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Waiver of Liability for Asbestos Exposure Rialto Bridge Pre-Bid .pdf

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Waiver of Liability for Asbestos Exposure Rialto Bridge Pre-Bid .pdf Powered By Docstoc
					                          Waiver of Liability for Asbestos Exposure

                                 Rialto Bridge Pre-Bid Meeting

I,                                   , am an owner, employee, or agent of the undersigned
company, which is considering bidding on the Remediation and Demolition Project issued for
bid on January 12, 2011. I understand that access to the interior of the Former Quality Shoe
Building located at 224 East 4th Street in Loveland, Colorado is restricted and regulated due to
damaged and friable asbestos containing materials and debris within the building. I have been
provided with an opportunity to read the Terracon Consultants, Inc. report titled “Asbestos
Survey, Rialto Bridge Project/Former Quality Shoes, 224 East 4th Street, Loveland, Colorado”
dated January 10, 2011, Terracon Project No. 20107030 (“Report”), which describes the extent
of asbestos containing materials within the Former Quality Shoe Building.

I understand that:

    •   Each person who wishes to enter the interior of the Former Quality Shoe Building at the
        pre-bid meeting for a guided tour will be required to wear appropriate personal
        protective equipment (PPE) prior to entry and will be required to provide evidence of
        qualification to use such PPE. Minimum PPE required to enter the Former Quality Shoe
        building includes: a tight fitting air purifying respirator (APR) equipped with high-
        efficiency particulate air (HEPA) filtering cartridges; disposable protective coveralls with
        integrated booties and hood designed to protect against asbestos fibers and dust (such
        as Tyvek® or equivalent); steel-toed boots; hard hat; and safety glasses. Evidence of
        qualification to wear the required PPE includes a copy of a medical examination
        clearing me to wear the APR and a copy of a successful fit test, both completed within
        the past 12 months. Compliance with other relevant U.S. Occupational Safety and
        Health Administration (OSHA) regulations is the sole responsibility of each person and
        his or her employer. [29 CFR 1910.1001]
    •   Each person who wishes to enter the interior of the Former Quality Shoe Building at the
        pre-bid meeting for a guided tour shall have completed within the last 12 months, a
        minimum 2-hour asbestos awareness training course [40 CFR 763.120 and 29 CFR
        1910.1001], or training that meets the requirements of the Model Accreditation Plan [40
        CFR 763 Appendix C]. If a 2-hour asbestos awareness training course is used to meet
        this prerequisite, the training must have emphasized among other things: recognition of
        ACM and PACM, the health effects of asbestos, and ways in which to minimize
        exposure to ACM and PACM that may be damaged and friable.
    •   During the guided tour, each person who has entered the Former Quality Shoe Building
        will be prohibited from eating, drinking, smoking, chewing tobacco or gum, or applying
        cosmetics (including lip balm) while inside of the Former Quality Shoe Building. 29 CFR
        1910.1001]
    •   During the guided tour, no destruction of walls, floors, or other structures or materials
        will be permitted.
    •   After the guided tour, each person who has entered the Former Quality Shoe Building
        will be required to decontaminate their PPE in the following manner:
            o   All coveralls worn during the guided tour will be removed and left within the
                Former Quality Shoe Building. The coveralls will not be returned; rather they will
                be disposed during planned abatement activities.
            o   The City will provide wet wipes to be used to decontaminate APRs worn during
                the guided tour. The wet wipes will be left within the Former Quality Shoe
                Building, and they will be disposed during planned abatement activities.

I understand, affirm, and agree that I voluntarily waive, release, indemnify, hold harmless, and
discharge the City of Loveland, Colorado and Rialto Bridge, LLC, and their respective officers,
employees, owners, managers, agents, and assigns, and their contracted entities, from any and
all liability, claims, demands, actions, rights of actions, or legal proceedings whatsoever, should
I become injured by, or exposed to, asbestos containing materials while in the restricted interior
of the Former Quality Shoe Building. I acknowledge that injury associated with asbestos
exposure can lead to respiratory illness, and that symptoms of exposure may be significantly
delayed in onset.

I have checked the appropriate box below and provided or shown proof of the following
documentation at the pre-bid meeting prior to entering the Former Quality Shoe Building:

    Medical examination clearance for use of an APR
    Most recent fit test
    Most recent certificate from asbestos awareness training or training included in the
     Model Accreditation Plan (i.e., Worker, Contractor/Supervisor, Inspector/Management
     Planner, Project Designer, or Project Monitor)


____________________________________
Printed Name

____________________________________
Signature

____________________________________
Date

       As owner, employee, or agent of the following:

       ____________________________________
       Company Name

       ____________________________________
       Company Address

				
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