Visitor Contractor Wellness Check.docx
DOCX document 19 KB Posted
- Attached to
- Chiller Replacement Federal contract opportunity
- Solicitation number
- 12305B21R0010
About this file
This document contains a federal contract solicitation and daily visitor wellness check questionnaire. The United States Department of Agriculture Agricultural Research Service is seeking proposals to replace two chillers at the Beltsville Agricultural Research Center building 001 with a more energy efficient 258-ton chiller. The solicitation is set aside for small businesses with a size standard of $16.5 million. The period of performance is 142 days from notice to proceed. Bid, payment, and performance bonds are required. Questions are due by May 7th.
The visitor wellness check questionnaire requires all visitors and contractors to confirm their contact information and answer health screening questions daily before entering USDA facilities. Questions address COVID-19 symptoms, travel history, and potential exposure to infected individuals.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| ON SITE SIGN IN SHEET FOR SITE VISIT FOR REPLACEMENT OF CHILLERS.pdf | ||
| Modification 0005.pdf | ||
| Questions and Answers 2.pdf | ||
| 12305B21R0010 Amendment 0005.pdf | ||
| Solicitation Amendment 0003.pdf | ||
| Mechanical Plans 2.pdf | ||
| 12305B21R0010 Amendment 0002.pdf | ||
| Questions and Answers 1.pdf | ||
| Solicitation Amendment.pdf | ||
| 12305B21R0010.pdf | ||
| REV. #1 SOW FOR BUILDING #001 258 TON CHILLER #2 REPLACEMENT.docx | DOCX document | |
| Mechanical Plans.pdf | ||
| Wage Determination.pdf | ||
| Submittal Register For Bldg. #001 Chiller Replacement Project W.O. #2104443.doc | DOC document | |
| CHILLER-2 - Certified Drawing(1).docx | DOCX document | |
| ARS371.pdf | ||
| ARS372.pdf | ||
| Attachment 6 Sample COVID Safety Plan.pdf |
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Text version
ARS, Northeast Area Mission Critical/Time Sensitive Activities During Pandemic Visitor/Contractor Daily Wellness Check Questionnaire
All Visitors and Contractors entering or performing work at a USDA/Agricultural Research Service facility must complete a “Wellness Survey” each day they are onsite (some locations may use the ARS Check Survey in addition to this form) and before entering a building or facility. Should the Visitor/contractor respond “Yes” to a question they will be interviewed by the “Location Pandemic Coordinator” or their alternate to seek clarification on the “Yes” response. Based on the clarification, the individual(s) may not be allowed access to the facility.
Visitors/Contractors please provide the following contact Information:
Name:
Business:
Contact Number:
E-Mail Address:
Location POC
Purpose of Visit:
Wellness Check – Please answer the following questions to the best of your knowledge for the current day.
1. In the last 14 days, have you traveled to or from a region outside of your regular commuting area where local ordinances required quarantine or other COVID-19 related travel mandates (e.g., test results, travel form/registration)?
Yes / No
2. Have you been diagnosed with, or experienced any symptoms of COVID-19 in the past 14 days or since last check in, including the following: fever (100.4 degrees F or greater), or chills, cough, loss of taste or smell, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, sore throat, congestion or runny nose, nausea or vomiting, diarrhea?
Yes / No
3. Have you had close contact with anyone diagnosed with COVID-19 or showing symptoms of COVID-19 within the past 14-days? Close contact is defined as being within six feet of a person for more than 15 minutes.
Yes / No Please return the completed questionnaire to your Point of Contact at the location on the day of arrival. If you have any questions, please contact them in advance of your arrival.
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10/8/2020 8:21 AM
File details come from the government source that posted it. Updated .