Injury Illness Prevention Plan - Flipbook - Page 78
Health and Safety Program Manual
Teamwrkx
Construction, Inc.
Issue Date: 10/16/23
Revision Date: 10/16/23
Subcontractor Safety Management
Reference: S-1
Attach the certificate provided by your insurance carrier.
ADDITIONAL INFORMATION
Please list any additional information that you feel will help us determine your firm’s qualifications and
expertise:
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
This Pre-qualification Questionnaire was completed by:
Name: ________________________ Title: _____________________
Date: _________________________
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