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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. 1213C for <br /> INDIAN RIVER COUNTY SHOOTING RANGE HUNTER EDUCATION CLASSROOM <br /> 2. This Sworn Statement is submitted by Proctor Construction Company LLC <br /> (Legal Name of Entity Submitting Sworn Statement) = <br /> , <br /> F- <br /> L: <br /> hereinafter "BIDDER". The BIDDER's address is t <br /> 2050 US Hwy 1 Ste 200 Vero Beach FL 32960 <br /> BIDDER's Federal Employer Identification Number(FEIN)is 46-4750281 <br /> d m relationship to the BIDDER <br /> 3. My name is Donald C Proctor an y p <br /> (Print Name of Individual Signing) <br /> is CEO <br /> (Position or Title) <br /> am an <br /> ' nature at the <br /> end of this Sworn Statement, that I <br /> through m <br /> sI <br /> cert' g y g <br /> rfY <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 /> sbd, pct <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 rpethod(s)of compliance on this Project: T- <br /> W ILA, 6 ir (�EN&"O t 0ve-ft-c1-r-4 VAS p <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. O,O <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 s method( ) � L./s of compliance on this Project: N 01- PP b L4- <br /> 00454-Florida Trench Safety Act-REV 04-07 <br /> 00454-1 <br /> FAPublic WorkslENGINEERING DIVISION PROJECTS11213C IRC Shooting Range Hunter Eduction ClassrooraMminlbld documentsWaster Contract Doauments100454- <br /> cln.6rn T-nch Safely Act-REV 04-07.doo <br />