PSM_-_Contractor_Annual_Audit_Form.pdf
PDF 143 KB Posted
- Solicitation number
- 2025-RFP-077
- Issued by
- Polk County, Illinois
About this file
This is a Contractor Annual Audit Form used by the City of Lakeland's Risk Management and Purchasing division for the Annual Fireworks Display Services contract. The form serves as a safety and compliance evaluation tool for contractors performing fireworks display services scheduled for December 4, 2025, during the Christmas Parade and July 3, 2026, during the Red, White & Kaboom event at Lake Mirror facility. The RFP #2025-RFP-077 was released on October 9, 2025, with questions due by October 21, 2025, and proposals due by October 30, 2025, at 2:00 pm. The contract includes potential renewal options for three consecutive years upon mutual consent. The audit form functions as a mandatory evaluation mechanism requiring contractors to demonstrate robust safety practices, protocols, and compliance documentation throughout the contract period.
The total budget allocation is $24,000, with $9,000 designated for the Christmas Parade fireworks display and $15,000 for the Red, White & Kaboom event. Contractors must provide comprehensive insurance coverage including commercial general liability, business automobile liability, workers' compensation, and excess liability, with insurance representing 35 percent of the evaluation criteria. Additional evaluation criteria include outline of show (35%) and references from the past five years (30%). Contractors are required to submit human trafficking affidavits, drug-free workplace certifications, and comply with local vendor preference policies. The audit form specifically addresses Employer's Mutual Rating (EMR) and other safety metrics, demonstrating the City's emphasis on workplace safety evaluation and compliance documentation as essential components of contractor qualification and ongoing contract performance.
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Other files
| File | Type | Posted |
|---|---|---|
| Annual_Fireworks_Display_Services_(Addendum_#2_Revision).pdf | ||
| Annual_Fireworks_Display_Services.pdf | ||
| Indemnification_2025_Consultant.doc | DOC document | |
| Indemnification_2025_Contractor.doc | DOC document | |
| Indemnification_2025_Vendor.doc | DOC document | |
| Contractor_Safety_Evaluation_Form.pdf | ||
| Human_Trafficking_Affidavit.docx | DOCX document | |
| Indemnification_2025_Consultant_-_FDOT.docx | DOCX document | |
| Contractor_Safety_Evaluation_Form.pdf | ||
| Human_Trafficking_Affidavit.docx | DOCX document | |
| Indemnification_2025_Consultant.doc | DOC document | |
| Indemnification_2025_Contractor.doc | DOC document | |
| Indemnification_2025_Contractor_-_FDOT.docx | DOCX document | |
| Indemnification_2025_Vendor.doc | DOC document | |
| PSM_-_Contractor_Annual_Audit_Form.pdf | ||
| Indemnification_2025_Contractor_-_FDOT.docx | DOCX document | |
| Indemnification_2025_Consultant_-_FDOT.docx | DOCX document |
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Text version
City of Lakeland, Risk Management and Purchasing
PSM- Contractor Annual Audit Form
Contractor: _____________________________________ Date: _______________
Project: _______________________________________________________________
Location: ______________________________________________________________
Audit Item Audit Result Comments
EMR (<1.0)
Drug and Alcohol Policy Written Safety Plan Safety Compliance Program
Safety Records Employee Training Records
Acceptable Safety Performance Onsite
Contractor, ___________________________________, ☐ is ☐ is not approved for continued inclusion on the PSM-Approved Contractors List.
Audit performed by: ______________________, Title: __________________________
Auditors signature: ______________________________________ Date: ___________
File details come from the government source that posted it. Updated .