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STATUS:
APPROVED
273 D -PBS-UB Kinsey-Palmview ES FCA Renovations
General Information
Subcontractor:
Stryker Electrical Contracting, LLC
Subcontractor Project Manager:
KEVIN JULIANO/LAMAYA JENNINGS
Phone #:
7722193389
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?
YES
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 | YES | 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:
LaMaya Jennings
Position:
Assistant Project Manager
Email:
Signature:
⚠️ For LEGO CO Safety Department Use ONLY
Observations:
- Attach the complete Safety Plan of Stricker Electric in digital format. We have worked with this subcontractor in the past, and I understand that the company has a good safety plan. I am not sure why the company’s safety plan was not attached.
- Attach the appropriate plans in the sections that request specific safety plans, such as the Lockout/Tagout (LO/TO) plan. The document you submitted does not constitute an adequate LO/TO safety plan.
- In the CPR certificate section, attach only valid CPR certificates that are current and less than two years old.
03/17/2026 10:00 AM
- CORRECTED
- CORRECTED
- NOTED
03/25/2026 10:17 AM
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