36C25019B0019-0002003.docx
DOCX document Posted
- Attached to
- Replace Animal Research Facility Phase 3 - 539-327 Federal contract opportunity
- Solicitation number
- 36C25019B0019
About this file
This document contains a pre-solicitation notice and contractor evaluation form for a federal construction project. The Department of Veterans Affairs is seeking a service-disabled veteran-owned small business to complete phase 3 of replacing an animal research facility at the Cincinnati VA Medical Center. The project scope involves constructing 22,000 square feet of wet labs and administrative spaces attached to an existing building and includes associated finishes, mechanical, electrical and security systems work. All work must be completed within a projected 450-day period of performance. Interested offerors should register at FBO.gov to receive any amendments when the full solicitation is issued around October 16, 2019, with proposals due approximately 30 days later. The pre-award evaluation form requests contracting safety and environmental records from 2015 to present for the NAICS code 236220 commercial and institutional building construction project.
36C25019B0019 0002 Contractor EMR Certification Form.docx
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Pre-Award Contractor Safety and Environmental Record Evaluation Form
Information provided below is current and applicable to Project 539-327:
Company Name: Address: Telephone: Fax: Email: Contact:
1. Utilizing your OSHA 300 Forms, please complete the following information:
| Category |
| 2015 |
| 2016 |
| 2017 |
| 2018 |
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.
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 six-digit North American Industrial Classification System (NAICS) Code for this acquisition: 236220
3. Who administers your company’s Safety and Health Program?
4. Company’s Insurance Experience Modification Rate (EMR):
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