• A. Company Information

  • How would you like your Company's Name listed in the OSHAlogs system?
  • (Choose One Below)
  • Main Headquarters Address - Please Include Street, City, State, and Zip
  • If same as above, leave blank.
  • Each location will be considered an "establishment" and require its own OSHA 300 and OSHA 300A. List each locations SIC Code and NAICS Code. If you do not know these codes you can always leave blank and add them later.
    Location NameLocation(s) Full AddressSIC CodeNAICS Code 
  • B. User Information

  • This will be your Company's primary user and will have full access to OSHAlogs. This would typically be an HR person or Safety Manager.
    First NameLast NameTitleEmail Address
  • These users will have access to the system, but their access will be more limited than that of an Administrator User
    First NameLast NameTitleEmail Address 
  • C. Work Comp Policy Information

    If UNICO or UNITEL currently manages your WorkComp policy, you do not need to fill out the below fields.
  • Start Date:End Date:
  • Once you have completed the above form, click submit below. A UNICO Group Representative will contact you to complete your enrollment within 2 business days.