Attachment 8 - Contractors Employee Statement of Compliance.pdf

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Attached to
Y1PZ--863-NSP26-003 National Shrine Project at Mound City National Cemetery
Solicitation number
36C78626B0016
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About this file

This is a Contractor's Employee Statement of Compliance form required for all employees working on a National Cemetery Administration contract.

The form establishes mandatory compliance requirements for contractor employees performing work at national cemeteries, which are designated as national shrines honoring veterans. Employees must acknowledge briefings and understanding of strict adherence to the Performance Work Statement, Performance Work Requirements Summary, and Guidance Specifications. Key compliance commitments include: maintaining awareness of remains buried at the work site and providing utmost care to those remains and associated headstones and flat grave markers; prohibiting walking, standing, leaning, sitting, jumping, or driving on any headstones, markers, or monuments; prohibiting placement or leaning of tools and equipment on these memorials; using only COR-approved methods and tools (excluding pickaxes) to remove headstones and markers from their sockets; protecting removed headstones and markers from damage or soiling by storing them carefully on associated gravesites in accordance with contract specifications; and accepting contractor responsibility for replacing any damaged headstones or markers and restoring damaged turf. Employees must also commit to immediately notifying the Cemetery Director, COR, and Contracting Officer of any on-site activity, incident, emergency, or disaster resulting in exposure or damage to remains, containers, or outer burial containers, taking immediate protective steps, and ceasing work until receiving permission to proceed.

The form requires completion for both new employees and annual confirmation by November 1 each contract year or immediately after Notice to Proceed (NTP). Annual compliance statements cover the period from October 1 through September 30 of the following calendar year. The form includes signature block requirements and 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.

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