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TRENCH SAFETY ACT COMPLIANCE STATEMENT <br /> Project Indian River County North WTP Raw Water Transmission System <br /> Bid Number # 2010024 <br /> Instructions <br /> ety Act " requires all <br /> Florida Statutes Sections 553 . 60 through 553 . 64 , known as the "Trench <br /> 1Tw ihcOccufpational Safety and <br /> contractors engaged by Indian River County , Florida to complySubpart <br /> Health Administration ' s excavation safety standard , found in 29 Safety . 1926 .650e Statement <br /> All prospective contractors are required to sign this Trench <br /> Sa ty <br /> and provide compliance cost information where indicated beloaw e he costs for d . Certify this omplyii ng ewiStatentin <br /> the Trench Safety Act must be incorporated into this Project ' s b <br /> the presence of a notary public , <br /> Certification with OSHA excavation safety <br /> 1 . 1 understand that the Trench Safety Act requires me to comply <br /> standards found in 29 C . F . R . section 1926 . 650 Subpart P . IillAlly with <br /> o Thein excess of five <br /> AcAct and I will design and provide trench safety systems at <br /> all trench <br /> L_ : . n e . i , rte! <br /> feet in depth foi ti 11S r- 10JEoUt . <br /> 2 . Thestimated cost imposed by compliance with The Trench Safety Act will be : <br /> 14 ;21500s4:`J _ Dollars ozs9 per linear foot of trench to be excavated . <br /> 3 . The estimated cost imposed by compliance with the Trench Safety Act will be : <br /> E . mac) Dollars $F per square foot of special shoring used . <br /> 4 . The amount listed above has been included within the Base Bid . <br /> �,-1A <br /> Certified : _ �_ t S ' <br /> ( Contractor) <br /> By : <br /> ( Signature) <br /> (Typed or Printed Name ) <br /> STATE OF : fLl7 � Q� � <br /> COUNTY OF : _ , ' �' ' 0 e <br /> . 10 <br /> The foregoing instrument was acknowledged before me this ;Z0 day of � J ( V ) 2 <br /> t w" s e; of �t <br /> b <br /> y who is personally known to m or has produced <br /> E s entification and who did (did not) take an oath . <br /> f Yp 1 <br /> Notary Public � *`� vlclael � wRlcf]FlMd <br /> 3 ** ,�N NOtW public • State of w+y c. ,mrug, M,rcMy Commission Expires : 0 �3 I 0 � <br /> a '� � � onunlselon0ob ?* * - - -- s <br /> 00300 - 5 <br />