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r <br /> BSK & ASSOCIATES <br /> s . HEALTH AND SAFETY COMPLIANCE <br /> I, the undersigned, have received a copy of the ealth and safety plan for the project identified <br /> below. I have read the plan, understand it, and agree to comply with all of the health and safety <br /> requirements therein. I understand that I may be prohibited from continuing work on the project <br /> for failing to comply. <br /> I have been briefed by a project safety authority on the health and safety requirements of the <br /> project. <br /> PROJECT NUMBER Date of Plan <br /> PROJECT TITLE <br /> FIRM <br /> Print Name Signature Date <br /> Print Name Signature Date <br /> Print Name Signature Date <br /> Print Name Signature Date <br /> Print Name Signature Date <br /> Print Name Signature Date <br /> Print Name Signature Date <br /> �a � <br />