Laserfiche WebLink
Bid No. 2019005/IRC-1760 <br />SWORN STATEMENT UNDER THE FLORIDA TRENCH. SAFETY ACT <br />THIS FORM MUST BE SIGNED BY THE BIDDER WHO WILL BE RESPONSIBLE FOR THE <br />EXCAVATION WORK ("BIDDER"), OR ITS AUTHORIZED REPRESENTATIVE, IN THE <br />PRESENCE OF A NOTARY PUBLIC AUTHORIZED TO ADMINISTER OATHS. <br />This Sworn Statement is submitted with Project No. IRC -1760 for <br />VICTOR HART SR. COMPLEX DRAINAGE IMPROVEMENTS <br />2. This Sworn Statement is submitted by Guettler Brothers Construction, LLC <br />(Legal Name of Entity Submitting Sworn Statement) <br />4401 Whiteway Dairy Rd, Ft. Pierce, FL 34947 , hereinafter <br />"BIDDER". The BIDDER's address is <br />BIDDER's Federal Employer Identification Number(FEIN) is --20-3608929----_..-- --. <br />3. My name is Ben Guettler and my relationship to the BIDDER <br />(Print Name of Individual Signing) <br />is Manager <br />(Position or Title) <br />I certify, .through my signature at the end of this Sworn Statement, that I am. an authorized <br />representative of the BIDDER. <br />4. The Trench Safety Standards that will be in effect during the construction of this Project are <br />contained within the Trench Safety Act, Section 553.60 et.seq. Florida Statutes and refer to the <br />applicable Florida Statue(s) and/or OSHA Regulation(s) and include the "effective date" in the <br />citation(s). Reference to and compliance with the applicable Florida Statute(s) and OSHA <br />Regulation(s) is the complete and sole responsibility of the BIDDER. Such reference will not be <br />checked by OWNER or ENGINEER and they shall have no responsibility to review or check the <br />BIDDER's compliance with the Trench 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 $ Z., 000 based <br />on the linear feet of trench to be excavated over five (5) feet deep, for compliance with the <br />applicable Trench Safety Standards, and intends to comply with said standards by instituting the <br />following specific, method(s) of compliance on this Project: <br />'be.�cht ria+, <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 ENGINEER <br />for accuracy, completeness, or any other purpose. The OWNER and ENGINEER shall have no <br />responsibility to review or check the BIDDER's compliance with the Trench Safety Standards. <br />Page 23 of 39 <br />