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STATUS:
APPROVED
267H1 - Ft. Lauderdale Esp renovations
General Information
Subcontractor:
Superior Electrical Contractors
Subcontractor Project Manager:
Daniel Puente
Phone #:
3053320100
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)?
NO
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? |
|---|---|---|---|---|
YES | YES | 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:
Daniel Puente
Position:
Project Manager
Email:
Signature:
⚠️ For LEGO CO Safety Department Use ONLY
- The attached Safety Plan contains numerous blank pages, which must either be removed or clearly marked as “intentionally left blank.” Additionally, the plan includes illegible pages. Furthermore, the plan is signed by Reynaldo Madiedo II, who is also identified as the Safety Officer representing SECI. Please provide the contact information for this individual, as he is not listed as Key Personnel nor in the Emergency Contact List.
- Please attach the proper OSHA 300A for the year 2024.
- Kindly use the Basic Safety AHA template as indicated in the form.
09/05/2025 10:13 AM
- Provide a safety plan
- Please attach the proper OSHA 300A for the year 2024. NOT CORRECTED
- Kindly use the Basic Safety AHA template as indicated in the form. NOT CORRECTED
09/05/2025 1:43 PM
- CORRECTED
- CORRECTED
- CORRECTED
09/08/2025
MOBILIZATION APPROVED
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