TRENCH_SAFETY_COMPLIANCE.docx
DOCX document 23 KB Posted
- Attached to
- Mack Bayou Road Pedestrian Improvements Phase I
- Solicitation number
- ITB 25-04
- Issued by
- Walton County, Florida
About this file
The document is a Trench Safety Compliance form from the Board of County Commissioners of Walton County, Florida, intended for use in a bid submission. The form is specifically related to the Mack Bayou Road Pedestrian Improvements Phase I project located in Santa Rosa Beach, Florida, which involves constructing a multi-use path approximately 10,845 linear feet long, stretching from Monarch Drive to Harborview Road. The project includes milling and resurfacing of the existing road, with a contract duration of 180 days for substantial completion and an additional 30 days for punch list completion.
The compliance form requires bidders to specify their trench safety standards, appropriate safety measures, and financial allocations for trench excavation and shoring safety requirements. Bidders must demonstrate compliance with applicable Trench Safety Standards, indemnify the county and engineer against potential claims, and confirm they have reviewed available geotechnical information. The form must be signed in the presence of a notary public, indicating a formal commitment to safety protocols and regulatory adherence during the project's construction phase.
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Other files
| File | Type | Posted |
|---|---|---|
| Mack_Bayou_Road_Pedestrian_Improvements_Phase_I_(Addendum_#7_Revision).pdf | ||
| Copy_of_MACK_BAYOU_ROAD_MULTI-USE_TRAIL_PHASE_1__Bid_Schedule_updated_.xlsx | XLSX spreadsheet | |
| UPDATED_Revised_Plans-Addendum.pdf | ||
| Contract_No._25-04.pdf | ||
| UNAUTHORIZED_ALIENS.pdf | ||
| PUBLIC_ENTITY_CRIMES.pdf | ||
| BID_FORM.docx | DOCX document | |
| FDOT_Grant_No._G2R99.pdf | ||
| Public_Construction_Bond.doc | DOC document | |
| TE_No_.1.pdf | ||
| 01_Final_Permit_453753-001-002-EE.pdf | ||
| Mack_Bayou_Phase_1_Plans.pdf |
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Text version
TRENCH SAFETY COMPLIANCE
BOARD OF COUNTY COMMISSIONERS,
WALTON COUNTY, FLORIDA
THIS FORM MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC BY AN OFFICER AUTHORIZED TO ADMINISTER OATHS.
| 1. | This Sworn Statement is submitted with Bid No. __________ for _____________________________________________________________________ |
| ____________________________________________. |
2. This Sworn Statement is submitted by _______________________________________ whose business address is ________________________________________________ and (if applicable) its Federal Employer Identification Number (FEIN) is _____________.
3. My name is ________________________________________________; I hold the position of ____________________________________ with the above entity.
4. The Trench Safety Standard that will be in effect during the construction of this Project is __________________________________________________________.
(refer to Fla. Statute or OSHA Standard)
| 5. | The undersigned assures that the entity will comply with the applicable Trench Safety Standards and agrees to indemnify and hold harmless the County and ENGINEER, and any of their agents or employees from any claims arising from the failure to comply with said standard. |
| 6. | The undersigned has appropriated $__________________ per linear foot of trench to be excavated over 5' deep for compliance with the applicable standards and intends to comply by instituting the following procedures: |
7. The undersigned has appropriated $__________________ per square foot for compliance with shoring safety requirements and intends to comply by instituting the following procedures:
8. The undersigned, in submitting this Bid, represents that he or she has reviewed and considered all available geotechnical information and made such other investigations and tests as he or she may deem necessary to adequately design the trench safety system(s) he or she will utilize on this Project.
| ____________________________________ |
| (Signature) |
Date: ______________________________
STATE OF FLORIDA
COUNTY OF ___________
________________________ who is personally known to me, the undersigned authority or who produced the following identification ____________________________, and who after first being sworn by me, executed the foregoing instrument by means of ☐ physical presence or ☐ online notarization on this _____ day of _____________________, 20____.
[SEAL] ________________________________
NOTARY PUBLIC
File details come from the government source that posted it. Updated .