Attachment C - DC-029.pdf
PDF 61 KB Posted
- Solicitation number
- Oak-0000000905
- Issued by
- Bay County, Michigan
About this file
This document is a Contract Addendum and Certification for Safety Compliance issued by the Oakland County Water Resources Commissioner's office, located in Waterford, Michigan. The form is designed to ensure contractor compliance with Michigan Occupational Safety & Health Administration (MIOSHA) safety standards for work performed for the Water Resources Commissioner's office, its drainage districts, municipal customers, and other systems. The addendum requires contractors to certify that they strictly follow MIOSHA safety and health standards, provide a qualified or competent safety person on-site, and submit a list of such persons prior to commencing work.
The document mandates that if a qualified safety person is not present, work must cease until such a person arrives. Contractors must also commit to notifying the Water Resources Commissioner's office in writing of any changes to the information provided in the certification. The form serves as a formal commitment to workplace safety, with the signatory representing their legal authority to execute the document and affirming the truthfulness and completeness of the statements made.
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Other files
| File | Type | Posted |
|---|---|---|
| Oakland County WRC Community Water and Sewer Contract (5).docx | DOCX document | |
| Attachment B - ACORD - Maintenance Requirements 2019.12.19.pdf | ||
| Oak-0000000905 WRC As Needed Hydropneumatic Tank Maint.docx | DOCX document |
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Text version
Contract Addendum and Certification for Safety Compliance
This Contract Addendum and Certification for Safety Compliance is effective as of between the Contractor identified below and the Oakland County Water Resources Commissioner’s office, whose address is One Public Works Drive, Waterford, Michigan 48328.
1. By executing this Contract Addendum, the Contractor certifies that it, its employees, agents, subcontractors, and assigns strictly follows all Michigan Occupational Safety & Health Administration (MIOSHA) safety and health standards relevant to the work being performed for the Oakland County Water Resources Commissioner’s office, its drainage districts, municipal customers, private systems, or other customers, at any and all times during which work is being performed.
2. The Contractor further certifies that it will provide a qualified or competent person, whichever is required pursuant to MIOSHA safety and health standards for the work being performed, to oversee safety on the job site.
3. If a qualified or competent person is not present on the job site, then work must not proceed until a qualified or competent person is present.
4. The Contractor must provide a list of all qualified or competent persons to the Oakland County Water Resources project engineer or field staff prior to commencement of any work.
5. If at any time, any of the information provided in this Certification changes, the Contractor agrees to notify the Oakland County Water Resources Commissioner’s office in writing prior to any further work performed on a job site.
Contractor name, address and telephone number: Contractor’s safety coordinator:
The signatory below hereby certifies that the statements and representations of fact made by such signatory contained in this document are true, accurate, and complete. This Contract Addendum and Certification for Safety Compliance has been made, presented, and delivered for the purpose of ensuring compliance with MIOSHA safety standards and may be relied upon by the Oakland County Water Resources Commissioner’s office as a true statement of the facts set forth in this document.
By signing below on behalf of the Contractor, the signatory represents that he or she is duly authorized and has legal capacity to execute and deliver this Certification.
Signature
Print Name: Title:
Form DC–029 Contract Addendum and Certification for Safety Compliance
OAKLAND COUNTY WATER RESOURCES COMMISSIONER
Page 1 of 1 Rev. 08/19/2024
File details come from the government source that posted it. Updated .