PSM_-_Contractor_Audit_Form.pdf

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Attached to
Annual 15KV CIRCUIT BREAKER MULTI-YEAR AGREEMENT
Solicitation number
2026-ITB-126
Issued by
Polk County, Florida

About this file

This is a Contractor Audit Form issued by the City of Lakeland, Risk Management and Purchasing Department, used to evaluate contractor performance and compliance during contract execution. The form is designed to assess contractors on specified audit items, with dedicated sections for recording audit results and relevant comments. The associated contract opportunity is a one-year agreement for the purchase of Magnetically Actuated 15kV Circuit Breakers, with options for four additional one-year renewals upon mutual consent, for a potential contract term not to exceed five years. The City of Lakeland will procure four specific circuit breaker models: Part# 1092125 (15KV Vacuum Interrupter 1200A 125VDC), Part# 1092200 (15KV Vacuum Interrupter 2000A 125VDC), Part# 1092048 (15KV Vacuum Interrupter 1200A 48VDC), and Part# 1092148 (15KV Vacuum Interrupter 2000A 48VDC). The contract may be utilized by other City of Lakeland departments as applicable.

The audit form does not specify pricing terms, set-asides, or funding amounts within the provided documentation. The form was last revised on April 1, 2026, and serves as a standardized tool for the City of Lakeland's Risk Management and Purchasing Department to conduct ongoing contractor evaluations throughout the contract performance period. No specific bidding deadlines, site visit requirements, or bidders' conference information is detailed in this audit form document.

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Text version

RISK MANAGEMENT AND PURCHASING REVISED 04/01/2026

City of Lakeland, Risk Management and Purchasing RMP- Contractor 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 .