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STATUS:
APPROVED
299A1 - Lawton Chiles ES
General Information
Subcontractor:
V Vid Painting LLC
Subcontractor Project Manager:
Armando Ibarra
Phone #:
407-947-6546
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:
Jairo Alvarenga
Position:
Project Manager
Email:
Signature:
⚠️ For LEGO CO Safety Department Use ONLY
Observations:
- Please provide an adequate Safety Plan.
- Attach the Emergency Contact List. If the list is the same as the Key Personnel, please make sure to change the page title accordingly.
- Properly complete the first page of the Basic Safety AHA.
- Include the appropriate description in the COI.
- Provide the OSHA 30 certification.
- You submitted only one OSHA 10 certificate. Will the work be performed by only one worker? Please confirm the list of workers by email to rq@legocc.com.
- Provide the First Aid and CPR certificate.
09/17/2025 1:07 PM
Observations:
- CORRECTED
- CORRECTED
- CORRECTED
- CORRECTED
- CORRECTED
- CORRECTED
- CORRECTED
10/23/2025 11:30 AM
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