclosure 2) will be completed
and signed by employees wishing to make such purchases.
3.2.1. NOTE: This form will serve as the Safety Coordinator’s authorization to
order equipment, if necessary; and will serve as the accounting
department’s and Creative Business Resources’ authorization to deduct
the stated amount from the employee’s next paycheck.
3.2.2. A copy of the form will be submitted to Creative Business Resources and
appropriate instructions given to deduct this expense from the employee’s
next paycheck.
3.3. Any employee wishing to purchase prescription safety glasses through the
company will:
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EMPLOYEE ISSUE/PURCHASE OF PERSONAL PROTECTIVE EQUIPMENT
3.3.1. Contact his personal optometrist or ophthalmologist for an examination.
(Note: The employee must obtain a prescription for safety glasses from a
licensed ophthalmologist or optometrist.)
3.3.2. The examiner will complete the prescription form and the employee will
present the completed form to the Safety Coordinator or designated
company representative.
3.3.3. The employee will sign a “Purchase/Deduction Authorization” form
(Enclosure 2), and await the delivery of the glasses.
3.3.4. Upon receipt of the completed “Purchase/Deduction Authorization” form,
the Safety Coordinator or designated company representative will order the
glasses and distribute copies of the completed “Purchase/Deduction
Authorization” form to the accounting department.
3.3.5. Prescription glasses will be ordered only if the employee has worked at
least one week.
3.4. Equipment expressly forbidden by regulation cannot be sold to employees and
is not authorized on company projects.
4.
ISSUANCE AND PURCHASE
4.1. Issuance and purchase forms will be placed into the employee file and
reviewed upon termination of employment.
4.2. At the discretion of management, hard hats and safety glasses may be kept by
employees upon termination of employment.
4.3. Documentation Control
4.3.1. If the employee receives company-issued personal protective equipment:
4.3.1.1. Employee verifies equipment.
4.3.1.2. Employee signs issuance form.
4.3.1.3. Issuance form is placed into employee file.
4.3.1.4. Issuance form is reviewed at the termination of employment.
4.3.1.5. Cost of lost, missing or damaged items are deducted from final
earnings.
4.3.2. If the employee wishes to purchase personal protective equipment through
(Client Company):
4.3.2.1. Employee fills out the “Purchase/Deduction Authorization” form.
4.3.2.2. Equipment is ordered.
4.3.2.3. “Purchase/Deduction Authorization” form is submitted to the
accounting department, and ultimately to Creative Business
Resources.
4.3.2.4. The purchase is deducted from the employee’s next paycheck.
4.3.2.5. The “Purchase/Deduction Authorization” form is placed in the
employee’s file.
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5.
ENCLOSURES
5.1. Acknowledgement of Company-Issued Equipment form
5.2. Purchase/Deduction Authorization form
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ENCLOSURE 3.1
ACKNOWLEDGEMENT OF COMPANY-ISSUED
EQUIPMENT
Name:
Date: ____________________
I acknowledge receipt and acceptance of the below referenced equipment. Upon
termination of my employment with (Client Company), I agree to return this equipment
in acceptable working order.
In the event the equipment is lost, damaged or is not returned, I agree to have the
purchase price deducted from my final earnings.
Qty
ITEM
MODEL/
MAKE
SERIAL #
PURCHASE
PRICE
Hard Hat
Safety Glasses
Meta-tarsal Guards
Full Body Harness
Single lanyard
Double Lanyard
Issued by :
Date: __________________
Authorized/Accepted By:
Date:
Place in employee file.
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_________
EMPLOYEE ISSUE/PURCHASE OF PERSONAL PROTECTIVE EQUIPMENT
ENCLOSURE 3.2
PURCHASE/DEDUCTION AUTHORIZATION
Name:
Date:
__________________________
I authorize (Client Company) to purchase the below referenced equipment
on my behalf. I acknowledge that by completing this form I am authorizing
(Client Company) to deduct the cost of this purchase from my next payroll
check. I realize that all warranty issues will be my sole responsibility.
This form will authorize (Client Company) to order and Creative Business
Resources’ payroll department to deduct the stated amount from my next
payroll check.
Equipment expressly forbidden by regulation cannot be sold to employees
and is not authorized on company projects.
Qty
ITEM
MODEL/
MAKE
SERIAL #
PURCHASE
PRICE
Total
Authorized/Accepted By:
Date: ________________
Distributed By:
Date: _______________
Deducted By:
Date: _________________
Place in employee file.
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