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Confidential Disclosure Agreement

Communication of Environmental and Health and Safety Requirements

Visitor Safety Acknowledgment Form: COVID Protocol

Associate, Contractor, Visitor Health History Screening

 

Confidential Disclosure Agreement

In consideration of the undertaking with Master Automatic Machine Company (“MASTER AUTOMATIC, INC.”) to engage in the services of manufacturing, purchasing, engineering, and/or consulting (Name as identified below) and all affiliates associated with (Company as identified below) (hereinafter called CUSTOMER/CONTRACTOR) to perform, purchase or contract certain services with MASTER AUTOMATIC, the parties have executed this Confidential Information Disclosure Agreement.

Confidential Information within the terms of this agreement shall mean ALL information disclosed by MASTER AUTOMATIC to the CUSTOMER/CONTRACTOR. All information obtained by the CUSTOMER/CONTRACTOR as a consequence of or through its performing services/relationship with MASTER AUTOMATIC, which information may or may not be generally known in the industry, ascertainable from public sources or not previously known by the CUSTOMER/CONTRACTOR in which MASTER AUTOMATIC is or may become engaged will be considered proprietary information at the time of its disclosure by MASTER AUTOMATIC about MASTER AUTOMATIC’S products, services, applications and or any other information relating to research, development, inventions, manufacturing, purchasing, accounting, engineering, merchandising, processing and selling through the disclosure of which MASTER AUTOMATIC developed or disclosed out of the performance of services or employment with or for the CUSTOMER/CONTRACTOR.

The CUSTOMER/CONTRACTOR and employees of said CUSTOMER/CONTRACTOR will not now or at any time hereafter disclose the confidential information to any person, firm, corporation, association or other entity for any reason or purpose whatsoever, except to the extent of disclosure that is required by law or written authorization from an executive or manager of MASTER AUTOMATIC. In the event of a breach or threatened breach by the CUSTOMER/CONTRACTOR of this Confidential Information Disclosure Agreement, MASTER AUTOMATIC INC. shall be entitled to an injunction from the Wayne County, Michigan, Circuit Court, which the parties expressly select as the venue for such action, restraining CUSTOMER/CONTRACTOR from disclosing in whole or in part the confidential information. Nothing herein shall be constructed as to prohibiting MASTER AUTOMATIC, INC. from pursuing any other legal and financial remedies available to it for such breach or threatened breach of agreement.

I have read, understood, and acknowledge the above information. 

I Agree

Communication of Environmental and Health and Safety Requirements

Master Automatic has identified the need to make contractors aware of Environmental policies and procedures necessary to the success of our Environmental Management System. Therefore, Master Automatic has developed this contractor information and requirement guide and each contractor will be supplied with a copy.

Master Automatic asks that all contractors keep this information on file and use it to train any and all of their associates who will be required to work on Master Automatic property.

Environmental Policy

The Environmental Policy is available on Master Automatic’s website.

General Rules

  • Practice good housekeeping.
  • Report unsafe conditions/practices promptly to your designated supervisor.
  • Wear Personal Protective Equipment when required.
  • Follow all labels and warnings.
  • Report spills, accidents, or “near misses” promptly.
  • Never block exits, fire equipment, electric panels or eye wash stations.
  • Never compromise your safety for any reason.
  • Follow EMS procedures relevant to your job area/function.
  • Use Lock-Out/Tag-Out procedures when required.
  • Eat and drink in specified areas only.
  • Do not handle / mix product.

Reporting of Injuries

If you should have an accident or be injured while working on a job at Master Automatic, report it to your Master Automatic contact immediately, regardless of how small or insignificant it may seem.

Safety Glasses and Hearing Protection 

All contractors working, or who are required to spend time in designated safety glass / hearing protection areas are required to wear them at all times in those areas.

MASTER AUTOMATIC Contractor Chemical Information Policy

Any time contractors bring chemicals onsite they must provide to Master Automatic

  • SDS Sheets
  • Any certification needed to use said chemical
  • A list of laws and regulations that may be required to comply with
  • Any potential environmental hazards which could be caused by the chemical.
  • Permission from the EMR (Donn Dirven)

Contractor Lock-Out/Tag-Out Procedure and Policy

From time to time a contractor may be needed to work on Master Automatic equipment. During these times, the contractor will be required to comply with Master Automatic’s Lock-Out/Tag-Out Policy, with each party using his/her own lock to insure personal safety.

Evacuation

All employees and contractors are required to exit the building when directed to do so by the area management. Evacuation routes are posted within the facility and indicate the proper meeting place outside of the building. Contractors are asked to familiarize themselves with the evacuation routes outlined for the area in which they will be working.

Spill Emergencies

All spills are to be reported immediately to the area supervisor. In order to facilitate proper cleanup, it is imperative that all secondary containers are clearly labeled to identify contents. Additionally, all primary containers are to be properly capped after use to prevent spills.

I have read, understood, and acknowledge the above information.

I Agree

Visitor Safety Acknowledgment Form: COVID Protocol


Master Automatic has identified the need to make all visitors/contractors aware of Safety policies and procedures pertaining to the COVID-19 Pandemic. Master Automatic has developed these requirements to protect the health and safety of our workforce and any visitors (customers, contractors, etc.) in our facilities. It is expected that all visitors will abide by the guidelines set forth below. Those that fail to do so will be escorted from the premises.

General Rules

  • Pursuant to CDC recommendations, only essential visitors will be allowed on-site access by appointment.  Prior to entry into any Master Automatic facility, visitors will undergo a general health screening process. Those that do not successfully complete the screening process will not be granted entry into the facility.
  • Visitors that arrive on-site without the required PPE to enter the facility will be provided with a Visitor PPE Kit. All items are to be used as instructed. Violation of any PPE requirement will be grounds for removal from the premises. 
  • Visitors are expected to be mindful of traffic flow patterns throughout the facility (including designated entrances and exits) and to abide by social distancing requirements wherever possible. 
  • Vendors, Customers, and other short-term Visitors must be escorted through the facility by their Master Automatic contact at all times. 
  • It will be the responsibility of each visitor and their Master Automatic contact to ensure that surfaces, tools, and equipment are properly sanitized after contact or use. 

Personal Protective Equipment Requirements

All visitors will be required to wear a mask at all times while in the facility.

Additionally, all visitors working or spending time in designated safety glass / hearing protection areas are required to wear them at all times in those areas. 

I have read, understood, and acknowledge the above information.

I Agree

Associate, Contractor, Visitor Health History Screening

The safety of our associates, customers, families and visitors remains Master Automatic’s overriding priority.  As the coronavirus disease 2019 (COVID-19) outbreak continues to evolve and spreads globally Master Automatic is monitoring the situation closely and will periodically update company policy based on current recommendations form the Centers for Disease Control (CDC).

To prevent the spread of COVID-19, reduce the potential risk of exposure and pursuant to Exec Order 2020-77, we are conducting a screening questionnaire for all associates, contractors and visitors.  Your participation is important to help us take precautionary measures to protect you and everyone in this facility.  We appreciate your cooperation in completing this questionnaire.

Questionnaire:

  • I have not been asked to self-quarantine by a health official within the last 14 days due to a suspected exposure or positive diagnosis.
  • I have not come in close contact with anyone with a suspected (self-quarantine) or positive diagnosis for COVID within the last 14 days.
  • I do not have any symptoms such as: cough or shortness of breath / difficulty breathing OR at least two of the following:

1. Fever or Chills
2. Fatigue
3. Muscle or body aches
4. Headache
5. New loss of taste or smell
6. Sore throat
7. Congestion or runny nose
8. Nausea or vomiting
9. Diarrhea

Temperature Check:

I maintain a temperature less than or equal to 98.9 degrees

I have read, understood, and acknowledge the above information. 

I Agree

COV1-006

Rev. Date: 11/19/20

First Participant's Name

First Name*

Last Name*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email
A signed copy of this waiver will be sent to the email address you provide.
Additional Information

Your Organization or Company *

Who are you here to visit? *
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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