PSM_-_Contractor_Annual_Audit_Form.pdf

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Attached to
Continuing Contract for Professional Municipal Engineering Services (CCNA)
Solicitation number
2026-RFQ-075
Issued by
Polk County, Florida

About this file

This is a Contractor Annual Audit Form used by the City of Lakeland's Risk Management and Purchasing Department in conjunction with a three-year continuing contract for Professional Municipal Engineering Services. The audit form is designed to assess contractor performance and compliance on municipal engineering projects within the City of Lakeland's jurisdiction. The form includes fields for contractor identification, project details, location information, and evaluation of audit items, with particular attention to EMR (Experience Modification Rate) documentation. The underlying contract opportunity is structured as a three-year initial term with options for two additional one-year renewals upon mutual consent between the City and the selected engineering firm, issued in accordance with Florida's Consultant's Competitive Negotiation Act (F.S. 287.005).

The audit form serves as a monitoring and accountability mechanism for contractors performing under the municipal engineering services contract with the City of Lakeland, Florida. This document is a standard compliance tool that would be completed during or after project execution to verify contractor qualifications, insurance status, and safety metrics. The form's focus on EMR indicates the City's emphasis on worker safety and claims history as key performance indicators for contractor evaluation and potential contract renewal or continuation decisions.

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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 .