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TRENCH SAFETY ACT COMPLIANCE STATEMENT <br /> Project Public Supply Well Construction and Testing <br /> Bid Number #2007044 <br /> Instructions <br /> Florida Statutes Sections 553 . 60 through 553 .64, known as the "Trench Safety Act " requires all contractors <br /> engaged by Indian River County, Florida to comply with Occupational Safety and Health Administration's <br /> excavation safety standard, found in 29 C . F.R. s. 1926. 650 Subpart P . All prospective contractors are <br /> required to sign this Trench Safety Act Compliance Statement and provide compliance cost information <br /> where indicated below. The costs for complying with the Trench Safety Act must be incorporated into this <br /> Project's base Bid. Certify this Statement in the presence of a notary public. <br /> Certification <br /> 1 . I understand that the Trench Safety Act requires me to comply with OSHA excavation safety standards <br /> found in 29 C.F.R. section 1926 . 650 Subpart P . 1 will comply with The Trench Safety Act and I will <br /> design and provide trench safety systems at all trench excavations in excess of five feet in depth for this <br /> Project. <br /> 2 . The estimated cost imposed by compliance with The Trench Safety Act will be: <br /> nx� P i � rao�lc�rh(P Dollars $ 1 ' per linear foot of trench to be excavated. <br /> 3 . The estimated cost imposed by compliance with the Trench Safety Act will be: <br /> n r)e 10,W1ifah1PDollars $ t - per square foot of special shoring used . <br /> 4. The amount listed above has been included within the Base Bid. <br /> Certified : �1e1`S Y I ( �ry � cnS Z C <br /> (Contractor) <br /> BY � c � hPrfi � . I(nhlrnPieC G = <br /> (Signature) <br /> (Typed or Printed Name) <br /> STATE OF: T l O r i d Q <br /> COUNTY OF : �PP <br /> The foregoing instrument was acknowledged before me this o� ,' day of 1?24,& L 2006 <br /> by < � � T f of GP//✓ CGn /P2 r s � C <br /> who is personally known to me or has produced f3 <-- <br /> dentification and who did (did not) take an oath . as <br /> Notary Public (affix seal) <br /> MARIE CHRISTINE SIMPSON <br /> 2 . "� MY CAMMISSION #D0641534 <br /> My Commission Expires : IXPIRES: ocr27, 2o07 <br /> `"4^� Bontled Nrough lst Stale Insurance <br /> 6706-43015 - 155\2/710-/ 00300-7 VRB <br />