36C24718R0307-0001004.docx
DOCX document 17 KB Posted
- Attached to
- VISN 7 CONSTRUCTION MATOC - BLUE CORD DESIGN AND CONSTRUCTION Federal contract opportunity
- Solicitation number
- 36C24718R0307
About this file
This notice announces an upcoming request for proposal for a Multiple Award Task Order Contract for construction services. The Veterans Affairs Veterans Integrated Service Network 7 intends to award approximately eighteen indefinite delivery indefinite quantity contracts to qualified small businesses for a total contract value not to exceed $500 million over five years. The North American Industry Classification System code is 236220 and the small business size standard is $36.5 million. This is a 100% set-aside for Service-Disabled Veteran Owned Small Businesses. The scope of work will include a broad range of construction, maintenance, alteration, and repair services at Veterans Affairs medical facilities in VISN 7. Task orders will range in value from $2,000 to $20 million and be awarded on a best value basis according to Federal Acquisition Regulation Part 15.3 procedures. The solicitation is expected to be released on or around March 30, 2018 and will include seed projects for pricing and technical evaluation.
36C24718R0307 0001 ATTACHMENT 5 - EXPERIENCE MODIFICATION RATE FORM.docx
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Other files for this federal contract opportunity
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|---|---|---|
| 36C24718D0134-001.docx | DOCX document | |
| 36C24718D0134-000.docx | DOCX document | |
| 36C24718R0307-0004000.docx | DOCX document | |
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| 36C24718R0307-0002005.pdf | ||
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Text version
Attachment 5 Experience Modification Rate Form Offeror To Complete & Submit With Proposal
Company Name: ______________________________________________ Address: _____________________________________________________
Telephone: ______________________ Email: _______________________________________________________ Contact: ______________________________________________________
1. Utilizing your OSHA 300 Forms, please complete the following information:
| Category |
| 2015 |
| 2016 |
| 2017 |
Number of man hours (jobsite and office).
Number of cases involving days away from work, restricted activity, or both (Column H and I of OSHA 300).
Days away, restricted, or transferred rate (# of days away, restricted, or transferred cases x 200,000/# of man hours) (DART Rate).
Number of serious, willful, or repeat violations from OSHA within the last 3 years. Please attach explanation for any violations. (Four serious, one repeat, or one willful disqualifies the contractor.)
Please attach copies of the following documents: OSHA 300 and 300a Forms. These forms can be accessed through the OSHA publications search page: http://www.osha.gov/pls/publications/publication.html.
| 2. | Provide your six-digit North American Industrial Classification System (NAICS) Code for this acquisition: __________________________________ | |
| 3. | Who administers your company’s Safety and Health Program? __________________________________ | |
| 4. | Company’s Insurance Experience Modification Rate (EMR) for the past 3 years (an EMR of | greater than 1.0 may disqualify the offeror): _____________ |
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