Employee Name: 

Manager's Name:

Your Samsara Safety Score has been as follows:

Past 7 days: 

Past 30 days: 

Past 90 days: .

The following actions/events are effecting your Safety Score: .

The purpose of this notification is to inform you that your score must improve to at least an 85 or higher over the next two weeks or this could lead to further disciplinary actions, including up to termination.  You must then continue to maintain your Safety Score at 85 or higher moving forward.

You are a valuable employee to Windstar Lines, Inc. and we want you to be able to continue with this relationship and employment with us.