PSM_-_Contractor_Annual_Audit_Form.pdf

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Attached to
Annual Water Treatment Plant High Service Pump Maintenance Contractor
Solicitation number
2026-RFP-078
Issued by
Polk County, Florida

About this file

This is a Contractor Annual Audit Form created by the City of Lakeland Risk Management and Purchasing Department, designed to evaluate contractor performance on projects for the City of Lakeland, Florida. The form is used to assess contractors on specified audit items and record results and comments related to project execution. The audit covers various performance metrics, including EMR (Experience Modification Rate) and other compliance indicators relevant to contractor evaluation. The form provides a standardized template for documenting contractor performance throughout the contract period, enabling the City to maintain oversight of service delivery and contractor qualifications on an annual basis.

The form does not specify pricing terms, set-asides, funding sources, or contract renewal options within its structure. Rather, it functions as an evaluation and documentation tool to be completed during the contract term to assess ongoing contractor compliance and performance. This audit mechanism supports the City's contractor management procedures and helps ensure that selected contractors, such as those providing specialized services like high service pump maintenance at water treatment facilities, continue to meet established performance standards and contractual obligations throughout their engagement with the City.

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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 .