STATUS:
APPROVED
267H1 - Ft. Lauderdale Esp renovations
General Information
Subcontractor:
Thermal Concepts LLC
Subcontractor Project Manager:
Larry Miklolashek
Phone #:
9549313031
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? |
|---|---|---|---|---|
YES | 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:
Gerrie L Marshall
Position:
Director of Safety and Risk management
Email:
Signature:
⚠️ For LEGO CO Safety Department Use ONLY
1.- Please include a simple list of your Key Personnel with names, phone numbers, and emails.
2.- Please submit the OSHA 300A for the year 2024.
3.- Please use the Basic Safety AHA template provided in the form and in the observations email.
09/03/2025 6:40 PM
NEW NOTES///////
1.- CORRECTED
2.- CORRECTED
3.- Please sign and include the name of the competent person on page #14 of the AHA. (new )
09/05/2025 11:19 AM
NEW NOTES///////
1.- CORRECTED
2.- CORRECTED
3.- CORRECTED
MOBILIZATION APPROVED
09/12/2025 10:52 AM