PSM_-_Contractor_Annual_Audit_Form.pdf
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- 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
PSM - Contractor Annual Audit Form Summary
This document is a Contractor Annual Audit Form created by the City of Lakeland's Risk Management and Purchasing Department. The form serves as an audit checklist for evaluating contractor performance and compliance on city projects. The form includes sections for capturing basic project information such as contractor name, audit date, project title, and project location. The document contains an audit items section that evaluates contractors across multiple compliance and performance categories, with columns designated for audit results and supporting comments. One identified audit item includes EMR (Experience Modification Rate), which is a standard metric used in workers' compensation insurance assessment.
The form represents a standardized assessment tool designed to ensure contractors maintain compliance with city requirements and industry standards throughout project execution. While the specific audit criteria and scoring methodology are not fully detailed in the provided excerpt, the document's structure indicates that the City of Lakeland uses this systematic approach to monitor contractor performance on an annual basis. No specific pricing, set-aside provisions, incumbent information, or contract award details are addressed in this audit form, as it functions as an internal compliance and performance evaluation document rather than a procurement solicitation or contract award notice.
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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 .