Exhibit_A_-_Contractor_Safety_Responsibility_Form.pdf

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Attached to
CRAWFORD CANYON PARK AND SIDEWALK EXTENSION PROJECT
Solicitation number
IFB-080-2331001-JM2
Issued by
Orange County, San Francisco City, California

About this file

Contractor Safety Responsibility Form Summary

This is a Contractor Safety Responsibility Form issued by Orange County Public Works for the Crawford Canyon Park and Sidewalk Extension Project in Orange County, California. The document establishes comprehensive safety requirements and responsibilities for all contractors and subcontractors engaged on the project. The form covers mandatory safety protocols including injury and illness prevention programs, personal protective equipment requirements, hazardous materials handling, confined space procedures, excavation safety with competent person requirements, fall protection, scaffolding standards, lockout/tagout procedures, and environmental compliance measures. Contractors must submit a completed Injury and Illness Prevention Program (IIPP) to the Project Manager prior to project commencement and maintain training documentation throughout the project duration. All contractors are required to sign an acknowledgment form certifying their understanding of and commitment to comply with the outlined safety policy and procedures.

The form references California Labor Code and Title 8 regulations requiring contractors to report fatal injuries, serious injuries, or illnesses to Cal/OSHA within eight hours, with minimum civil penalties of $5,000 for non-compliance. Additional requirements include mandatory use of properly labeled safety containers for hazardous materials, compliance with air emissions and environmental permits, proper disposal of hazardous waste and storm drain/sanitary sewer protection, and specific protocols for projects involving offensive odors that may require after-hours work with personnel evacuation procedures. The document emphasizes that personal protective equipment use is mandatory with contractor enforcement responsibility, and contractors must provide competent persons for excavation sites and ensure compliance with all referenced Cal/OSHA standards and manufacturer requirements for equipment and scaffolding.

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Text version

Safety Responsibilities, Contractors

306 07

Safety Responsibilities

PURPOSE:

SCOPE:

at any time it determines that the contractor’s actions are exposing non y

9 1 1

714 285 5535

714 558 4451

As of January 1, 2003 – If an employer fails to report to Cal/OSHA a fatal injury or serious injury or illness to an employee within 8 hours will be subject to a minimum civil penalty of $5,000.

to Cal/OSHA .

5535 6288 furnish person is person’s condition through the County Project Manager.

Those projects involving offending odor ents may require work during “after hours” ontractor’s personnel shall evacuate to a location 150 feet away from the “ALL CLEAR” is announced and they are instruc .

, 19, , 8, 3220 undo risk.

h.

, 8, 1513

Injury and Illness Prevention Program to the Project Manager prior to the start of the project. The contractor’s IIPP shall in evaluating the contractor’s IIPP.

, 8 1509 3203

, 8, 5194

Personal Protection use is mandatory and enforcement is the responsibility of the contractor. Contractor’s

, 8, 1514

Smoking

7 1

Trash, Waste, and Scrap Disposal

, 8, 1736 b

, 8, 1707

Asbestos / Lead

, 8, 5208

Confined Space ontractor’s Con

, 8, 5157

, 8, 2974 providing a “Competent Person” at every excavation site. This individual must be

, 8 1541

Fall Protection

● Boatswain’s chairs are

, , 1671.1

Hazardous Materials

“safety” cans that have been properly labeled as to their contents.

bungs, top

, 8, 5191

Lockout/Tagout ontractor’s Locko

, , Sections 3314 and 4413

Scaffolding

, Article 21, 22 and 23 and the manufacturer’s requirements. Each two

Air Emissions

Environmental Permits, Registrations, and Notifications

Hazardous Waste

Storm Drains / Sanitary Sewer formed during “off hours”

Training Documentation a , CONTRACTOR SAFETY POLICY ACKNOWLEDGEMENT FORM

I, ________________________________________, certify that I have read the contractor Safety Policy and fully understand my responsibilities with respect to the policy and procedures as outlined. I further agree to comply with the provisions of this program.

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