Safety Compliance (5).pdf
PDF 111 KB Posted
- Attached to
- WRC: Sewage Disposal System Maint. & Repairs
- Solicitation number
- Oak-0000000971
- Issued by
- Oakland County, Michigan
About this file
This document is a Contract Addendum and Certification for Safety Compliance form issued by the Oakland County Water Resources Commissioner's office in Michigan. The form requires contractors to certify strict adherence to Michigan Occupational Safety & Health Administration (MIOSHA) safety and health standards for all work performed for the Water Resources Commissioner's office, its drainage districts, municipal customers, and other systems. Contractors must provide a qualified or competent safety person to oversee job site safety, submit a list of such persons prior to work commencement, and immediately notify the office of any changes to the information provided in the certification.
The document is part of a larger contract opportunity for sewage disposal system maintenance and rehabilitation, which involves cleaning, closed circuit television inspection, and sewage system repairs. The form emphasizes the critical importance of workplace safety compliance, requiring contractors to verify their commitment to MIOSHA standards through a formal certification process. By signing the document, the contractor affirms the accuracy of the information provided and demonstrates legal authorization to execute the safety compliance agreement.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Oakland County WRC Community Water and Sewer Contract (4).docx | DOCX document | |
| WRC Sewage System Maintenance _ Rehabilitation Specs (1).docx | DOCX document | |
| Sewage Disposal Maintenance _ Repairs RFP 7-3-2025.docx | DOCX document | |
| Attachment A - Pricing Sheet.docx | DOCX document |
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Text version
Form DC–029 Contract Addendum and Certification for Safety Compliance
OAKLAND COUNTY WATER RESOURCES COMMISSIONER
Page 1 of 1 Rev. 02/22/2017
Contract Addendum and Certification for Safety Compliance
This Contract Addendum and Certification for Safety Compliance is effective as of ___________ between the Contractor identified below and the Oakland County Water Resources Commissioner’s office, whose address is One Public Works Drive, Waterford, Michigan 48328.
1. By executing this Contract Addendum, the Contractor certifies that it, its employees, agents, subcontractors, and assigns strictly follows all Michigan Occupational Safety & Health Administration (MIOSHA) safety and health standards relevant to the work being performed for the Oakland County Water Resources Commissioner’s office, its drainage districts, municipal customers, private systems, or other customers, at any and all times during which work is being performed.
2. The Contractor further certifies that it will provide a qualified or competent person, whichever is required pursuant to MIOSHA safety and health standards for the work being performed, to oversee safety on the job site.
3. If a qualified or competent person is not present on the job site, then work must not proceed until a qualified or competent person is present.
4. The Contractor must provide a list of all qualified or competent persons to the Oakland County Water Resources project engineer or field staff prior to commencement of any work.
5. If at any time, any of the information provided in this Certification changes, the Contractor agrees to notify the Oakland County Water Resources Commissioner’s office in writing prior to any further work performed on a job site.
Contractor name, address and telephone number: Contractor’s safety coordinator:
The signatory below hereby certifies that the statements and representations of fact made by such signatory contained in this document are true, accurate, and complete. This Contract Addendum and Certification for Safety Compliance has been made, presented, and delivered for the purpose of ensuring compliance with MIOSHA safety standards and may be relied upon by the Oakland County Water Resources Commissioner’s office as a true statement of the facts set forth in this document.
By signing below on behalf of the Contractor, the signatory represents that he or she is duly authorized and has legal capacity to execute and deliver this Certification.
Signature
Print Name:
Title:
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