Injury or Illness Incident Report

The Injury or Illness Incident Report is to be completed by the Job Supervisor whenever there is an injury or illness on the job site of sufficient severity to warrant filing this report.

The filing of the report is at the discretion of the Job Supervisor. However, it is recommended that a report be filed for each reported injury or illness incident, no matter the severity. It is better to file a report and not need it than to need a report and not have filed it.

The OSHA FORM 301 Information form can be used in place of, or in combination with, this form.

When submitted, form responses are sent to the email addresses provided and then deleted.
IF YOU WISH TO RETAIN THE INFORMATION YOU HAVE ENTERED, ADD AN EMAIL ADDRESS BEFORE SUBMITTING.

INJURY OR ILLNESS INCIDENT REPORT

SITE SUPERVISOR
Complete upon the occurrence of any injury or illness on the job site.

PROJECT MANAGER
Copy to Project Binder, Copy to Accounting/Risk Management.

ACCOUNTING/RISK MANAGEMENT
File in Safety Compliance folder for minimum 5 years.

Project

Builder

Site Supervisor

Subcontractor

Incident date

We are issuing an Injury or Illness Incident Report

This incident report is for is for:

An accident An illness on the job site

The Subcontractor was notified of the incident.

Yes No

The following information relates to the affected person

Name of the affected party

Age of the affected party

Address of the affected party

Phone of the affected party

Subcontractor Telephone

Subcontractor's Worker's Comp Insurance carrier

The injury or illness incident

Where on the project did the incident take place?

What work was being done at the time of the incident?

If "Other", describe

Full names of any other persons affected in this incident.

Full names of any witnesses to this incident.

Treatment or First Aid provided

Details of treatment or first aid provided

Name of person(s) providing treatment or first aid

Was an ambulance called?

Yes No NA

If so, name of ambulance company

Was the affected person taken to a treatment facility?

Yes No NA

If so, name of the treatment facility

Follow-Up

To whom did you report the incident?

What action is suggested to prevent a recurrence of the incident?

Note 1

Note 2

Note 3

Send to

Site Supervisor

Subcontractor

Project Manager

Risk Management

Copy to

When the “Send Inspection Report” button is selected, an email with all the information in this Inspection Report will be sent to the “Builder email” address of the Company Representative completing this report and to the “Subcontractor email” address and “Copy to” addresses if provided.

🏅 Create a Business Worth Owning

📶 Integrated step-by-step program using all tools and systems

💡 Two coaching sessions per month

📊 Monthly scorecard to measure the journey

🛠️ Tools: All tools (Chart of Accounts, Cost Codes, BBOS Estimator, Builder Business Model Canvas, SubManager, ClientManager, Policy Handbook, Management Scorecard).

🤝 What we do together:

A 180+-day engagement covering financials, estimating, subcontractors, clients, and workforce.
Coaching sessions every two weeks to review your real numbers and coach policy implementation.
A monthly “Business Health Scorecard” that shows where you are strong and where to strengthen.
Focus on building a business system that allows you to:
- move out of day-to-day management;
- develop a valuable legacy enterprise; and
- create a business with significant market value.

💲 Investment: $3,500-$5,000.

🪜 Progression logic:

This is the capstone — combining all five prior steps into one system that builds a business worth owning.

🎯Outcome: "Now I control my business, not the other way around."

👷 Manage Your Workforce

👷‍♀️ Put the right people in the right position

📄 Create an Organization Chart and Position Descriptions

📄 Integrate employment policies

🛠️ Tools: OrgChart, Position Descriptions, Company Policy Template

🤝 What we do together:

Create a Company organization chart.
Create Job Descriptions.
Implement employee policy handbook
Identify inefficiencies in labor margins.
Discover hidden labor costs.

💲 Investment: $1,250-$1,500.

🪜 Progression logic:

Labor is usually the last controllable variable — now you are tackling optimization and efficiency.

🎯Outcome: "Now I am in control of the work that must be completed, and my employees understand their positions and accountabilities."

🗣️ Control the Client Relationship

📄 Client log, Change Order system

📄 Notice of Completion, Draw Requests

📄 Communication templates for disputes

🛠️ Tools: ClientManager, Client Contact Log, Initial Specifications, NAHB Residential Construction Guide

🤝 What we do together:

Implement a structured client management system.
Introduce the Client Contact Log.
Provide templates for change order and scope adjustments.
Train on reducing disputes and managing client expectations.

💲 Investment: $750-$1,250

🪜 Progression logic:

With the business financially stable and risk-protected, control of clients and their expectations ensures smoother operations and fewer profit leaks.

🎯Outcome: "Now I can manage clients and their expectations without projects spinning out of control."

🧯Identify and Manage Risks

🏠 Project Risks:

Site Risks – site injuries with no primary insurance coverage.
Reputational Risks – You don’t deliver what you promised because your subcontractors were not on the same page.
Capacity Risks – You can’t deliver what you promised because you don’t have the organizational structure to support your sales.

🔍 Management Risks:

Company Structural Risks – You don’t have the right people in the right positions.
Promotional Risks – Your market doesn’t know or care about your products.
Competitive Risks – You haven’t differentiated your company, so lowest price is the only way you can compete.
Market Demand Risks – a bad market cycle will cripple or destroy your business.

🛠️ Tools: SubManager, Organizing for Success, Builder Business Model Canvas, Budgeting Forecasts

🤝 What we do together:

Implement Terms and Conditions, Scopes of Work, and Inspection Reports for all Subcontractors.
Review how you track subcontractor insurance and compliance.
Analyze your organizational structure to optimize production capacity.
Review your business model.
Create “Expected Case”, “Best Case”, and Worst Case” budgeting scenarios.

💲 Investment: $1,000-$1,500

🪜 Progression logic:

After financial clarity and profitable estimating, risk management provides the next layer of company stability.

🎯Outcome: "Now I can reduce or transfer risk exposure; identify and appeal to my primary market; and plan for any type of economic environment."

🧮Price with Confidence

🔍 Audit your estimating process

🔎 Review all active projects monthly for budget-to-actual performance

🔍 Debrief every completed project for profitability and work flow

📶 Install a margin-tracking dashboard

🛠️ Tools: BBOS Estimator, Overhead Calculator, Completed Project Profitability Report

🤝 What we do together:

Audit your current estimating process.
Benchmark your margins against industry and market standards.
Optimize estimating margins for maximum profitability.
Track true budget-to-actual expenditures.

💲 Investment: $750-$1,250

🪜 Progression logic:

Once finances are stable, you can sharpen your pricing to stop leaving money on the table.
You’ll know the margin to use to make sure overhead is allocated profitably.

🎯Outcome: "Now I can bid jobs knowing I'll profit, not just hoping for profit."

💰90-Day Financial Reset

🗄️ Rebuild Chart of Accounts on NAHB Model

🗃️ Rebuild Cost Codes on CSI model

🛠️ Tools: Accounting platform, NAHB Chart of Accounts, CSI Cost Codes, Management Scorecard

🤝 What we do together:

Access to your accounting platform is required.
Rebuild your Chart of Accounts for project-level profitability.
Create and align Cost Codes so estimating, job costing, and reporting all “speak the same language.”
One-on-one coaching call every two weeks during the program to interpret your numbers.

💲 Investment: $1,500-$3,000

🪜 Why start here?

Without financial clarity, nothing else matters.
The reason you are in business is to make a profit.
Do you KNOW if you are doing that?

🎯Outcome: "Now I know if my business is profitable and my business model is sound."

You will be re-directed to the Home Page where you can use the menu to access Courses, Memberships, or Application Portals.

Injury or Illness Incident Report

The Injury or Illness Incident Report is to be completed by the Job Supervisor whenever there is an injury or illness on the job site of sufficient severity to warrant filing this report.

When submitted, form responses are sent to the email addresses provided and then deleted. IF YOU WISH TO RETAIN THE INFORMATION YOU HAVE ENTERED, ADD AN EMAIL ADDRESS BEFORE SUBMITTING.

INJURY OR ILLNESS INCIDENT REPORT

Note 1

Note 2

Note 3

🏅 Create a Business Worth Owning

📶 Integrated step-by-step program using all tools and systems

💡 Two coaching sessions per month

📊 Monthly scorecard to measure the journey

🛠️ Tools: All tools (Chart of Accounts, Cost Codes, BBOS Estimator, Builder Business Model Canvas, SubManager, ClientManager, Policy Handbook, Management Scorecard).

🤝 What we do together:

💲 Investment: $3,500-$5,000.

🪜 Progression logic:

🎯Outcome: "Now I control my business, not the other way around."

👷 Manage Your Workforce

👷‍♀️ Put the right people in the right position

📄 Create an Organization Chart and Position Descriptions

📄 Integrate employment policies

🛠️ Tools: OrgChart, Position Descriptions, Company Policy Template

🤝 What we do together:

💲 Investment: $1,250-$1,500.

🪜 Progression logic:

🎯Outcome: "Now I am in control of the work that must be completed, and my employees understand their positions and accountabilities."

🗣️ Control the Client Relationship

📄 Client log, Change Order system

📄 Notice of Completion, Draw Requests

📄 Communication templates for disputes

🛠️ Tools: ClientManager, Client Contact Log, Initial Specifications, NAHB Residential Construction Guide

🤝 What we do together:

💲 Investment: $750-$1,250

🪜 Progression logic:

🎯Outcome: "Now I can manage clients and their expectations without projects spinning out of control."

🧯Identify and Manage Risks

🏠 Project Risks:

🔍 Management Risks:

🛠️ Tools: SubManager, Organizing for Success, Builder Business Model Canvas, Budgeting Forecasts

🤝 What we do together:

💲 Investment: $1,000-$1,500

🪜 Progression logic:

🎯Outcome: "Now I can reduce or transfer risk exposure; identify and appeal to my primary market; and plan for any type of economic environment."

🧮Price with Confidence

🔍 Audit your estimating process

🔎 Review all active projects monthly for budget-to-actual performance

🔍 Debrief every completed project for profitability and work flow

📶 Install a margin-tracking dashboard

🛠️ Tools: BBOS Estimator, Overhead Calculator, Completed Project Profitability Report

🤝 What we do together:

💲 Investment: $750-$1,250

🪜 Progression logic:

🎯Outcome: "Now I can bid jobs knowing I'll profit, not just hoping for profit."

💰90-Day Financial Reset

🗄️ Rebuild Chart of Accounts on NAHB Model

🗃️ Rebuild Cost Codes on CSI model

🛠️ Tools: Accounting platform, NAHB Chart of Accounts, CSI Cost Codes, Management Scorecard

🤝 What we do together:

💲 Investment: $1,500-$3,000

🪜 Why start here?

🎯Outcome: "Now I know if my business is profitable and my business model is sound."

When submitted, form responses are sent to the email addresses provided and then deleted.
IF YOU WISH TO RETAIN THE INFORMATION YOU HAVE ENTERED, ADD AN EMAIL ADDRESS BEFORE SUBMITTING.