PSM_-_Contractor_Annual_Audit_Form.pdf

PDF 143 KB Posted

Attached to
Congestion Relief Alternative for SR99 State and local contract opportunity
Solicitation number
2026-RFP-009
Issued by
Polk County, California

About this file

This is a Contractor Annual Audit Form issued by the City of Lakeland's Risk Management and Purchasing department in Florida. The form is designed to evaluate contractor performance and compliance on projects managed by the City. The audit document includes fields for contractor identification, project details including project name and location, and a structured audit section that assesses specific items with corresponding result designations and comment fields. The form includes an audit item related to EMR (Experience Modification Rate), indicating that contractor safety and workers' compensation history are part of the evaluation criteria.

The audit form serves as a tool for the City to monitor ongoing contractor performance throughout the contract period and ensure adherence to municipal standards and requirements. This particular form appears to be a standard annual assessment instrument used across the City's contracting operations to maintain accountability and document contractor compliance with established performance metrics and safety standards.

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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 .