SAFETY QUOTIENT. PARTICIPANT REPORT For Self-Coaching & Self-Awareness. May 25, Sample Report - John Doe

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SAFETY QUOTIENT TM PARTICIPANT REPORT For Self-Coaching & Self-Awareness Sample Report - John Doe May 25, 2015

PART A SAFETY RISK FACTORS Safety Personality Defined This section is a summary of your safety-related personality traits calculated from the assessment you completed. Everyone has core personality traits and tendencies or "default settings" that affect behaviors. Default settings can be hard to change, but you can reduce risk by increasing self-awareness & choosing safe behaviors. Your Primary Traits Calm Distractible Impulsive These are the most extreme scores from your personality profile below. Your Safety Personality Profile: MID RANGE RIGHT SIDE Resistant Accommodating Questions existing rules and processes, may be resistant to feedback. RESISTANT ACCOMMODATING Follows rules and processes without questioning. Anxious Calm Quickly feels stress in unexpected or unfamiliar situations. ANXIOUS CALM Even-tempered, stress tolerant, calm under pressure. Impatient Patient Becomes annoyed or irritated when under stress. IMPATIENT PATIENT Not easily frustrated or annoyed by others. Distractible Focused Seeks stimulation and variety. May become distracted. DISTRACTIBLE FOCUSED Less likely to seek stimulation & variety. Able to ignore distractions Impulsive Cautious Decides quickly, may underestimate consequences of actions. IMPULSIVE CAUTIOUS Tends to carefully evaluate situations before deciding. Thrill-Seeking Apprehensive Seeks excitement and adventure, comfortable with uncertainty and risk. THRILL-SEEKING APPREHENSIVE Tends to avoid or be uncomfortable with risk and uncertainty. MID RANGE RIGHT SIDE The marker represents your results. The average results of working adults is at the middle point of each dimension. Disclaimer: We cannot predict the occurrence of specific incidents. We can only predict the probability that people will engage in certain behaviors which, if they persist, will increase the likelihood of incidents. These assessment results should always be considered in the context of all available information about a person and should not be used as the sole factor for making employmentrelated decisions. 2015 TalentClick Workforce Solutions Inc 2 of 12

PART B SELF-COACHING CONSIDERATIONS Dimension 1: Resistant vs. Accommodating Resistant Questions existing rules and processes, may be resistant to feedback. RESISTANT MID RANGE RIGHT SIDE Accommodating Follows rules and processes without ACCOMMODATING questioning. You scored in the MID RANGE. This area measures rule-following and openness to new ideas, re-training and coaching. People who score in the mid range have an average level of openness to re-training, new ideas, coaching and generally accept existing rules and processes. Positive aspects of how you scored: You're comfortable working within existing rules & procedures You respect policies and rules You're comfortable questioning how things are done Risk areas and self-coaching tips for you: It s ok to stop and question things if you need to Ask your supervisor if you want to know the reasons for rules Give your improvement ideas to your supervisor, not your co-workers Consider Resistant vs. Accommodating and think of how it applies to you: Please think of an example of where being Resistant vs. Accommodating contributed to an unsafe behavior. Describe Example: I don't stop and question things even if a policy or procedure doesn't seem right for a situation. What you can do to improve your safety-related behavior related in this area? Please add your ideas Example: I should stop and ask my supervisor when things don't seem right, even when I'm already following standard procedures. 2015 TalentClick Workforce Solutions Inc 3 of 12

PART B SELF-COACHING CONSIDERATIONS Dimension 2: Anxious vs. Calm Anxious Quickly feels stress in unexpected or unfamiliar situations. ANXIOUS MID RANGE RIGHT SIDE Calm Even-tempered, stress tolerant, calm CALM under pressure. You scored on the RIGHT SIDE. This area measures a person's ability to handle stress and think clearly under stress and pressure. People who score on the right side tend to be calm and confident under stress and pressure. Positive aspects of how you scored: You're able to think clearly and make good decisions under pressure You can be effective in situations where you need to stay calm in stressful situations You would be a calming influence on other team members Risk areas and self coaching tips for you: Let others know when you are stressed since you may not show it Volunteer for tasks that require thinking clearly under pressure Keep in mind that you have to react immediately in urgent situations Consider Anxious vs. Calm and think of how it applies to you: Please think of an example of where being Anxious vs. Calm contributed to an unsafe behavior. Describe Example: I tend to procrastinate tasks because I know it will all work out in the end. This causes some last minute panic though when I'm rushing. What you can do to improve your safety-related behavior related in this area? Please add your ideas Example: I should make a point to notice when a task is more urgent so it gets the immediate attention it needs. 01/00/00 2015 TalentClick Workforce Solutions Inc 4 of 12

PART B SELF-COACHING CONSIDERATIONS Dimension 3: Impatient vs. Patient Impatient Becomes annoyed or irritated when under stress. IMPATIENT MID RANGE RIGHT SIDE Patient Not easily frustrated or annoyed PATIENT by others. You scored in the MID RANGE. This area measures a person's level of emotional control and how stress affects how they deal with others. People who score in the mid range can usually handle stress without becoming annoyed or irritated by others. Positive aspects of how you scored: You respond well to positive feedback You can stay even-tempered under typical job stress You will be a supportive team member Risk areas and self coaching tips for you: Help others by being a supportive team member Don't avoid correcting the unsafe behavior of other team members You may become more critical of others' behavior when under stress Consider Impatient vs Patient and think of how it applies to you: Please think of an example of where being Impatient vs. Patient contributed to an unsafe behavior. Describe Example: I get really annoyed when I'm trying to focus and I get interrupted. This happens often with a worker who is too talkative. What you can do to improve your safety-related behavior related in this area? Please add your ideas Example: I should let others know not to interrupt me unless it's important. If I get interrupted anyway I shouldn't take it personally and get mad. 01/00/00 2015 TalentClick Workforce Solutions Inc 5 of 12

PART B SELF-COACHING CONSIDERATIONS Dimension 4: Distractible vs. Focused Distractible MID RANGE RIGHT SIDE Focused Seeks stimulation and variety. May become distracted. DISTRACTIBLE FOCUSED Less likely to seek stimulation and variety. Able to ignore distractions. You scored in the MID RANGE. This area measures a person's level of focus and their need for variety and stimulation. People who score in the mid range can usually stay focused without becoming distracted or bored. Positive aspects of how you scored: You're able to remain focused and alert You can remain mindful of details You won't usually become bored or distracted easily Risk areas and self coaching tips for you: You may become bored when doing long stretches of repetitive work Ask your supervisor for occasional variety in your tasks Organize yourself fully before and after tasks Consider Distractible vs. Focused and think of how it applies to you: Please think of an example of where being Distractible vs. Focused contributed to an unsafe behavior. Describe Example: A few weeks ago I had to do the same task over and over and I got so bored that my mind started wandering. I almost made a few mistakes because I wasn't paying close attention. What you can do to improve your safety-related behavior related in this area? Please add your ideas Example: I could talk to my supervisor about assigning me different types of work more often so I can get more variety in my work. 01/00/00 2015 TalentClick Workforce Solutions Inc 6 of 12

PART B SELF-COACHING CONSIDERATIONS Dimension 5: Impulsive vs. Cautious Impulsive MID RANGE RIGHT SIDE Cautious Decides quickly, may underestimate consequences of actions. IMPULSIVE CAUTIOUS Tends to carefully evaluate situations before deciding. You scored in the MID RANGE. This area measures a person's level of caution when making decisions. People who score in the mid range have an average level of caution and usually evaluate their decisions before acting. Positive aspects of how you scored: You're able to take immediate action in unusual situations You usually consider the possible negative consequences of your actions You'll learn from your mistakes Risk areas and self coaching tips for you: Watch that you don't rush and take unsafe risks Always consider possible negative consequences of your actions Remember that sometimes it's best to take immediate action Consider Impulsive vs. Cautious and think of how it applies to you: Please think of an example of where being Impulsive vs. Cautious contributed to an unsafe behavior. Describe Example: I tend to rush sometimes and take risks I shouldn't. Last week I was up on a ladder and I used the top step to get something just out of my reach. I almost fell off. What you can do to improve your safety-related behavior related in this area? Please add your ideas Example: I should have taken the time to get a higher ladder. I should stop and think about what could go wrong so I don't put myself in a risky situation. 01/00/00 2015 TalentClick Workforce Solutions Inc 7 of 12

PART B SELF-COACHING CONSIDERATIONS Dimension 6: Thrill-Seeking vs. Apprehensive Thrill-Seeking Seeks excitement and adventure, comfortable with uncertainty and risk. THRILL-SEEKING MID RANGE RIGHT SIDE Apprehensive Tends to avoid or be uncomfortable with risk and APPREHENSIVE uncertainty. You scored in the MID RANGE. This area measures a person's level of excitement seeking. People who score in the mid range have an average level of excitement seeking and usually do not prefer risk taking and uncertainty. Positive aspects of how you scored: You're open to trying new ways of completing tasks You're not likely to be fearful of taking reasonable risks You're able to recognize risks that can be avoided Risk areas and self coaching tips for you: You may benefit from getting help from team members to recognize risks you may overlook You may not always recognize when risks should not be tolerated You may become bored with tasks that you have already mastered Consider Thrill-Seeking vs. Apprehensive and think of how it applies to you: Please think of an example of where being Thrill- Seeking vs. Apprehensive contributed to an unsafe behavior. Describe Example: Last week I had to do some high altitude work and it bothered me. I kept thinking about all the things that could have gone wrong and I couldn't focus and do good work. What you can do to improve your safety-related behavior related in this area? Please add your ideas Example: If a risky task is uncomfortable for me I can ask my supervisor to switch my tasks with another worker. 01/00/00 2015 TalentClick Workforce Solutions Inc 8 of 12

PART C SafeSELF ACTION PLAN Creating your action steps to be safer on the job Your SafeSELF Action Plan allows you to provide details on two safety-related behaviors that you want to focus on to improve your personal safety and the safety of others. The SafeSELF Action Plan will walk you through how to understand why the risky action occured and how to create a safer environment for yourself and others going forward. Your First Example: Please provide a specific example of a behavior or action from your own experience that was a risk to yourself and/or others. The example could be from Part B or another experience like a vehicle or first aid incident. 1. Decribe what you were thinking and feeling at the time. 2. Describe what triggered your behavior or what caused you to act this way. 3. Describe the potential consequences. Who was affected? Who else could have been impacted? 4. What are your goals for improving? What is the end result you are committing to reaching? 5. What are some difficulties you might face when trying to improve? 6. What can you do to minimize these difficulties? 7. What are the benefits to you and to other for improving? 01/00/00 2015 TalentClick Workforce Solutions Inc 9 of 12

PART C SafeSELF ACTION PLAN Creating your action steps to be safer on the job Your Second Example: Please provide a specific example of a behavior or action from your own experience that was a risk to yourself or others. The example could be from Part B or another experience like a vehicle or first aid inncident. 1. Decribe what you were thinking and feeling at the time. 2. Describe what triggered your behavior or what caused you to act this way. 3. Describe the potential consequences. Who was affected? Who else could have been impacted? 4. What are your goals for improving? What is the end result you are committing to reaching? 5. What are some difficulties you might face when trying to improve? 6. What can you do to minimize these difficulties? 7. What are the benefits to you and to other for improving? 01/00/00 2015 TalentClick Workforce Solutions Inc 10 of 12

PART D YOUR COMMITMENT 1. I acknowledge that my number one priorities while working on behalf of this company are: My perso al safety a d the ell ei g of those ho ork for, ith or arou d e The prote tio of the e iro e t Co plia e ith all appli a le se urity regulatio s 2. I commit to taking the action steps outlined in Part C: Creating Your Action Steps to improve my personal safety and the safety of others. Behavior 1: Behavior 2: 3. I agree to provide progress updates to my supervisor at all future reviews that will include: a. Progress reports against my goals of improving the two safety behaviors I described in Part C: Creating Your Action Steps. b. Any challenges I am facing in meeting my improvement goals and what I am doing to address these challenges.. A y i ide ts of high risk eha ior I e e gaged i. d. Any help or assistance I need in meeting my improvement goals. (Your Name) (Supervisor Name) (Your Signature) (Supervisor Signature) (Date) (Date) 01/00/00 2015 TalentClick Workforce Solutions Inc 11 of 12

ABOUT SAFETY QUOTIENT TM SQ TM DEFINED SQ TM is an assessment tool that measures the key personality factors linked to safety outcomes in the workplace SAFETY SELF-AWARENESS Safety Self-Awareness is the process of understanding and recognizing how your thoughts, feelings, and behaviors affect safety outcomes on the job. Learn more about your personality Improve your safety on the job through selfawareness Achieve a safer workplace for yourself and your coworkers About this Report Purpose Summarize your Safety Personality Profile and selfcoaching suggestions Content Your Safety Personality Profile Self-coaching tips to improve safety Workbook for Safety Self-Awareness Your committment Keep in mind - Consider other factors that affect safety in addition to personality: Physical & environmental conditions Personal situation (stress, sleep, illness, etc.) 01/00/00 2015 TalentClick Workforce Solutions Inc 12 of 12