The purpose of this check-off list is to assist university personnel in assessing contractor compliance to state and federal regulations that address occupational and environmental safety.

YES / _ NO

_____ /_____1. Does the contractor have a written LOTO Program that they can provide to the University?

_____/_____2. Are the contractor’s employees provided with locks and tags?

_____ / ____3. Will the University employees need to lockout energy sources in conjunction with the contractor?(If yes – then the University must provide the contractor with a copy of our LOTO Program and notify all parties involved that LOTO will occur.)

_____/_____4.Will entry into a permit required confined space be necessary?

_____ /_____5.Does the contractor have a formal CSE program in accordance with OSHA requirements?

_____/_____6.Does the contractor have the necessary equipment to safely enter the space?

_____/_____7.Has the University supplied information on the hazards associated with the space(s)? (All permit confined space entries on campus must be logged in with the Power Plant prior to entry.)

_____ /_____8.Will the contractor be working on a roof?

_____ /_____9.Does the contractor have a formal fall protection program in accordance with OSHA requirements?

____ /_____10.Does the contractor have the necessary fall protection equipment to safely perform the tasks?

____ /_____11.Is scaffolding going to be used?

____ /_____12.Does the contractor have a scaffold- competent person?

____ /_____13.Will the scaffolding be secured so as to discourage student access?

_____/_____14.Does the contractor have a Trenching/Shoring policy in accordance with OSHA requirements?

_____/_____15.Does the contractor have a soils competent person on staff?

_____ /_____16.Does the contractor have the equipment necessary to safely excavate/trench?

_____ /_____17.Is the contractor prepared to secure any open excavation that may be considered an attractive nuisance?

_____/ _____18. Does the contractor plan to use ANY chemical products on University property?

_____/_____19.Has the contractor provided the University with the Material Safety Data Sheet(s) ?

_____/_____20. Has EH&S been sent copies?

______/_____21. Has the area been inspected for PACM?

______/ _____22. Has the contractor trained his/her employees in asbestos recognition hazards?

______/ _____23. Is sampling for ACM necessary?

______/ _____24. Has prior sampling of this area been done and are the results available?

______/ _____26. Is there a possibility of lead paint?

______/ _____27. Has testing been done?