STATUS:
APPROVED
267F1 - Corrections for Rohde Office Towers Restrooms (Phase 1 of 8)
General Information
Subcontractor:
PM Electrical Contractors, Inc.
Subcontractor Project Manager:
Pedro Hernandez
Phone #:
(305) 796-4940
Email:
SECTION #1: Job-Site Specific Accident Prevention Plan
Please download the documents you wish to review.
Key personnel
Emergency List
OSHA 300
Appointment Letter
Basic Safety AHA:
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)?
YES
8.-
Do you plan to perform any excavation work at any point during your project?
NO
9.-
10.-
Do you anticipate performing any electrical or demolition work at any stage of your project?
YES
Attach a copy of your Certificate of Insurance (COI):?
SECTION #3: Equipment Certification (If Applicable)
Do you plan to use any of the following equipment during your activities on the project?
Scissor Lift Use? | Boomlift? | Forklift? | Welder? | Heavy Equipment? |
|---|---|---|---|---|
NO | NO | NO | NO | NO |
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:
Name:
Pedro bernardo Garcia
Position:
President/Owner
Email:
Signature:
⚠️ For LEGO CO Safety Department Use ONLY
Observations:
1.- Attach your company’s LO/TO program in option 9 of the form.
2.- Verify whether you will not be using any chemicals such as adhesives, solvents, cleaning products, or any other items containing chemicals, as these would need to be considered for the SDS.
04/07/2026 2:08 PM
Observations:
1.- CORRECTED
2.- NOTED
04/07/2026 3:30 PM