This form must be completed and submitted at least 10 days prior to the designated mobilization date. All documents must be uploaded in DOCUMENT format. The form will not allow uploading images.
The Safety Department may take 1 to 3 business days to review your documents and either approve or reject your mobilization request.
No mobilization is permitted without prior approval, and any subcontractor who mobilizes without the official mobilization approval letter will be subject to immediate sanctions.
SECTION #1: Job-Site Specific Accident Prevention Plan
1.- Accident Prevention Plan with scope of work
2.- Key Personnel
3.- Company Emergency Contact List
4.- OSHA 300 A (Last 3 Years)
5.- Appointment Letter
If you do not have a specific form, you may use the following template for your reference. However, the information provided is the sole responsibility of the person submitting this form.
Appointment Letter Template
6.- Activity hazard Analysis. (A.H.A.)
Download, review, and sign the Basic AHA. The content of the AHA is the subcontractor’s responsibility, so any necessary modifications must be made before signing and submitting it.
This AHA is for reference purposes only.
7.- Do you plan to perform work at heights greater than 6 feet at any time using ladders, scaffolds, or any aerial work platform (AWP)?
If your answer is “YES,” then attach the Fall Protection Program. If your answer is “NO,” proceed to the next question.
7.- Do you plan to perform any excavation work at any point during your project?
If your answer is “YES,” then attach the Excavation Safety Plan. If your answer is “NO,” proceed to the next question.
8.- Do you anticipate performing any electrical or demolition work at any stage of your project?
If your answer is “YES,” then attach the LO/TO Program. If your answer is “NO,” proceed to the next question.
9.- Attach a copy of your Certificate of Insurance (COI):?
10.- Safety Data Sheet
SECTION #2: Required Training
1.- OSHA 30. Attach the OSHA 30 certificate of the supervisor assigned to the project. You may add additional OSHA 30 certificates if needed using the additional buttons.
2.- OSHA 10: Attach a PDF document containing all OSHA 10 cards for your workers. Please remember that the OSHA 10 must be the official DOL card—certificates are not accepted unless they include the trainer’s information and a verifiable certificate number.
3.- Attach the First Aid/CPR/AED certificate of at least one worker or supervisor who will be present on-site at all times while your company is performing work on the project.
4.- If you will be performing work at heights, remember to attach the Fall Protection training certificates for your workers. If you will not be performing any work at heights, proceed to the next question.
SECTION #3: Equipment Certification (If Applicable)
1.- Do you plan to use any of the following equipment during your activities on the project?
If you answered “Yes” to any of the previous questions, please attach the certificate(s) of the operator(s) below.
Person Responsible for Submitting the Information:
The person submitting and signing this electronic form declares that they do so in good faith and to the best of their knowledge, understanding that all information must be truthful and authentic. They also assume full responsibility for any incorrect or deliberately false information provided in this form.
Mobilization Checklist
Select your LEGO Co. point of contact — this can be the Superintendent or Project Manager assigned to your project.