DeMaria’s Response to COVID-19

COVID-19 Questionnaire

The safety of DeMaria’s employees, customers, subcontractors, suppliers, and families is our
top priority. As the Coronavirus Disease of 2019 (COVID-19) continues to spread, DeMaria
Staff will continue to closely monitor the situation and provide updates to the company on
recommendations from the Center for Disease Control and World Health Organization.

To prevent the spread and reduce the risk of COVID-19 to our employees, visitors and
subcontractors, we are administering this questionnaire. Your participation is crucial in
helping us protect yourself and everyone else in our offices and project sites. Thank you for
taking the time to fill this out as it contributes to the health and safety of everyone.

DeMaria COVID-19 Employee Questionnaire

Name*
First Last
Phone*
Project Site*
1. Have you returned from any countries within the past 14 days? If so, which countries? Please include locations of any layovers you might have had during your travel.*
- Yes
- No
2. Have you been in close contact with people potentially exposed or diagnosed with COVID-19 within the past 14 days?*
- Yes
- No
3. Have you been in close contact with anyone who has traveled to any countries within the past 14 days? If so, which countries? Please include any layovers they might have had during their travel.*
- Yes
- No
4. Have you experienced any cold or flu-like symptoms in the last 14 days (fever, cough, sore throat, respiratory illness, or difficulty breathing)?*
- Yes
- No
Signature*
Date
MM slash DD slash YYYY

If the answer is YES to any of the above questions, access to a DeMaria Jpb site will be denied.

Note: Please advise your supervisor immediately if any of your responses to the above
questionnaire change. The information documented on this form will be used to determine if you
will be granted access to DeMaria offices or project sites.

DeMaria Office and Project Site Employee Procedures

To protect the health and safety of everyone at our offices and project sites, given the coronavirus
outbreak’s continued spread, we will now require additional screening of all employees prior to
entry into our DeMaria offices and project sites.

Effective immediately, all employees entering DeMaria offices and project sites are required to
complete a questionnaire. If any questions are answered “yes” access will be denied. The
employee will be respectfully asked to make other arrangements.

If an employee is approved to enter and plans to be on DeMaria premises for consecutive days,
there is no need to repeat the questionnaire each day, unless any responses change. Changes
should be reported to the employee’s supervisor.

If you have traveled to any of the following countries within the last 14 days (including any travel
layovers), or have been exposed to someone who has, access will be denied. This is a list that is
updated by the CDC to include any countries where there is a widespread, sustained (ongoing)
transmission of the COVID-19 virus.

• China
• Iran
• South Korea
• Italy
• Japan
• Europe
• United Kingdom
• Ireland

Why DeMaria? Consider this DeMaria Quick Fact:

Incorporated in
1969

Learn About the DeMaria Difference