DXP COVID-19 - Questionnaire - 2022

THE INDUSTRIAL DISTRIBUTION EXPERTS
Thank you for notifying the HR/Safety Team of this potential exposure. The HR/Safety Team will contact
the employee to get additional detail; however, to assist us in managing the high volume of calls/emails, we
ask that you complete the following questions to the best of your ability or “N/A” if unknown.
1. Employee Name: Travis Turknett

2. Location: Sacramento, California
3. Position: Service Technician
4. Employee Contact #: (916) 917-7553
5. Employee’s Current Status:
X Tested Positive: 7/30/22

*Please immediately disinfect all commonly touched surfaces and areas within six feet of the
employees’ work area and refer to the Positive Notification section on page 2.
X Symptomatic: Date of First Symptom 7/29/22

Exposure to an Infected Individual:N/A
6. Is employee currently at work?

*If so, at minimum implement social distancing and/or send the employee home if symptoms include
fever, or fever and additional symptoms.
7. Last date worked at the location? 7/29/22
8. Is the employee fully vaccinated? Yes

*If so, the employee should submit a copy of the vaccine card to [email protected].
9. Is the employee in a position that can work remote? No
10. Determine DXP locations/customer locations that the employee visited following the date of
possible exposure.
11. Determine all individuals by name (including visitors, vendors, customers, etc.) who may have
been exposed to the employee following the known exposure. If exposure is unknown,
determine all employees by name who may have been exposed. Exposure is defined as being
within six feet of an infected individual for a total of 15 minutes or more over a 24-hour period
during the first 48-hours of the infected individual exhibiting symptoms, or 48-hours before the
administration of the COVID-19 test of an asymptomatic infected individual.
If an employee tests positive, discuss sending home employees who worked closely with that employee
following his/her known exposure. If exposure is unknown, review all employees who may have been
exposed to ensure the infection does not spread. *Please note: Prior to returning to work Human Resources
will reach out to the impacted employee(s) and follow up with the manager to discuss their return to work.
Manager Name John Finch Date 8/1/22
DXP ENTERPRISES, INC. Page 1 of 2

THE INDUSTRIAL DISTRIBUTION EXPERTS
Manager: HR will work with managers to notify employees who may have had a potential exposure based
on contact tracing. Managers may also use the below language to notify employees that a co-worker has
tested positive for COVID-19.
This should be modified to fit the circumstances at your location.
Once you finalize the communication:
1. Copy and paste the content into a new email.

2. Address the email to all employees at the location.
3. Enter the subject line as: COVID-19 Positive Notification
4. Attach the DXP COVID-19 Guidelines (provided in the email from the HR Safety Team).
Due to privacy, please do not share the name of the employee who tested positive with others outside of
management or Human Resources.
To: Location Employees

Subject: COVID-19 Positive Notification
Attached: DXP COVID-19 Guidelines
We regret to inform you that an employee at our location has received a positive COVID-19 test result.
Therefore, out of an abundance of caution, potentially exposed employees will be tested and/or the decision
has been made to authorize remote work in order to monitor symptoms and mitigate the spread of the illness.
Close contact employees will be notified as appropriate.
We have implemented cleaning and disinfecting procedures to ensure the facility is thoroughly sanitized.
Given current circumstances it is extremely important that you immediately seek medical attention in the
event you begin to feel ill and notify your management and HR. Please reference the attached DXP COVID-
19 Guidelines that addresses topics such as COVID-19 Illness/Reporting and Exposure protocols, and
prevention methods.
Your health and well-being is our top priority. We urge you to continue to take all necessary precautions
and we will contact you with periodic updates.
DXP ENTERPRISES, INC. Page 2 of 2

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THE INDUSTRIAL DISTRIBUTION EXPERTS

1. Employee Name: Travis Turknett

X Tested Positive: 7/30/22

X Symptomatic: Date of First Symptom 7/29/22

6. Is employee currently at work?

7. Last date worked at the location? 7/29/22

8. Is the employee fully vaccinated? Yes

9. Is the employee in a position that can work remote? No

Manager Name John Finch Date 8/1/22

DXP ENTERPRISES, INC. Page 1 of 2

This should be modified to fit the circumstances at your location.

Once you finalize the communication:

1. Copy and paste the content into a new email.

To: Location Employees

DXP ENTERPRISES, INC. Page 2 of 2

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