PSM_-_Contractor_Annual_Audit_Form.pdf

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Attached to
Landscaping Services
Solicitation number
2025-RFQ-009
Issued by
San Joaquin County, Sunnyvale City, Florida

About this file

The document is a PSM- Contractor Annual Audit Form issued by the City of Lakeland's Risk Management and Purchasing department. The form is designed to conduct an annual audit of contractors to evaluate their safety performance and compliance across multiple criteria. Key audit items include evaluating the contractor's Experience Modification Rate (EMR), drug and alcohol policy, written safety plan, safety compliance program, safety records, employee training records, and overall safety performance onsite. The form provides a structured checklist for auditors to assess and document a contractor's safety practices, with a final determination on whether the contractor remains approved for inclusion on the PSM-Approved Contractors List.

The audit form does not contain specific pricing, funding, or contract details, but serves as an internal evaluation tool to maintain high safety standards for contractors working with the City of Lakeland. The checkboxes and blank fields allow for a comprehensive review of each contractor's safety protocols, with space for comments and a final approval/disapproval recommendation. By systematically reviewing these critical safety components, the City aims to ensure that contractors meet their safety performance standards and mitigate potential workplace risks.

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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 .