Safety Services Invoice Form - Associated Builders and Contractors

Safety Manager*

Company*

Contact Name

First Last

Type of Work*

Contract Work

Quarter of Contract Work

Year of Contract Work

Number of Visits Per Month

Training

Select Training

Training Date

Open Class Training

Price: $65.00

$65 per hour. Enter number of hours for Quantity.

In-house Training

Price: $200.00

$200 per hour. Enter number of hours for Quantity.

Equipment Evaluations

Price: $200.00

$200 per hour. Enter number of hours for Quantity.

OSHA 10 Hour

20 People or Less: $1,400.00
Over 20 People: $1,500.00
Over 30 People: $2,200.00

OSHA 30 Hour

Price: $4,500.00

$4,500/class

Arc Flash Safety

Price: $200.00

$200 per hour. Enter number of hours for Quantity.

Confined Space Entry Awareness

Price: $200.00

$200 per hour. Enter number of hours for Quantity.

Confined Space Entry Certification

Price: $200.00

$200 per hour. Enter number of hours for Quantity.

Number of Training Sessions

First Aid – Session 1

First Aid / CPR / AED / Bloodborne Pathogen – Session 1

10 or Fewer People: $700.00
More than 10 People: $800.00

First Aid – Session 1 Training Date

First Aid – Session 1 Training Time

:

First Aid – Session 2

First Aid / CPR / AED / Bloodborne Pathogen – Session 2

10 or Fewer People: $700.00
More than 10 People: $800.00

First Aid – Session 2 Training Date

First Aid – Session 2 Training Time

:

First Aid – Session 3

First Aid / CPR / AED / Bloodborne Pathogen – Session 3

10 or Fewer People: $700.00
More than 10 People: $800.00

First Aid – Session 3 Training Date

First Aid – Session 3 Training Time

:

First Aid – Session 4

First Aid / CPR / AED / Bloodborne Pathogen – Session 4

10 or Fewer People: $700.00
More than 10 People: $800.00

First Aid – Session 4 Training Date

First Aid – Session 4 Training Time

:

Forklift Certification Straight Mast (Class IV & V)

Price: $200.00

$200 per hour. Enter number of hours for Quantity.

Forklift Certification Rough Terrain (Class VIII)

Price: $200.00

$200 per hour. Enter number of hours for Quantity.

MEWP / Scissors Lift / Aerial Lift Safety

Price: $200.00

$200 per hour. Enter number of hours for Quantity.

Rigging & Signal Person

Price: $200.00

$200 per hour. Enter number of hours for Quantity.

Silica Sampling

Half Day: $800.00
Full Day: $1,600.00

Trenching & Excavating

Price: $200.00

$200 per hour. Enter number of hours for Quantity.

Job Site Services

Price: $200.00

$200 per hour. Enter number of hours for Quantity.

Other: Training Description

Other: Fee

Materials Cost

Number of Attendees - OSHA 10

Price: $20.00

Number of Attendees - OSHA 30

Price: $30.00

OSHA 30 Book Fee

Number of Books for OSHA 30

Total for OSHA 30 Books

Price: $0.00

Number of Attendees - Arc Flash

Price: $15.00

Number of Attendees - Confined Space Awareness

Price: $15.00

Number of Attendees - Confined Space Certification

Price: $25.00

Number of Attendees - First Aid / CPR / AED

Price: $15.00

Number of Attendees - Forklift Certification Straight Mast (Class IV & V)

Price: $25.00

Number of Attendees - Forklift Certification Rought Terraine (Class VII)

Price: $25.00

Number of Attendees - MEWP / Scissors Lift / Aerial Lift Safety

Price: $25.00

Number of Attendees - Rigging & Signal Person

Price: $50.00

Number of Attendees - Trenching & Excavation

Price: $25.00

Lab Fees

Additional Costs

Number of Miles

Per Mile

Mileage Due

Price: $0.00

Lodging

Truck Rental

Other

Comments

Please explain costs associated with "Other" from above or any other notes for this invoice.

Commission Amount

Total to Invoice

$0.00