2004-105 - Laserfiche WebLink

Home Browse Search

SECTION 08454 Sworn Statement Under the Florida Trench Safety Act THIS FORM MUST BE SIGNED BY THE BIDDER WHO WILL BE RESPONSIBLE FOR THE EXCAVATION WORK ("BIDDER!) , OR ITS AUTHORIZED REPRESENTATIVE, IN THE PRESENCE OF A NOTARY PUBLIC AUTHORIZED TO ADMINISTER OATHS. 1 . This Swam Statement Is submitted with Project No. 0386 for the Pelican Island National �- Wildlife Refuge Upland Restoration Project. 2 . This Swam Statement is submitted by Sitewerks , Inc. (Legal Name of Entity submitting swam Statement) TThh BIDOER's address is h rd Ave . Pero%each , FL 3190 BIDDER's Federal Employer Identification Number ( FEIN ) Is 3 . My name is Jeff Brewster and my relationship to the BIDDER nt of individual cloning) is vice PresiTeh ""e (Position or Title) I certify , through my signature at the end of this Swam Statement, that I am an i authorized representative of the BIDDER. 4 . The Trench Safety Standards that will be in effect during the construction of this Project _ are contained within the Trench Safety Act Section 553 .60 et.sea . Florida Statutes and refer to the applicable Florida Statue(s) and/or OSHA Regulation (s) and include the "effective date" in the citation(s ). Reference to and compliance with the applicable Florida Statute(s) and OSHA Regulation(s ) is the complete and sole responsibility of the BIDDER. Such reference will not be checked by OWNER or ENGINEER and they shall have no responsibility to review or check the BIDDER's compliance with the Trench Safety Standards . 5 . The BIDDER assures the OWNER that it will comply with the applicable Trench Safety ' Standards and agrees to indemnify, defend and hold harmless ' the OWNER and ENGINEER, and any of their agents or employees, from any claims arising from the failure of the BIDDER to identify applicable standards or to comply with said standards. As specific consideration for the indemnification above , the OWNER agrees to give the BIDDER twenty-five dollars ($25. 00) , which the OWNER agrees is paid on behalf of all parties indemnified hereinabove . 6 . The BIDDER has allocated and included in its bid the total amount of $ 0 t based on the linear feet of trench to be excavated over five (5) feet deep , for compliance with the applicable Trench Safety Standards, and intends to comply with said standards by instituting the following specific method(s ) of compliance on this Project: N/A The determination of the appropriate method (s) of compliance is the complete and sole responsibility of the BIDDER . Such methods will not be checked by the OWNER or ENGINEER for accuracy, completeness, or any other purpose . The OWNER and ENGINEER shall have no responsibility to review or check the BIDDER's compliance with the Trench Safety Standards .