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I <br /> I <br /> i <br /> SECTION 00454 - SWORN STATEMENT UNDER THE FLORIDA <br /> TRENCH SAFETY ACT <br /> THIS FORM MUST BE SIGNED BY THE BIDDER WHO WILL BE RESPONSIBLE <br /> •• FOR THE EXCAVATION WORK (" BIDDER119 OR ITS AUTHORIZED <br /> REPRESENTATIVE, IN THE PRESENCE OF A NOTARY PUBLIC AUTHORIZED TO <br /> ADMINISTER OATHS . <br /> 1 . This SwornStatement is submitted with Project No. 0612 Wabasso Beach Park f <br /> Restoration . <br /> rf <br /> 2 . This SwornStatement is submitted by Ocean Gate General Contractors, Inc. <br /> (Legal Name of Entity Submitting Sworn statement) ! <br /> i" hereinafter "BIDDER" . The BIDDER's address is <br /> 2854 SE Federal Highway Stuart, FL 34994 i <br /> BIDDER's Federal Employer Identification Number ( FEIN) is 651084099 i <br /> 3. My name is Mark MacDonald and my relationship to the BIDDER <br /> (Print Name of Individual Signing) <br /> is President <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. f <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 I <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. y <br /> 5 . The BIDDER assures the OWNER that it will comply with the applicable Trench Safety <br /> Standards . l0 000 .00 <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: <br /> BenchingTrench Shielding and Trench Bnxec <br /> k <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 l <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 $ 10,000 . 00 <br /> based on the square feet of shoring to be used for compliance with shoring safety f <br /> requirements and intends to comply with said shoring requirements by instituting the <br /> 6� <br /> following specific method(s) of compliance on this Project: Trench Boxing <br /> I; t� <br /> ti L <br /> Last Revised 1212007 00454 - 1 Wabasso Beach Pk. Restoration <br /> F:\Public Works\Cliff Suthard\Wabasso Beach ParkW Construction Bid Documents\Bid Documents as of 1 -�2008\Div 0 AS OF 1- <br /> Mr 8-2008\00454 - Florida Trench Safety Act.doe t <br /> i <br /> t <br />