PSM_-_Contractor_Annual_Audit_Form.pdf

PDF 143 KB Posted

Attached to
CIP-005-7 and CIP-007-6 OT Firewall Infrastructure and Compliance Assessment
Solicitation number
2026-RFP-007
Issued by
Polk County, Florida

About this file

This is a Contractor Annual Audit Form used by the City of Lakeland's Risk Management and Purchasing department to evaluate contractor performance and compliance. The form is designed to assess contractors working on various projects and locations within the city's jurisdiction. The audit instrument includes evaluation criteria for items such as Experience Modification Rate (EMR), though the document provided is incomplete and does not show the full scope of audit items, scoring methodology, or evaluation standards that would typically be included in such an assessment tool.

The form appears to be a standard administrative document used for ongoing contractor monitoring rather than a project-specific solicitation document. It lacks pricing information, contract terms, set-asides, incumbent contractor details, funding sources, or award timelines. The incomplete nature of the provided document suggests this is a template or blank form awaiting completion during an actual contractor audit process related to the Lakeland Electric OT firewall infrastructure and compliance assessment project, though specific audit parameters and evaluation criteria are not fully visible in the submitted file.

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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 .