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STATUS:
REJECTED
299A1 - Lawton Chiles ES
General Information
Subcontractor:
VMG Mechanical LLC
Subcontractor Project Manager:
Brandon Hillard
Phone #:
4077393798
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?
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? |
|---|---|---|---|---|
YES | NO | YES | YES | 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:
Brandon Hillard
Position:
Project Manager
Email:
Signature:
⚠️ For LEGO CO Safety Department Use ONLY
Observations:
- Please correct the Appointment Letter; the document you sent is the template provided by LEGO without any modifications.
- Use the Basic Safety AHA template provided in the form.
- Correct the description on the COI.
- Submit the OSHA 10 certificates for your workers.
- Submit the operator’s certificate for the forklift.
- Submit the welder’s certificate or the continuity log.
09/30/2025 2:38 PM
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