Attachment No 07 - NCA Contractor Safety Checklist - FY-25.pdf

National Cemetery Administration Safety Checklist for Contractors

Date of Review

Location (Cemetery name and location) Cemetery Contact

Contract Number Contractor Name

Reviewer’s Name (Print) Reviewer’s Signature

This checklist serves as a guide only, it does not replace or eliminate the need to comply with the requirements set forth in OSHA 29 CFR 1910 General Industry Regulations and OSHA 29 CFR 1926 Construction Regulations. Based on a risk assessment of contracted activities and on mandatory OSHA compliance programs, the Contractor shall address all applicable occupational risks and compliance plans. Plans may include but not be limited to:

Item Description Yes No N/A Remarks (Any No or N/A item)

1. Statement of Safety and Health Policy (Due with Quote/Proposal)

a. Includes: Copy of current company Safety and Health Policy Statement, detailing commitment to providing a safe and healthful workplace for all employees.

b. Includes: Contractor’s written safety program goals, objectives, and accident experience goals for the current contract.

c. Includes: Risk Management Processes. Detailed project-specific hazards and controls shall be provided by a Job Hazard Analysis (JHA) for each major phase/activity of work.

2. Responsibilities and Lines of Authorities (Due 90 days post-award)

a. Includes: A statement of the contractor’s ultimate responsibility for the implementation of their Safety and Health Program.

b. Includes: Lines of authority.

c. Includes: The identification and job responsibilities of personnel responsible for safety - at both contractor (Corporate) and cemetery level.

3. Accident Prevention Plan (Due with Quote/Proposal)

a. Accident Reporting and Investigation Procedures PREVENTION: Identify tasks – Identify hazards in tasks – Identify controls to protect from the hazards.

POST INJURY: Bodily injury, property damage incidents, and near misses must be immediately reported to the construction project manager and the Collateral Duty Safety Officer. This does not relieve contractors of OSHA or insurance carrier reporting requirements. The contractor shall conduct an accident investigation. The CO/ COR/ Collateral Duty Safety Officer must be copied on the investigation report within 30 days of the accident.

b. OSHA 300 Log

c. Accident Reporting

• The plan identifies how, when, and who shall complete the Exposure data (man-hours worked).

complete accident investigations, reports, and logs.

make immediate notification of major accidents (fatality or any amputation, loss of an eye, or hospitalization of an employee).

d. Emergency Response Plans:

• Procedures & Tests/Drills Program

• Severe Weather Plan

• Spills Plans

• Fire Prevention Plan/Fire Extinguisher Training

• Posting of Emergency Telephone Numbers

4. Medical Support Outline on-site medical support and off-site medical arrangements including rescue and medical duties for those employees who are to perform them, and the name(s) of on-site Contractor personnel trained in first aid and CPR. A minimum of two employees shall be certified in first aid and CPR per shift/site.

5. Training (Due 30 days post-award or prior commencement of work)

a. Includes requirements for new hire Safety Orientation training at the time of initial hire of each new employee.

b. Includes the list of mandatory training and certifications applicable to this project (e.g., fall protection, confined space entry, equipment operator, vehicle operator, HAZCOM training, PPE) and any requirements for periodic retraining/ recertification.

c. Includes the identity requirements for emergency response training.

d. Includes the procedures for periodic safety and health training for supervisors and employees.

6. Safety and Health Inspections (Due 90 days post-award)

a. Includes the name(s) of individual(s) responsible for conducting safety inspections. (e.g., PM, safety professional, QC, supervisors, employees).

b. Includes proof of inspector's training/ qualifications.

c. Indicates when inspections will be conducted.

d. Furnished sample forms upon which inspections will be recorded.

e. Indicates deficiency tracking system and follow-up procedures.

f. Includes the names of competent and/or qualified person(s) and proof of competency/ qualification to meet specific OSHA competent/ qualified person(s) requirements.

g. Includes any internal/external inspections (e.g., OSHA, NCA AWE)

7. Site Specific Plans and Procedures (Due with Quote/Proposal)

a. Site Sanitation Plan (29 CFR 1910.141)

b. Respiratory Protection Plan (29 CFR 1910.134)

c. Hazard Communication Program (HAZCOM)

d. Abrasive Blasting Plan (29 CFR 1910.94(a)(5)-(6))

e. Heat/Cold Stress Monitoring Plan

f. Crystalline Silica Monitoring Plan (29 CFR 1910.1053)

g. Hazardous Energy Control Plan – Lock Out Tag Out (LOTO)

h. Fall Protection & Prevention Plan (Site- Specific)

i. Confined Space Entry Program

j. Hearing Conservation (29 CFR 1910.95(c)

k. Flammable Liquid Storage (29 CFR

1910.106 (d))

l. Excavation Safety Plan

m. Other:

n. Other:

o. Other:

8. Other:

9. Other:

10. Other:

Remarks: