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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 . 1142 for Miscellaneous Drainage <br /> Culvert Replacements <br /> 2 . This Sworn Statement is submitted by _ r V v �/t v ru 4 <br /> (Legal Nam f ntity Sub itting Sworn Statement) <br /> VVA CI) <br /> hereinafter " B DDER" . The IDDE 's addrQss is _ <br /> 13 S4� D i % v �' �, ► c �'. ,� ,. ��'j <br /> BIDDER ' s Federal Employer lk*nfificlaition Number ( FEIN ) is <br /> 3 . My name is AA � and my relationship to the BIDDER <br /> (Pr a of Individual Signing) <br /> e > . is �t'c ► Gk QM)r <br /> (Position or Title) <br /> 1 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 seg 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 $ ( �. b0 • oto <br /> based on the linear feet of trench to be excavated over five (5 ) feet deep , for compliance <br /> t 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 /> 7 . The BIDDER has allocated and included in its bid the total amount of $ 196-0 & as <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 /> FAPublic Works\ENGINEERING DIVISION PROJECTS\1142-Mist Culvert Replacemenls\Ndmim\bid documents\00454 - Florida Trench Safety Act - REV 04-07.doc <br />