PSM_-_Contractor_Annual_Audit_Form.pdf

PDF 143 KB Posted

Attached to
CIP-005-7 and CIP-007-6 OT Firewall Infrastructure and Compliance Assessment
Solicitation number
2026-RFP-007
Issued by
Polk County, Florida

About this file

PSM - Contractor Annual Audit Form Summary

This is a Contractor Annual Audit Form issued by the City of Lakeland's Risk Management and Purchasing department. The form is designed to be completed by contractors working on projects for the City of Lakeland and requires documentation of the contractor's name, project title, project location, and audit results across multiple audit items. The form specifically includes a field for EMR (Experience Modification Rate) documentation, though the complete audit criteria are not fully detailed in the provided excerpt. No specific response deadlines, site visits, bidder conferences, or contract term information is included in this form document itself, as it functions as a post-award compliance and audit tool rather than a solicitation document.

The audit form serves as an ongoing compliance mechanism for contractor performance monitoring and does not contain pricing information, set-asides, incumbent vendor details, or funding requirements. The form is intended to support the City's contractor management and risk assessment processes by documenting periodic audits of contractor performance metrics and safety records throughout the contract period.

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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 .