PSM_-_Contractor_Annual_Audit_Form.pdf
PDF 143 KB Posted
- 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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Other files
| File | Type | Posted |
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| LAKELAND_CRA_–_DOWNTOWN_DISTRICT_REDEVELOPMENT_PLAN_UPDATE.pdf | ||
| Contractor_Safety_Evaluation_Form.pdf | ||
| Indemnification_2025_Consultant_-_FDOT.docx | DOCX document | |
| Indemnification_2025_Contractor_-_FDOT.docx | DOCX document | |
| Indemnification_2025_Vendor.doc | DOC document | |
| Indemnification_2025_Consultant.doc | DOC document | |
| Indemnification_2025_Contractor.doc | DOC 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 .