AWAIR: Accident and Injury Prevention Program

AWAIR: Accident and Injury Prevention Program Coborn s Incorporated Safety Statement and Objectives The Coborn s Incorporated ( Coborn s ) Accident and Injury Prevention Program philosophy is that every employee is entitled to a safe and healthful work environment. We have adopted a Safety First attitude and culture designed to Start F-R-E-S-H (Focus-Review-Evaluate- Suggest-Help) with Safety; and therefore our Program is focused on the protection of our employees and customers. It is the responsibility of every employee to make safety and injury prevention a top priority. We acknowledge that every employee is concerned for his or her own safety and the safety of co-workers and customers and will recognize that safety rules and policies are for their protection. The goals we have set for our Injury Prevention Program will be achieved only through a cooperative effort among all employees. Safe work habits, on the job awareness and knowledge of all safety rules and policies are a condition of employment at Coborn s. All employees are required to attend training to become familiar with rules and policies and to abide by them. These rules and policies will be enforced just as any other company policy. Failure to comply will be subject to disciplinary action, up to and including termination. All employees are encouraged to make suggestions that will assist in maintaining safe work conditions and should bring these suggestions to their supervisor s attention. It is through our joint participation that accidents can be prevented, but only you can make safe work practices a habit. Accidents cause pain and suffering and wasted time and money, not only in increased workers compensation and general liability claims, but also in lost work time. Coborn s is committed to providing our employees with a safe place to work and our customers a safe place to shop. We require your assistance and participation to ensure the safety of our employees and customers. Our policy toward safety is in no way limited to the rules that follow. All unsafe practices, whether listed here or not, will be addressed. Our goal is simple: To Work Towards Zero Accidents. Chris Coborn President /CEO Policy: AWAIR Program Date Issued: May 1, 2013 Date Updated: May 1, 2013 Page 1 of 15

COBORN S INJURY PREVENTION PROGRAM This written safety program has been adopted to confirm our commitment To Work Towards Zero Accidents and to provide a framework for our safety efforts. Procedure This program includes the topics required by the Minnesota A Workplace Accident and Injury Reduction (AWAIR) Act: Responsibilities: How Managers, Supervisors, Leads and Employees are responsible for implementing the program and how the continued participation of management will be established, measured, and maintained. Hazards: The methods used to identify, analyze, and control new or existing hazards, conditions, and operations. Communications: How the plan will be communicated to all affected employees so that they are informed of work-related hazards and controls. Accident Investigation: How workplace accidents will be investigated and corrective action implemented. Enforcement: How safe work practices and rules will be enforced. Safety Responsibilities All responsibilities will be clearly communicated and understood. No person should be held responsible for performing a function unless that person has been properly trained and has the authority to accomplish it. At Coborn s, safety responsibilities are assigned to Management, the Safety Manager, Workers Compensation/General Liability Claims Coordinator, Location Managers, Supervisors and all Employees. Everyone is responsible for safety in the workplace and complying with company safety rules, safety policies, and OSHA regulations. Management: Management accepts the responsibility for impressing upon all employees that safety and injury prevention have a high priority at Coborn s and that all rules and policies will be followed. 1. Provide leadership and guidance for the acceptance, maintenance and enforcement of the AWAIR Program. 2. Establish safety policies and procedures. 3. Provide resources for training and monitoring the AWAIR Program. Policy: AWAIR Program Date Issued: May 1, 2013 Date Updated: May 1, 2013 Page 2 of 15

4. Periodically review safety records and reporting functions. 5. Establish and support the various safety related committees and programs. 6. Maintain open lines of communication between Employees, Supervisors and Management relative to the free exchange of safety suggestions and information. 7. Monitor the follow-up on recommendations made to improve performance and prevent accidents. 8. Support and participate in the accident investigations and reviews results and action items. 9. Annually review the AWAIR program and any recommended revisions, make appropriate revisions and work with the Safety Manager, Safety Committees and Managers to communicate revisions throughout the organization. Safety Manager: At Coborn s the primary responsibility for the AWAIR Program rests with the Safety Manager who is responsible for the daily maintenance of the AWAIR Program and provides leadership to the employees in their daily functions related to safety. 1. Be knowledgeable in safety management principles. 2. Stay informed on safety regulations. 3. Establish and implement all necessary employee safety training and develop controls that ensure that safe procedures are followed. 4. Maintain all policies and procedures for safety. 5. Work closely with all company operations and insurance carrier representatives to ensure that safety compliance is in accordance with operating procedures, and that safe work methods are established and maintained. 6. Make periodic inspections of areas of the organization to identify safety hazards. 7. Take action to correct all unsafe conditions or practices. 8. Maintain all safety meeting minutes. 9. Ensure compliance with all company, local, state and federal safety regulations. 10. Facilitate and lead the Corporate Safety Committee and provide guidance to location Safety Committees. 11. Comply with proper procedures for accident investigation and reporting. Assist with accident investigations. 12. Ensure viability of material safety data sheets (MSDS) through audits and communication with vendors. 13. Audit safety performance and the goal of the AWAIR program. 14. Review and, if necessary, recommend amendments to the AWAIR program annually. 15. Follow up on recommendations made by Management, Employees, the Safety Committee, and outside inspectors and consultants. Workers Compensation/General Liability Claims Coordinator: The Workers Compensation/General Liability Claims Coordinator performs a variety of routine and complex administrative and technical tasks and supports the AWAIR Program by managing the Company data requirements, compiling and submitting required reports and generating safety related information and reports for use by all individuals. Policy: AWAIR Program Date Issued: May 1, 2013 Date Updated: May 1, 2013 Page 3 of 15

1. Review First Reports of Injury forms and file workers compensation claims to the insurance company. 2. Maintain injury/illness record keeping system and monitor Return To Work Program. 3. Maintain medical records related to work injuries. 4. Maintain a working relationship with insurance carrier. 5. Compile and distribute to locations annual summary of occupational injuries and illnesses to be posted from February 1 through April 30 of each year. 6. Maintain records of all accident investigations. 7. Provide analysis of severity and frequency data and trends to the management team and Corporate Safety Committee. Location Managers: Location Managers are responsible for translating policies into action and for promoting safety activities among employees. They provide leadership for their employees in their daily functions related to safety. 1. Periodically inspect all areas to identify safety hazards and take action to correct all unsafe conditions or practices. 2. Ensure compliance with all company, local, state and federal safety regulations. 3. Train/retrain employees initially and as needed for those involved in accidents and/or whose performance or actions make additional training necessary. 4. Enforce the use of required personal protective equipment. 5. Ensure claims forms are completed and submitted within 24 hours of being reported. Due to the critical necessity of submitting forms within 24 hours, failure to do so may result in disciplinary action up to and including termination. 6. Ensure accident investigations are properly completed by Supervisor/Department Manager. Review, sign and submit the accident investigation form to the Safety Manager. 7. Ensure that all corrective actions for safety hazards are promptly abated. Supervisors/Department Managers: Supervisors/Department Managers are responsible for addressing the AWAIR Program on a daily basis and with a high degree of proficiency. They will communicate and enforce all safety policies and procedures. 1. Be knowledgeable in safety and health principles. 2. Maintain a mindset of being on the lookout at all times for unsafe practices and conditions in their areas. 3. Consistently enforce safety programs, policies and procedures. 4. Orient new employees to safe job procedures, job assignments, job requirements and all rules related to their job. 5. Coach employees to correct unsafe behaviors and encourage safe behaviors, to include acknowledging safe work habits and counseling employees for safety violations. 6. Discuss any current safety issues with employees at the beginning of each shift. 7. Address all safety concerns reported by staff by initially investigating the issue, determine if the concerns are valid, and take corrective action wherever necessary. 8. Ensure that injuries are reported and followed up on within 24 hours. Due to the critical necessity of submitting forms within 24 hours, failure to report injuries within 24 hours may result in disciplinary action up to and including termination. Policy: AWAIR Program Date Issued: May 1, 2013 Date Updated: May 1, 2013 Page 4 of 15

9. Conduct accident investigations and completed detailed accident investigation form to include corrective action and steps to prevent recurrence. 10. Ensure that safety equipment and personal protective equipment is available, used, and in good working order. 11. Assist in performing safety inspections and audits. 12. Promptly rectify deficiencies found in observations, inspections, and accident investigations. 13. Participate in supervisory safety training. 14. Maintain satisfactory standards of housekeeping throughout the organization. 15. Train/retrain employees initially and as needed for those involved in accidents and/or whose performance or actions make additional training necessary. Employees: We want Coborn s employees to be the safest, most knowledgeable and most conscientious employees in our industry with a commitment to Start F-R-E-S-H (Focus-Review-Evaluate- Suggest-Help) with Safety. To develop and maintain this professional image, our management must provide all employees with proper training. All employees, regardless of position, will be responsible to comply with the safety rules. 1. Consistently demonstrate safe work habits and perform all tasks in a safe manner. If unsure how to perform the task safely, employees must consult with their supervisor prior to performing the task. 2. Comply with company safety rules, safety policies, and OSHA regulations. 3. Utilize all provided personal protective equipment and be familiar with the proper maintenance of it. 4. Report all injuries, accidents, near misses, and unsafe conditions immediately to Manager/Supervisor/Lead. Failure to report injuries within 24 hours may result in disciplinary action up to and including termination. 5. Assist in keeping the store/facility clean and orderly and immediately notify Management of any safety hazards. 6. Attend and participate in training sessions and required safety training. 7. Participate in accident investigations as required. 8. Help train co-workers in safety operations. Safety Committee: Each location within Coborn s will establish a Safety Committee that will meet on a regular basis. For locations with 50 or more employees, the Safety Committee will meet on a monthly basis and locations with fewer than 50 employees, the Safety Committee will conduct quarterly meetings. Any interested employee at the location can be involved in the Safety Committee as long as the management/non-management ratio of the committee is in compliance with the Company s Safety Committee s Policy. 1. Include all levels of employees and promote active participation from senior management. 2. Conduct regular safety inspections of all areas in the store/facility and suggest corrective action on all hazards noted. 3. Review all accidents, observations, and safety data provided and monitor progress of corrective actions of hazard abatement. Policy: AWAIR Program Date Issued: May 1, 2013 Date Updated: May 1, 2013 Page 5 of 15

4. Meet as required with a pre-planned agenda and careful documentation of who attended, what was discussed and what action was taken. Safety inspections and meetings must be conducted within each month. 5. Submit copies of the meeting minutes along with the safety inspection results to the Safety Manager by the 10 th of the month following the meeting. 6. Be responsible to promote and publicize safety awareness that will lead to accident and injury prevention. 7. Bring ideas and suggestions before management that will encourage safety awareness in all employees. 8. Monitor the safety program effectiveness. Hazard Identification, Analysis, and Control Hazard identification, analysis and control are the processes used for identifying hazards and developing safe job procedures. Coborn s is committed to providing a safe and healthful environment for its employees. Part of providing this environment involves identifying potential hazards in the workplace. These workplace hazards will be identified through: 1. Periodic review of accident records 2. First reports of injury 3. Accident investigations 4. OSHA logs 5. Safety inspections 6. Employee suggestions 7. Analyzing new equipment or procedures Hazards will be abated by: 1. Engineering the problem out 2. Employing safer equipment, materials or process 3. Training employees 4. Promoting and enforcing safety policies 5. Use of personal protective equipment Inspection of work areas and tasks will be performed daily in each department and performed monthly by the Safety Committee to identify hazards that could place employees and customers at risk. These hazards will be prioritized and scheduled for prompt correction by the Manager/Supervisor. The Safety Manager will be responsible for keeping the documentation on the monthly safety inspections and will monitor the abatement of the recognized hazards. The Safety Committee will conduct a monthly inspection of the store/facility utilizing the Company Safety Inspection Sheet, including, but not limited to the following areas: 1. Fire extinguishers ensure checked and tag initialed monthly. 2. Emergency lighting check to ensure proper working order. Policy: AWAIR Program Date Issued: May 1, 2013 Date Updated: May 1, 2013 Page 6 of 15

3. Eye wash stations test and initial inspection tag. 4. First Aid and emergency response material ensure fully stocked, no expired supplies and is operational. Maintenance will be responsible for contacting and monitoring outside vendors regarding inspection of other necessary equipment. Specific tasks requiring the use of personal protective equipment have been identified and the appropriate personal protective equipment provided to the locations. Instructions for its use and care will be provided and monitored by each Department Manager. Changes in equipment or procedures will be analyzed by the Location Managers in cooperation with the Safety Manager to determine if new or revised personal protective equipment is required. This information will be presented to management to help develop a personal protective equipment policy. Management and Supervisors at all levels will be responsible to be on the lookout for unsafe practices and conditions and to promptly correct when identified. Communication of the AWAIR Program The AWAIR program will initially be communicated to all employees through a training session. All new employees will be trained at the time they are hired. Copies of the program will be available to employees on the Intranet or by contacting the Human Resources Department and/or Safety Manager and will be incorporated as part of the New-Hire paperwork. Employees are encouraged to make safety suggestions to management staff, safety team members or by contacting the Safety Manager. Safety information will be communicated through new employee orientation, safety training, posters, safety bulletin boards, safety newsletters and one-on-one safety guidance by Supervisors and Managers. Periodic safety meetings and training sessions will be scheduled on various safety related topics. All safety training must be documented. The date of training, signatures of attendees, name of instructor, and topics covered will be listed on the attendance form. These forms will be retained by the Human Resource Department and/or Safety Manager for future reference. Safe work practices will be emphasized during on-the-job skills training. Hazardous product information will be in MSDS manuals, on container labels, and warning labels. This information must be understood and followed by all employees. Written policies will be distributed and employees must sign-off after reading them. Policy: AWAIR Program Date Issued: May 1, 2013 Date Updated: May 1, 2013 Page 7 of 15

Employee Training The training of all employees (including management) is vital in a successful Injury Prevention Program. Coborn s management provides training to all employees. Safety training is not a one-time occurrence. Continual monitoring and interaction between employees and Supervisors demonstrates accident prevention efforts. Safety rules and safe work procedures should be discussed specifically with each employee on an ongoing basis. Work routines should be reviewed periodically. Employees should be given explanations of potential hazards to avoid and safeguards to follow. Discussions should include a review of safety procedures, along with an explanation of why they are necessary. It may become necessary to retrain employees in safety rules or procedures. It is vital to our Injury Prevention Program that all safety training programs and meetings be carefully documented. Training programs will include but are not limited to the following: 1. AWAIR Program 2. Annual Safety Training 3. Power Industrial Truck Training 4. All other company safety and health policies Accident Reporting and Investigation The management at Coborn s accepts the responsibility for minimizing losses due to unsafe practices by promptly and accurately investigating all accidents whether an injury occurs or not. Accident investigation is a vital part of our Injury Prevention Program and is designed to prevent or control unsafe practices. The information obtained in a thorough investigation will assist in determining when an accident occurred and then give a basis for taking corrective action. The investigation must include a written report. Accident Investigation Procedure: The Supervisor/Department Manager is responsible for conducting the accident investigation. The Location Manager is responsible for overseeing and ensuring the investigation is submitted. However, the Safety Manager or Workers Compensation/General Liability Claims Coordinator may find it necessary to also be involved in the investigation. An investigation should always be done as soon after the accident as possible. Facts should be gathered and statements taken while the accident is still fresh in the minds of those involved. If possible, every employee and/or customer who is involved or who witnessed the incident should be interviewed. All possible causes should be studied and accurate details should be obtained. The accident investigator should interview witnesses separately and caution should be used in jumping to hasty conclusions. If the accident was captured on video, ensure the video is saved on a disc and the disc is forwarded with the report. Remember, the purpose of the investigation is fact-finding not fault finding. Policy: AWAIR Program Date Issued: May 1, 2013 Date Updated: May 1, 2013 Page 8 of 15

Every accident must be taken seriously. When an employee or customer is injured, the Location Manager, or Manager on Duty must be notified immediately. NOTE: Incidents resulting in death, amputation, or severe injuries requiring hospitalization, the Location Manager must immediately notify the District Manager, Chief Operations Officer and Human Resources Director. Once notified, the Location Manager or Manager of Duty will follow these procedures: Accident Reporting for Employee Injuries: 1. The Location Manager or Manager on Duty will assess the situation and talk with the employee so proper medical attention can be provided. For serious injuries or those requiring immediate medical attention, immediately dial 911 (after obtaining an outside line). For non-serious injuries or for assistance until professional help arrives, generally, only those employees properly trained on how to respond and to protect themselves are to provide first aid. Employees that have not received proper training should call a member of the Emergency Response Team to respond. Should an emergency necessitate response prior to help arriving, emergency first aid may be administered with proper infection control procedures followed. In a serious incident, do not attempt to move the employee. Instead comfort them and offer any other assistance they may need. If necessary, monitor foot traffic around the employee to prevent further injury. 2. In non-emergency situations, the Location Manager or Manager on Duty will complete a First Report of Injury (FROI) form immediately and send it to the claims.line@cobornsinc.com or fax it to Claims at (320) 252-0014. In emergency situations, the FROI should be completed and submitted as soon as practical to do so. North Dakota locations will complete a First Report of Injury on-line via the North Dakota Workforce Safety & Insurance (WSI) website and submit forms to WSI via the internet with a copy sent to the Worker s Compensation/General Liability Claims Coordinator. All FROI forms must be submitted within 24 hours. 3. The Location Manager, or Manager on Duty, must take pictures of the accident scene using a digital camera or manual camera for locations without e-mail. Take photos of any spill/hazard, even if the floor is clean and dry, indoors or outdoors. The area should be documented as it appeared at the time the incident occurred. If the accident was captured on video, ensure the video is saved on a disc and the disc is forwarded with the report. 4. After the injured worker is attended to, remove any safety hazards, take care of any maintenance issues and if necessary, address safety violations. If clean-up is required, Emergency Response Team members or the Sanitation Staff will be responsible for clean-up. Ensure proper infection control procedures are followed and appropriate personal protective equipment is utilized. In the event major clean-up service is needed, the area should be sealed off and the ServiceMaster on-call Project Manager (800-245- 4622) contacted to provide clean up services. 5. The injured employee s direct Supervisor/Department Manager will be responsible for completing an investigation to find all the causes and to determine corrective action to prevent recurrence. The Supervisor/Department Manager will complete the Supervisor s Investigation Report in its entirety, including witness interview information, and submit it to the Location Manager for review and signature (See Preparing a Written Report below for details). 6. The Location Manager will send the Supervisor s Investigation Report to the Policy: AWAIR Program Date Issued: May 1, 2013 Date Updated: May 1, 2013 Page 9 of 15

claims.line@cobornsinc.com or fax to Claims immediately at (320) 252-0014. 7. If possible, the Location Manager will correct any apparent hazards immediately or take appropriate action to ensure it will be corrected. 8. If an accident results in an employee receiving work restrictions, we will make every effort to return the employee back to work as soon as possible following the Company s Return to Work Policy. Any limitations will be accommodated to the best of our ability. Location Managers are responsible for monitoring employee s work restrictions and immediately notify the Workers Compensation/General Liability Claims Coordinator of any changes. Accident Reporting for Customer Injuries: 1. The Location Manager or Manager on Duty will assess the situation and talk with the customer so proper medical attention can be provided. Offer to call for emergency services if needed. If necessary, a member of the Emergency Response Team will be contacted and, upon customer approval or if the customer is unconscious, 911 called (after obtaining an outside line). If the customer denies emergency services but it appears that they may not be making a rational decision and you deem that emergency services may be necessary, notify them that you will be calling 911 to error on the side of caution; however they may refuse services when they arrive. If services are refused, there is no cost to them. Should an emergency necessitate response prior to help arriving, emergency first aid may be administered with proper infection control procedures followed. In a serious incident, do not attempt to move the customer. Instead comfort them and offer any other assistance they may need. If necessary, monitor foot traffic around the customer to prevent further injury. 2. In non-emergency situations, the Location Manager or Manager on Duty will complete a Customer Incident/Accident form immediately and send it to the claims.line@cobornsinc.com or fax it to Claims at (320) 252-0014. In emergency situations, the form should be completed and submitted as soon as practical to do so. Forms must be submitted within 24 hours. When gathering information on a claim, gather the facts in a neutral tone. Talk to the injured person and comfort them while waiting for medical attention. Listen carefully to the customer s claim. You may also obtain further details as they tell their account of what happened. Remember do not admit fault or offer/promise any payment or coverage as we cannot make that determination. 3. Inform them that our insurance provider will be in contact with them within 24 hours of receiving the claim. 4. The Location Manager, or Manager on Duty, must take pictures of the accident scene using a digital camera or manual camera for locations without e-mail. Take photos of any spill/hazard, even if the floor is clean and dry, indoors or outdoors. The area should be documented as it appeared at the time the incident occurred. If the accident was captured on video, ensure the video is saved on a disc and the disc is forwarded with the report. 5. After the injured customer is attended to, remove any safety hazards, take care of any maintenance issues and if necessary, address safety violations. If clean-up is required, Emergency Response Team members or the Sanitation Staff will be responsible for clean-up. Ensure proper infection control procedures are followed and appropriate personal protective equipment is utilized. In the event major clean-up service is needed, Policy: AWAIR Program Date Issued: May 1, 2013 Date Updated: May 1, 2013 Page 10 of 15

the area should be sealed off and the ServiceMaster on-call Project Manager (800-245- 4622) contacted to provide clean up services. 6. The Location Manager should complete the Employee Witness form with any employees that may have witnessed the incident and forward them with the Customer Incident/Accident form to the claims.line@cobornsinc.com or fax to Claims immediately at (320) 252-0014. 7. If possible, the Location Manager will correct any apparent hazards immediately or take appropriate action to ensure it will be corrected. Preparing a written report: All possible questions related to the accident must be answered and corrective actions must be recommended. 1. Personnel and background information. Name of the person involved in the accident. What are the nature of the injuries and the injured body parts? If an employee, what are the employee s regular job tasks? 2. Accident description and related information. Give the exact location of the accident. What specifically was the injured person doing at the time? What type of accident occurred? Was the employee properly trained to perform the task? 3. Witness information. Information on witnesses name, what they were doing at the time of the incident, and detailed account of what witnesses saw or heard prior to, during or immediately after the incident. Confine information to facts only. 4. Analysis of accident causes. What did the injured person do or fail to do that may have contributed directly to the accident? What defective or otherwise unsafe condition of tools, equipment, machinery, structures or work contributed directly to the accident? Was personal protective equipment (PPE) required and, if so was it available and worn? Was employee instructed on use of PPE? What was the primary type of unsafe action or condition involved? 5. Actions to prevent accident recurrence. Indicate actions needed to prevent recurrence. Identify persons responsible for planned corrective actions. 6. Miscellaneous information. Who investigated the accident? Enforcement Process Responsibilities do not stop with Management. Employees are responsible to obey all company rules and to work in such a manner that will prevent injury to themselves, co-workers, or customers. The Company s intent is not to discipline employees who are involved in non-preventable accidents. Coborn s position is to work with employees to assist them in performing duties safely. Should there be a violation of safety rules or policies, we will issue the appropriate level of disciplinary action. Employees may be terminated for flagrant violations of company policies and procedures. Termination may also occur if an employee persists in continued or repeated violations of company rules after repeated warnings and continues at an unacceptable level of performance. Policy: AWAIR Program Date Issued: May 1, 2013 Date Updated: May 1, 2013 Page 11 of 15

Work Standards and Rules All Coborn s employees are expected to be familiar with and abide by the following rules. Our policy toward safety is in no way limited to these rules alone. All unsafe practices, whether listed here or not, will be addressed. Failure to comply with any safety rule will be cause for disciplinary action, up to and including termination. All employees will: 1. Always report any injuries, accidents and near misses to their Manager/Supervisor/Lead immediately. Notify management and correct unsafe conditions immediately. 2. Know where first aid facilities are located. All injuries should be treated at once. 3. All employees must wear personal protective equipment, such as hand, eye and hearing protection and other items when in designated areas or performing tasks that require such protection. Appropriate footwear is required. 4. Do not remove safety guards from any saw, machine or hand tool and do not operate any saw, machine or hand tool without a safety guard. De-energize all equipment prior to cleaning and/or maintenance. 5. Refrain from practical jokes and horseplay which can lead to accidents. Such activities will not be tolerated. Never distract another employee. 6. Obey all warning tags and signs posted throughout the workplace or affixed to machinery and/or hand tools. 7. Be careful when lifting or pushing heavy objects. Avoid unnecessary back injuries by following rules of common sense: a) Use equipment to move heavy items whenever practical. b) Use team lifting to share the load. c) If an employee must lift a load alone, they will: i. Know their limitations and do not exceed them. ii. Keep neutral curve in low back. iii. Keep head up. iv. Lift with legs. v. Bring load in close. 8. Know your locations emergency procedures and evacuation policy. 9. Keep all areas neat, orderly and free from trash and debris. 10. Check the condition of all personal protection equipment, machinery and extension cords daily. Never remove ground wires from electrical tools or extension cords. Ensure any defective PPE, machinery or extension cords are taken out of service, tagged for no use and reported to management for repair. Unless it is a part of your regular job, never attempt to make electrical repairs. 11. Possessing, using, selling or being under the influence of alcohol, marijuana, hallucinogens or any other drugs or controlled substances on company property at any time or when on company time away from the workplace is strictly prohibited and may result in termination of employment. Policy: AWAIR Program Date Issued: May 1, 2013 Date Updated: May 1, 2013 Page 12 of 15

Company Safety Goals and Objectives Coborn s is committed to providing its employees with a safe and healthful working environment. To achieve this environment the company has established the following goals and objectives: 2013 Goals: 1. Create and encourage an organizational safety culture to Start F-R-E-S-H with Safety to encourage all employees to promote and act safely in all work activities and work towards zero accidents and injuries. 2. Implement and modify safety programs to ensure the proper training and compliance of all local, state and federal regulations. 2013 Objectives: 1. Institute an Injury Prevention Program that will reduce number of injuries and accidents to a minimum, and continue to work towards zero accidents. 2. Investigate all accidents to address cause and whenever able, take corrective actions within 24 hours to prevent a reoccurrence. 3. Review and modify, if needed, safety training to be not only compliant, but meaningful and user friendly. 4. Provide additional presence at facilities by completing Corporate Safety Audits. Location specific Safety Goals and Objectives: Contact your Location Manager for the list of goals established for your location. Policy: AWAIR Program Date Issued: May 1, 2013 Date Updated: May 1, 2013 Page 13 of 15

AWAIR: Accident and Injury Prevention Program Employee Acknowledgement Form Coborn s is committed to providing a safe working and shopping environment for our employees and customers. We value you and your well-being, both at work and away from work, and it is critical to the success of your family, local community, and Coborn s. As a Coborn s employee, you are required to report any unsafe work practices or safety hazards encountered on the job. Due to the critical necessity of timely reporting, all accidents, injuries and near misses (no matter how slight) are to be immediately reported to the Manager/Supervisor/Lead. A key factor in implementing this policy will be the strict compliance to all applicable federal, state, local, and Coborn s policies and procedures. Failure to comply with these policies, including failure to report injuries within 24 hours, may result in disciplinary action, up to and including termination. Coborn s will make every reasonable effort to provide a safe and healthful workplace that is free from any recognized or known potential hazards. Everyone at Coborn s must be involved and committed to safety. This will require a team effort. Everyone s goal must be to constantly improve safety awareness and to prevent accidents and injuries. Together, we can prevent accidents and injuries and keep each other safe and healthy in the work that provides our livelihood, together we can Start F-R-E-S-H with Safety. By signing this document, I confirm the receipt of Coborn s AWAIR: Accident and Injury Prevention Program. I have read and understood all policies, programs, and actions as described, and agree to comply with these set policies. Print Name Work Location Signature Date Policy: AWAIR Program Date Issued: May 1, 2013 Date Updated: May 1, 2013 Page 14 of 15

Location specific Safety Goals and Objectives: The following local goals have been established: Location: Year: Goals: 1.. 2.. Location Manager Signature Date: (Once reviewed and signed, fax a copy of this page to the HR Department at (320) 203-6264, Attn: Safety Manager) Policy: AWAIR Program Date Issued: May 1, 2013 Date Updated: May 1, 2013 Page 15 of 15