Section J.pdf

SECTION J

DOCUMENTS, EXHIBITS, AND OTHER ATTACHMENTS

TABLE OF CONTENTS

SECTION J

ATTACHMENT

NUMBER

ATTACHMENT TITLE

J-0200000-01 DEFINITIONS AND ACRONYMS

J-0200000-02 DIRECTIVES, INSTRUCTIONS & REFERENCES

J-0200000-03 BASE MAP

J-0200000-04 INVOICING PROCEDURES

J-0200000-05 FORMS (WILL BE USED AFTER CONTRACT AWARD; PROVIDED FOR

INFORMATIONAL PURPOSES IN SOLICITATION)

J-0200000-06 CONTRACTOR SIGNIFICANT INCIDENT REPORT (CSIR) INSTRUCTIONS

J-0200000-07 ELINS

J-1700000-01 EQUIPMENT RENTAL HISTORICAL DATA

ATTACHMENT J-0200000-01

DEFINITIONS AND ACRONYMS

Definition Description Competent Person A person who has the professional experience and training necessary to identify existing and predictable hazards at a work or service environment, and who has the authority to take prompt and corrective action to eliminate or remove dangers from the environment.

Contracting Officer

(KO)

That individual with the authority to enter into, administer, and/or terminate contracts and make related determinations and findings. The term includes certain authorized representatives of the Contracting Officer acting within the limits of their authority as delegated by the Contracting Officer.

Contractor That entity or its representative responsible for the delivery of the services or materials specified in this contract, as designated by contract award. The term Contractor as used herein refers to both the prime Contractor and any subcontractors. The prime Contractor shall insure that subcontractors comply with the provision of this contract.

Contractor Representative

That individual appointed by the Contractor, either orally or in writing, who has been assigned responsibility for executing the requirements of this contract.

Direct Material Costs The actual vendor invoice charges for materials used for performance of work under this contract. Direct material costs shall include transportation charges when such charges are included on the invoice by the vendor, as well as any discounts allowed for prompt payment and discounts or rebates for core value or salvage value that accrue to the Contractor. When questions arise concerning the cost of materials, material costs will be based on the lowest of quotes provided by the Contractor from at least three different commercial vendors for the direct material cost. The Government retains the right to obtain additional quotes in questionable situations. The lowest price will be used.

Equipment Tangible asset that is functionally complete for its intended purpose, durable, and non-expendable.

Facility A building or structure designed and created to serve a particular function.

Frequency Of Service Daily (D5). Services performed once each calendar day, Monday through Friday, including holidays unless otherwise noted.

Weekly (W). Services performed 52 times during each 12-month period of the contract at intervals of six to eight calendar days.

Monthly (M). Services performed 12 times during each 12-month period of the contract at intervals of four business weeks.

Maintenance And Repair

The preservation or restoration of a piece of equipment, system, or facility to such condition that it may be effectively used for its designated purposes. Maintenance/repair may be adjustment, overhaul, reprocessing, or replacement of constituent parts or materials that are missing or have deteriorated by action of the elements or usage, or replacement of the entire unit or system if beyond economical repair.

Performance Assessment

A method used by the Government to provide some measure of control over the quality of purchased goods and services received.

Pre-Expended Bin Materials And Supplies

The minor materials and supplies that are incidental to the job, for which the total direct cost of any one material line item shown on the material estimate is $10.00 or less.

Examples of pre-expended bin materials and supplies include, but are not limited to, solder, lead, flux, electrical connectors, electrical tape, fuses, nails, screws, bolts, nuts, washers, spacers, masking tape, sand paper, solvent, cleaners, lubricants, grease, oil, rags, mops, glue, epoxy, spackling compound, joint tape, plumbers tape and compound, clips, welding rods, and touch up paint.

Quality Control (QC) A method used by the Contractor to control the quality of goods and services produced.

Response Time The time allowed the Contractor after initial notification of a work requirement to be physically on the premises at the work site with appropriate personnel, tools, equipment, and materials, ready to perform the work required.

Acronyms Title ACO Administrative Contracting Officer BW Biweekly CDR Contract Discrepancy Report CIA Controlled Industrial Area DoD Department of Defense DoN Department of Navy DRMO Defense Reutilization Management Office EPA Environmental Protection Agency EPCRA Emergency Planning and Community Right-to-Know Act FAR Federal Acquisition Regulation FFP Firm Fixed Price FSC Facility Support Contract GFE Government-furnished Equipment GFF Government-furnished Facilities GFM Government-furnished Materials GPWS Guide Performance Work Statements ICP Integrated Contingency Plan IDIQ Indefinite Delivery Indefinite Quantity KO Contracting Officer LAN Local Area Network M Monthly MSDS Material Safety Data Sheets NAVFAC Naval Facilities Engineering Command NMCI Navy Marine Corps Intranet NOSC Navy-On-Scene Coordinator PAP Performance Assessment Plan PAR Performance Assessment Representative PAW Performance Assessment Worksheet PM Project Manager PWS Performance Work Statement Q Quarterly QC Quality Control SC Security Clearances SM Semimonthly SPAR Senior Performance Assessment Representative TE Technical Exhibit VIQ Variation in Quantity WBS Work Breakdown Structure

ATTACHMENT J-0200000-02

DIRECTIVES, INSTRUCTIONS, AND REFERENCES

Reference Title

NAVFAC P-307 Management of Weight Handling Equipment

EM 385-1-1 U.S. Army Corps of Engineers Safety and Health Requirements

P.L. 91-596 Occupational Safety and Health Act

ATTACHMENT J-0200000-03

NAVAL STATION GREAT LAKES MAP

See Attached File (Base Map.pdf)

The method of invoicing is dependent upon how the order is placed. DoD EMALL orders will not exceed $100,000.

If the order exceeds $100,000, a Delivery Order will be issued.

1. DOD FedMall Orders: The Contractor shall be paid for COMPLETED and ACCEPTED work issued via DOD FedMall utilizing the Government Purchase Card (GPC) as a method of payment. The card holder’s GPC number provided with each DOD FedMall MOMS Order will be processed as a credit card transaction through the Contractor’s financial banking institution. The Contractor shall provide the card holder with a separate receipt for each credit card transaction processed, and a copy of the corresponding DOD EMALL MOMS Order on the day payment is requested. These receipts will be used by the card holder to reconcile their monthly GPC statements.

2. Delivery Orders: Contractor invoices for completed work issued on a Standard Form 1449, Order for Supplies or Services shall be submitted electronically via the DOD Wide Area Workflow (WAWF) system as prescribed in DFARS 252.232-7003, Electronic Submission of Payment Requests.

Invoices will be routed in the WAWF system to the office of the Contracting Officer that issued each Delivery Order. Individual Delivery Orders will include a WAWF Routing Table which provides the invoice document type, DODAAC Code with corresponding extensions, as well as inspection and acceptance locations when submitting invoices in WAWF. Electronic procedures for invoicing are listed below.

ROUTING DATA TABLE

Field Name in WAWF Data to be entered in WAWF Pay Official - DoDAAC N68732 Issue By - DoDAAC N40085 Admin - DoDAAC N40085 Inspect By - DoDAAC N68950 Ship To Code NONE Ship From Code NONE Mark For Code NONE Service Approver (DoDAAC) NONE Service Acceptor (DoDAAC) NONE Accept at Other - DoDAAC N68950 LPO - DoDAAC N68950 DCAA Auditor - DoDAAC NONE Other - DoDAAC(s) (Accept By) N68950

WAWF is a secure, web-based system which benefits your company by allowing you to submit invoices electronically, track receipt/acceptance documents and payment of your invoice online.

Naval Facilities Engineering Command, Midwest, implemented the use of WAWF in FY2009. The subject contract is eligible for WAWF and all invoices must be submitted through this system.

To aid you in this process, we highly encourage that you visit and review the following websites for WAWF Vendor resources.

− Vendor Getting Started Guide – http://www.dfas.mil/contractorpay/electroniccommerce/wawfvendortools/WAWFVendorGettingStartedGuide.pdf

− Introductory Movie – http://www.dfas.mil/contractorpay/electroniccommerce/ECToolBox/WAWKFl.wmv

− Web-based training – http://www.wawftraining.com

− WAWF practice site – https://wawftraining.eb.mil/ (at this web page, click on “Training Instructions” found on the left side for further instructions on using this site)

− Request for classroom training – http://www.dfas.mil/contractorpay/electroniccommerce/wawftrain.html

− WAWF Vendor Tools – http://www.dfas.mil/contractorpay/electroniccommerce/wawfvendortools.html

Please contact the Contracting Officer/Contract Specialist with any questions.

ATTACHMENT J-0200000-04

INVOICING PROCEDURES

http://www.dfas.mil/contractorpay/electroniccommerce/wawfvendortools/WAWFVendorGettingStartedGuide.pdf http://www.dfas.mil/contractorpay/electroniccommerce/ECToolBox/WAWKFl.wmv http://www.wawftraining.com/ https://wawftraining.eb.mil/ http://www.dfas.mil/contractorpay/electroniccommerce/wawftrain.html http://www.dfas.mil/contractorpay/electroniccommerce/wawfvendortools.html

ATTACHMENT J-0200000-05

FORMS

See attached file for use

(CSIR.pdf)

Initial Report Follow-up Report Final Report

Contractor Significant Incident Report (CSIR)

1. General Information Contracting Activity/ROICC Office:

Accident Classification:

Injury Fatality Environment Procedural Issues Lessons Learned Illness Property Damage

Other_______________________________

Involving:

Confined Space Equip/Mrt Ver/Mat Handling (Heavy Construction Equip.)

Hazardous Material Crane and Rigging Equip/Mrt Ver/Mat Handling (Material Handling)

Trenching/Excavation Diving Equip/Mrt Ver/Mat Handling (Man-Lift/Elevated Platform)

Waterfront/Marine Operations

Demolition/Renovation Fall from Ladder Fall from Scaffold

Other___________________ Electrical Fall from Roof Fire

2. Personal Information Name (Last, First, MI):

Age: Sex:

Job Title/Description:

Employed By:

Supervisor Name (Last, First, MI) & Title:

Was the person trained to perform this activity/task?

Yes No

What type of training was received (OJT, classroom, etc.)?

Date of the most recent formal training and topics discussed?

3. Witness Information

Witness #1: Name (Last, First, MI):

Supervisor Name (Last, First, MI):

Witness #2: Name (Last, First, MI):

Supervisor Name (Last, First, MI):

Additional Witnesses:

4. Contract Information Type of Contract:

A/E BOS CLEAN Construction Design Build FSCC FSSC JOC RAC Service Other_______________________________

Contract Number & Title:

Industrial Group & Industrial Type:

Prime Contractor Name/Address/Phone & Fax No:

Safety Manager (Last, First, MI):

Insurance Carrier:

Sub-Contractor Name/Address/Phone & FAX No:

Safety Manager (Last, First, MI):

Insurance Carrier:

5. Accident Description Date of Accident:

Time of Accident: Exact Location of Accident:

(List any additional witnesses on a separate sheet and attach.)

Describe the accident in detail in your words: (Use the back of page if you need additional space)

Direct Cause(s) of Accident:

Indirect Cause(s) of Accident:

Action(s) taken to prevent re-occurrence or provide on-going corrective actions:

Corrective Action Beginning Date:

Anticipated Completion Date:

Personal Protective Equipment:

Available and used Available and not used Not Required Not related to Mishap Wrong PPE for job

List PPE Used:

Type of Construction Equipment (Make, Model, Serial #, VIN#) Involved:

Was Hazardous Material Spilled/Released?

Please List Hazardous Material(s) Involved:

Who provided first aid or cleanup of mishap site?

Any blood-borne pathogen exposure, other than EMTs? Yes No

Who?

List OSHA and EM-385-1-1 standards that were violated:

Was site secured and witness statements taken immediately? Yes No

By Whom?

6. Injury Illness/Fatality Information Severity of Injury/Illness:

Fatality Lost Workday Case Involving Days Away From Work Temporary Disabillity Recordable Workday Case Involving Restricted Duty Permanent Total Disability Other Recordable Case Recordable First Aid Case Permanent Partial Disability Non-Recordable Case No Injury

List Primary Body Part Affected:

List Other Body Part(s) Affected:

Nature of Injury/Illness for Primary Body Part (Examples: Amputation, Burn, Hernia):

Type of Accident (Examples: Fall same level, Lifting, Bitten, Exerted):

Source of Accident (Examples: Crane, Carbon Monoxide, Ladder, Welding Equipment):

7. Causal Factors (Explain answers on supplementary sheet)

• Design – Design of facility, workplace, or equipment was a factor? Yes

No

• Inspection/Maintenance – Inspection & Maintenance procedures were a factor? Yes

No

• Persons Physical Condition – In your opinion, the physical condition of the person was a factor?

Yes

No

• Operation Procedures – Operating procedures were a factor? Yes

No

• Job Practices – One or more job safety/health practices not being followed when the accident occurred contributed to the accident?

Yes

No

• Human Factors – One or more human factors, such as a person’s size or strength contributed to the accident?

Yes

No

• Environmental Factors – Heat, cold, dust, sun, glare, etc., contributed to the accident? Yes

No

• Chemical and Physical Agent Factors – Exposure to chemical agents, such as dust, fumes, mist, vapors, or physical agents such as noise, radiation, etc., contributed to the accident?

Yes

No

• Office Factors – Office setting such as lifting office furniture, carrying, stooping, contributed to the accident?

Yes

No

• Support Factors – Inappropriate tools/resources were provided to perform the task? Yes

No

• PPE – Improper selection, use or maintenance of PPE contributed to the accident? Yes

No

• Drugs/Alcohol – In your opinion, were drugs or alcohol a factor? Yes

No

• Job Hazard Analysis – The lack of an adequate (IAW-EM-385-1-1 Sec 01.A) activity hazard analysis was a contributing factor.

Yes

No

• Job Hazard Analysis – JHA was not site specific and/or did not address the type of work/operations performed when the mishap occurred.

Yes

No

• Management – A lack of adequate supervision contributed to the accident. Yes

No

• Management – Inadequate information was provided at pre con meeting. Yes

No

8. OSHA Information Date OSHA was Notified:

Date(s) of Investigation: Date of citation:

(Attach Copy)

Dollar amount of Penalties:

9. Report Preparer Name (Last, First, MI):

Date of Report:

Title:

Employer:

Phone #:

Signature:

ATTACHMENT J-0200000-06

FORMS

See attached file for use

(Initial Mishap Notification Rpt.pdf )

Initial Mishap Notification Report

Date:

Navy Civilian Employee Contract Employee Military

1. Name of employee, activity, installation, and exact location where incident occurred:

2. Name of contractor, title of contract, and number of contract:

3. Type of work being performed:

4. Date and time of incident:

5. Brief description of the incident (Include photographs if available):

6. Extent of property damage:

7. Extent of injuries:

8. Employee immediate supervisor or responsible person:

9. Immediate actions taken:

10. Follow up actions to be taken:

11. Safety investigator(s) assigned:

12. Initial lessons learned: (Final lessons learned format within 30 days)

ATTACHMENT J-0200000-07

CONTRACTOR SIGNIFICANT INCIDENT REPORT (CSIR) INSTRUCTIONS

Complete Sections Appropriate to Incident (Rev. 06/02).

NOTE: THE ATTACHED CSIR FORM IS TO BE USED BY CONTRACTORS TO RECORD THE

RESULTS OF THEIR ACCIDENT/INCIDENTS INVESTIGATIONS AND SHALL BE PROVIDED TO

THE CONTRACTING OFFICER WITHIN THE REQUIRED TIMEFRAMES.

GENERAL. Complete a separate report for each person who was injured in the accident. A report needs to be completed for all OSHA recordable accidents, property damage in excess of $2000.00 (This amount is for record purposes only. GOV is not required to enter property damage reports into FAIR database if it is less than $10,000.00.), WHE accidents, or near miss/high visibility mishaps. Please type or print legibly. Appropriate items shall be marked with an “X” in box(es), non-applicable sections shall be marked “N/A”. If additional space is needed, provide the information on a separate sheet of paper and attach to the completed form.

Mark the report:

INITIAL – If this form is being used as initial notification of a Fatality or High Visibility Mishap. The initial form is due within 4 hours of a serious accident. A form marked ‘Follow-up’ or ‘Final’ is required within 5 days.

FOLLOW-UP – If you are providing additional information on a report previously submitted.

FINAL – If you are providing a completed report and expect no changes.

SECTION 1 – GENERAL INFORMATION

CONTRACTING ACTIVITY/ROICC OFFICE - Enter the name and address of the Contracting Office administering the contract under which the mishap took place (e.g. ROICC MCBH, ROICC NORFOLK, PWC GUAM, etc.).

ACCIDENT CLASSIFICATION - INJURY/ILLNESS/FATALITY/PROPERTY DAMAGE/-PROCEDURAL ISSUES/- ENVIRONMENTAL/LESSONS LEARNED/OTHER – Mark the appropriate block(s) if the incident resulted in any of these conditions.

INVOLVING - If the mishap involved any of the conditions listed under “Involving” mark the appropriate box(es). Specific questions associated with each of these conditions are available from the Contracting Officer to assist you in your investigation. When these questions are used they shall be attached as part of this report.

SECTION 2 - PERSONAL INFORMATION

NAME - Enter last name, first name, middle initial of person involved.

AGE - Enter age.

SEX - Enter M for Male and F for Female.

JOB TITLE/DESCRIPTION - Enter the job title/description assigned to the injured person (e.g. carpenter, laborer, surveyor, etc.).

EMPLOYED BY - Enter employment company name of the person involved.

SUPERVISOR’S NAME & TITLE - Enter name and title of the immediate supervisor.

WAS PERSON TRAINED TO PERFORM ACTIVITY/TASK? - For the purpose of this section “trained” means the person has been provided the necessary information (either formal and/or on-the-job (OJT) training) to competently perform the activity/task in a safe and healthful manner.

TYPE OF TRAINING - Indicate the specific type of training (classroom or on-the-job) that the injured person received before the accident happened.

DATE OF MOST RECENT FORMAL TRAINING/TOPICS DISCUSSED - Enter the month, day, and year of the last formal training completed that covered the activity/task being performed at the time of the accident. List topics that were discussed at the training identified above.

SECTION 3 - WITNESS INFORMATION

The following applies to Witness #1 and Witness #2:

WITNESS NAME - Enter last name, first name, middle initial of the witness.

JOB DESCRIPTION/TITLE - Enter the job title/description assigned to the witness (e.g. carpenter, laborer, surveyor, etc.).

EMPLOYED BY - Enter the name of the employment company of the witness.

SUPERVISORS NAME - Enter name of immediate supervisor of the witness.

ADDITIONAL WITNESSES - Provide same information, as above, for each witnesses. Use additional pages if necessary.

SECTION 4 - CONTRACTOR INFORMATION

TYPE OF CONTRACT - Mark appropriate box. A/E means architect/engineer. If “OTHER” is marked, specify type of contract on line provided.

CONTRACT NUMBER/TITLE - Enter complete contract number and tile of prime contract (e.g. N62477-85-C-0100, 184 Pearl City Hsg.

Revitalization).

CONSTRUCTION INDUSTRIAL GROUP AND INDUSTRIAL TYPE – This is the type of construction that will be done at this project.

1. First, you must choose the Industrial Group. You have 4 choices to choose from: (NOTE! Review of the Industrial Types below and knowing what the projects scope of work is will assist you in deciding what the Industrial Group should be.)

a. Buildings

b. Heavy Industrial

c. Infrastructure

d. Light Industrial

2. Once you have chosen the Industrial Group, you now select the Industrial Type. You have multiple choices under each Group, chose the one you feel fits the project most closely because on most projects there won’t be an exact match:

a. Buildings:

(1) Communications Ctr.

(2) Dormitory/Hotel

(3) High-rise Office

(4) Hospital

(5) Housing

(6) Laboratory

(7) Low-rise Office

(8) Maintenance Facility

(9) Parking Garage

(10) Physical Fitness Ctr.

(11) Restaurant/Nightclub

(12) School

(13) Warehouse

b. Heavy Industrial:

(1) Chemical Mfg.

(2) Electrical (Generating)

(3) Environmental

(4) Metals Refining/Processing

(5) Mining

(6) Natural Gas Processing

(7) Oil Exploration/Production

(8) Oil Refining

(9) Pulp and Paper

c. Infrastructure:

(1) Airport

(2) Electrical Distribution

(3) Flood Control

(4) Highway

(5) Marine Facilities

(6) Navigation

(7) Rail

(8) Tunneling

(9) Water/Wastewater

d. Light Industrial:

(1) Automotive Assembly/Mfg.

(2) Consumer Products Mfg.

(3) Foods

(4) Microelectronics Mfg.

(5) Office Products Mfg.

(6) Pharmaceuticals Mfg.

CONTRACTOR’S NAME/ADDRESS/PHONE NUMBER

(1) PRIME - Enter the exact name (title of firm), address, phone and fax numbers of the prime contractor.

(2) SUBCONTRACTOR - Enter the exact name, address, phone and fax numbers of any subcontractor involved in the accident.

SAFETY MANAGER’S NAME

(1) PRIME - Enter the name of the prime contractor safety manager.

(2) SUBCONTRACTOR - Enter the name of the subcontractors safety manager.

INSURANCE CARRIER

(1) PRIME - Enter the exact name/title of the prime’s insurance company. Policy number not required.

(2) SUBCONTRACTOR - Enter the exact name of the subcontractor’s insurance company. Policy number not required.

SECTION 5 - ACCIDENT DESCRIPTION

DATE OF ACCIDENT - Enter the month, day, and year of accident.

TIME OF ACCIDENT - Enter the local time of accident in military time. Example: 14:30 hrs. (not 2:30 p.m.).

EXACT LOCATION OF ACCIDENT - Enter facts needed to locate the accident scene (installation/project name, building/room number, street, direction and distance from closest landmark, etc.).

DESCRIBE THE ACCIDENT IN DETAIL. Fully describe the accident in the space provided. If property damage involved, give estimated dollar amount of damage and/or repair costs involved. If additional space is needed continue on a separate sheet and attach to this report. Give the sequence of events that describe what happened leading up to and including the accident. Fully identify personnel and equipment involved and their role(s) in the accident. Ensure that relationships between personnel and equipment are clearly specified. Ensure questions below regarding direct cause(s), indirect cause(s), and actions taken are answered. NOTE! Review questions in Section 7 below before completing.

DIRECT CAUSE(S) - The direct cause is that single factor which most directly leads to the accident. See examples below.

INDIRECT CAUSE(S) - Indirect cause are those factors, which contributed to, but did not directly initiate the occurrence of the accident.

Examples for Direct and Indirect Cause:

1. Employee was dismantling scaffold and fell 12 feet from unguarded opening.

Direct cause: Failure to provide fall protection at elevation Indirect causes: Failure to enforce safety requirements: improper training/motivation of employee (possibility that employee was not knowledgeable of fall protection requirements or was lax in his attitude toward safety); failure to ensure provision of positive fall protection whenever elevated; failure to address fall protection during scaffold dismantling in phase hazard analysis.

2. Private citizen had stopped his vehicle at intersection for red light when vehicle was struck in rear by contractor vehicle. (note contractor vehicles were in proper safe working condition.)

Direct cause: Failure of contractor driver to maintain control of and stop contractor vehicle within safe distance.

Indirect cause: Failure of employee to pay attention to driving (defensive driving).

ACTION(S) TAKEN TO PREVENT RE-OCCURRENCE OR PROVIDE ON-GOING CORRECTIVE ACTIONS. Fully describe all the actions taken, anticipated, and recommended to eliminate the cause(s) and prevent reoccurrence of similar accidents/illnesses. Continue on back or additional sheets of paper if necessary to fully explain and attach to the complete report form.

CORRECTIVE ACTION DATES -

(1) Beginning - Enter the date when the corrective action(s) identified above will begin.

(2) Anticipated Completion - Enter the date when the corrective action(s) identified above will be completed.

PERSONAL PROTECTIVE EQUIPMENT (PPE) - Mark appropriate box(es) and list PPE which was being used by the injured person at the time of the accident (e.g. protective clothing, shoes, glasses, goggles, respirator, safety belt, harness, etc.)

TYPE OF CONTRACTOR EQUIPMENT - Enter the Serial Number, Model Number and specific type of equipment involved in the mishap (e.g. dump truck (off highway), crane (rubber tire), pump truck (concrete), etc.).

WAS HAZARDOUS MATERIAL SPILLED/RELEASED? - Mark appropriate block and list name(s) of any reportable quantities of hazardous materials spilled/released during the mishap.

WHO PROVIDED FIRST AID OR CLEAN-UP OF MISHAP SITE? - List name(s) of individual(s) and employer, if known.

ANY BLOOD-BORNE PATHOGEN EXPOSURE, OTHER THAN EMT? - Mark appropriate block and list name(s) of individual(s) and employer, if known.

LIST OSHA AND/OR EM 385-1-1 STANDARDS THAT WERE VIOLATED. - Self-explanatory.

WAS SITE SECURED AND WITNESS STATEMENT TAKEN IMMEDIATELY? - Mark appropriate block and list by whom.

SECTION 6 - INJURY/ILLNESS/FATALITY INFORMATION

SERVERITY OF INJURY/ILLNESS – Mark appropriate box.

ESTIMATED DAYS LOST - Enter the estimated number of workdays the person will lose from work. Update when final data is known.

ESTIMATED DAYS HOSPITALIZED - Enter the estimated number of workdays the person will be hospitalized. Update when final data is known.

ESTIMATED DAYS RESTRICTED DUTY - Enter the estimated number of workdays the person, as a result of the accident, will not be able to perform all of their regular duties. Update when final data is known.

BODY PART(S) AFFECTED - Enter the most appropriate primary and when applicable, secondary, etc. body part(s) affected (e.g. arm: wrist:

abdomen: single eye; jaw : both elbows: second finger: great toe: collar bone: kidney, etc.).

NATURE OF INJURY/ILLNESS FOR PRIMARY BODY PART - Enter the most appropriate nature of injury/illness (e.g. amputation, back strain, dislocation, laceration, strain, asbestosis, food poisoning, heart conditions, etc.).

TYPE AND SOURCE OF INJURY/ILLNESS - Type and Source Codes are used to describe what caused the incident.

(1) TYPE Code stands for an “Action” (Example: Worker, installing conduit, lost his balance and fell five feet from a ladder. Type Code:

Fell different levels”.) Select the most appropriate Type of injury from the list below:

TYPE OF INJURY/ILLNESS

STRUCK

BY/AGAINST

CONTACTED

CONTACTED WITH (INJURED PERSON MOVING)

CONTACTED BY (OBJECT WAS MOVING)

FELL, SLIPPED, TRIPPED

SAME LEVEL/DIFFERENT LEVEL/NO FALL

EXERTED

LIFTED, STRAINED BY (SINGLE ACTION)

STRESSED BY (REPEATED ACTION)

CAUGHT

ON/IN/BETWEEN

EXPOSED

INHALED/INGESTED/ABSORBED/EXPOSED TO

PUNCTURED, LACERATED

PUNCTURED BY/CUT BY/STUNG BY/BITTEN BY

TRAVELING IN

(2) SOURCE Code stands for an “object or substance.” (Example: Worker, installing conduit, lost his balance and fell five feet from a ladder. Source Code: “Ladder”.) Select the most appropriate Source of injury from the list below:

SOURCE OF INJURY/ILLNESS

BUILDING OR WORKING AREA

WALKING/WORKING AREA

STAIRS/STEPS

LADDER

FURNITURE

BOILER/PRESSURE VESSEL

EQUIPMENT LAYOUT

WINDOWS/DOORS

ELECTRICITY

DUST, VAPOR, ETC.

DUST (SILICA, COAT, ETC.)

FIBERS

ASBESTOS

GASES

CARBON MONOXIDE

MIST, STEAM, VAPOR, FUME

WELDING FUMES

PARTICLES (UNIDENTIFIED)

ENVIRONMENT CONDITION

TEMPERATURE EXTREME (INDOOR)

WEATHER (ICE, RAIN, HEAT, ETC.)

FIRE, FLAME, SMOTE (NOT TABACCO)

NOISE

RADIATION

LIGHT

VENTILATION

TOBACCO SMOKE

STRESS (EMOTIONAL)

CONFINED SPACE

CHEMICAL, PLASTIC, ETC.

DRY CHEMICAL - CORROSIVE

DRY CHEMICAL - TOXIC

DRY CHEMICAL - EXPLOSIVE

DRY CHEMICAL - FLAMMABLE

LIQUID CHEMICAL - CORROSIVE

LIQUID CHEMICAL - TOXIC

LIQUID CHEMICAL - EXPLOSIVE

LIQUID CHEMICAL - FLAMMABLE

PLASTIC

WATER

MEDICINE

MACHINE OR TOOL

HAND TOOL (POWERED: SAW, GRINDER, ETC.)

HAND TOOL (NON POWERED)

MECHANCIAL POWER TRANSMISSION APPARATUS

GUARD, SHIELD (FIXED, MOVEABLE, INTERLOCK)

VIDEO DISPLAY TERMINAL

PUMP, COMPRESSOR, AIR PRESSURE TOOL

HEATING EQUIPMENT

WELDING EQUIPMENT

INANIMATE OBJECT

BOX, BARREL, ETC.

PAPER

METAL ITEM, MINERAL

NEEDLE

GLASS

SCRAP, TRASH, WOOD

FOOD

CLOTHING, APPAREL, SHOES

MACHINE OR TOOL

HAND TOOL (POWERED: SAW, GRINDER, ETC.)

HAND TOOL (NON POWERED)

MECHANCIAL POWER TRANSMISSION APPARATUS

GUARD, SHIELD (FIXED, MOVEABLE, INTERLOCK)

VIDEO DISPLAY TERMINAL

PUMP, COMPRESSOR, AIR PRESSURE TOOL

HEATING EQUIPMENT

WELDING EQUIPMENT

INANIMATE OBJECT

BOX, BARREL, ETC.

PAPER

METAL ITEM, MINERAL

NEEDLE

GLASS

SCRAP, TRASH, WOOD

FOOD

CLOTHING, APPAREL, SHOES

VEHICLE

AS DRIVER OF PRIVATELY OWNED, RENTAL VEH.

AS PASSENGER OF PRIVATELY OWNED, RENTAL VEH.

DRIVER OF GOVERNMENT VEHICLE

PASSENGER OF GOVERNMENT VEHICLE

COMMON CARRIER (AIRLINE, BUS, ETC.)

AIRCRAFT (NOT COMMERCIAL)

BOAT, SHIP, BARGE

ANIMATE OBJECT

DOG

OTHER ANIMAL

PLANT

INSECT

HUMAN (VIOLENCE)

HUMAN (COMMUNICABLE DISEASE)

BACTERIA, VIRUS (NOT HUMAN CONTACT)

MATERIAL HANDLING EQUIPMENT

EARTHMOVER (TRACTOR, BACKHOE, ETC.)

CONVEYOR (FOR MATERIAL AND EQUIPMENT)

ELEVATOR, ESCALATOR, PERSONNEL HOIST

HOIST, SLING CHAIN, JACK

CRANE

FORKLIFT

HANDTRUCK , DOLLY

PERSONAL PROTECTIVE EQUIPMENT

PROTECTIVE CLOTHING, SHOES, GLASSES, GOGGLES

RESPIRATOR, MASK

DIVING EQUIPMENT

SAFETY BELT, HARNESS

PARACHUTE

SECTION 7 - CAUSAL FACTORS

Review thoroughly. Answer each question by marking the appropriate block. NOTE! If any answer is yes, explain in section 5 above.

(1) DESIGN - Did inadequacies associated with the building or work site play a role? Would an improved design or layout of the equipment or facilities reduce the likelihood of similar accidents? Were the tools or other equipment designed and intended for the task at hand?

(2) INSPECTION/MAINTENANCE - Did inadequately or improperly maintained equipment, tools, workplace, etc., create or worsen any hazards that contributed to the accident? Would better equipment, facility, work site or work activity inspections have helped avoid the accident?

(3) PERSONS PHYSICAL CONDITION - Do you feel that the accident would probably not have occurred if the employee was in “good” physical condition? If the person involved in the accident had been in better physical condition, would the accident have been less severe or avoided altogether? Was overexertion a factor?

(4) OPERATION PROCEDURES - Did lack of or inadequacies within established operating procedures contribute to the accident? Did any aspect of the procedures introduce any hazard to, or increase the risk associated with the work process? Would establishment or improvement of operating procedures reduce the likelihood of similar accidents?

(5) JOB PRACTICES - Were any of the provision of the Safety and Health Requirements Manual (EM 385-1-1) violated? Was the task being accomplished in a manner which was not in compliance with an established job hazard analysis or activity hazard analysis? Did any established job practice (including EM 385-1-1) fail to adequately address the task or work process? Would better job practices improve the safety of the task?

(6) HUMAN FACTORS - Was the person under undue stress (either internal or external to the job)? Did the task tend toward overloading the capabilities of the person: i.e., did the job require tracking and reacting to many external inputs such as displays, alarms, or signals? Did the arrangement of the workplace tend to interfere with efficient task performance? Did the task require reach strengths, endurance, agility, etc., at or beyond the capabilities of the employee? Was the work environment ill-adapted to the person? Did the person need more training, experience, or practice in doing the task? Was the person inadequately rested to perform safely?

(7) ENVIRONMENTAL FACTORS - Did any factors such as moisture, humidity, rain, snow, sleet, hail, ice, fog, cold, heat, sun temperature changes, wind, tides, floods, currents, terrain; dust, mud, glare, pressure changes, lighting, etc., play a part in the accident?

(8) CHEMICAL AND PHYSICAL AGENT FACTORS - Did exposure to chemical agents (either single shift exposure or long-term exposure such as dusts, fibers, (asbestos, etc.), silica, gases (carbon, monoxide, chlorine, etc.), mists, steam, vapors, fumes, smoke, other particulates, liquid or dry chemicals that are corrosive, toxic, explosive or flammable, by-products of combustion or physical agents such as noise, ionizing radiation, non-ionizing radiation (UV radiation created during welding, etc.) contribute to the accident/incident?

(9) OFFICE FACTORS - Did the fact that the accident occurred in an office setting or to an office worker have a bearing on its cause?

For example, office workers tend to have less experience and training in performing tasks such as lifting office furniture. Did physical hazards within the office environment contribute to the hazard?

(10) SUPPORT FACTORS - Was the person using an improper tool for the job? Was inadequate time available or utilized to safely accomplish the task? Were less than adequate personnel resources (in terms of employee skills, number of workers, and adequate supervision) available to get the job done properly? Was funding available, utilized and adequate to provide proper tools, equipment, personnel, site preparation, etc.

(11) PERSONAL PROTECTIVE EQUIPMENT - Did the person fail to use appropriate personal protective equipment (gloves, eye protection, hard-toed shoes, respirator, etc.) for the task or environment? Did protective equipment provided or worn fail to provide adequate protection from the hazard(s)? Did lack of or inadequate maintenance of protective gear contribute to the accident?

(12) DRUGS/ALCOHOL - Is there any reason to believe the person’s mental or physical capabilities, judgment, etc., were impaired or altered by the use of drugs or alcohol? Consider the effects of prescription medicine and over the counter medications as well as illicit drug use. Consider the effect of drug or alcohol induced “hangovers”.

(13) JOB/ACTIVITY HAZARD ANALYSIS - Was a written Job/Activity Analysis completed for the task being performed at the time of the accident? If one was made, did it address the hazard adequately or does it need to be updated? If none made, will one be made? These may also need to be addressed in the Corrective Actions Taken section. Mark the appropriate box. If one was made, attach a copy of the analysis to the report.

(14) MANAGEMENT - Did the lack of supervisor or management support play a part in the mishap? Mark the appropriate box.

SECTION - 8 OSHA INFORMATION - Complete this section if applicable

SECTION 9 - REPORT PREPARER

Providing a completed CSIR to the Contracting Officer is the PRIME CONTRACTOR’S RESPONSIBILITY. Enter the name, date of report, title, employer, phone number and signature of person completing the accident report and provide it to the Contracting Officer, or his representative, responsible for oversight of that contractor activity. NOTE! If prepared by other than the Prime Contractor, a person employed by the Prime Contractor must sign that they have reviewed and concur with the report and its findings (e.g. company owner, project supervisor/foreman, Safety Officer, etc.).

ATTACHMENT J-0200000-08

ELINS

See file attached for use (ELINS.pdf)

ATTACHMENT J-1700000-01

HISTORICAL DATA

(Rental Period from 10/13/13 to 8/15/19)

Order Date Description 10/28/13 1 Day LeeBoy Paver 12/10/13 1 Month: JLG 1230ES 12/19/13 8Hrs:300TonCranew/Oper.

1/14/14 1 Month: JLG 1230ES 1/17/14 4 Hours: 40 Ton Crane/Long 1/23/14 1 Week: 40' Electric Scissor Lift 1/24/14 Add'l Funding for 40' Scissor Lift 1/24/14 Tear Off Box to Go with Crane 1/28/14 1 Hour: 40 Ton Long Boom Crane 1/30/14 1 Month: JLG 1230ES 2/21/14 1 Week: 150KW Electric Heater 2/25/14 1 Month: JLG 1230ES 2/25/14 1 Week: Cables for Heater 3/4/14 1 Week: 10K Propane Forklift

3/13/14 1 Week: 10K Propane Forklift 3/14/14 1 Month: 26' x 32" Scissor Lift 3/17/14 1 Month: 5K Electric Forklift 3/17/14 1 Month: 45' Elec Art Manlift 3/19/14 1 Week: 150KW Electric Heater 3/19/14 1 Week: Cables for Heater 3/26/14 2 Months: JLG 1230ES 3/28/14 1 Week: 150KW Electric Heater 3/28/14 1 Week: Cables for Heater 4/7/14 1 Month: 47" Roller 4/7/14 1 Week: Husqvarna FS6600 Saw 4/8/14 1 Month: 5K Electric Forklift 4/8/14 1 Month: 45' Elec Art Manlift 4/8/14 1 Week: 66' Articulating Condor

4/11/14 3 Months: 37K Excavator 4/16/14 1 Month: 66' Condor 4/16/14 1 Week: 66' Articulating Condor 4/22/14 8 Hours: Rigger 4/22/14 8 Hours: Rigger 4/28/14 8 Hours Crane Rental 5/1/14 1 Day: 9K Shooting Boom Forklift 5/8/14 1 Week: 19' Scissor Lift 5/8/14 1 Week: 20' Single Manlift

(Rental Period from 10/13/13 to 8/15/19) Order Date Description

5/8/14 1 Month: Portable Toilet 5/13/14 1 Month: 5K Electric Forklift 5/13/14 1 Month: 45' Elec Art Manlift 5/13/14 1 Month: 66' Articulated Condor 5/14/14 1 Month: 47" Roller 5/22/14 1 Week: 19' Electric Scissor Lift 5/22/14 1 Month: JLG 1230ES 5/22/14 1 Day: 110' Condor 5/27/14 1 Week: 19' Scissor Lift 5/27/14 1 Month: 66' Condor 5/27/14 1 Month: 66' Condor 5/30/14 1 Month: 66' Art Condor 6/6/14 1 Month: 26' x 46" Scissor Lift 6/6/14 1 Hour: 20/25 Ton Crane 6/9/14 3 Months: 5 Ton AC w/Heater 6/9/14 3 Months: 5 Ton AC w/Heater 6/9/14 3 Months: 5 Ton AC w/Heater 6/9/14 3 Months: 5 Ton AC w/Heater

6/12/14 1 Month: 47" Roller 6/12/14 1 Month: 5K Electric Forklift 6/12/14 1 Month: JLG 1230ES 6/12/14 1 Week: 66' Articulated Condor 6/12/14 1 Week: 66' Articulated Condor 6/12/14 1 Week: 66' Articulated Condor 6/12/14 1 Week: 66' Articulated Condor 6/13/14 4 Hours: 30/35 Ton Crane 6/18/14 1Week : 19x30 Elect.ScissorLift 6/18/14 1Week : 19x30 Elect.ScissorLift 6/18/14 1 Month: 45'Elect Art Manlift 6/19/14 1 Month: 47" Roller 6/19/14 8 Hours:40 Ton LongBoomCrane 6/19/14 8 Hours: 40 Ton Long Boom Crane 6/19/14 8 Hours:40 Ton Long BoomCrane 6/19/14 8 Hours: 40 Ton Long Boom Crane 6/19/14 8 Hours:40 Ton Long BoomCrane 6/19/14 1 Week: Leeboy 5000 Paver 6/19/14 Spreader Bar for 40 Ton Crane 6/19/14 Spreader Bar for 40 Ton Crane

(Rental Period from 10/13/13 to 8/15/19) Order Date Description

6/19/14 Spreader Bar for 40 Ton Crane 6/19/14 Spreader Bar for 40 Ton Crane 6/19/14 Spreader Bar for 40 Ton Crane 6/19/14 4 Months: 280 Ton Chiller 6/19/14 4 Months: 280 Ton Chiller 6/19/14 4 Months: 280 Ton Chiller 6/19/14 4 Months: 280 Ton Chiller 6/20/14 1 Month: Wacker RT82 Trench Roller 6/20/14 1 Week: (6) 4000 Watt Light Towers 6/20/14 8 Hours: 40 Ton Long Boom Crane 6/20/14 3 Months: 12K Excavator 6/20/14 3 Months: 12K Excavator 6/20/14 3 Months: 12K Excavator 6/20/14 3 Months: 12K Excavator 6/23/14 3 Months: 37K Excavator 6/23/14 3 Months: 37K Excavator 6/23/14 3 Months: 37K Excavator 6/23/14 3 Months: 37K Excavator 9/27/14 1 Month: Backhoe Loader/24" Bucket 9/27/14 8 Hours: 40 Ton LB Crane/Spreader Bar 9/27/14 8 Hours: 40 Ton LB Crane/Spreader Bar 9/27/14 1 Month: 12' Single Manlift 9/27/14 1 Month: 12' Single Manlift 9/27/14 1 Month: 12' Single Manlift 9/27/14 1 Month: 12' Single Manlift 9/27/14 1 Month: 12' Single Manlift 9/27/14 1 Month: 12' Single Manlift 9/27/14 1 Month: 12' Single Manlift 9/27/14 1 Month: 12' Single Manlift 9/27/14 1 Month: 47" Roller

10/21/14 1 Week: 900 CFM Compressor 10/30/14 1 Month: 47" Roller 11/17/14 8 Hours: 300 Ton Crane/Rigger/Spreader 12/2/14 1 Month: 47" Roller

01/22/15 3 Months: 12' Single Manlift 01/22/15 3 Months: 12' Single Manlift 01/22/15 3 Months: 12' Single Manlift 01/22/15 3 Months: 12' Single Manlift

(Rental Period from 10/13/13 to 8/15/19) Order Date Description 01/22/15 3 Months: 12' Single Manlift 01/29/15 3 Months: 12' Single Manlift 01/29/15 3 Months: 12' Single Manlift 01/29/15 3 Months: 12' Single Manlift 01/29/15 3 Months: 12' Single Manlift 01/30/15 1 Month: Post Driver 02/06/15 2 Weeks: 12" Brush Chipper 02/13/15 2 Weeks: 12" Brush Chipper 02/13/15 2 Weeks: 12" Brush Chipper 02/13/15 1 Week: 30' Articulating Manlift 02/17/15 2 Weeks: 47" Roller 03/12/15 1 Week: 30' Articulating Manlift 03/12/15 1 Month: Post Driver 04/02/15 1 Month: 66' Articulated Manlift 04/02/15 3 Months: 12' Single Manlift 04/02/15 3 Months: 12' Single Manlift 04/02/15 3 Months: 12' Single Manlift 04/02/15 3 Months: 12' Single Manlift 04/02/15 3 Months: 12' Single Manlift 04/02/15 3 Months: 12' Single Manlift 04/02/15 1 Month: 47" Roller 04/09/15 8 Hours: 40 Ton Long Boom Crane 04/10/15 1 Week: Hydraulic Hammer 04/10/15 1 Week: Hydraulic Hammer 04/10/15 1 Month: 47" Roller 04/16/15 1 Month: 66' Articulated Manlift 04/16/15 8 Hours: 40 Ton Long Boom Crane 04/16/15 Extend to 1 Month: Hydraulic Hammer 04/17/15 1 Month: 54" Roller in lieu of 47" 04/20/15 1 Month: 66' Articulated Manlift 04/21/15 1 Day: 125' Manlift 04/21/15 Future Use 04/21/15 1 Month: 8" Planer 04/21/15 1 Month: 45' Elec Art Manlift 04/27/15 8 Hours: 300 Ton Crane 05/04/15 1 Month: 66' Articulated Manlift 05/06/15 1 Month: 66' Articulated Manlift 05/08/15 2 Weeks: 12" Brush Chipper

(Rental Period from 10/13/13 to 8/15/19) Order Date Description 05/08/15 2 Weeks: 12" Brush Chipper 05/08/15 2 Weeks: 12" Brush Chipper 05/08/15 1 Month: Hydraulic Hammer 05/19/15 2 Days: Leeboy 8510 Paver 05/27/15 1 Day: 125' Manlift 05/27/15 8 Hours: 40 Ton Long Boom Crane 05/27/15 1 Day: Spreader Bar 06/01/15 1 Month: 54" Roller in lieu of 47" 06/02/15 2 Days: Leeboy 8510 Paver 06/04/15 1 Day: 10K Shooting Boom Forklift 06/09/15 1 Month: Rammer 06/09/15 1 Week: 12" Brush Chipper 06/09/15 1 Month: 66' Articulated Manlift 06/12/15 1 Month: 66' Articulated Manlift 06/16/15 1 Month: 66' Articulated Manlift 06/16/15 1 Week: (6) Light Towers 06/16/15 1 Month: (3) 20' Single Manlifts 06/18/15 8 Hours: 40 Ton Long Boom Crane 06/18/15 1 Week Rental: 12K Mini Excavator 06/18/15 1 Day: Spreader Bar and Debris Box 06/24/15 8 Hours: 40 Ton Long Boom Crane 06/24/15 1 Day: Spreader Bar 07/12/15 60' Articulating Boom Lift 07/21/15 2 Weeks: 12" Brush Chipper 07/21/15 2 Weeks: 12" Brush Chipper 07/21/15 8 Hours: 40 Ton Long Boom Crane 07/21/15 1 Day: Spreader Bar 07/21/15 1 Month: 54" Roller in lieu of 47" 07/21/15 1 Month: 54" Roller in lieu of 47" 07/22/15 1 Week: Asphalt Planer Attachment 07/22/15 1 Week: Asphalt Planer Attachment 07/28/15 1 Day: 135' Boomlift 07/31/15 1 Month: 66' Articulated Manlift 07/31/15 4 Hours: 40 Ton Long Boom Crane 07/31/15 1 Day: Spreader Bar 08/06/15 1 Week: Mini Excavator 08/06/15 1 Week: Mini Excavator 08/07/15 2 Weeks: 12" Brush Chipper

(Rental Period from 10/13/13 to 8/15/19) Order Date Description 08/07/15 1 Month: 66' Articulated Manlift 08/07/15 1 Month: 54" Roller in lieu of 47" 08/20/15 4 Hours: 40 Ton Long Boom Crane 08/20/15 2 Weeks: 12" Brush Chipper 08/20/15 1 Day: Spreader Bar 08/26/15 2 Weeks: 12" Brush Chipper 08/26/15 1 Month: 66' Articulated Manlift 08/26/15 1 Month: Trench Roller 08/27/15 1 Month: 66' Straight Manlift 08/28/15 1 Month: 66' Articulated Manlift 09/10/15 8 Hours: 40 Ton Long Boom Crane 09/10/15 1 Day: Spreader Bar 09/11/15 2 Weeks: 12" Brush Chipper 09/11/15 1 Month: 66' Articulated Manlift 09/11/15 1 Month: 54" Roller in lieu of 47" 09/16/15 1 Month: 66' Articulated Manlift 09/16/15 1 Day: 10K Shooting Boom Forklift 09/16/15 3 Months: 12' Single Manlift 09/16/15 3 Months: 12' Single Manlift 09/16/15 3 Months: 12' Single Manlift 09/16/15 3 Months: 12' Single Manlift 09/16/15 3 Months: 12' Single Manlift 09/16/15 3 Months: 12' Single Manlift 09/16/15 3 Months: 12' Single Manlift 09/16/15 3 Months: 12' Single Manlift 09/17/15 1 Month: 66' Articulated Manlift 09/17/15 1 Month: 66' Articulated Manlift 09/17/15 1 Month: 66' Articulated Manlift 10/27/15 4 Hours Premium Time: 40 Ton LB Crane 10/29/15 1 Week Rental: 1600 CFM Compressor 10/29/15 1 Month: 66' Articulated Manlift 10/29/15 1 Month: 20' Conex Box 10/30/15 2 Weeks: 12" Brush Chipper 11/04/15 8 Hours: 300 Ton Crane-Bar-Rigger-CW 11/04/15 8 Hours: 300 Ton Crane-Bar-Rigger-CW 11/06/15 1 Week: 49K Excavator 11/06/15 1 Week: 49K Excavator 11/09/15 1 Week: Hammer Attachment for Exc

(Rental Period from 10/13/13 to 8/15/19) Order Date Description 11/09/15 1 Week: Hammer Attachment for Exc 11/18/15 1 Week: 49K Excavator 11/19/15 1 Week: Hammer Attachment for Exc 12/01/15 1 Month: 20' Conex Box 12/01/15 1 Month: 20' Conex Box 12/01/15 1 Month: 54" Roller in lieu of 47" 12/01/15 1 Month: 54" Roller in lieu of 47" 01/19/16 1 Week: 10K Shooting Boom Forklift 01/22/16 1 Month: JD 410J Backhoe Loader 01/22/16 2 Weeks: 12" Brush Chipper 01/22/16 1 Month: 66' Articulated Manlift 01/22/16 1 Month: 66' Straight Manlift 01/22/16 3 Months: 12' Single Manlift 01/22/16 3 Months: 12' Single Manlift 01/22/16 3 Months: 12' Single Manlift 01/22/16 3 Months: 12' Single Manlift 01/22/16 3 Months: 12' Single Manlift 01/22/16 3 Months: 12' Single Manlift 01/22/16 1 Week: 30' Art Elecric Manlift 01/22/16 1 Month: (3) 20' Single Manlifts 01/22/16 1 Month: 54" Roller in lieu of 47" 01/29/16 1 Month: JD 410J Backhoe Loader 01/29/16 12 Months: 40' Storage Container 01/29/16 12 Months: 40' Storage Container 01/29/16 12 Months: 40' Storage Container 01/29/16 12 Months: 40' Storage Container 01/29/16 12 Months: 40' Storage Container 01/29/16 12 Months: 40' Storage Container 01/29/16 12 Months: 40' Storage Container 01/29/16 12 Months: 40' Storage Container 01/29/16 12 Months: 40' Storage Container 01/29/16 12 Months: 40' Storage Container 01/29/16 12 Months: 40' Storage Container 02/05/16 1 Month: 60" Elec Art Boomlift 02/05/16 1 Month: 60" Elec Art Boomlift 02/09/16 1 Month: 60" Elec Art Boomlift 02/11/16 1 Month: 26' x 46" Elec Scissor Lift 02/16/16 1 Month: 66' Articulated Manlift

(Rental Period from 10/13/13 to 8/15/19) Order Date Description 02/16/16 1 Month: (3) 20' Single Manlifts 02/17/16 3 Weeks: 12" Brush Chipper 02/17/16 1 Month: 12' Single Manlift 02/18/16 1 Month: 66' Articulated Manlift 02/18/16 1 Month: 66' Straight Manlift 02/19/16 4 Hour Crane on 9-17 and 4Hr on 9-30 02/19/16 1 Month: JD 410J Backhoe Loader 02/19/16 1 Month: 54" Roller in lieu of 47" 02/23/16 1 Month: JD 410J Backhoe Loader 02/23/16 1 Month: 66' Articulated Manlift 02/23/16 1 Month: 54" Roller in lieu of 47" 03/08/16 1 Month: JD 410J Backhoe Loader 03/08/16 1 Month: 66' Articulated Manlift 03/08/16 1 Day: 125' Manlift 03/08/16 1 Month: 54" Roller in lieu of 47" 03/15/16 1 Month: 60" Elec Art Boomlift 03/15/16 1 Month: 60" Elec Art Boomlift 03/15/16 1 Month: 60" Elec Art Boomlift 03/15/16 1 Month: 26' x 46" Elec Scissor Lift 03/23/16 2 Weeks: 60' Art Manlift 03/23/16 1 Month: 60" Elec Art Boomlift 03/23/16 1 Month: 60" Elec Art Boomlift 03/28/16 1 Month: 66' Elect Art Boomlift 03/28/16 12' Single Manlift 03/28/16 12' Single Manlift 03/28/16 12' Single Manlift - 1 Month 03/29/16 55' Shooting Boomlift - 1 Week 04/04/16 1 Month: 66' Art. Manlift 04/07/16 1 Month: 66' Art. Manlift 04/11/16 1 Month:SewerJetterTrk/Vactor2112 04/11/16 1 Day : Crane Rental 04/11/16 1 Month:SewerJetterTrk/Vactor2112 04/11/16 1 Day : Crane Rental 04/21/16 1 Month: 66' Art Manlift 04/21/16 1 Month: 66' Art Manlift 04/21/16 MiniExcavator 04/21/16 47" Double Drum Roller 04/22/16 60' Art Manlift - 1 Month

(Rental Period from 10/13/13 to 8/15/19) Order Date Description 04/22/16 60' Art Manlift - 1 Month 04/22/16 60' Art Manlift - 1 Month 04/22/16 1 Week: Forklift 04/25/16 1 Week: Forklift 05/03/16 1 Day 50 Ton Crane 05/03/16 40' Art Manlift 1 Week 05/03/16 1 Day: Spreader Bar 05/05/16 1 Month:SewerJetterTrk/Vactor2112 05/05/16 1 Month:SewerJetterTrk/Vactor2112 05/05/16 1 MonthExtension: SewerJetterTrk/Vactor2112 05/05/16 1 MonthExtension: SewerJetterTrk/Vactor2112 05/17/16 1 Day : Crane Rental (6 Hrs) 05/17/16 1 Day: Spreader Bar 05/18/16 1 Day: Paver 05/26/16 1 Day : Crane Rental 05/26/16 1 Day: Spreader Bar 06/02/16 60' Art Manlift - 1 Month 06/02/16 60' Art Manlift - 1 Month 06/02/16 60' Art Manlift - 1 Month 06/02/16 60' Art Manlift - Damages 06/06/16 120' Manlift 06/10/16 2 Weeks: Hyd. Concrete Breaker 06/10/16 1 Month: 12' Single Manlift 06/21/16 1 Week: (5) Light Towers 06/22/16 1 Week: (4) Light Towers 06/22/16 1 Month Ext: 47" Roller 06/22/16 1 DAY: Crane/Spreader Bar 06/29/16 2 WK Ext: Hydraulic Hammer 06/29/16 30' Electric Condor 1 week 07/05/16 2 Wks: Genie Lift 07/07/16 1 WK: Floor Saw 07/07/16 2 Month: Trench Box 07/11/16 4Hour Crane/Spreader Bar 07/13/16 3 Months: Excavator Rental 07/13/16 3 Months: Excavator Rental 07/13/16 3 Months: Excavator Rental 07/20/16 Hammer 07/26/16 60' Manlift

(Rental Period from 10/13/13 to 8/15/19) Order Date Description 07/26/16 60' Manlift 07/29/16 1 Month: Condor 07/29/16 1 Month: Condor 07/29/16 3 Months: Hammer for Excavator 08/25/16 1 Month: 66' Manlift 08/25/16 1 Week: 30' Art Manlift 08/25/16 1 Month: Drum Roller Extension 09/06/16 1 Month: 40 ft Art Boom 09/06/16 1 Month: Roller Extension 09/15/16 1 Day: 125' Manlift 09/15/16 1 Day: Crane Rental 09/15/16 1 Day: Crane Rental 09/15/16 1 Week: Trencher 09/15/16 1 Week: Bobcat 09/16/16 1 Month: Generator 09/16/16 1 Week: 30' Art Manlift 09/16/16 1 Month: Roller Extension 09/16/16 2 Week Ext: Drum Roller 09/16/16 1 Month: Bobcat Hammer 10/14/16 1 Month: 40' Electric Lift 10/14/16 1 WK: Trencher 10/14/16 1 Month: Roller Extension 10/18/16 2 Week: Condor Extension 10/18/16 Vactoe Sewer Rental 10/19/16 1 Day: Atrium Lift 10/20/16 1 Month: 66' Art Manlift 10/20/16 1 Month: 66' Art Manlift 10/20/16 1 Month: 66' Art Manlift 10/20/16 1 Day Crane Rental/Spreader Bar 10/20/16 1 Wk: 66' Condor 10/24/16 1 Week: Air Compressor 10/24/16 1 Week Articulated Condor 10/25/16 1 Week Wheel Loader 10/27/16 1 Day Crane Rental 11/02/16 1 Month Ext: 66' ART Manlift 11/02/16 1 Wk: Mini Excavator 11/02/16 1 Week: 66' Art Condor 11/03/16 1 Month: 66' Condor

(Rental Period from 10/13/13 to 8/15/19) Order Date Description 11/07/16 1 Week: Asphalt…