Employee Portal

Time-Off Request

*Submitted time-off request forms do not guarantee you will get the day off. All requests must be approved and confirmed.

Time-Off Request Form

Name

First Name

Last Name

Today's Date

MM

DD

YYYY

Email

Time Off Start Date

MM

DD

YYYY

Time Off Start Time

Hour

Minute

Second

Return to Work Date

MM

DD

YYYY

Return to Work Time

Hour

Minute

Second

Reason (Vacation, Personal, Etc.)

Employee Safety / Suggestion Report

Employee Safety/Suggestion Report

Name of Employee Making Report (Optional)

First Name

Last Name

Email (Optional)

Today's Date

MM

DD

YYYY

What was the unsafe condition, or violation of Code of Safe Practices?

What was the location of the unsafe condition or violation of Code of Safe Practices?

What are the names of the contractors involved or affected?

What are the names of employees involved or affected?

What is the cause of the unsafe condition or violation of Code of Safe Practices?

Was a safety rule of the Code of Safe Practices violated? If yes, specify which rule was violated.

Has the General Contractor been notified of the situation?

Yes

No

What suggestions do you have to correct the situation?

Schedule for Monday 2-24-25