Supplier/Visitor/Subcontractor Assessment Form
Due to the evolving situation with the novel Coronavirus (COVID-19), the Danco Group is taking precautionary measures of all individuals who enter our offices and jobsites by completing a Safety Assessment.The Danco Group reserves the right to evaluate the potential for health and safety risks at our discretion and deny access on any premises.
Your name and email
Do you certify that you have provided the below information accurately to the best of your knowledge? Do you understand that if your travel status changes and/or you have contact with a confirmed or suspected case of COVID-19 and/or experience a fever, a cough, or have difficulty breathing, you must notify the project supervisor or Danco Jobsite representative IMMEDIATELY? [ Please type your name below to sign]
In the last 14 days, have you been in close contact with a CONFIRMED or SUSPECTED COVID-19 case? (If YES, you are not allowed to access the worksite. We will adjust appropriately.)
In the last 14 days, have you experienced any of the following: fever, sore throat, cough, or difficulty breathing? (If YES, you are not allowed to access the worksite and please call your health care provider or DHHS.)
If the answer is YES to any question above the individual is not cleared to enter any entity at the DANCO GROUP and is required to speak with Julianne Eagle, 707-410-6227
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