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Universal Health & Safety Plan <br /> For use on all high-risk,industrial and HAZWOPER projects <br /> Department of Toxic Substances Control <br /> 4. Subcontractor Selection <br /> Performance of the project scope of work DOES involve the use of one or more subcontractors.The requirements for <br /> subcontractor selection and subcontractor safety responsibilities are outlined in AECOM Procedure S3AM-213-PR <br /> Subcontractor Management. The Project Manager is responsible for determining that the subcontractors being selected have <br /> been prequalified to work through the use of Subport or alternately stringent process as specified in the procedure. <br /> 4.1 Subcontractor Pre-Qualification <br /> Ensure all subcontractors including lower tier subcontractors are prequalified to perform work for AECOM. SubPort is the <br /> preferred method for pre-qualifying subcontractors. If a subcontractor is conditionally approved, ensure the subcontractor meets <br /> all conditions of approval. <br /> If a subcontractor requires a variance, complete the Subcontractor Variance form, <br /> Complete the table below, identifying all AECOM-Controlled subcontractors working in the field (any contractor paid directly by <br /> AECOM or otherwise under our responsibility is considered AECOM—Controlled, even if we do not directly control their day-to- <br /> day operations or supervise their work). <br /> GPRS <br /> Subport Supplier Number:88742 <br /> Scope of Work: High-Risk Tasks performed? Contractor Site Safety Officer&Contacts: <br /> Describe Contractor's Scope of Field Work See SWP Cover Sheet for List of High-Risk Tasks Provide Name and Cell Phone <br /> Utility Clearance Z Yes(List) 1. Extreme heat 2. Exposure Casey Kearcher(503)502-4781 <br /> to vehicular traffic <br /> ❑ No <br /> Required Subcontractor Documents: <br /> PM must verify that the following documents are in-place for each subcontractor; check to verify. <br /> • Copy of their Project/Site-specific ■ Copy of task specific THAs/JHAs and ❑x Copy of the signed contract <br /> health and safety plan inspection/tailgate forms <br /> • Copy of their business license and ❑ Copy of their Corporate Safety Z Other Acknowledgement of the <br /> training certificates(task specific) Management Manual cultural sensitivity/resources training <br /> Subport Review: ❑ Approved—Skip to next Subcontractor <br /> ❑X Conditionally Approved- Identify conditions and controls below. <br /> Check`common subport conditions'that apply,add additional conditions,and describe how the conditions will be met <br /> Subport Conditions(check or add any that apply) How will the condition be met? <br /> ❑ AECOM Safety Plan must cover Subcontractor's work, and Subcontractor must <br /> provide a THA for their tasks <br /> ❑X PM must verify that Subcontractor adheres to AECOM safety plan Field oversight and documentation <br /> ❑ Subcontractor variance is required-the form can be found at this link: N/A <br /> https://mvecosystem.aecom.com/ppf/forms/Forms/S3NA 213 FM2 Subcontractor <br /> %20Variance%20Form.docx <br /> ❑X Supervision required AECOM will be onsite <br /> ❑ Special Conditions apply(related to Demolition, Diving, Underbridge Inspection Unit N/A <br /> work, and Rope Access Work <br /> ©AECOM Restricted <br /> Universal Heath and Safety Plan Template(S4(DSC)AM-209-FM-C) 12 <br /> Revision 12 September 9,2021 <br /> PRINTED COPIES ARE UNCONTROLLED.CONTROLLED COPY IS AVAILABLE ON COMPANY INTRANET. <br />