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TRENCH SAFETY ACT COMPLIANCE STATEMENT <br /> Project Name : Highland Drive Storm Sewer Replacement at IRFWCD B - 10 Canal <br /> Project Number: 0447 <br /> Project Location : Indian River County , Florida <br /> Instructions : Florida Statutes Section 553 . 60 through 553 . 64 , known as the "Trench <br /> Safety Act" requires all contractors engaged by Indian River County , Florida , to comply <br /> with Occupational Safety and Health Administration ' s excavation safety standard , found in <br /> 29 C . F . R . s . 1926 . 650 Subpart P . All prospective contractors are required to sign this <br /> Trench Safety Act Compliance Statement and provide compliance cost information where <br /> indicated below . The costs for complying with the Trench Safety Act must be incorporated <br /> into this Project' s base Bid . Certify this Statement in the presence of a notary public or <br /> other officer authorized to administer oaths . <br /> CERTIFICATION : <br /> 1 . I understand that the Trench Safety Act requires me to comply with OSHA <br /> excavation safety standards found in 29 C . F . R . s . 1926 . 650 Subpart P . I will comply with <br /> The Trench Safety Act and I will design and provide trench safety systems at all trench <br /> excavations in excess of five feet in depth for this Project . <br /> 2 . The estimated cost imposed by compliance with The Trench Safety Act will be : <br /> �— <br /> Dollars $ � ° per linear foot of trench to be excavated . <br /> 3 . The estimated cost imposed by compliance with the Trench Safety Act will be : <br /> /0 co � Dollars $ per square foot of special shoring used . <br /> .. 4 . The amount listed above has been included within the Base Bid , <br /> TIMOTHY ROSE C T CTING , INC . <br /> By : <br /> imothy W . Rose , Preside <br /> STATE OF FLORIDA <br /> COUNTY OF INDIAN RIVER <br /> The foregoing instrument was acknowledged before me this k— day of <br /> November , 2004 , by Timothy W . Rose t of TIMOTHY ROSE CONTRACTING , <br /> INC . , a Florida corporation , 6tho is personally knoto e--or-trds--pfodtFeed--wn <br /> ion <br /> Notary Public ( sign ). _� _ � ti � (affix seal ) <br /> My Commission Expires : <br /> " KIMBERUE T. PETERSON <br /> MY COMMISSION M DD 252404 <br /> qe' PThESotCBmbc <br /> Bonded ruNbl December <br /> Underwriters <br /> rr <br />