2021 Award Application

Liberty Mutual Insurance and CPWR invite you to submit innovations released by you (published, patented, or made available for public use or sale) during the period between January 1, 2020 and February 28, 2021 that are designed to reduce the risk of injuries and/or fatalities in the construction industry. An applicant may be an individual or organization.

The winner of the Liberty Mutual Safety Innovation Award in Construction will receive a $15,000 cash prize and a plaque. In addition, honorable mention awards may be bestowed at the discretion of the judging panel. Each honorable mention will receive a $5,000 cash prize. Framed certificates will be awarded to each member of an honorable mention awardee’s team.

Finalists will be recognized at a national safety-related conference, as well as in news releases and articles distributed broadly to the insurance industry, trade and union publications, and other relevant organization and stakeholder publications.

Consent*
I have read and agree to the application terms.
Contact Information:

Please correct errors.
Organization Name*
Organization Website*
Address*
Organization Street Address 1 Organization Street Address 2 Organization City Organization State Organization Zip
Submitter’s Name*
First Last
Submitter’s Title*
Submitter’s Email*
Submitter’s Phone*
Submitter’s Date of Birth*
Date Format: MM slash DD slash YYYY
Innovation Title*
In ten words or less please provide the title for your innovation award entry:
Innovation Launch*
Choose the earliest date that the essential nature of the innovation was revealed to the public or a patent granted. Note: Judges will conduct an independent search to determine the earliest date the innovation appeared publicly. Innovations made public before January 1, 2020 will not be eligible.
The Risk*
In 300 words or less, please describe the risk that your innovation will address:
Innovation Description*
In 300 words or less, please describe the risk that your innovation will address:
Demonstration of Safety Impact and/or Validation*
In 300 words or less, please provide evidence that the intervention has or will, for example, improve safety climate; reduce or eliminate a hazard or exposure; reduce injuries/illnesses; improve project management practices, procurement, selection of contractors or how work is organized:
Scalability to small construction firms*
In 100 words or less, please describe how this invention can be scaled to small construction firms:
Financial Impact*
In 100 words or less, please describe the current or anticipated return on investment relative to innovation costs:
Viability*
In 100 words or less please describe the likelihood of bringing the innovation to market and/or reduction of barriers to adoption:
Testimonial*
In 300 words or less please provide a testimonial from at least one stakeholder
Upload Image(s):
Drop files here or

Accepted file types: jpg, png, tif.
Please attach at least one high-resolution photo. You may include up to four photos. Each photo should be no larger than 20MB. Please begin photo file name with the project title.

Allowed file types include .jpg, .png, and .tif.
Upload Video:
Accepted file types: mp4.
Please attach a 3-5 minute video describing and/or demonstrating use of the intervention (evidence-based technology, work practice, or program). Please begin the video file name with the project title.

Your video file must be formatted as .mp4 with a maximum file size of no more than 256 MB.
Team members
Please provide background information on any additional team members. Add mores as needed:
Name
Title
Home Address
Email
Home Phone
Date of Birth
Date Format: MM slash DD slash YYYY
Name
Title
Home Address
Email
Home Phone
Date of Birth
Date Format: MM slash DD slash YYYY
Name
Title
Home Address
Email
Home Phone
Date of Birth
Date Format: MM slash DD slash YYYY
Name
Title
Home Address
Email
Home Phone
Date of Birth
Date Format: MM slash DD slash YYYY
Name
Title
Home Address
Email
Home Phone
Date of Birth
Date Format: MM slash DD slash YYYY
Name
Title
Home Address
Email
Home Phone
Date of Birth
Date Format: MM slash DD slash YYYY
Team Members
Name Title Home Address Email Home Phone Date of Birth

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Liberty Mutual Safety Innovation Award

2021 Award Application

Contact Information:

Team members

Name	Title	Home Address	Email	Home Phone	Date of Birth