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SECTION 00454 = Sworn Statement Under the Florida Trench Safety Act <br /> THIS FORM MUST BE SIGNED BY THE BIDDER WHO WILL BE RESPONSIBLE <br /> FOR THE EXCAVATION WORK ( " BIDDER") , OR ITS AUTHORIZED <br /> ' REPRESENTATIVE , IN THE PRESENCE OF A NOTARY PUBLIC AUTHORIZED TO <br /> ADMINISTER OATHS . <br /> 1 , This Sworn Statement is submitted with Project No . 0378 for 26th Street Bridge <br /> Replacement Project. <br /> 2 . This Sworn Statement is submitted by <br /> bEl " - <br /> (Legal <br /> Name of Entity Submitting Swam Statement) <br /> her inafter " I D D E TheAber (('FEIN ) isM =JGQ2qkq <br /> DER' address is _ <br /> J 9 ;6J L -� <br /> BIDDER' s Federal Employer Identification Nu <br /> u <br /> 3 . My name is rm4 V\ and my relationship to the BIDDER <br /> (P nt Name endividual Signing)) <br /> is <br /> (Position or Title) <br /> I certify , through my signature at the end of this Sworn Statement, that I am an <br /> authorized representative of the BIDDER. <br /> 4 , The Trench Safety Standards that will be in effect during the construction of this Project <br /> are contained within the Trench Safety Act, Section 553 . 60 et . sea , Florida Statutes and <br /> refer to the applicable Florida Statue (s ) and/or OSHA Regulation (s ) and include the <br /> "effective date" in the citation (s ) . Reference to and compliance with the applicable <br /> Florida Statute (s ) and OSHA Regulation (s) is the complete and sole responsibility of the <br /> BIDDER . Such reference will not be checked by OWNER or ENGINEER and they shall <br /> have no responsibility to review or check the BIDDER ' s compliance with the Trench <br /> Safety Standards , <br /> 5 , The BIDDER assures the OWNER that it will comply with the applicable Trench Safety <br /> Standards , <br /> 6 , The BIDDER has allocated and included in its bid the total amount of $ E o <br /> based on the linear feet of trench to be excavated over five ( 5 ) feet deep , for compliance <br /> with the applicable Trench Safety Standards , and intends to comply with said standards <br /> by instituting the following specific method (s ) of compliance on this Project : <br /> The determination of the appropriate method ( s ) of compliance is the complete. and sole <br /> responsibility of the BIDDER. Such methods will not be checked by the OWNER or <br /> ENGINEER for accuracy , completeness , or any other purpose . The OWNER and <br /> ENGINEER shall have no responsibility to review or check the BIDDER 's compliance <br /> with the Trench Safety Standards . <br /> 00454 - 1 0375-00454 - Florida Trench Safety Act <br /> FAEngineering\Capital Projects10378-26th Street Bridge\0376-26th Street Bridge CONTRACT DOC\0378-00454 - Florida Trench Safety Act.doc Rev. 05/01 <br />