36C25020B0011-009.docx
DOCX document Posted
- Attached to
- P400--Demolish Buildings 25, 42, 122 610-18-101
- Solicitation number
- 36C25020B0011
About this file
This document contains a pre-award contractor safety and environmental record evaluation form and details of a related federal contract opportunity for demolition services. The pre-award form requests a contractor's OSHA 300 forms from 2017 to 2019 including man hours, days away from work cases, and DART rates. It also requests copies of OSHA 300A forms, the contractor's NAICS code, safety program administrator, and insurance EMR.
The federal contract opportunity is a 100% SDVOSB set-aside issued by the VA for demolition of Buildings 25, 42, and 122 at the Northern Indiana VA Medical Center. The solicitation number is 36C25020B0011 and the project is 610-18-101. The NAICS code is 236220 for the $2-5 million project. The solicitation will be posted on April 28, 2020 on SAM.gov and proposals will be due approximately 30 days later. The selected contractor must be able to provide safety and environmental violations records and have an EMR less than 1.0. The duration of the project cannot exceed 365 days from NTP. Payment and performance bonds will be required.
36C25020B0011 EMR Attachment.docx
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Wage Determination.pdf | ||
| 36C25020B0011 0001.pdf | ||
| BID SCHEDULE.pdf | ||
| 36C25020B0011-006.pdf | ||
| 36C25020B0011-004.pdf | ||
| 36C25020B0011-005.pdf | ||
| 36C25020B0011-007.pdf | ||
| 36C25020B0011-010.docx | DOCX document | |
| 36C25020B0011-003.docx | DOCX document | |
| 36C25020B0011-008.pdf |
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Text version
Pre-Award Contractor Safety and Environmental Record Evaluation Form Information provided below is current and applicable to Solicitation 36C2520B0011.
Company Name: ______________________________________________ Address: _____________________________________________________ Telephone: ______________________ Fax: ________________________ Email: _______________________________________________________ Contact: ______________________________________________________
1. Utilizing your OSHA 300 Forms, please complete the following information:
| Category |
| 2017 |
| 2018 |
| 2019 |
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: __________________________________ |
| 3. | Who administers your company’s Safety and Health Program? ____________________________ |
| 4. | Company’s Insurance Experience Modification Rate (EMR): ____________________________ |
File details come from the government source that posted it. Updated .