I confirm that I am authorized to provide these employer details and that they are accurate to the best of my knowledge. I understand that this intake does not verify hazards, guarantee compliance, or replace the employer’s responsibility to review, implement and maintain its safety program.

This is an intake acknowledgment, not a liability waiver or signed service agreement. Legal & disclaimer

Employer agreement & signature

Free IIPP Development Agreement & Employer Acknowledgment

Provider: Safety People LLC · Version: unreviewed-v1

Workplaces covered: the locations listed in your intake above.

1. Scope of the free service

Safety People LLC will prepare an Injury and Illness Prevention Program document using information supplied by the Employer. Unless separately agreed in writing, this offer excludes site inspections, independent hazard verification, employee training, implementation, and ongoing updates.

2. Information supplied by the Employer

The Employer agrees to provide accurate, complete information about its operations, workplaces, equipment, hazards, and existing safety practices. The Employer will identify missing or inaccurate information and request necessary corrections before adopting the document.

3. Employer review and responsibility

The Employer must review the document for suitability before use and designate personnel responsible for implementing and maintaining its IIPP. Receiving the document does not replace the Employer’s duties to identify hazards, correct unsafe conditions, train employees, and maintain required records.

4. Separate requirements

An IIPP does not replace other required safety programs, permits, procedures, or task-specific training. Additional requirements may apply depending on the Employer’s operations and hazards.

5. No guarantee or legal advice

The document is consulting assistance, not legal advice or government approval. Safety People LLC does not guarantee inspection results, freedom from citations, or prevention of injuries. Applicable requirements and workplace conditions may change after delivery.

6. Limits of this acknowledgment

This agreement documents the service’s scope and the Employer’s responsibilities. It does not waive rights or liabilities that cannot lawfully be waived. Any additional liability limitation requires attorney-reviewed language.

7. Acceptance

I confirm that I am authorized to sign for the Employer and accept these terms before receiving the document.

Authorized representative’s full nameTitle / roleLegal employer nameTyped signatureI have read the agreement above, am authorized to sign for the employer, and consent to signing electronically. I understand it has not been attorney-reviewed.

Your signature, agreement version and signing time are saved with this intake. The IIPP is prepared and delivered separately by Safety People.

Your workplace. Your IIPP.