10-Combined Corporate Accountability and Workforce Safety Affidavit 3-21-2024 FINAL.docx
DOCX document 31 KB Posted
- Solicitation number
- 542974
- Issued by
- Wayne County, Detroit City, Michigan
About this file
This is a Combined Affidavit of Workforce Safety & Corporate Accountability required by the City of Detroit Office of Contracting and Procurement (OCP) on behalf of the City of Detroit Housing and Revitalization Department (HRD) in partnership with the Detroit Water and Sewerage Department for the CDBG-DR Alley Sewer Repair Project. The affidavit must be completed and notarized by an authorized representative—typically the Chief Executive Officer or designee—of any contractor bidding on the as-needed services contract for inspection, rehabilitation, and replacement of alley sewers in Detroit. The document does not specify project quantities, response dates, due dates, site visits, or bidders' meetings; rather, it establishes compliance requirements that contractors must certify prior to award.
The affidavit requires contractors to attest to two categories of compliance. Under Workforce Safety, contractors must confirm that all employees and subcontractors handling hazardous materials have completed hazardous materials awareness training per state and federal guidelines, and that all craft laborers have completed the OSHA 10-hour construction safety training course. Under Corporate Accountability, contractors must represent that they possess all required licenses, registrations, and certificates; have not had such credentials revoked in the past five years; and have not been debarred by any federal, state, or local governmental agency in the past three years. The City of Detroit treats any misstatement or false representation in the affidavit as fraudulent activity under City Ordinance 17-5-12(g)(1) and MCL 750.249. The affidavit must be notarized and submitted to the Office of Contracting and Procurement for clearance before contract award.
View the file
Other files
Show all 17
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
COMBINED AFFIDAVIT
OF
WORKFORCE SAFETY &
CORPORATE ACCOUNTABILITY
Contract No:_____________ I am , and state under oath:
I am the [INSERT OFFICER TITLE HERE] of [INSERT NAME OF ORGANIZATION] (“Contractor”), and represent that I am authorized to execute this affidavit on behalf of the Contractor, and its owners, directors, and officers. I am the Chief Executive Officer, or authorized designee, and attest to the Contractor’s compliance with the following requirements:
A. I represent that the following statements regarding Workforce Safety are true:
| (1) | All employees and subcontractors handling or interacting with hazardous materials have been properly trained, through completion in hazardous materials awareness training; or participation and completion in the requisite awareness training program compliant with state and federal guidelines; and |
| (2) | All employees and subcontractors providing craft labor have at a minimum completed the OSHA 10-hour construction training course for safety established by the U.S. Department of Labor, Occupational Safety and Health Administration. |
B. I also represent that the following statements regarding Corporate Accountability are true:
| (1) | The Contractor and its employees have the required licenses, registrations, and certificates required to perform the work as stated in the solicitation; and |
| (2) | The Contractor has not had any licenses, registrations, or certificates which are required for the performance of the contract revoked in the past five (5) years; and |
| (3) | The Contractor has not been debarred by any federal, state or local governmental agency or authority in the past three (3) years. |
I understand and acknowledge that the above representations are material and important and will be relied upon by the City of Detroit in determining the Contractor’s eligibility for this contract(s)/purchase order(s). I understand and acknowledge, and the Contractor understands and acknowledges that the City of Detroit will treat any misstatement or false representation in this affidavit as a fraudulent activity relating to the eligibility of award for this contract(s)/purchase order(s) under City Ordinance 17-5-12 (g)(1), with intent to defraud the City of Detroit pursuant to MCL 750.249.
**This Document MUST be Notarized** Complete the section below
Printed Name & Title of Authorized Representative:
Signature of Authorized Representative:
Date:
This document was acknowledged, subscribed, and sworn before me <INSERT DATE HERE> day of <INSERT MONTH HERE>, 20XX, by <INSERT NAME OF AUTHORIZED AGENT HERE>, the <INSERT OFFICER TITLE HERE> of <INSERT NAME OF ORGANIZATION HERE>.
Signature of Notary:
Printed Name of Seal of Notary:
My Commission Expires: / /
THIS SECTION IS FOR OCP USE ONLY:
Affidavits Received & Clearance Date: ______________
Version 3/21/2024
File details come from the government source that posted it. Updated .