PSM_-_Contractor_Annual_Audit_Form.pdf

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Attached to
Operation of Restaurant Concession at Military Park
Solicitation number
2025-RFP-017
Issued by
Allegheny County, Philadelphia City, New Jersey

About this file

The document is a PSM-Contractor Annual Audit Form issued by the City of Lakeland's Risk Management and Purchasing department, designed to evaluate and assess contractors for continued inclusion on their approved contractors list. The form provides a comprehensive safety audit checklist that includes key evaluation criteria such as EMR (Experience Modification Rate), drug and alcohol policy, written safety plan, safety compliance program, safety records, employee training records, and overall acceptable safety performance onsite.

The audit form serves as a standardized evaluation tool to determine a contractor's ongoing eligibility for future city projects, with a checkbox mechanism to approve or disapprove continued inclusion on the PSM-Approved Contractors List. The form allows for detailed documentation of audit results and comments for each safety-related item, providing a structured approach to assessing contractor safety performance and compliance. By maintaining this rigorous review process, the City of Lakeland can ensure that contractors meet specific safety standards and maintain a high level of professional competence and risk management.

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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 .