Exhibit L - Eng_Form_6209_Certificate of Compliance for LHE.pdf

ENG FORM 6209, JUN 2023

U.S. Army Corps of Engineers (USACE)

CERTIFICATE OF COMPLIANCE FOR LOAD HANDLING EQUIPMENT AND RIGGING

For use of this form, see EM 385-1-1; the proponent agency is CESO.

Purpose: This form designates and certifies that LHE, Rigging, and Operator(s) meet all applicable regulatory requirements.

This certificate must be signed by the official of the company that provides Load Handling Equipment (LHE)/Cranes and rigging gear for any application under this contract. Prior to the start of all LHE/crane activities, the completed certificate must be submitted to, and accepted by, the Contracting Officer according to Section 16-7 of the EM 385-1-1.

Project Name Contract Number

Contracting Officer's Name Phone Number

Prime Contractor Name Phone Number

Sub-Contractor Name Phone Number

SSHO or QC Name Phone Number

LHE Manufacturer LHE Type LHE Capacity

LHE Operator(s) Name(s)

I certify that the:

LHE identified above and all rigging gear conform to the EM 385-1-1, applicable ASME standards, manufacturer's instructions, federal, state, and local requirement to include inspections and tests.

Operator(s) identified above are trained, qualified, and designated to operate the LHE identified above.

Operator(s) identified above are trained not to bypass safety devices during LHE operations.

Operator(s) identified above received a physical examination within the past three years and meets the physical qualifications of ASME B30.5.

Operator(s), rigger(s), and company official (staff) understand the requirement that all accidents will be immediately reported to the Contracting Officer.

This completed and signed CoC will be posted and maintained with each Crane/LHE.

Name of Company's Official Representative: Title of Company's Official Representative

Signature of Company's Official Representative Date

ENG FORM 6209, JUN 2023

U.S. Army Corps of Engineers (USACE)

CERTIFICATE OF COMPLIANCE FOR LOAD HANDLING EQUIPMENT AND RIGGING

For use of this form, see EM 385-1-1; the proponent agency is CESO.

Purpose: This form designates and certifies that LHE, Rigging, and Operator(s) meet all applicable regulatory requirements.

This certificate must be signed by the official of the company that provides Load Handling Equipment (LHE)/Cranes and rigging gear for any application under this contract. Prior to the start of all LHE/crane activities, the completed certificate must be submitted to, and accepted by, the Contracting Officer according to Section 16-7 of the EM 385-1-1.

I certify that the:

1.0 darwin.chen@usace.army.mil 2023-05-05 Forms Design Team Darwin Chen 2023-05-30

CERTIFICATE OF COMPLIANCE FOR LOAD HANDLING EQUIPMENT AND RIGGING

CERTIFICATE OF COMPLIANCE FOR LOAD HANDLING EQUIPMENT AND RIGGING