Attachment 8 - Contractors Employee Statement of Compliance.pdf
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- Solicitation number
- 36C78626B0014
About this file
This is a Contractor's Employee Statement of Compliance form required for National Cemetery Administration contracts.
The form mandates that all contractor employees complete and sign a compliance statement acknowledging briefing on National Cemetery Administration standards and procedures. New employees and contractors must complete the statement immediately, while current employees must submit annual confirmations by November 1 of each contract year or immediately after Notice to Proceed (NTP). The compliance statement covers the period from October 1 through September 30 of the following year. Employees must initial each of seven key compliance areas: (1) adherence to Performance Work Statement and specifications due to cemetery status as national shrines; (2) awareness of remains buried at work sites and exercise of utmost care; (3) prohibition on walking, standing, leaning, sitting, jumping on, or driving over headstones, markers, or monuments; (4) prohibition on placing or leaning tools and equipment on grave markers; (5) use of approved methods and tools to remove headstones and markers, with pickaxes explicitly prohibited; (6) proper storage of removed headstones and markers on associated gravesites in protected conditions rather than on dirt or mud; (7) contractor responsibility for replacing damaged headstones, markers, and restoring damaged turf; and (8) immediate notification to the Cemetery Director, Contracting Officer's Representative (COR), and Contracting Officer of any exposure or damage to remains, containers, or burial containers, with immediate protective measures and work stoppage until director authorization. The signed statement must be returned to the COR by the specified deadline.
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Text version
ATTACHMENT 8
CONTRACTOR’S 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 Nov. 1 of each Contract year or immediately after NTP.)
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’s Representative (COR) to lift headstones and markers out of the ground in order to avoid damage;
pickaxes 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 must 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 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 ‘s 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 OR AFTER NTP.
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.
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