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STATUS:
APPROVED
267H1 - Ft. Lauderdale Esp renovations
General Information
Subcontractor:
Jumep Multy Services LLC
Subcontractor Project Manager:
Emmanuel Lataillade
Phone #:
561-309-6405
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?
NO
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:
Emmanuel Lataillade
Position:
Operations Manager
Email:
Signature:
⚠️ For LEGO CO Safety Department Use ONLY
Mobilization Not Approved:
- The OSHA 300 logs must be printed, signed, and scanned, with the correct information. Please remember that the OSHA 300 is only required for companies with 10 or more employees on payroll.
- The COI does not include Workers’ Compensation.
- The Basic Safety AHA was not properly completed. It must include the project information and all relevant details.
//////// NEW NOTES///////
- The OSHA 300 was not reviewed again since the company has fewer than 10 employees.
- The subcontractor corrected the COI.
- The BASIC SAFETY AHA was submitted properly.
MOBILIZATION HAS BEEN APPROVED
08/14/2025 1:37 PM
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