36C25020B0023-005.docx
DOCX document Posted
- Attached to
- Upgrade Exterior Signage 506-19-202
- Solicitation number
- 36C25020B0023
About this file
This document contains a pre-award contractor safety evaluation form and details of a federal contract opportunity for upgrade exterior signage at a Veterans Affairs medical center. The evaluation form requests safety-related information including OSHA recordable incident rates for the past three years, descriptions of any serious violations, and insurance experience modification rates. The signage upgrade opportunity involves assessing and updating exterior traffic and wayfinding signs on the campus to meet VA guidelines. The project scope, 180-day period of performance, NAICS code of 236220 for commercial and institutional building construction, and anticipated award of a firm fixed price contract within 120 days of bid receipt are outlined. Interested contractors are directed to register on the Contract Opportunities website to access solicitation documents for the project scheduled for release on February 20th, 2020.
36C25020B0023 S02 Contractor EMR Certification Form 2018.docx
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Other files
| File | Type | Posted |
|---|---|---|
| 36C25020B0023-0004002.pdf | ||
| 36C25020B0023-0004001.pdf | ||
| 36C25020B0023-0004000.docx | DOCX document | |
| 36C25020B0023-0003001.pdf | ||
| 36C25020B0023-0003000.docx | DOCX document | |
| 36C25020B0023-0002000.docx | DOCX document | |
| 36C25020B0023-0001002.docx | DOCX document | |
| 36C25020B0023-0001001.pdf | ||
| 36C25020B0023-0001003.pdf | ||
| 36C25020B0023-0001000.docx | DOCX document | |
| 36C25020B0023-003.pdf | ||
| 36C25020B0023-004.pdf | ||
| 36C25020B0023-001.docx | DOCX document | |
| 36C25020B0023-006.docx | DOCX document | |
| 36C25020B0023-002.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 36C25020B0023 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 .