Florida_Trench_Safety_Form.pdf

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Attached to
Ridgecrest YMCA Elevator Modernization
Solicitation number
26-0529-ITB-C
Issued by
Pinellas County, Florida

About this file

This is a Florida Trench Safety Form and Certification Statement required for the Ridgecrest YMCA Elevator Modernization project located at 1801 119th Street N, Largo, Florida. The form documents bidder acknowledgment and compliance with the Florida Trench Safety Act (Section 553.60 et. seq. Florida Statutes), which establishes Federal excavation safety standards set forth at 29 C.F.R. Section 1926.650 Subpart P as the interim state standard. Bidders are required to disclose the trench safety measures they will employ, measured in linear feet or square feet, along with associated unit costs and extended costs for each safety method. The form requires bidders to specify quantities and pricing for up to five distinct trench safety measures used during pipe installation excavation work.

The contractor bears sole responsibility for selecting and implementing appropriate trench safety systems based on geotechnical data from the County, their own sources, and all other relevant information. The disclosed trench safety costs are for procedural compliance purposes only and do not constitute the full extent of the contractor's obligation to comply with applicable standards. Contractors must provide any additional funds necessary to achieve full compliance at no additional cost to the County. Acceptance of a bid does not represent that the County has evaluated the adequacy of disclosed costs or relieves the contractor of its responsibility for complete compliance. Failure to complete this certification and disclosure form may result in the bid being declared non-responsive.

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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

File details come from the government source that posted it. Updated .