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STATUS:
REJECTED
267Q - Marathon Regional Service Center Design and Replace Chiller
General Information
Subcontractor:
Bella Construction of Key West
Subcontractor Project Manager:
Isbaella Braswell
Phone #:
+1 305231521
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?
YES
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 | YES |
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:
Isbaella Braswell
Position:
Project Manager
Email:
Signature:
⚠️ For LEGO CO Safety Department Use ONLY
Observations:
- Please attach the COI including GL and WC.
- Please attach the SDS required for the project.
- Please attach the workers' OSHA 10 certificates.
- Please attach the First Aid/CPR certification for the project supervisor.
- The document attached is only for a forklift and does not include the instructor’s signature or other required information. Please attach your workers’ operator cards. Remember that each piece of equipment requires specific training.
04/09/2026 4:15 PM
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