09 - Asbestos Responsibility Form sample.pdf
PDF 98 KB Posted
- Attached to
- ITB# 26-15 Roofing Contractor Package #1
- Solicitation number
- 26-15
- Issued by
- Boulder County, Lakewood City, Colorado
About this file
This document is an Asbestos Management Plan Contractor Responsibility form issued by the Boulder Valley School District (BVSD), specifically drafted by the Environmental Services Department. The form establishes mandatory requirements for contractors working in BVSD facilities, requiring strict adherence to AHERA, EPA, and Colorado Department of Public Health and Environment regulations regarding asbestos treatment and management during construction, renovation, or maintenance projects. Contractors are required to review the asbestos management plan before beginning work and must immediately notify BVSD Environmental Services of any potential asbestos-containing building material (ACBM) disturbance or discovery.
The document serves as a legally binding acknowledgment that requires contractors to understand and commit to protecting against asbestos exposure, with potential financial liability for unauthorized disturbance or damage to ACBM. By signing the document, contractors agree to immediately report any scope changes or unexpected encounters with potential asbestos-containing materials, allowing BVSD Environmental Services to identify areas of concern and facilitate necessary abatement. The form includes signature lines for an authorized company representative, ensuring comprehensive documentation and contractor accountability for asbestos management protocols.
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Text version
Boulder Valley School District
Asbestos Management Plan Contractor Responsibility
It is the expectation of the Boulder Valley School District that contractors adhere to all AHERA, EPA, and Colorado Department of Public Heath and Environment regulations regarding asbestos treatment and management before and during any construction, renovation or maintenance project.
To that end, contractors are expected to review the asbestos management plan before the work begins. Any activity that could potentially disturb asbestos containing building materials must be brought to the attention of BVSD Environmental Services Department prior to the start of work, and if the scope of work changes during the course of the project. Environmental Services will identify all areas of concern and facilitate any necessary abatement in order to help make all projects successful.
Therefore, contractors and their subcontractors must provide this signature sheet prior to the start of work to ensure they are aware of BVSD expectations and understand their responsibility.
I have read and understand the BVSD Asbestos Management Plan for the buildings in which I will be working. I agree not to disturb or damage any asbestos containing building materials (ACBM), which have been identified in the Asbestos Management Plan. In the event the scope of work changes during the course of the project, or our work causes us to encounter building materials that may be ACBM, we agree to notify BVSD Environmental Services immediately. If any identified ACBM is disturbed or damaged as a result of the work, the contractor and/or their subcontractor may be held financially responsible for all related remediation.
Company Name: ______________________________________________
Authorized Representative: ______________________________________ Print
Signature
Date: ____________
Drafted and Required by:
BOULDER VALLEY SCHOOL DISTRICT ENVIRONMENTAL SERVICES DEPARTMENT
File details come from the government source that posted it. Updated .