Attachment A-II.docx
DOCX document 313 KB Posted
- Attached to
- Bridge Operations-Fort Street Bridge
- Solicitation number
- RFP-591-200000001437-1
- Issued by
- Wayne County, Michigan
About this file
This is an attachment to RFP 200000001437 containing required forms for bridge operations and incident reporting. The document includes four primary forms: Bridge Operator's Report (Form 0406), Unnecessary Bridge Openings Report, Contractor/Operator's Inspection Form, and Equipment Checklist. The forms are designed to document bridge operations, track vessel passages, record unnecessary openings, conduct regular inspections of bridge operations and operator performance, and maintain inventory of required safety equipment.
The Equipment Checklist specifies mandatory safety equipment including two first-aid kits, two life jackets, two life rings, 150 feet of rope, six fire extinguishers (four ABC 10lb and two BC 10lb), emergency warning flags, two flashlights, six traffic cones, and two reflective vests. The inspection form evaluates bridge operators' knowledge, operational ability, safety conditions, appearance, and housekeeping on a good/fair/poor scale. The Unnecessary Bridge Openings form captures detailed information about vessels causing unnecessary bridge operations, including vessel identification, timing, and cause of unnecessary opening.
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Other files
| File | Type | Posted |
|---|---|---|
| Proposal-instructions-confidential-treatment-vendor-questions-worksheet.docx | DOCX document | |
| Attachment A-VIII Fort St Bridge.docx | DOCX document | |
| Attachment A-IV.docx | DOCX document | |
| Attachment A-VII Fort St Bridge.pdf | ||
| Attachment A-V.docx | DOCX document | |
| Schedule B Pricing.docx | DOCX document | |
| Attachment A-I.docx | DOCX document | |
| Contract terms.docx | DOCX document | |
| Schedule A-Statement of Work.docx | DOCX document | |
| Attachment A-III.docx | DOCX document | |
| Attachment A-VI.docx | DOCX document |
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Text version
RFP 200000001437
ATTACHMENT A-II
FORMS
1. BRIDGE OPERATOR’S REPORT (Form 0406)
2. UNNECESSARY BRIDGE OPENINGS
3. CONTRACTOR/OPERATOR’S INSPECTION
4. EQUIPMENT CHECK LIST
5. ACCIDENT INCIDENT
UNNECESSARY BRIDGE OPENINGS
BRIDGE NAME: BRIDGE No.
BRIDGE LOCATION:
· NUMBER OF VESSEL (IF NUMBERED):
· NAME OF VESSEL:
· HOME PORT (IF SHOWN):
· NAME & ADDRESS OF OWNER:
| MONTH: | DAY: YEAR: | TIME: AM: | PM: |
| DIRECTION OF PASSAGE: UP STREAM: | DOWN STREAM: |
CAUSE OF UNNECESSARY BRIDGE OPENING
APPURTENANCES UNESSENTIAL TO NAVIGATION:
ANTENNA: OUTRIGGER: DECORATIVE MAST:
FLAGPOLE: FALSE STACK: CANVAS TOP:
OTHER:
CLEARANCE GAUGE: FEET
ESTIMATED CLEARANCE OF VESSEL’S HIGHEST FIXED POINT: FEET
REMARKS:
BRIDGE OPERATOR:
(VIOLATION CANNOT PROCEED WITHOUT THIS INFORMATION)
CONTRACTOR/OPERATOR’S INSPECTION
BRIDGE NAME:
INSPECTOR: TIME: DATE:
| EVALUATION |
| GOOD |
| FAIR |
| POOR |
A. Bridge Operators Overall Knowledge Of Functions
1. Knowledge of routine operations procedures
2. Knowledge of emergency operating procedures
3. Knowledge of administrative requirements
4. Knowledge of Coast Guard Regulations
B. Bridge Operators Overall Operational Ability
1. Ability to operate bridge
2. Bridge logs (Completeness)
C. Bridge Navigation And Safety Conditions
1. Navigation lights (daily checks)
2. Fender systems
3. Other safety devices
D. Bridge Operators Appearance
E. Housekeeping Overall
1. Operators bridge house floors
2. Bridge house windows
3. Control console and switchgear
4. Walkways and platforms
5. Commode
F. Overall Bridge Condition
EQUIPMENT CHECK LIST
BRIDGE NAME:
| 1. | FIRST-AID KIT – (2 required) | |
| a. | In a readily accessible place? | |
| b. | Has it been used? | |
| c. | Has it been replenished? |
| 2. | LIFE JACKETS – (2 required) and LIFE RINGS – (2 required) | |
| a. | Is the required number accounted for? | |
| b. | Ripped, torn, or cracked? | |
| c. | General Condition: New Good Fair Poor |
| 3. | ROPE, 150 linear feet 1/4 inch (plus vertical distance of the draw span to water) | |
| a. | Is it in a readily accessible condition? | |
| b. | General Condition: New Good Fair Poor |
| 4. | FIRE EXTINGUISHERS (6 required) | |
| a. | Are there 4 ABC, 10 lbs.? | |
| b. | Are there 2 BC, 10 lbs.? | |
| c. | Date filled? | |
| d. | Has the pin been broken? |
| 5. | BIG RED FLAG FOR EMERGENCY SHIP WARNING | |
| a. | Is the required number accounted for? | |
| b. | Are they properly stored? |
| 6. | FLASHLIGHTS – (2 required) | |
| a. | Is the required number accounted for? | |
| b. | Are they in working condition? | |
| c. | Are the batteries good? |
| 7. | ARE THE FOLLOWING AVAILABLE? | |
| a. | Cones – (6 required) | |
| b. | Vests (Reflectorized) – (2 required) |
| 8. | ARE THE FOLLOWING WORKING SATISFACTORILY? | |
| a. | Commode | |
| b. | Fan/air conditioner | |
| c. | Door locks | |
| d. | Telephone |
e. Intercom (if available)
9. COMMENTS:
PROJECT MANAGER DATE
ACCIDENT INCIDENT
LOCATION:
TIME OF ACCIDENT: ____________ DATE: ____________ HOUR: ______ AM: PM:
WEATHER CONDITIONS: ______________________________ (CLEAR, RAIN, FOG, ETC.)
| OPERATOR’S NAME, ADDRESS & PHONE NUMBER |
| VEHICLE / BOAT IDENTIFICATION NUMBER |
| DRIVERS LICENSE NUMBER |
| INSURANCE COMPANY |
MDOT PROPERTY DAMAGED:
DESCRIPTION OF ACCIDENT:
POLICE AGENCY REPORT NUMBER:
SKETCH IF NECESSARY
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