2-Certification_of_Safety_Program_(1).pdf
PDF 34 KB Posted
- Attached to
- Hazardous Waste Removal Services
- Solicitation number
- HAZ2604A
- Issued by
- Los Angeles County, San Francisco City, California
About this file
This is a Certification of Safety Program Compliance form issued by the William S. Hart Union High School District for Project Number FE 12, applicable to contractors performing work on the Hazardous Waste Removal Services bid package (HAZ2604A). The form serves as a required certification document that contractors must submit with each payment request to confirm continuous implementation of all safety programs mandated by law and contract documents, including California OSHA requirements and required safety meetings. The certification must be completed and signed by an authorized representative of the prime contractor, with the contractor's legal company name as it appears on their contractor's license, and must cover the period ending date corresponding to each payment request submission.
Submission of this certification is a condition precedent to payment authorization for contractors. Eligible contractors for the hazardous waste removal services must possess an active class-type license (A, B, C-12, C-21, C-36, C-57, or C-61/D40) along with a HAZ-Hazardous Substance Removal Certification. The form requires documentation of continuous safety program compliance throughout the payment period and serves as documentation that contractors are meeting all safety obligations under California law and the contract terms before funds are released.
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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 .