Att 5 - Employee Compliance Statement.docx

EMPLOYEE STATEMENT OF COMPLIANCE

EMPLOYEE NAME: ______________________________

POSITION/TITLE: ______________________________

DATE: ______________________________

Please check the appropriate blank.

____ New Employee, New Contractor

____ Annual Confirmation for current Employees or Contractor(s) (Due on November 1 of each Contract year)

FOR ALL EMPLOYEES

I have been briefed and understand the following guidance:

INITIALS

_________ The National Cemetery Administration honors veterans with a final resting place and lasting memorial that commemorate their service to our Nation. National Cemeteries are National Shrines. Therefore, the standards for management, maintenance, appearance and operational procedures have been established by the National Cemetery Administration to reflect this Nations’ concern and respect for those interred there. For this reason, my strict adherence to the Performance Work Statement, Performance Work Requirements Summary and Guidance Specifications shall be required and shall be essential.

_________ I will remain aware of the remains buried in the grounds where work is being performed. The utmost care must be given to these remains and the headstones and flat grave markers that mark those gravesites and memorialize the service of individuals.

_________ I will not walk, stand, lean, sit or jump on headstones, markers, or monuments. Nor will I drive over them.

_________ I will not place or lean tools, equipment, or other items on headstones, markers, or monuments at any time.

_________ I have been briefed on the approved methods and tools to remove headstones and markers from their sockets in accordance with the Contract Specifications. I will use the tools and methods approved by the Contracting Officer Representative (COR) to lift headstones and markers out of the ground in order to avoid damage; pick axes are not an acceptable tool.

_________ I will not place headstones or markers on dirt piles or mud once they are removed from their sockets; in order to show appropriate respect towards the families visiting the gravesites and the remains that are buried, I will ensure headstones and markers are carefully stored on each associated gravesite and protected from damage or soiling, in accordance with Contract Specifications.

_________ I understand that the Contractor shall be responsible for replacing damaged headstones and markers and for restoring turf damaged during performance of this work.

_________ Should any on-site activity, incident, emergency, or disaster result in exposure and/or damage to any remains, container for remains (i.e., casket or urn), or outer burial container, I will IMMEDIATELY notify the the Cemetery Director, the COR and/or the Contracting Officer; I will take immediate steps to protect and render safe any exposed remains; and stop any further work until the Cemetery Director provides the Contractor Supervisor guidance regarding disposition of the remains and permission to proceed.

SIGNATURE BLOCK

Signature

Printed Name

Date

IF THIS STATEMENT IS THE EMPLOYEE’S ANNUAL COMPLIANCE STATEMENT, THIS COMPLIANCE STATEMENT MUST BE RETURNED TO THE COR BY NOVEMBER 1.

AS TO STATEMENTS OR COMMITMENTS OF FUTURE ACTIONS, THIS COMPLIANCE STATEMENT COVERS THE PERIOD FROM OCTOBER 1 OF THE CALENDAR YEAR DURING WHICH THIS COMPIANCE STATEMENT IS DUE THROUGH SEPTEMBER 30 OF THE NEXT CALENDAR YEAR.