Florida_Trench_Safety_Form.pdf
PDF 96 KB Posted
- Attached to
- Ridgemoor Blvd and Brooker Creek at Brooker Creek Bridge #154153 Bridge Replacement Project (PID 005749A)
- Solicitation number
- 26-0506-ITB-C
- Issued by
- Pinellas County, Clewiston City, Florida
About this file
This is a Florida Trench Safety Certification and Disclosure Statement form required by the State of Florida for the Ridgemoor Boulevard Bridge Replacement Project in Pinellas County. The form establishes compliance requirements under the Florida Trench Safety Act (Section 553.60 et seq., Florida Statutes), which adopts Federal excavation safety standards from 29 C.F.R. Section 1926.650 Subpart P as the interim state standard. Bidders must acknowledge their responsibility to comply with all applicable excavation and trench safety standards, and must consider geotechnical data from the County and other sources in designing their trench safety systems. The form requires bidders to disclose the specific trench safety measures to be employed, the linear feet of trench excavation under each measure, unit costs, and extended costs for up to five different safety measures. Bidders may use additional sheets if necessary, and failure to complete the form may result in the bid being declared non-responsive.
The disclosure of trench safety costs on this form is for procedural compliance purposes only and does not establish the full extent of the contractor's safety obligations or constitute a basis for contract price adjustments based on actual trench excavation quantities. The contractor assumes sole responsibility for selecting the data upon which the safety system design is based and for the adequacy of the system itself. The County's acceptance of the bid does not represent an evaluation of cost adequacy or relieve the contractor of its obligation to comply with applicable trench safety requirements. Contractors must furnish additional funds at no additional cost to the County if necessary to achieve full compliance with the Florida Trench Safety Act, except as otherwise provided in the contract documents.
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Text version
FLORIDA TRENCH SAFETY
FLORIDA TRENCH SAFETY ACT
CERTIFICATION AND DISCLOSURE STATEMENT
The undersigned acknowledges the requirements of the Florida Trench Safety Act (Section 553.60 et. seq. Florida Statutes).
A. The Bidder further acknowledges that the Florida Trench Safety Act, (the Act) establishes the Federal excavation safety standards set forth at 29 C.F.R. Section 1926.650 Subpart P, as the interim state standard until such time as the state of Florida, through its Department of Labor and Employment Security, or any successor agency, adopts, updates, or revises said interim standard. This State of Florida standard may be supplemented by special shoring requirements established by the State of Florida or any of its political subdivisions.
B. The Bidder, as Contractor, shall comply with all applicable excavation/trench safety standards.
C. The contractor shall consider the geotechnical data available from the County, if any, the Contractor's own sources, and all other relevant information in its design of the trench safety system to be employed on the subject Project. The Contractor acknowledges sole responsibilities for the selection of the data on which it relies in designing the safety system, as well as for the system itself.
D. The amounts that the Bidder has set forth for pipe installation includes the following excavation/trench safety measures and the linear feet of trench excavated under each safety measure. These units, costs, and unit values shall be disclosed solely for the purpose of compliance with procedural requirements of the Act. No adjustment to the Agreement Time or price shall be made for any difference in the actual number of linear feet of trench excavation, except as may be otherwise provided in these Contract Documents.
Trench Safety Measure (Description)
Units of Measure
(LF, SF)
Unit (Quantity)
Unit Cost
Extended Cost
1. $ $
2. $ $
3. $ $
4. $ $
5. $ $ For Information Only, Not for Payment Purposes $
FLORIDA TRENCH SAFETY
Bidder may use additional sheets as necessary to extend this form. Failure to complete the above may result in the bid being declared non-responsive.
A. The amount disclosed as the cost of compliance with the applicable trench safety requirements does not constitute the extent of the Contractor’s obligation to comply with said standards. The Contractor shall extend additional sums at no additional cost to the County, if necessary, to comply with the Act (except as otherwise be provided).
B. Acceptance of the bid to which this certification and disclosure applies in no way represents that the County or its representatives has evaluated and thereby determined that the above costs are adequate to comply with the applicable trench safety requirements nor does it in any way relieve the Contractor of its sole responsibility to comply with the applicable trench safety requirements.
Company Name
Name and Title
Address: Telephone/Fax
Federal Employee ID NO. (FEIN)
Email of Account Representative
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