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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 . 0816 for <br /> The Enclave . r� <br /> 2 . . This Sworn Statement is submitted by <br /> �rJ ,�� ` rpr <br /> (Legal Name of Entity Submitting Sworn Statement) <br /> hereinafter " BIDDER" . The BIDDER's address is _ <br /> BIDDER 's Federal Employer Identification Number ( FEIN ) is - <br /> 3 . My name is1 C1� �R e��i� and my relationship to the BIDDER <br /> //�� ( rint N me o Individual Signing) <br /> is !'P ES.; eATr <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 $ � , <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 : /o P <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 /> 7 ) The BIDDER has allocated and included in its bid the total amount of $ 04* coo <br /> based on the square feet of shoring to be used for compliance with shoring safety <br /> requirements and intends to comply with said shoring requirements by instituting the <br /> following specific method (s ) of compliance on this Project : <br /> 00454 - Florida Trench Safety Act - REV 04-07 .doc <br /> 00454 - 1 <br /> FAEngineering\Special ProjectAEndeve SubdivialonZontract Documents\Contract Documents\The Enclave.doc\00454 - Florida Trench Safety Act - REV 04-07.doc <br />