Laserfiche WebLink
TRENCH SAFETY ACT COMPLIANCE STATEMENT <br />Project VZ1?J. ii ( ES!I , tac - in2a'? Pf/ I/ <br />Bid Number # ,a DO S 036) (J,O <br />Instructions <br />Florida Statutes Sections 553.60 through 553.64, known as the "Trench Safety Act" requires all <br />contractors engaged by Indian River County, Florida to comply with Occupational Safety and <br />Health Administration's excavation safety standard, found in 29 C.F.R. s. 1926.650 Subpart P. <br />All prospective contractors are required to sign this Trench Safety Act Compliance Statement <br />and provide compliance cost information where indicated below. The costs for complying with <br />the Trench Safety Act must be incorporated into this Project's base Bid. Certify this Statement in <br />the presence of a notary public. <br />Certification <br />1. I understand that the Trench Safety Act requires me to comply with OSHA excavation safety <br />standards found in 29 C.F.R. section 1926.650 Subpart P. I will comply with The Trench Safety <br />Act and I will design and provide trench safety systems at all trench excavations in excess of five <br />feet in depth for this Project. <br />2. The estimated cost imposed by compliance with The Trench Safety Act will be: <br />100 Dollars $ 10 c0 per linear foot of trench to be excavated. <br />3. The estimated cost imposed by compliance with the Trench Safety Act will be: <br />Dollars $.16 per square foot of special shoring used. <br />4. The amount listed above has been included within the Base Bid. <br />Certified: yn �.1�- r� <br />1( . %12. Coif ! l od'�.l`..c iiC' <br />(Contractor) <br />By: <br />c r 4 7.)Qi,d_ (Signature) <br />Q-ke.-LLDO (Typed or Printed Name) <br />STATE OF: <br />COUNTY OF: I'\; D i ('4-V.0 A i o. <br />The foregoing instrument was acknowledged before me this If /"t -V-1 of t Y� 1r:�� <br />by 1 i v m f‘ -C).',4(-7 -©fes <br />who is personally known -to me or has produced <br />s fifItlitior atid-wh-o did did not) take an oath. <br />Notary Public-.' <br />My Commissib Expires: <br />00300-6 <br />GLORIA J. KUa9c$( <br />MY COMMISSION # DD 719964 <br />EXPIRES: May 26, 2009 <br />Bonded Thru Notary pudic Undnrailsp <br />