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Republic Services Safety Training Certification For Temporary Workers

REPUBLIC SERVICES ONLY FORM

Must be provided to Republic Services before beginning to perform any work.

I have received the following safety training on the dates indicated below:

Republic Services Heat Considerations Training Video, Required for non-clerical/administrative
Republic Services Introduction Video, Required
Republic Services Closing Video, Required
Contingent Workforce Safe Work Practices Booklet Required
Republic Services Collection Video, Required if performing Services at these types of locations
Republic Services Recycle Centers Video, Required if performing Services at these types of locations
Republic Services Post Collection Video, Required if performing Services at these types of locations

I have received the information in the Contingent Workforce Safe Work Practices Booklet (the Booklet) in a format and language that I understand, and I have received the other training noted above. If there is anything that I do not understand in the Booklet or training videos, I acknowledge that it is my responsibility to ask for an explanation and clarification. I understand all safety training I have received. I also understand that it is my responsibility to wear all safety equipment as required and to comply with all applicable safety training, rules and regulations.

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Agency Representative Name: | Agency Representative Position:

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February 7, 2021 9:36 pm CDT

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