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 issued by William S. Hart Union High School District for Project Number FE 12. The form is a mandatory certification that contractors must complete and submit with each payment request, affirming their continuous implementation of safety programs as required by law, including but not limited to CAL-OSHA requirements. Contractors must fully document their adherence to safety regulations and confirm that all required safety meetings have been conducted during the period covered by the payment request.

The form serves as a critical compliance document that ties safety program implementation directly to payment processing. By requiring this certification, the school district ensures that contractors maintain rigorous safety standards throughout the project duration. The document provides a standardized template for contractors to certify their safety compliance, with space for the contractor's full legal name, an authorized signer's name, signature, and date of submission.

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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 .