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SECTION 00454 - Sworn Statement Under the Florida Trench Safety Act. <br />THIS FORM MUST BE SIGNED BY THE BIDDER �WHOOWILLBE R iTS REASPONSIBLEE <br />FOR THE EXCAVATION WORK ("BIDDER"), <br />REPRESENTATIVE, IN THE PRESENCE OF A NOTARY PUBLIC AUTHORIZED TO <br />ADMINISTER OATHS. <br />1 This Sworn Statement is submitted with Project No. 0381 for Oslo Road Boat Ramp <br />Repairs. <br />2. <br />This Sworn Statement is submitted by Pt=.)i-C.¢ Pete C OS t ,r`'t- ` t 01,..) Co p ` C <br />(Legal Name of Entity Submitting Sworn Statement) <br />address <br />102,0 t exe, C OJ ti ti s GC Co,;• ems .. <br />hereinafter "BIDDER. Theft BIDDER'S <br />d ? £J t-11 C..`c Qt'ry ,,Vetr o Re�`i tom, r pi, (3,;,-,,9i09 <br />BIDDER'S Federal Employer Identification Number (FEIN) is ,.*-9C) - C,,' ` ?. d <br />3. My name is <br />y PtV,. nnor,C -T 1'z-, and my relationship to the BIDDER <br />is <br />(Print Name of Individual Signing) <br />is V re. ; Qe'`l -kr Ci'tu C <br />(Position or Title) <br />I certify, through my signature at the end of this Swom 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 Safetv Act, Section 553.60 et.sec . 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 referencetvorcheck the BIDDER <br />liew be <br />checked by OWNER compliance with the Trench or ENGINEE <br />and <br />they shall <br />have no responsibility to <br />review <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 included xcava ed over five (5) feet deep, focompliance <br />ts bid the total amount of $ <br />based on the linear feet of trench <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 />6 eT —wen u4 (ree Te -x 14ji : ' Deep. <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 $ <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 />0 Tr(i►cJ 76 6, rek-z -. ` A?,, <br />00454 - Florida Trench Safety Act <br />00454 - 1 <br />("min Ravi Haat Ramo\1)381 Contract Documents and Speeiricationst00454 - Florida Trench Seiety Ad dOC <br />