2-Certification_of_Safety_Program_(1).pdf

PDF 34 KB Posted

Attached to
Culinary Arts Modernization Project
Solicitation number
WSH2511A
Issued by
Los Angeles County, San Francisco City, California

About this file

This document is a Certification of Safety Program Compliance form from the William S. Hart Union High School District, specifically for Project Number FE 12. The form requires contractors to certify their continuous implementation of safety programs as mandated by law, including CAL-OSHA requirements, for a specific project period. Contractors must complete this certification as a condition for receiving payment, affirming that all required safety programs and meetings have been consistently maintained during the billing period.

The form is a standard compliance document that must be submitted with each payment request, demonstrating the contractor's commitment to workplace safety regulations. It requires the contractor to provide their full legal company name, an authorized signer's name, and a dated signature, thereby formally attesting to their ongoing safety program adherence. The document is part of the project's administrative documentation process, ensuring that safety standards are continuously met throughout the project's duration.

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Text version

William S. Hart Union High School District Project Number

FE 12

Project Forms

CERTIFICATION OF SAFETY PROGRAM COMPLIANCE

FOR THE PERIOD ENDING _________________________________

(Period Ending Date on Payment Request)

TO: WILLIAM S. HART UNION HIGH SCHOOL DISTRICT

PROJECT:

BID PACKAGE:

I understand that each Contractor is required to fully and continuously implement safety program(s), as required by law, to include but not limited to CAL-OSHA requirements.

I hereby certify, as a condition precedent to receiving payment, that all safety programs required by law and by the Contract Documents have been continuously implemented during the period covered by this Payment Request, to include required safety meetings.

Proper Company Name of Contractor (exactly as it appears on Contractor’s License)

Print or Type Name of Authorized Signer by

Signature of Prime Contractor Dated

(This Certification shall be provided by Contractor with each Payment Request)

Period Ending Date on Payment Request:
Proper Company Name of Contractor exactly as it appears on Contractors License:
Name:
Bid Package No:
Project Name:

File details come from the government source that posted it. Updated .