WORKPLACE SAFETY MILESTONE AWARD

This award is given to MEMBER organizations showing an Experince Modification Rate* (EMR) of 1.0 or below for 5 consecutive years.
CRITERIA
A. The awards will be based on an EMR of 1.0 or below for a minimum of 5 years in a row.
B. Applicant must submit documentation from ND WSI verifying their EMR.
If your organization is too small for WSI to calculate your EMR, call us (701-223-6372) to discuss other qualifications.

WPS Award reporting as*

Entire Company

Separate Plant or Division

NDSC Member Company Name (as it will appear on award)*

Separate Plant or Division Name

2020 EMR Rating*

2021 EMR Rating*

2022 EMR Rating*

2023 EMR Rating*

2024 EMR Rating*

First Name*

Last Name*

Job title

Street address*

Street address 2

City*

State/Province*

Postal code*

Phone Number*

Email*

Notes or Supporting Documentation
(Optional)

File upload

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Notes or supporting documentation

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