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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 FOR <br /> THE EXCAVATION WORK ( " BIDDER" ) , OR ITS AUTHORIZED REPRESENTATIVE , IN <br /> THE PRESENCE OF A NOTARY PUBLIC AUTHORIZED TO ADMINISTER OATHS , <br /> 1 . This Sworn Statement is submitted with Project No' s . 0522 for 1 St Road from 35th <br /> Avenue to 32nd Avenue and 0436 for 10th Court SW from Oslo Road to 7 Street SW . <br /> 2 , This Sworn Statement is submitted by SPS a'n4ra (: l n47 C=- <br /> (Legal Name of Entity Subhiitting Sworn Statement) <br /> & tom Ccn � �.I .. . 4{ n / . I�� , � ?� ijl- l3 F' , � �. (. � , hereinafter <br /> " BIDDER" . The BIDD R's address is <br /> BIDDER' s Federal Employer Identification Number (FEIN ) isI IN <br /> 3 . My name is \ ! M (, ' j' J Ina nn and my relationship to the BIDDER <br /> (P iintrName of Individual Signing) <br /> is �. �1kC� ('+ Adfn (Y) I etrrxt- ir-- <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 Florida <br /> 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 $_ rdad <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 with <br /> the Trench Safety Standards , <br /> 7 ) The BIDDER has allocated and included in its bid the total amount of $ <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 <br /> 00454 - 1 <br /> F:\Engineering\Petition Paving\0522 1 st Rd. from 32nd Ave. to 35th Ave\Bid Documents\00454 - Florida Trench Safety AcLdoc <br />