Att_9.5_CELRB_Crane_Certificate_of_Compliance.doc

CERTIFICATE OF COMPLIANCE

This certificate shall be signed by an official of the company that provides cranes for any application under this contract. Post a completed certificate on each crane utilized during this contract

PRIME CONTRACTOR/PHONE

CONTRACT NUMBER

CRANE SUPPLIER/PHONE

(if different from prime contractor)

CRANE(S) NUMBER

(i.e., ID number)

CRANE MANUFACTURER/TYPE/CAPACITY

CRANE OPERATOR'S NAME(S)

I certify that

1. The above noted crane and associated rigging gear conform to applicable USACE & OSHA regulations and applicable ASME B30 standards. The following USACE, OSHA regulations and ASME standards apply: EM 385-1-1, 29 CFR 1910.180 & B30.8-2004

2. The operators noted above have been trained and are qualified for the operation of the above noted crane(s).

3. The operators noted above have been trained not to bypass safety devices during lifting operations.

COMPANY OFFICIAL SIGNATURE

DATE

COMPANY OFFICIAL NAME/TITLE

POST ON CRANE

(IN CAB OR VEHICLE)