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W ,oro. <br /> WASTE MANAGEMENT <br /> CONTRACTOR'S SAFETY DECLARATION <br /> As the duly authorized representative and agent of , hereinafter called "Contractor", I hereby certify <br /> and agree for myself and for and on behalf of Contractor that: <br /> 1. Contractor shall have all of its agents and employees who will work on site complete all four (4) <br /> of the mandatory Contractor Safety Orientation (CSO) courses identified below before they <br /> are allowed to work. This is an automated program the Contractor will implement from their own <br /> office prior to bringing employees to the Waste Management job-site. Upon completion of the <br /> CSO, Contractor's agents and employees shall print and retain the ID Card and keep it with them <br /> at all times. <br /> • Basic Landfill Electrical Safety Landfill Gas Operations <br /> 2. In addition to the CSO course(s) checked above, Contractor has received an orientation briefing <br /> including, but not limited to, the site-specific Health and/or Safety Rules, accident/injury reporting, <br /> emergency procedures and potential hazards in the Contractor's work area and has reviewed the <br /> site-specific rules provided for the site where the work will be performed as provided in the on-line <br /> training program; <br /> 3. Contractor shall instruct all of its agents and employees in the topics covered at the above <br /> orientation, before its agents and employees are allowed to work on site; <br /> 4. Contractor has received a written copy of the site-specific Health and/or Safety Rules and shall <br /> ensure that its employees and agents comply with those rules, as well as any applicable federal, <br /> state and local health and safety regulations; <br /> 5. Contractor shall provide any required respirators and personal protective equipment for its <br /> employees and agents working on the property; <br /> 6. Contractor employees have been medically qualified, as may be required by state and federal <br /> regulations, to perform their work assignments (including the wearing of respirators and personal <br /> protective equipment); <br /> 7. Contractor employees have received training, in accordance with applicable OSHA regulations, in <br /> appropriate health and safety topics (including, but not limited to, respiratory protection, hearing <br /> conservation, hazard communication and equipment operation); <br /> 8. Contractor performs maintenance on owned or lease vehicles and equipment, as per state and <br /> federal regulations. Known defects will be repaired prior to operation and, as defects become <br /> apparent during equipment operation, the equipment will be taken out of service until repairs are <br /> made. <br /> Contractor's Health and Safety Form 1 Oct-16 <br /> Ver. 2.0 <br />