PSM_-_Contractor_Annual_Audit_Form.pdf

This document is a PSM-Contractor Annual Audit Form from the City of Lakeland's Risk Management and Purchasing department. The form is designed to conduct a comprehensive annual safety audit of contractors, evaluating multiple aspects of their safety performance and compliance. The audit assesses key areas including EMR (Experience Modification Rate) which must be below 1.0, drug and alcohol policies, written safety plans, safety compliance programs, safety records, employee training records, and overall onsite safety performance.

The form provides a standardized template for auditors to document their findings and determine whether a contractor remains approved for inclusion on the PSM-Approved Contractors List. The checkboxes at the bottom of the form allow the auditor to indicate whether the contractor is or is not approved for continued inclusion based on the audit results. The document includes space for recording the contractor's name, project details, location, audit results, comments, auditor's name, title, signature, and date of audit completion.