| Keuka Café® Footwear is engineered for safety, style,
comfort and durability at an affordable price. Designed to protect workers on
slippery surfaces, Keuka Café® Footwear is the brand of choice for restaurants,
hotels, supermarkets, factories and industrial areas throughout the U.S. &
Canada.
WHAT IS THE KEUKA CAFÉ® FOOTWEAR CONFIDENCE GUARANTEE?
We are so confident that our Keuka Café® slip-resistant footwear product line
will help reduce slips and falls in your workplace, we will pledge to pay up to
$5,000 towards direct medical expenses paid by you (Company) for injuries
sustained from slips and fall accidents by any of your Company employees
wearing a pair of Keuka Café® footwear purchased through a payroll deduction
plan or through a 100% subsidized company purchase.
With the average cost of a lost-time slip, trip and fall accident being $28,000
(National Safety Council statistic), it’s worth it to any company to develop a
slip-resistant footwear program.
CONFIDENCE GUARANTEE Guidelines
1. The employee must have been wearing a pair of Keuka Café®
footwear purchased through a payroll deduction program or a 100% subsidized
company program within 6 months of the accident date.
2. Exclusions from this offer include: accidents sustained
due to objects on the floor, icy surfaces, coolers areas, freezers areas, in
subzero areas, or in climatic controlled areas.
3. Maximum claim: limited to the lesser of either $5,000 or
the completed claim amount.
4. Maximum reimbursement during the calendar year is 10% of
the company’s net purchase of the Keuka Café® footwear for the calendar year in
which the accident occurs.
5. Keuka Footwear, Inc. reserves the right
to require written certification by the employee and/or the manager confirming
any of the above conditions on the form(s) provided, by Keuka Footwear, Inc.
6. If the Company is more than sixty (60) days delinquent in
its payment of any Keuka Footwear, Inc. invoices, this CONFIDENCE GUARANTEE may
be canceled at anytime.
7. Keuka Footwear, Inc. reimbursements via the CONFIDENCE
GUARANTEE are for direct medical expenses only. Claims other than direct
medical expenses will not be considered for payment including but not limited
to expenses due to lost time at work.
8. The limited warranty is only effective for slips and falls
that occur on the floor at the Company's workplace.
9. Stairs are expressly excluded from any coverage in any form
within the context of the warranty.
10.ShoeGuard™ is a
shoe covering and does not possess the same fit characteristics as Keuka Cafe®
footwear. Therefore, ShoeGuard™ is excluded from the warranty. CONFIDENCE GUARANTEE CLAIM PROCEDURE
No reimbursement amount shall be paid to the CONFIDENCE GUARANTEE Participating
Company for any accident, which is not reported in writing to Keuka Footwear,
Inc. within twenty-one (21) days of the date of the accident.
CANCELLATION OF CONFIDENCE GUARANTEE
This CONFIDENCE GUARANTEE shall automatically terminate upon the termination of
the Employee Payroll Deduction Plan or the 100% company subsidized program with
Keuka Footwear, Inc.
CONFIDENCE GUARANTEE REIMBURSEMENT PROCEDURES
When a location Manager informs your Corporate Risk/Safety Manager that an
employee has incurred a slip and fall accident wearing Keuka Café®
Slip-resistant footwear, the following process needs to be followed:
1. The footwear must have been purchased within six (6)
months through a payroll deduction plan or 100% company subsidized program. 2. The Corporate Safety/Risk Manager should forward a copy of
an accident report to the facility manager where the accident occurred. 3. The accident report should be completed, signed and
notarized by the facility manager and then forwarded back to the Corporate
Safety/Risk Manager. 4. The Corporate Safety/Risk Manager must send the accident
report to Keuka Footwear, Inc. within twenty-one (21) days of the incident.
Please send these forms to:
Keuka Footwear, Inc. PO Box 693 Penn Yan, NY 14527 Attn: Michael O’Brien
Upon review, Keuka Footwear, Inc. will reimburse your company the lesser of
either $5000 or the completed claim amount for direct medical expenses only,
not to exceed 10% of the Company’s net purchases for the year, after you
forward us a copy of the claim closure from your insurance carrier or any other
proof that you paid direct medical expenses for this claim.
LIMITED WARRANTY Subject to the definitions, terms and conditions set forth below, Keuka
Footwear, Inc. hereby agrees to pay the CONFIDENCE GUARANTEE participating
company the direct medical expenses paid by the CONFIDENCE GUARANTEE
participating company, provided the claim is for injuries sustained by the
employee as a result of a slip and fall accident while the employee is wearing
Keuka Café® slip-resistant shoes. The Keuka Café® footwear needs to be purchased
via a Keuka Footwear, Inc. payroll deduction plan or a 100% company subsidized
program within a six-month period prior to the accident.
DEFINITIONS: A. A “CONFIDENCE GUARANTEE Participating Company” is a
company having an employee payroll deduction plan or a 100% subsidized program
with Keuka Footwear, Inc. in effect on the date the company applies for
reimbursement from Keuka Footwear, Inc.
B. The “reimbursable amount” is the amount of the claim paid
by the CONFIDENCE GUARANTEE Participation Company to its employee for direct
medical expenses only for injuries sustained by its employee or $5,000
whichever is less (not to exceed 10% of the Company’s net purchases for the
year in which the accident occurs).
TERMS AND CONDITIONS
A. No reimbursable amount shall be paid by Keuka Footwear,
Inc. to the CONFIDENCE GUARANTEE Participating Company if such reimbursable
amount would cause the total reimbursable amounts paid to the CONFIDENCE
GUARANTEE Participating Company during the Calendar year to exceed ten percent
(10%) of the CONFIDENCE GUARANTEE Participating Company’s net purchases of
Keuka Footwear, Inc. Slip-resistant shoes during the calendar year.
B. No reimbursable amount shall be paid by Keuka Footwear,
Inc. to the CONFIDENCE GUARANTEE Participating Company if the accident occurred
due to tripping on an object on the floor, icy surface, cooler areas, freezer
areas, in subzero area, or in any other climatic controlled areas. Keuka
Footwear, Inc. reimbursements via the CONFIDENCE GUARANTEE are for direct
medical expenses only. Claims other than direct medical expenses will not be
considered for payment including but not limited to expenses due to lost time
at work. This limited warranty is only valid for slips and falls that occur on
the floor at the Company's workplace. Stairs are expressly excluded from any
coverage in any form within the context of the warranty.
C. This limited warranty may be canceled by Keuka Footwear,
Inc. at any time if the CONFIDENCE GUARANTEE Participating Company is more than
Sixty (60) days delinquent in its payment of any Keuka Footwear, Inc. invoice.
D. No reimbursable amount shall be paid to the CONFIDENCE
GUARANTEE Participating Company for any accident, which is not reported in
writing to Keuka Footwear, Inc. within twenty-one (21) days of the date of the
accident. Keuka Footwear, Inc. reserves the right to condition payment of
such reimbursable amount to the CONFIDENCE GUARANTEE Participating Company upon
receipt of written certification by the injured employee or the manager as to
the facts and circumstances of such accident.
E. CONFIDENCE GUARANTEE is applicable to accidents occurring
on or after June 1, 2005.
GOVERNING LAW This Limited Warranty is governed by the Laws of the State of New York. |