PSM_-_Contractor_Annual_Audit_Form.pdf
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- Attached to
- Unit 5 Spring 2025 Outage Contractor Services
- Solicitation number
- 2025-RFP-002
- Issued by
- Sangamon County, 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 assess their safety performance and compliance across multiple criteria, including EMR (Experience Modification Rate), drug and alcohol policies, written safety plans, safety compliance programs, safety records, employee training records, and overall onsite safety performance.
The audit form provides a structured evaluation mechanism to determine a contractor's continued eligibility for inclusion on the PSM-Approved Contractors List. By systematically reviewing key safety metrics and documentation, the City of Lakeland can ensure that contractors maintain high safety standards and meet the municipality's risk management requirements. The form allows auditors to comprehensively document their findings and make a final determination on whether a contractor remains approved for future work, with checkboxes to indicate approval or non-approval status.
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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 .