MENU EMPLOYMENT FORMS MORROW STEEL FABRICATORS INC. - QUESTIONNAIRE All employees, current and future, must complete this questionnaire. It will be made a part of your employee file. Instructions: Please complete this questionnaire in full. Your response will in no way affect your employment, so please answer all questions truthfully. Any false statements or misrepresentations, or concealment in an effort to secure employment are grounds for dismissal. Information on this form is for insurance purposes and will only be released with your signed permission. Please complete the following: Name* First Middle Initial Last Date of Birth* Date Format: MM slash DD slash YYYY Phone SSN Current Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Afghanistan Åland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos Islands Colombia Comoros Congo, Democratic Republic of the Congo, Republic of the Cook Islands Costa Rica Côte d'Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini (Swaziland) Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestine, State of Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Réunion Romania Russia Rwanda Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Islands Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay US Minor Outlying Islands Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Country How Long? How long in Florida? During the past five (5) years do you or have you: a. Been in a hospital, sanitarium, or other institution for observation, treatment, diagnosis or an operation? Yes No Are you restricted or unable to perform certain body motions or assume certain body positions? Yes No Have you ever had an injury to the back or neck? Yes No Have you ever had a Workmen's Compensation claim? Yes No Any permanent physical conditions? Head injury Arthritis or Rheumatism Loss of Sight (either eye) Dizziness or fainting spells High Blood Pressure Kidney Trouble Back Surgery Phlebitis Diabetes Heart Trouble Knee Injury Cancer Epilepsy Polio IRONWORKERS' STANDARDS OF EXCELLENCE The purpose of the Ironworkers' Standards of Excellence is to reinforce the pride of every Ironworker and our commitment to be the most skilled, most productive and safest craft in the Building Trades. As Union Ironworkers, we pledge ourselves to uphold our word, as given through our Collective Bargaining Agreement, and display the professionalism expected of our trade and Union in all aspects of our employment as exemplified by the values engrained in our Standards of Excellence. It is a commitment to use our training and skills, each and every day, to produce the highest quality work worthy of our name and consistent with the collective bargaining agreement. As an Iron Worker member, I agree to: 1. Adhere to my responsibilities under the Collective Bargaining Agreement for start and quit times, as well as lunch and break times. 2. Allow my Representatives to handle any disagreements or breaches by refusing to engage in unlawful job disruptions, slowdowns or any activities that affect our good name. 3. Respect the Customer's and Employer's rights, property and tools as I do my own. 4. Meet my responsibility to show up every day; outfitted for work and fit for duty without engaging in substance abuse. 5. Cooperate with the Customer and Employer to meet their statutory, regulatory, and contractual responsibilities to maintain a safe, healthy and sanitary workplace. 6. Do my best to work in a manner consistent with the quality, productivity, and safety of every task that I am assigned. 7. Do my best to help every co-worker return home safe at the conclusion of every shift. The Ironworkers' Standards of Excellence will increase the pride, the productivity, and the craftsmanship of every Ironworker throughout North America. This commitment will improve work place conditions, increase work opportunities, help maintain our wages, benefits and standard of living. In addition, the Standards of Excellence will help our signatory employers complete their projects on time, on budget with no injuries or accidents. In accordance with Article XXVI of the International Constitution, charges may be preferred against any member for violations of the Ironworkers' Standard of Excellence, including but not limited to the following reasons: Taking a job referral and not reporting to work. Failing pre-employment qualifications. Discharged for excessive absenteeism. Fines for the first offense shall be no less than $100.00 or no more than one (1) day's pay including fringe benefits and working assessments. I acknowledge this responsibility and pledge my word to do the same.* Yes No CELL PHONE POLICY FOR FIELD FORCES Morrow Steel recognizes that workers who are involved in construction using tools; working at heights; and working around mechanized equipment, need to have all senses focused on the work area. Cell phones can easily distract from the day-to-day work activities and can very easily lead to a serious accident. Therefore, all Morrow Steel employees working on a project site must receive, read and comply with this policy. In the interest of the safety and wellbeing of all Morrow Steel employees, and others working in their vicinity, the following cell phone policy is effective immediately. Employees are not permitted under any circumstance to use a personal cell phone while working. This includes, any form of phone access (i.e. texting, email, internet access, music...) In otherwords, no phone usage at all. If you have it on your person, it is not to be taken out at any time, for any reason, unless you are on an authorized lunch break. Violation will be cause for immediate dismissal from the project and possible termination. Exceptions: Company issued cell phones, or personal cell phones, being used by superintendents or foremen for business use only. You may give your superintendent/foreman's number to family in the event of an emergency. I acknowledge this responsibility and pledge my word to do the same.* Yes No MORROW STEEL ERECTORS, INC. CORPORATE DRUG & ALCOHOL POLICY This policy shall serve as notice to all potential applicants and new and current employees that Morrow Steel Erectors, Inc. desires that all of our facilities and remote jobsites are Drug-Free Workplaces. The work performed by Morrow Steel Erectors, Inc. employees is complex and requires constant decision making. In keeping with the requirements of Florida Statute 440.102 you are hereby notified that as a condition of your employment with this firm you are subject to drug testing to determine the presence drugs listed in Rule 38F-9.007 and/or a blood alcohol level in excess of .05. Alcohol and other controlled substances can seriously affect the following skills: Judgment Coordination Alertness Perception Concentration Reaction Time There are many signs and symptoms which indicate an alcohol or controlled substance dependency problem; among them are: Increased drinking and periods of intoxication Developing a tolerance for the drug or alcohol Secret or solitary drinking Hiding drug use from others Personality deterioration Persistent family or work problems Tremors of the hands - Noticeable weight change Mood swings and blaming others for problems Obviously, individuals who are under the influence of alcohol or controlled substances are not mentally or physically capable of working safely. Morrow Steels' policy is intended to outline the measures MS will take to prevent these individuals from working while under the influence. As a condition of employment with Morrow Steel Erectors, Inc. all employees who are selected for testing are required to immediately submit for testing when selected or informed to do so. Some projects may be considered Drug Free projects and as such any Morrow Steel employees can be subject to random testing by the General Contractor. Failure to report for testing when notified, or failure to make oneself available for testing within prescribed time period following an accident is cause for immediate dismissal (with cause). If a employee tests positive for alcohol misuse (BAC above .04 during working hours), or use of controlled substances, the following rules will apply: You may give your superintendent/foreman's number to family in the event of an emergency. I acknowledge this responsibility and pledge my word to do the same.* Yes No CORPORATE DRUG & ALCOHOL POLICY ADDENDUM Due to changes in Florida law, we would like provide additional clarification on the use of medical marijuana. Under the current Florida and federal laws, Morrow Steel does not have to cover medical marijuana under its prescription drug coverage. The Florida law does not require that an employer stop drug testing for marijuana and the client is still within in its right to continue a compliant random drug test policy. Even though an employee may carry a medical marijuana card obtained thru the state and prescribed by a physician, the substance remains federally illegal and therefore, the employer retains the right to maintain its drug test policy. Under the current Florida and federal laws, Morrow Steel can continue to require drug testing for prospective hires, even if they hold medical marijuana cards. Employers can still follow their policies for refusing to hire candidates or retain workers who fail a test, including someone who smoked or ingested marijuana at home for a medical reason prior to work or taking a test. Morrow Steel will maintain a drug free work place. As documented in our new hire packet, we will not allow alcohol and controlled substances at our workplace. This can provide an unsafe work environment and will not be tolerated. Random drug testing occurs for our field operations, which failing a test can lead to disciplinary actions, including termination. We appreciate you and your committed work ethic towards safety at Morrow Steel. I acknowledge this responsibility and pledge my word to do the same.* Yes No RULES AND REGULATIONS HARD HATS AND SAFETY GLASSES ARE TO BE WORN AT ALL TIMES, BY ALL PERSONNEL, WHEN ON THE JOBSITE. HARD SOLED SHOES MUST BE WORN ON THE JOBSITE. REMOVE ALL HANGING AND HAND JEWELRY BEFORE WORK. INSPECT AND/OR REPAIR ALL FRAYED OR BROKEN EXTENSION CORDS. KEEP WORK AREAS CLEAN AND FREE OF DEBRIS. NOTIFY YOUR SUPERINTENDENT IMMEDIATELY IN THE EVENT OF AN ACCIDENT OR INJURY. WEAR FACE SHIELDS OR GOGGLES WHEN GRINDING. WELDERS SHOULD WEAR PROPER PROTECTIVE EQUIPMENT: (i.e. leathers, hoods, and gloves) ALL PERSONNEL MUST ADHERE TO MS'S FALL PROTECTION PLAN FOR THE PROJECT. INSPECT ALL LADDERS FOR PROPER FOOTING AND RUNGS. USE AND RESPECT ALL LOCK-OUT / TAG-OUT PROCEDURES WHEN MACHINERY IS UNDERGOING MAINTENANCE. NEVER OPERATE MACHINERY FOR WHICH YOU HAVE NOT BEEN TRAINED AND CLEARED TO USE. THE USE OF ALCOHOL AND/OR OTHER CONTROLLED SUBSTANCES IS STRICTLY FORBIDDEN. VIOLATORS ARE SUBJECT TO IMMEDIATE TERMINATION. FAILURE TO REPORT ACCIDENTS OR INJURIES ON THE JOB, WILL BE CAUSE FOR TERMINATION. I acknowledge this responsibility and pledge my word to do the same.* Yes No FALL PROTECTION PLAN Morrow Steel Erectors, Inc. has a strict Fall Protection Plan in place on all projects. I have been informed that anytime I am working at heights above six (6) ft. I am required to wear a full body harness and lanyard (PPE), and the lanyard is to be tied-off in an appropriate manner. This applies 100% of the time, whether I am working on the iron - or within the confines of a scissor lift, man lift, or any other mechanical means. As a condition of my employment with Morrow Steel Erectors, Inc., I acknowledge there is zero tolerance for failure to be tied off; and that if I am observed not wearing the appropriate PPE and tieing off as required, I am subject to immediate termination. I further assert that I have received training in proper Fall Protection procedures, which includes erecting, maintaining, disassembling, and inspecting the fall protection systems to be used. Morrow Steel has provided me with the following Fall Protection Equipment: Description Full Body Harness: Price $150.00 Retractable Lanyard: Price $325.00 I agree that upon completion of the project (or my termination) I will return said gear, or it will be deducted from my last paycheck. I also have the option to purchase said gear at any time, while employed and have the cost deducted from my pay. I acknowledge this responsibility and pledge my word to do the same.* Yes No IN CASE OF AN EMERGENCY PLEASE NOTIFY: RELATIONSHIP TO EMPLOYEE: Phone DIRECT DEPOSIT AUTHORIZATION FORM Name First Last SOCIAL SECURITY NUMBER: EFFECTIVE DATE: Date Format: MM slash DD slash YYYY BANK NAME: BANK ROUTING NUMBER: ACCOUNT NUMBER ACCOUNT TYPE Checking Savings I authorize MORROW STEEL ERECTORS, INC. to initiate accounting transactions to deposit my employee pay directly into the account(s) indicated above and to correct any errors which may occur from these transactions. I also authorize the Financial Institution to post these transactions to these accounts. This authorization is to remain in force until MORROW STEEL ERECTORS, INC. receives written notice from me to cancel or change this authorization.* Yes No PAYCHECK STUB E-MAIL AUTHORIZATION I am currently utilizing direct deposit and I elect to start receiving my paycheck stub electronically. I understand that no paper check stub will be sent. I also agree that it is my responsibility to update the e-mail address provided. This election will remain in force until a change is requested in writing. Current, private e-mail address: CORONAVIRUS (COVID-19) PREVENTION AND ACTION PLAN Morrow Steel recognizes that in order to ensure the health and safety of our workforce, and that of other workers, on projects where multiple crafts and trades interact, it is necessary to prepare an infectious and communicable disease prevention plan. The following outlines the various components of Morrow Steel's plan and the steps you as our supervision and workers will take to prevent the transmission of communicable diseases. All workers will be made aware of the signs and symptoms typically associated with a virus such as the COVID-19 flu. They will be advised of the highly contagious nature of the virus, and that contact with anyone demonstrating any of the symptoms may be cause for self-quarantine or isolation. SIGNS AND SYMPTOMS OF COVID-19 If an employee has any of the following - they must notify you, their Supervisor, and NOT come to work. ✓ Fever ✓ Coughing and/or Sneezing ✓ Shortness of breath They should inform you immediately if any of the following have occurred: - Worker has been in close contact with an individual exhibiting COVID-19 symptoms - Worker has recently traveled to or from a Level 3 location as defined by the CDC within the last 14 days - Worker has been in close contact in the last 14 days with anyone who has been diagnosed with COVID-19. SAFE WORK PRACTICES In order to prevent the transmission of the virus in our personal and professional lives the following Safe Practices are highly recommended when out in public, and will be strictly enforced on this project: → Practice good hygiene by washing hands frequently with soap and water for at least 20 seconds. > Use alcohol-based hand sanitizer that contains at least 60-95% alcohol. > Keep hands away from your mouth, nose and eyes. Steer clear of people who are coughing or who appear ill, and avoid contact with others if you may be experiencing flu-like symptoms. > Maintain social distancing of 6 feet or more. > Avoid large groups as reasonably as possible (10 persons or more). > If the nature of the work/tasks is such that you cannot effectively maintain groups less than 10 with social distancing, our supervision shall explore ways of sequencing, scheduling, phasing, etc. in order to maintain compliance with this requirement. ► Cover your mouth with a tissue or in your elbow if you cough or sneeze. Immediately dispose of tissues in the trash receptacle and then wash and/or sanitize your hands. > Clean and disinfect frequently touched objects and surfaces using household cleaning sprays or solutions. ► Don't share PPE, and if possible, don't share tools or other types of equipment. > If possible, tools and equipment shall be wiped down with disinfectants prior to being used by other workers. > We recognize that exposure can occur anywhere and an infected individual may not realize they have contracted the virus until they begin to manifest symptoms. REPORTING PROCEDURES IN THE EVENT OF INFECTION • Any workers (including lower-tier subcontractors) experiencing COVID-19 signs and symptoms shall immediately notify you, their Supervisor, who will notify the General Contractor and the office. Any workers observing a co-worker or other worker showing COVID-19 signs and symptoms shall immediately notify their Supervisor and Contractor. The Supervisor shall remove the worker from the area, then investigate to see if other workers were potentially exposed. Findings of the investigation shall be immediately provided to General Contractor. DAILY PRETASK SAFETY PLANNING As the supervisor on-site it is your responsibility to do the following: - Construction activities shall be sequenced to ensure social distancing of 6 feet or more, when possible. - JHA's shall be completed and reviewed with small groups of workers (10 individuals or less) and social distancing measures shall be maintained, as much as possible, with the only exceptions being the safe performance of the task if social distancing cannot be maintained without threatening the safety of the workers or others. - Alternative means of performing the task shall be prioritized over working at less than 6 feet of distance or more from others if reasonably possible. - COVID-19 awareness and preventative measures shall be an ongoing and recurring topic with workers (including lower-tier subcontractors) during all meetings. - Work shall be coordinated to ensure social distancing is not violated whenever feasible. - Attendance verification of all meetings shall be documented by emails, phone apps., scans, etc. - Delivery trucks shall be met at the project entrance by the applicable Morrow Steel employee then escorted by the Morrow's Foreman/DSP to the appropriate location. The delivery driver shall remain inside the cab of the truck at all times. CLEANING AND SANITATION + Our Supervision will ensure that soap or alcohol-based (60-95% alcohol) hand sanitizer is readily available to the workers, to include common areas (porta-johns) and meeting spaces. + Tools and Equipment shall be cleaned and disinfected at the end of each shift. + Aerial Work Platforms and any other shared tools/equipment being used by Subcontractor shall be cleaned and disinfected before allowing another worker to operate the machine/tool. + Seats, steering wheels, buttons, controls, gates, etc. shall be cleaned and disinfected after each use. + Personal tools shall not be stored in shared gang boxes. + Workers (including lower-tier subcontractors) handling tools, operating equipment, will must be properly trained and protected using necessary Personal Protective Equipment (PPE). + Workers will wear gloves at all times. + Protective safety eyewear shall be worn at all times. SIGNAGE AND POSTINGS We will make certain that Signs and Posters regarding COVID-19 prevention are posted in Human Resource area, Signage and posting shall include, but are not limited to: i. Hygiene Guideline ii. COVID-19 Awareness iii. Self-Reporting iv, CDC Facts CLEANING AND SANITATION The following are items to be cleaned in Office Trailers, Connex's and Common Areas - Doors/Handles Restrooms/Toilets Equipment seats, handles, buttons/switches, etc. Implements/Handrails Conference tables, desks, chairs Any common area keyboards, pens, highlighters, etc. • Any other hard surface that is touched by multiple individuals Be sure to keep personal items cleaned and disinfected. Examples include: * PPE (hard hats, safety glasses, safety vests) * Clothing * Technology (phones, iPads, laptops, etc.) Care should be given to ensuring tools and equipment in the field are cleaned on a daily basis, to include: o The surface of tools will be cleaned with a mild soap and damp cloth to remove dirt and grease and then decontaminate with a diluted bleach solution consistent with CDC recommendations. o Tools and Equipment shall be cleaned and disinfected at the end of each shift o Aerial Work Platforms and any other shared tools/equipment shall be cleaned and disinfected before allowing another worker to operate the machine/tool. o Seats, steering wheels, buttons, controls, gates, etc. shall be cleaned and disinfected after each use. o Personal tools shall not be stored in shared gang boxes. o Common Areas such as gang boxes, door knobs/handles, tables, stair towers shall be cleaned and disinfected at scheduled intervals throughout the workday. CONTRACTION OF OR EXPOSURE TO COVID-19 Individuals exhibiting a symptom or coming in close contact with a person with laboratory confirmed COVID-19 are asked to go home and self-isolate per CDC and public health policies. You will not be allowed to return to work until you are symptom free. People with COVID-19 who have quarantined (home isolated) can stop home isolation under the following conditions: If you WILL NOT have a test to determine if you are still contagious, you can leave home after ALL three of these things have happened: • You have had no fever for at least 72 hours (that is three full days of no fever without the use of medicine that reduces fevers) AND • other symptoms have improved (for example, when your cough or shortness of breath have improved) AND • at least 7 days have passed since your symptoms first appeared If you WILL BE tested to determine if you are still contagious, you can leave home after ALL three of these things have happened: • You no longer have a fever (without the use of medicine that reduces fevers) AND • other symptoms have improved (for example, when your cough or shortness of breath have improved) AND • If possible, you received two negative tests in a row, 24 hours apart. (your doctor will follow CDC guidelines). Contact management if you receive only one negative result for further guidance. I acknowledge this responsibility and pledge my word to do the same.* Yes No CONTACT 813-715-0404 info@morrowsteel.com 3620 Copeland Drive Zephyrhills, FL 33542 Like us on Facebook QUICK LINKS Careers © 2021 Morrow Steel Inc., All Rights Reserved. Crafted by LC