Project Management forms

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Form preview Exigent health form PROJECT OWNER S CERTIFICATION THAT ALL EXIGENT HEALTH AND SAFETY ITEMS HAVE BEEN CORRECTED SEND OR FAX SIGNED COPY TO LOCAL MF OFFICE Name of Project Owner the Project Owner the owner of Project Name City State Project Number the Project by and through its duly authorized representative identified below hereby certifies that 1. If repairs were not made the dangerous condition was eliminated. This certification is made by the Project Owner and is signed by a duly authorized representative of the Project Owner who is so authorized by reason of his/her position as the State Fully Relationship Between Signer of Certification and Project Owner All of the foregoing statements as well as the date signature and identifying information of the signer and the Project Owner that follows are HEREBY CERTIFIED as true and accurate this day of 20. All Exigent Health and Safety EH S items at the Project have been corrected* Such EHS items include those identified in the Notification of Exigent and Fire Safety Hazards Observed dated. 2. The attached Report accurately identifies the repairs that have been made to correct the EHS items the location of those repairs and the date or dates the repairs were made. All Exigent Health and Safety EH S items at the Project have been corrected* Such EHS items include those identified in the Notification of Exigent and Fire Safety Hazards Observed dated. 2. The attached Report accurately identifies the repairs that have been made to correct the EHS items the location of those repairs and the date or dates the repairs were made.

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