PSM_-_Contractor_Annual_Audit_Form.pdf

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, evaluating their safety performance and compliance across multiple criteria. The audit assesses key areas including EMR (Experience Modification Rate), drug and alcohol policy, written safety plan, safety compliance program, safety records, employee training records, and overall acceptable safety performance onsite.

The audit form provides a standardized mechanism for the City of Lakeland to review and determine a contractor's continued eligibility for inclusion on the PSM-Approved Contractors List. The form allows an auditor to systematically document audit results and comments for each specified safety criterion, with a final determination checkbox to approve or disapprove the contractor's continued status. The form includes signature lines for the auditor, providing an official record of the annual safety performance evaluation.