RFP_25_8428_DPS_Forms.pdf

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RFP 25 8428 DPS Occupational Medical Services
Solicitation number
PR8428
Issued by
Florida

About this file

This is a Request for Proposal (RFP) document issued by the Orlando Utilities Commission (OUC) in Florida for Occupational Medical Services. The solicitation seeks one or more qualified suppliers to provide comprehensive medical support including pre-employment post-offer examinations, general medical examinations, fitness-for-duty evaluations, exposure response, random drug and alcohol screenings, and Medical Director consultation to support OUC's Occupational Health and Safety Programs. Proposals are due July 17, 2025, at 2:30 PM EST. The anticipated contract term is five years with one potential one-year renewal option. Bidders must demonstrate at least five years of occupational medicine experience, maintain multiple service locations across Florida counties, and employ a Board Certified Occupational Medicine physician on staff. All site visits must be pre-approved by OUC's designated representative.

The RFP pricing structure allows for various service packages with potential zero-dollar placeholders to be completed by bidders, requiring all-inclusive costs without additional administrative fees. Payment terms offer a 1% discount if paid within 20 days or a 3% discount if paid within 10 days, with standard net 30-day terms. No bid bond or performance bond is required. The M/WBE goal is listed at 0%, and no specific set-aside for disadvantaged enterprises is specified. While no explicit budget range is stated, the comprehensive nature of services and multiple service dimensions suggest significant potential contract value. Evaluation criteria include qualifications, experience, responsiveness to requirements, safety and quality programs, financial soundness, pricing, electronic scheduling capabilities, reporting systems, and nationwide drug screening coverage.

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EXCEPTIONS

The undersigned Proposer, having read and examined the specifications and documents for the designated services and understanding the general conditions for contract under which services will be performed, does hereby propose to furnish all labor, equipment, and material to provide the services set forth in the Proposal.

The undersigned hereby declares that the following listing states any clarifications, any and all variations from and exceptions to the requirements of the specifications and documents. The undersigned further declares that the “work” will be performed in strict accordance with such requirements and understands that any exceptions to the requirements of the specifications and documents may render the Proposer's proposal non-responsive.

For the avoidance of doubt, all exceptions, clarifications, deviations, variances, or modifications to the specifications and/or any requirements, terms, and conditions as stated in this RFP (no matter how slight) shall be stated in this Exceptions Form. If no exceptions, clarifications, deviations, variances, or modifications are stated in this Exceptions Form, it shall be construed that the Proposal fully complies with the requirements, terms, and conditions as originally stated in this RFP. Any exceptions, clarifications, deviations, variances, or modifications not submitted in this Exceptions Form may be grounds for rejecting the Proposal.

Exceptions will not be allowed after submission of the proposal.

Please check one:

None

Exceptions:

(If more space is needed, please indicate exceptions here and attach additional pages as needed)

RFP 25 8428 DPS

SWORN STATEMENT UNDER SECTION 287.133 (3) (a) and 287.135, FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES AND SCRUTINIZED

COMPANIES

(To be signed in the presence of a notary public or other officer authorized to administer oaths.)

STATE OF ________________

COUNTY OF _______________

Before me, the undersigned authority, personally appeared ______________________ who, being by me first duly sworn, made the following statement:

1. The business address of __________________________________________ is _____________________________________________________________

2. My relationship to _______________________________________________ is _____________________________________________________________

[Relationship such as sole proprietor, partner, president, vice president].

3. I understand that any company listed on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Section as defined by Florida Statute 215.473 may not bid on, submit a proposal for, or enter into or renew a contract with an agency or local governmental entity for goods or services of $1 million or more. If found to be on the list, I understand that any contract with the governmental agency or entity will be terminated and that civil penalties as outlined in Florida Statute

287.135 will apply.

4. I understand that a public entity crime as defined in Section 287.133 of the Florida Statutes includes a violation of any state or federal law by a person with respect to and directly related to the transaction of business with any public entity in Florida or with an agency or political subdivision of any other state or with the United States, including, but not limited to, any bid or contract for goods or services to be provided to any public entity or such an agency or political subdivision and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation.

5. I understand that "convicted" or "conviction" is defined by the statute to mean a finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any federal or state trial court of record relating to charges brought by indictment or information after July 1, 1989, as a result of a jury verdict, nonjury trial, or entry of a plea of guilty or nolo contendere.

Public Entity Crimes Form_v.1_160708 1

6. I understand that "affiliate" is defined by the statute to mean (1) a predecessor or successor of a person or a corporation convicted of a public entity crime, or

(2) an entity under the control of any natural person who is active in the management of the entity and who has been convicted of a public entity crime, or (3) those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in the management of an affiliate, or (4) a person or corporation who knowingly entered into a joint venture with a person who has been convicted of a public entity crime in Florida during the preceding 36 months.

7. Neither the bidder or Contractor nor any officer, director, executive, partner, shareholder, employee, member or agent who is active in the management of the bidder or Contractor nor any affiliate of the bidder or Contractor has been convicted of a public entity crime subsequent to July 1, 1989.

[Draw a line through paragraph 7 if paragraph 8 below applies.]

8. There has been a conviction of a public entity crime by the bidder or Contractor, or an officer, director, executive, partner, shareholder, employee, member or agent of the bidder or Contractor who is active in the management of the bidder or Contractor or an affiliate of the bidder or Contractor. A determination has been made pursuant to Section 287.133(3) by order of the Division of Administrative Hearings that it is not in the public interest for the name of the convicted person or affiliate to appear on the convicted vendor list.

The name of the convicted person or affiliate is

_______________________________________. A copy of the order of the Division of Administrative Hearings is attached to this statement.

[Draw a line through paragraph 8 if paragraph 7 above applies.]

Signed by: ____________________________________

Printed Name: _________________________________

Sworn to and subscribed before me in the state and county first mentioned above on the ________ day of ___________________________ 20______.

Notary Public

(Affix Seal)

Type or Printed Name My Commission Expires

Public Entity Crimes Form_v.1_160708 2

DISPUTE DISCLOSURE for Solicitation #:

Answer the following questions by placing an "X" in the appropriate "YES" or "NO" box. If you answer "YES", please explain In the space provided, or via attachment.

Has your firm, or any of its officers, received a reprimand of any nature or been suspended by the Department of Professional Regulation or any other regulatory agency or professional association within the last five (5) years?

YES NO

Has your firm, or any member of your firm, been declared in default, terminated or removed from a contract or job related to the services your firm provides in the regular course of business within the last five (5) years?

YES NO

Has your firm had filed against it or filed any requests for equitable adjustment, contract claims or litigation in the past five (5) years that is related to the services your firm provides in the regular course of business?

YES NO

If yes, state the nature of the request for equitable adjustment, contract claim or litigation, a brief description of the case, the outcome or status of suit and the monetary amounts or extended contract time involved.

I hereby certify that all statements made are true and agree and understand that any misstatement or misrepresentation or falsification of facts shall be cause for forfeiture of rights for further consideration of this project.

Firm Date

Authorized Signature Officer Title

Printed or Typed Name

Dispute Disclosure Form_v.1_160708

RFP 25 8428 DPS

ADDENDA for Solicitation #:

The undersigned Proposer/Bidder acknowledges receipt of the following Addenda, which have been considered in preparing this Proposal.

Addendum No. 1 Dated

Addendum No. 2 Dated

Addendum No. 3 Dated

Addendum No. 4 Dated

RFP 25 8428 DPS

Signature

Signature

Signature

Rev 1 dated 8-30-18

STANDARD CONTRACT

THIS CONTRACT, made effective as of this XXXXXXXXXXXX, 200X, (“Effective Date”) is by and between the Orlando Utilities Commission with its principal office located at 100 W. Anderson Street, Orlando, Florida, Party of the First Part and hereinafter called (“OUC”), and XXXXXXXXXXXX, a XXXXX corporation with its principal office in XXXXXXXXXXXX, State X, Party of the Second Part and hereinafter called the (“Supplier”), jointly referred herein as the Parties.

WITNESSETH:

THAT WHEREAS, OUC has caused to be prepared, in accordance with law, specifications, drawings and other contract documents for the work as herein specified; and

WHEREAS, the said Supplier has submitted to OUC a proposal in accordance with the terms of this Contract; and

WHEREAS, OUC, in the manner prescribed by law, has determined the Supplier to be the most responsive and responsible bidder for the work and has awarded to the Supplier a contract therefore, for the sum or sums named in the Supplier's proposal or as otherwise amended by the Basis of Contract, a copy thereof being attached to and made a part of this Contract;

NOW, THEREFORE, in consideration of the compensation to be paid to the Supplier and of the mutual agreements herein contained, the Parties to these presents hereby agree, OUC for itself and its successors, and the Supplier for itself, himself, or themselves, or its, his or their successors and assigns, or its, his or their executors and administrators, as follows.

ARTICLE I. That the Supplier shall provide all labor, material and equipment necessary to provide XXXXXXXXXXXX beginning XXXXXXXXXXXX 200X through XXXXXXXXXXXX, 200X in accordance with the Contract Documents including any Basis of Contract attached and made a part hereof, and shall execute and complete all work included in OUC's official award of this Contract to the Supplier. Both Parties hereto agree that "Contract Documents" shall include the Contract, including any Basis of Contract, the Certificate of Counsel, the General Conditions, the General Requirements, the Technical Specifications, Drawings, the Bidding Documents associated with this Contract, and any other document included as part of the above referenced documents.

In the event there is a conflict or contradiction among any of the Contract Documents, the order of precedence shall govern any contracts initiated under this Contract and all services rendered hereunder:

A. This Contract, including any Basis of Contract.

B. OUC’s General Conditions included in the solicitation document.

C. OUC’s Solicitation (RFX XX XXXX OQ) with a due date of XXXXXXXXXXXX.

D. Supplier’s response to the Solicitation dated XXXXXXXXXXXX including approach, pricing, and schedule, if applicable.

ARTICLE II. That OUC will pay to the Supplier for the work embraced in this Contract, and the Supplier will accept as full compensation therefore, the sum (subject to adjustments as provided by the Contract) as submitted in the Supplier’s Proposal for XXXXXXXXXXX RFX XX XXXX OQ dated XXXXXXXXXXXX, 200X, for all work included in the Contract, designated in the foregoing Article I; payment to be made in the manner provided in the proposal attached hereto.

ARTICLE III. That time of completion is of the essence of the Contract, and that the Supplier shall proceed with the specified work and shall conform to the schedule specified in General Requirements, or elsewhere in the specifications, which has been made a part of this Contract.

ARTICLE IV. Supplier acknowledges and agrees that (i) all material and information which has or will come into its possession or knowledge in connection with this Contract or the performance hereof, consists of confidential and proprietary information of OUC, of its affiliates or third party vendors who have licensed the information to OUC under an obligation of confidentiality, and (ii) the disclosure to third parties or use by Supplier or third parties of such information will damage OUC. Supplier therefore agrees to hold such material and such information in strictest confidence, not to make use thereof other than for the performance of this Contract, and not to release such information or material to any person except for Supplier’s personnel who have a need to know such information for the purposes of this Contract and who have signed a written Contract expressly agreeing not to use or disclose it. This confidentiality obligation shall survive termination of this Contract.

IN WITNESS WHEREOF, the Parties agree the Effective Date of this Contract shall be the day and year first above written.

Orlando Utilities Commission

Signature

Print Name:

Title

Date

(Supplier)

Print Name:

Title

CERTIFICATE OF COUNSEL

(Where Supplier is a Corporation)

I do hereby certify that the Contract has been duly and lawfully executed by the Supplier acting by and through all officers and agents thereunto respectively required for the valid execution thereof, and that the same respectively constitutes a valid and binding obligation of such party. In lieu of Counsel Certification, a letter of signatory authority from the Corporate Secretary on official letterhead bearing the corporate seal may be submitted.

Signature of Counsel for Principal

Type or print name of Counsel

Type or print address of Counsel

CERTIFICATE OF COUNSEL

(Where Supplier is an individual or partnership)

I hereby certify that the Contract has been duly and lawfully executed by the Supplier, or if the Supplier be a partnership by a partner thereunto duly and lawfully authorized and that such person, officers and agents were thereunto lawfully authorized and that the same respectively constitutes a valid and binding obligation of such party.

Signature of Counsel for Principal

Type or print name of Counsel

Type or print address of Counsel

OUC Contractor Security Policy

CRIMINAL BACKGROUND CHECK AND BADGING

As part of the security clearance process, all contractor’s personnel that will be working on OUC’s properties for a total of more than 14 calendar days (consecutive or non-consecutive) will require a background check, as determined by the guidelines contained in this policy. Also, the OUC Security Department and/or the OUC designated representative reserves the right to require a background check and follow up based on the circumstances of a particular contract, including but not limited to those certain contracts that by their nature may require access to OUC’s information technology system(s). Any background check under this policy will cover a minimum of the immediate seven (7) year period prior to the date of the application for the OUC access badge or photo identification, or prior to the start date of work to be performed under the above stated type of contract. This background check procedure requires that the contractor’s employee be background checked in the states and/or countries where they have lived or worked in for the past seven (7) years preceding their application for an OUC access badge or photo identification, or the past seven

(7) years prior to the start of work pursuant to a contract that OUC determined to require a background check pursuant to this policy.

An OUC badge will not be issued to individuals who will be on-site for a total of 14 calendar days or less (consecutive or non-consecutive 14 day period per any one OUC project). Said individuals who will be on-site for a total of 14 calendar days or less need to sign in and out at the security desk using their company identification and government issued photo identification. All contractor’s employees and visitors who are not cleared through a background check and who do not receive an OUC badge, but who will be on OUC property, may be required to be escorted by an approved OUC representative, while on OUC property.

OUC will conduct all background checks for each of the contractor’s employees assigned to OUC prior to on-site work or prior to the start of work under those above stated contracts. The contractor will receive a secure link to OUC’s background check vendor. The contractor, or the contractor’s employee, will complete the documents in this l ink. These documents will include the appropriate disclosure(s) required by law, including those under the Fair Credit Reporting Act, and to electronically sign and complete the release form allowing OUC’s background check company to perform the appropriate therein designated background check(s) for the contractor’s designated personnel. OUC reserves the right to otherwise designate the method by which the forms authorizing the performance of the background checks may be provided for execution and the method by which the required disclosure documents may be provided. The contractor will be responsible for the cost associated with the background check.

Each of the contractor’s employees being background checked by OUC must electronically or physically sign the OUC authorization form(s), authorizing OUC, a n d / o r O U C ’ s d e s i g n a t e d b a c k g r o u n d c h e c k v e n d o r , to conduct the background check. Failure to execute same may result in OUC declining to allow contractor’s employee(s) access to any OUC property or asset.

It is to be understood by the contractor, and the contractor’s employees, that OUC’s evaluation of the background information is solely for deciding whether to grant the contractor’s employee access to OUC facilities for work related purposes. OUC reserves the right, in its sole discretion, to deny access to OUC’s property or assets for any of the contractor’s personnel based on an inadequate background check or due to the lack of sufficient or acceptable background information.

OUC may require that additional background information be obtained from a contractor’s personnel who have had one or more felony arrests and/or convictions. Likewise, criminal background checks that show a pattern of arrests and/or convictions for violence, larceny, illegal drug sales or similar acts may require additional information to determine whether access to OUC’s property or assets will be issued. Generally, the information sought will involve the underlying facts and circumstances that led to the arrest(s) and/or conviction(s).

The information may be obtained by interviewing said personnel or by having said personnel provide copies of arrest reports, incident reports, clerk of court case disposition documents, court documents, etc.

Based on OUC’s review of the results reported in the background check records, OUC may deny a contractor’s personnel access to OUC’s property or assets, regardless of the outcome of any criminal proceedings. OUC may deny access to a contractor’s personnel who fail to cooperate fully in the process.

All identification/access badges issued by OUC are the property of OUC and must be immediately returned under the following conditions: (1) upon expiration;

(2) when job function no longer requires use; (3) upon completion of the contract

(4) upon contract employee’s separation of employment; (5) if contract employee is convicted of, or found guilty of any criminal offense which is disqualifying under OUC’s background criteria; and (6) upon demand of OUC. Any misuse of, or willful failure to return, an OUC issued identification/access badge may be subject to civil and/or criminal prosecution, as appropriate. A fee will be charged to replace a lost/stolen or otherwise unaccounted for badge.

The Contractor shall notify and return all identification/access badges to OUC immediately after the Contractor’s employee(s) badge expires and/or whose work is terminated. If badges are not returned, the Contractor will be charged $100.00 per each non-returned badge. OUC may withhold final payment to the Contractor for work performed under the Contract until all identification/access badges have been surrendered or the $100.00 per badge charge has been paid to OUC.

Bid Protest Procedure

SCM-RFX-P-01

Version: 1.0 Effective Date: 10/21/19

Owner: Director of Supply Chain Management

Orlando Utilities Commission Bid Protest – SCM-P-01 v 1.0

1 SCOPE

It is OUC’s policy and intent to promote fair, open and competitive bidding for the procurement of goods and services consistent with applicable laws, policies and procedures. OUC’s method for affecting this practice is to give fair and timely evaluation to any qualified prospective bidder, proposer, supplier or contractor applying for consideration via the competitive bidding process.

In awarding contracts, OUC shall have the discretion to utilize its business judgment to determine the most responsive and responsible offer consistent with its procurement policies and procedures regarding bidding, proposals, negotiating and awarding contracts.

All bid award and non-award notifications are provided in writing to the respective parties.

2 BID PROTEST STEPS

In the event that a bidder wishes to dispute a bid award and issue a bid protest they must follow the guidelines as defined steps below:

Step 1.) Any bidder who submitted a bid or proposal and wishes to dispute a bid award must e-mail the buyer of record within 72 hours after the intent to award notification is issued by OUC and, within five (5) business days from the date the intent to award notification was issued file, by e-mail or hard copy letter, a formal written protest which must include a detailed description of the underlying reasons for the protest. Any grounds not included in the formal written protest are deemed waived.

Step 2.) Upon receipt of the formal written protest in Step 1, the buyer of record and their manager shall meet with the challenging bidder within 10 business days and may request additional information on the grounds expressly set forth in Step 1. The buyer, manager and bidder shall work together to try to resolve the dispute at this step.

Step 3.) If the subject of the protest is not resolved by mutual agreement at or after the meeting as set forth in Step 2, a challenging bidder may request a hearing before the Bid Protest Committee. The Bid Protest Committee shall consist of the Chief Financial Officer, and the Director of Supply Chain Management, a Legal Department representative and a technical representative (if requested by either party) from the issuing business unit. The hearing will be based solely on the information contained in the formal written protest from Step 1 as may have been clarified in Step 1. Within 2 weeks of the meeting this committee shall issue a decision. The decision of this committee will be final.

Orlando Utilities Commission Bid Protest – SCM-P-01 v 1.0

Document Revision History

Version Date Revision Comments Author

1.0 10/21/19 Initial release (PSC approval 10/17/2019) Bob Brunner

Rev. #26 12/17/07 1

ORLANDO UTILITIES COMMISSION

GENERIC CONTRACTOR ORIENTATION

SITE SPECIFIC WILL BE HANDED TO THE SUCCESSFUL CONTRACTOR PRIOR TO ARRIVING AT THE SITE.

CONTRACTOR / COMPANY NAME

Print Name of Company Above

OUC REPRESENTATIVE CONTRACTOR REPRESENTATIVE

Print Name Above Print Name Above Phone # Extension # Phone # Extension #

JOB/WORK INFORMATION

Date of Orientation

Date Work Begins Date Work is

Scheduled to Conclude

Check The Box On The Right If The Contractor Will Be Indicate Peak Number Of Contractor Personnel Expected To Be On Site In Box On The Right

Bringing Materials On Site That Require An MSDS

System Contractor Is Working On

Nature Of Work On Site

SCOPE OF CONTRACTOR ORIENTATION

All Contractors Working On Site Are Required To Review Sections I - IV.

Work Covered by Section V. Special Hazards And Work Conditions

Check Each Box Below that Represents the Needs of the Contractor for Section V of the Contractor Orientation.

1. Fall Arrest 5. Respiratory Protection 9. Process Safety Management

2. Lockout/Tagout 6. Confined Space Procedure 10. Commercial Diving

3. Exposed Energized Electrical Work 7. Welding & Cutting/Hot Work

4. Scaffold Requirements 8.Trenching and Excavations

The Following Procedures And Rules Have Been Developed To Protect The Employees And

Equipment Of The Orlando Utilities Commission. It Is Not Meant To Be All Inclusive Nor Does It Relieve Any Contractor Of Any Of Their Responsibility As Defined In The Contract, Or Any

Federal, State, Or Local Regulation.

Rev. #26 12/17/07 2

AREAS OF SPECIAL CONCERN

1.

2.

3.

4.

5.

6.

CONTRACTOR EMPLOYEE NOTIFICATION

The Contractor is responsible for informing their personnel of the above rules, regulations and information.

All employees who will be on site to perform work shall sign the Contractor Employee Notification List.

Failure to sign the Contractor Employee Notification List may result in removal of the Contractor employee from site.

CONTRACTOR INJURY/ILLNESS REPORTS

The Contractor shall provide an injury/illness report to OUC for any work related injury/illness that occurs on site within 48 hours of the event causing the injury/illness.

VIOLATIONS

1. Violations of the above rules and regulations may result in the employee and/or contractor being removed from the site.

OUC Representative Contractor Representative

EMERGENCY EVACUATION NOTIFICATION

1. I have read and understand that the Contractor Representatives must provide a completed Contractor

Evacuation List to Security before any personnel enter or any work will begin on site located at the main gate Security office.

Contractor Representative

Rev. #26 12/17/07 3

CONTRACTOR EMPLOYEE NOTIFICATION LIST

I have been informed, and understand the rules, regulations and information contained in the Contractor Orientation, and understand violation of these rules may result in my removal from site.

Print Name

2.

3.

5.

6.

7.

8.

9.

10.

11.

12.

14.

15.

16.

17.

18.

19.

20.

21.

22.

23.

24.

25.

Rev. #26 12/17/07 4

Competent and Qualified Person Designation Explanation

Definitions:

Competent Person - means one who is capable of identifying existing and predictable hazards in the surroundings or working conditions which are unsanitary, hazardous, or dangerous to employees, AND who has the authorization to take prompt corrective measures to eliminate them.

Qualified Person - means one who, by possession of a recognized degree, certificate, or professional standing, or who by extensive knowledge, training and experience, has successfully demonstrated his/her ability to solve or resolve problems relating to the subject matter, the work or the project. Note: Generally speaking, a "Qualified Person" is considered to have a higher level of expertise than a "Competent Person".

Explanation of Competent and Qualified Form:

29 CFR 1926 and 29 CFR 1910 (OSHA) requires your company to provide Competent Persons and/or Qualified Persons for various types of work. The Competent and Qualified Form has multiple boxes to be checked indicating the person(s) designated as "Competent/Qualified Person" for your company, depending on the scope of work. By checking each appropriate box as "Competent/Qualified Person" on the Competent and Qualified Form you are also indicating the person named has met any OSHA requirements for performing duties at this level of responsibility and has the authority to take prompt corrective measures to eliminate hazards and enforce safety rules for your company. Some of the check boxes on the Competent and Qualified Form may not have a specific OSHA regulation that mentions a "Competent or Qualified Person", however, this form is used to ensure OUC contacts the person(s) with the appropriate training and authority to take the actions necessary for the safety of your company's employees. While OUC does not require documentation prior to beginning work on site, OUC reserves the right to request documentation of the training and qualifications of those personnel designated as "Competent/Qualified Person" on the Competent and Qualified Form should plant management deem it necessary at a later date.

Example:

The ABC Construction Company will be replacing underground water piping attached to the potable water tank. Their work will require Lockout/Tagout, Confined Space Work, Welding & Cutting and Excavation while on site.

Name of Competent/Qualified Person:

John Doe

1. Fall Arrest 5. Respiratory Protection 9. Hazardous Materials

2. Lockout/Tagout 6. Confined Space Procedure 10. Commercial Diving

3. Exposed Energized Electrical Work 7. Welding & Cutting/Hot Work

4. Scaffold Requirements 8.Trenching and Excavations

11. Other

The Contractor Representative prints the name of the person(s) on the form who is to be the "Competent or Qualified Person" and checks each item in their scope of work for which they will be the "Competent or Qualified Person", if one person is to be the sole "Competent or Qualified Person", then the contractor should have each item in their scope of work check under his name. If multiple personnel, or personnel with varying qualifications are needed, write the name of the "Competent or Qualified Person" in the space provided and check only those items in the scope of work for which they will be the "Competent or Qualified Person".

Rev. #26 12/17/07 5

Competent and Qualified Form Based upon their training and experience, the following personnel have the authority of a Competent/Qualified Person Representative for the specific types of work noted by the check marks in the table below.

2. Lockout/Tagout 6. Confined Space Procedure 10. Commercial Diving

3. Exposed Energized Electrical Work 7. Welding & Cutting/Hot Work

11. Other

3. Exposed Energized Electrical Work 7. Welding & Cutting/Hot Work

3. Exposed Energized Electrical Work 7. Welding & Cutting/Hot Work

3. Exposed Energized Electrical Work 7. Welding & Cutting/Hot Work

3. Exposed Energized Electrical Work 7. Welding & Cutting/Hot Work

3. Exposed Energized Electrical Work 7. Welding & Cutting/Hot Work

3. Exposed Energized Electrical Work 7. Welding & Cutting/Hot Work

Rev. #26 12/17/07 6

CONTRACTOR EVACUATION LIST

CONTRACTOR/COMPANY:

DATE ENTERING SITE:

DATE LEAVING SITE:

The following Supervisor will account all personnel during an Emergency Evacuation that work for the above named Contractor.

This Page Must Go To The Security Office

Rev. #26 12/17/07 7

SAMPLE INFORMATION GUIDE

(Site Specific Guides will be handed to the contractor when first reporting to the project)

EMERGENCY # ________________________

OUC REPRESENTATIVE EXT. #

AREA SUPERVISOR EXT.

PLANT PAGING SYSTEM.

EVACUATION AREA(S):

PRIMARY =Site Specific.

SECONDARY = Site Specific

EMERGENCY PROCEDURES:

1. Medical, Fire and Other Plant Emergencies

A. For medical, fire and other plant emergencies the Control Room shall be notified using the OUC emergency telephone number _________________________.

The person making the call should be prepared to relay the following information:

- Type of emergency

- Location of emergency

- Severity of emergency

- Name of caller and telephone number call is being made from

B. The person making the call shall not break communication until directed to by the Control Room.

C. Medical and chemical emergencies will be announced over the Public Address system in conjunction with three two (2) second tones of the alarm system. Do not evacuate when the three two-second tones are used.

2. Evacuation Plan A. In the event a plant evacuation is required an alarm will be sounded (site specific). In between each alarm a verbal announcement will inform all personnel as to the nature of the emergency.

Regardless of the verbal announcement, personnel shall evacuate upon hearing the alarm and report to their evacuation areas. Regardless of where a fire is located all personnel must report to their evacuation areas when the alarm is sounded.

B. Outside contractor personnel shall assemble at ______________ Site Specific.

C. Supervisors shall be responsible to account for their personnel in the assigned areas. A Contractor

Evacuation List will be provided by the Contractor Representatives to Security prior to any personnel beginning work or entering the site. The Contractor Representative will also insure that all of the Contractor's personnel entering the site are informed of their evacuation area. Site Security shall drive to each evacuation area and check in with each Supervisor. Supervisors shall inform Security of any missing persons.

D. During the emergency use of the paging system, OUC radios, or calls to the Control Room should be limited to only those calls concerning additional information about the current emergency, or to report a new emergency. An "all clear" will be sounded when normal communications may resume.

E. Personnel shall remain at their assembly areas until released by the OUC designee in charge of the emergency scene.

Rev. #26 12/17/07 8

I. SECURITY

1. Identification and Access

A. Authorization for any Contractor, or person to enter to the site, or to remain on site, can be denied solely at the discretion of the Management or the designated OUC Representative.

B. All Contractor employees will provide photographic identification to Security as requested upon entering or exiting.

C. All Contractor employees shall be required to wear an identification badge. The badge shall be worn in plain view on the upper part of the body.

D. No employee shall enter any electrical enclosure or substation without prior approval.

E. Contractor Employees shall only be allowed in pre-approved areas.

F. The use of the plant restroom facilities shall be prohibited unless prior arrangements have been made.

G. Smoking shall only be allowed in designated areas.

2. Materials and Equipment

A. Property removal forms are required to take any material or equipment off site. They shall be signed by the appropriate OUC Supervisor.

B. The following are specifically prohibited on site: Firearms or other deadly weapons, explosives or fireworks, alcoholic beverages, narcotics or non-prescription drugs, pets, open fires, posting of unauthorized signs.

C. All vehicles and equipment entering the site are subject to search by Security or other personnel designated by

OUC. OUC reserves the right to forbid access to any vehicle, as well as the driver and occupants of any vehicle that is not searched or has deficiencies that may impair the safety of the vehicle or equipment.

D. Material and equipment shall be stored only in pre-approved areas. Unless prior approval is obtained, the use of OUC trash bins, dumpsters, etc., is not allowed. Contractors must make arrangements for storage and removal of all waste products or trash.

E. The use of cameras or video equipment shall be prohibited unless prior arrangements have been made.

II. HAZARDOUS MATERIALS ON SITE

1. Location of Extremely Hazardous Materials

A. The following Extremely Hazardous Materials are found on site in some OUC facilities:

1. Anhydrous Ammonia

2. Asbestos

3. Biocide

4. Chlorine

5. Hydrogen

6. Liquid Nitrogen

7. Radioactive Materials

8. Sodium Hydroxide

9. Sulfuric Acid

B. All Contractor personnel working on site must be aware of the presence and hazards of these materials. Any personnel working in the immediate area must be notified of the appropriate actions to take in an emergency involving these materials. The actions to be taken are:

1. Exit the area immediately.

2. Notify the Control Room using the Emergency Procedures noted in the Emergency Procedures section of this document.

3. Follow the directions given by OUC personnel as to evacuation, etc.

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C. Contractors whose scope of work will include performing maintenance, repair, renovation or specialty work on any system involving extremely hazardous materials shall perform a Job Hazard Analysis (JHA) for the work to be performed in conjunction with OUC personnel.

D. Contractors bringing hazardous or toxic materials on site shall provide, upon request, an emergency plan for any spill/release of the material they are using, and the appropriate training records for the type of work of the personnel are expected to perform.

E. Potable (Drinking) Water and Re-Use Water (Stanton Energy Center)

1. The only water that is acceptable for drinking on site is the following:

a. Spigots found at sinks in offices or restrooms.

b. Spigots found at sinks inside kitchens.

c. Drinking fountains.

DO NOT DRINK FROM ANY OTHER SOURCE OF WATER

2. Emergency Eyewash/Showers use potable water supplies, but it is not recommended they be used for drinking unless thoroughly flushed.

3. All plant Service Water and Fire Water is Re-Use water. This includes all outlets in the plant environment. The Re-Use water is treated wastewater from a local Orange County sewage treatment plant. Water reuse involves taking domestic wastewater, giving it a high degree of treatment, and using the resulting high-quality reclaimed water for a new, beneficial purpose. Extensive treatment and disinfection ensure that public health and environmental quality are protected. The treatment of wastewater prevents it from being considered a hazard for incidental contact. However, Re-Use Water is not considered suitable for drinking, or hygiene activities such as washing the face, hands, etc. When prolonged contact is likely to occur, rubber gloves, rain suits etc. should be used.

III. EMERGENCY PROCEDURES

1. Medical, Fire and Other Plant Emergencies

A. For medical, fire and other emergencies the appropriate OUC personnel (defined by OUC at beginning of the project) be notified using the company phone system.

1. The person making the call should be prepared to relay the following information:

- Type of emergency.

- Location of emergency.

- Severity of emergency.

- Name of caller and telephone number call is being made from.

2. The person making the call shall not break communication until directed to by the OUC person.

Depending on the OUC location Medical and chemical emergencies may be announced over the Public Address system in conjunction with three two (2) second tones of the alarm system. Do not evacuate when the three two-second tones are used.

B. Evacuation Plan

1. Some of the OUC locations have developed evacuation plans. They will be given to the contractor when they first arrive at the site.

IV. GENERAL SAFETY

1. Work Apparel and Hearing Protection

A. Hardhats and safety glasses shall be worn at all times (except while in air-conditioned areas or vehicles with enclosed cabs).

B. Good leather work shoes or boots shall be worn. Athletic and open toed shoes shall not be allowed.

Exception: Athletic style shoes which meet the requirements and specifications established in the

American Standard Safety Requirements for Foot Protection ANSI Z41-1991 may be worn.

Rev. #26 12/17/07 10

C. Shirts covering the full trunk and upper arm shall be worn. Cut off jeans or shorts shall not be allowed.

Minimum acceptable apparel is considered a Cotton Tee-Shirt and Cotton Pants. Personnel who may be exposed to arcs or flames shall not wear apparel that may increase their injuries in an accident. Further guidelines for proper apparel for personnel who may be exposed to arcs or flames can be found in 29 CFR

1910.269 and the additional requirements noted in Section V, Paragraph - 3 Exposed Energized Electrical Work of this document.

D. Hearing protection shall be worn while working in excessively noisy areas or when using tools that exceed 90 decibels. Further information on hearing protection requirements may be found in 29 CFR 1910.95.

2. Vehicular Safety

A. Unless otherwise stated, only company owned or rented vehicles will be allowed on site. All contractor employee personal vehicles shall park in the construction parking lot unless otherwise designated.

B. Personnel riding in the bed of a pickup truck shall not sit above the floor of the bed unless provided with a suitable seat with a backrest that prevents them from falling out of the vehicle. Sitting on the tailgate while the vehicle is in motion is strictly prohibited.

C. Personnel shall not ride on the running boards, fenders, etc., of any vehicle.

D. All persons operating motor vehicles must have the appropriate license for the vehicle being operated.

E. The project speed limit is 15 mph unless otherwise posted.

3. Housekeeping

A. Special attention shall be given to keeping the inside of the structures and surrounding grounds clean and free from trash and debris. Work areas and storage areas shall be continuously cleaned each workday.

B. All hoses, cables, extension cords, and similar materials shall be located, arranged, grouped and routed overhead so that they will not block any access way or work area, and will permit easy cleaning and maintenance.

C. Material and supplies shall be stored in an orderly manner to prevent their falling or spreading, and to eliminate tripping and stumbling hazards.

D. Flammable and combustible liquids shall only be stored, or dispensed, using Underwriters Laboratories or Factory Mutual listed safety containers and only in approved quantities.

E. Gas or diesel powered vehicles and equipment shall not be allowed in any building unless prior approval has been obtained; a Welding and Cutting Permit is utilized to receive approval.

F. Upon completion of work, all equipment, material and waste shall be removed from the plant site.

G. Any operation that produces air contaminants above the permissible exposure limits noted on the Material

Safety Data Sheet for the material being used, or above the limits set in Table Z-1-A (29 CFR 1910.1000), shall provide engineering controls to restrict the exposure of air contaminants above the limits to only those personnel working in the immediate area of the work to be performed. The suggested method of protecting the adjacent areas from air contaminants above the limits is a ventilation/exhaust system with tenting if necessary.

The exhaust of the system must have the appropriate filter(s) to prevent the air contaminants from producing an exposure above the permissible exposure limits. Other methods of controlling of air contaminant exposure requires approval by the Safety Manager prior to beginning to perform the work.

The need for protecting the adjacent areas from air contaminants shall be assumed unless the Contractor can provide documentation from a Certified Industrial Hygienist that the exposure level is below the permissible exposure limits. Any dust or other contaminant produced from the operation is the Contractor's responsibility, and the Contractor shall ensure it is cleaned/removed upon completion of the work unless prior arrangements have been made.

4. Hazardous or Toxic Materials

A. The Contractor shall provide Material Safety Data Sheets covering all hazardous materials furnished under or otherwise associated with the work under this contract in accordance with applicable federal, state and local laws.

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Before entering the site, the contractor must provide a copy of all the Material Safety Data Sheets for the materials that will be used on site to perform their work, or any of their subcontractor’s work. Should additional materials be needed after work has begun, the materials must receive approval by OUC and the MSDS must be on site and supplied to OUC before the material is brought on site.

B. All hazardous and toxic material brought on site, or generated by the work process, shall be clearly labeled with the Contractor's name. All containers must have the appropriate labels containing the information on the hazards of the materials. The minimum requirements for day use containers or similar containers that do not have the appropriate manufacturers warning label are: the trade name of the product, a hazard warning such as the NFPA 704 system or H.M.I.S. System.

C. Hazardous and toxic materials shall only be stored in pre-approved locations.

D. Contractors are responsible for all hazardous materials or toxic materials brought on site or generated by their work and shall properly dispose of all hazardous and toxic material for which they are responsible at their cost unless prior arrangements are made. Contractors shall immediately report any spills to the appropriate OUC representative.

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5. Fire Equipment and Fire Hydrants

A. Fire equipment and fire hydrants shall not be used unless there is an emergency or unless prior approval has been given.

B. To prevent hydrant damage when using a fire hydrant, it shall be opened all the way when in use and closed all the way when not in use.

C. If a plant fire extinguisher is used it shall be turned in to the appropriate OUC representative.

6. Ladders

A. All ladders and use of ladders shall comply with 29 CFR 1910.25, 1910.26 and 1910. 27.

B. Site Specific Rules regarding ladders are the following:

1. Portable metal ladders shall not be used. Exception: Such ladders may be used in specialized work, as high voltage substations, where non-conductive ladders might present a greater hazard. These ladders shall be properly marked.

2. Ladders shall not be used as scaffold platforms.

3. Boxes, chairs, etc., shall not be used as ladders.

4. Portable straight ladders shall be used only if they have non-skid bases.

5. When working from a portable ladder, employees shall ensure that the ladder is securely placed, held, tied, or otherwise made secure to prevent slipping or falling.

6. Personnel working from portable ladders shall wear fall arrest equipment whenever they are exposed to a fall of 24 feet or more.

7. Mechanical

A. Pulley, gear and similar equipment guards shall be replaced if removed.

B. No work shall be performed in close proximity to running conveyor belts.

C. No one shall ride, stand on, or cross over a conveyor.

8. Cranes, Hoists, Forklifts and Heavy Equipment

A. Prior approval must be obtained before using any plant crane, hoist, forklift or heavy equipment.

B. Only qualified persons shall operate any crane, hoist, forklift or heavy equipment.

C. All Contractor hoists and cranes must meet the requirements as specified in 29 CFR 1910 and 1926.

D. Upon request, the Contractor must provide the inspection records of any Contractor supplied hoist or crane to be used on site.

E. All forklift operators must have a license/certification as being qualified to operate a forklift and a current valid evaluation indicating they have the skills necessary for the type of forklift they will be using.

9. Area Protection and Access

A. Work area protection is the adequate protecting of all employees by the use of suitable barriers, warning signs, lights, flags, flagmen, etc., as the job requires on approaches to work areas, excavations, open manholes, floor holes, etc. Proper work area protection shall be preplanned.

B. Safe access shall be provided to all work areas.

C. Any open floor hole with a vertical dimension greater than four (4) feet shall have a suitable barrier with appropriately constructed guardrails, midrails and toeboards, or suitable cover, designed for 2 times the intended load. For short duration jobs, warning tape with signs denoting that 100% Fall Protection is needed, in conjunction with a standby employee to ensure personnel entering the designated area wear the appropriate fall arrest equipment, may be utilized. The barricade tape must be placed at least six (6) feet from the edge of the fall exposure and the standby employee must be present AT ALL TIMES WHEN THE FLOOR HOLE IS

OPEN.

D. Open manholes are required to have a suitable barrier with appropriately constructed guardrails, midrails and toeboards.

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E. Any Leading Edge type of fall exposure (roof, walkway without handrails etc.) in excess of four (4) feet shall be protected appropriately constructed guardrails, midrails and toeboards. For short duration jobs, warning tape with signs denoting 100% Fall Protection is needed may be used. The barricade tape must be placed at least six (6) feet from the edge of the fall exposure. All personnel entering past the barricade tape must wear the appropriate fall arrest equipment.

10. Tools and Equipment

A. All portable power tools, portable lighting, and other temporary equipment require the use of a Ground Fault

Circuit Interrupter (GFCI).

B. Electrical equipment and tools shall be wired and grounded as required by applicable electrical codes.

C. Appropriate guarding shall be used on tools and equipment.

D. Defective tools and equipment must be identified as defective by tagging, marking etc. and may not be used until repaired.

E. Use of OUC tools or equipment is forbidden unless authorized by the OUC Representative.

11. Operation and Modification of Equipment

A. Contractor employees shall not operate any switch, valve, breaker, etc., unless they receive approval from their OUC representative and the Tagging Authority for the equipment they need to operate.

B. Contractor employees shall not make any circuit logic, control modifications, or other modification to equipment without approval from the appropriate OUC representative.

V. SPECIAL HAZARDS AND WORK CONDITIONS

1. Fall Arrest

A. Fall arrest equipment shall be properly used when exposed to a fall in excess of six (6) feet, when the use of other fall protection means are not practical. Fall protection shall be provided 100% of the time personnel are exposed to a fall in excess of six (6) feet, with the exception of working from a portable ladder with a fall exposure of twenty-four (24) feet in height or lower. Any time personnel work from a portable ladder in excess of than twenty-four (24) feet, or climb a fixed ladder that has a fall exposure greater than twenty-four

(24) feet; the appropriate fall protection measures must be taken. Appropriate fall arrest equipment is considered the following:

1. A full body harness is required for use as part of the fall arrest system. A body belt or a chest harness is not considered proper fall arrest equipment.

2. All lanyards used for fall arrest shall have double locking snap hooks.

3. All lanyards used for fall arrest shall have a shock absorber that limits the arresting force to less than

900 pounds in the event of a fall.

4. Those devices which limit the fall distance in such a manner as to ensure the arresting force does not exceed 900 pounds may be used without a shock absorber (e.g.: retractable lifelines, ladder clamps, etc.).

Note: Floor Holes and Leading Edge Fall Exposures require fall protection or fall arrest at an exposure of 4 feet.

B. Additional requirements and information on fall protection may be found in 29 CFR SUBPART M.

2. LOTO Procedure (Lockout/Tagout)

A. Stanton Energy Center requires all contractors to…

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