36C25518R0049-00003000.docx

5. PROJECT NUMBER (if applicable)

CODE

7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER

3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE

OF PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO.

1. CONTRACT ID CODE

FACILITY CODE

CODE

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office.

is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

BY

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER

16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30

PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243 (Type or print) (Type or print) (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code) (If other than Item 6) (Specify type of modification and authority) (such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer) 00003 02-02-2018 657-343 36C255 Department of Veterans Affairs Network Contracting Office (NCO) 15 3450 S 4th Street Trafficway Leavenworth

KS

66048 36C255 Department of Veterans Affairs Network Contracting Office (NCO) 15 3450 S 4th Street Trafficway Leavenworth

KS

66048 To all Offerors/Bidders

36C25518R0049 02-02-2018

X X X X Project 657-343, Structural Improvements to Bldg. 42 in Marion VA Medical Center, IL.

The above cited solicitation is hereby amended as follows:

1. Provide the answers to the Request for Information (RFI) as seen on pages 2 and 3.

2. Provide changes to the solicitation as seen in the summary of changes in pages 4 and 5.

3. Replaces the Proposal Submittal Instructions in its entirety to reflect changes in the summary of changes above.

4. The solicitation/proposal due date remains the same (February 22, 2018).

VA Marion Structural Improvements to Bldg 42, Marion IL 657-343

SOLICITATION # 36C25518R0049

Provided in red text are the answers for following RFIs that were received for the Structural Improvements project in Marion, IL:

1. GI101 brace B, will this entire area be turned over to contractor or will it be sectioned off? Will this be determined by the COR or proposed options from the contractor?

RESPONSE: Completion of work at Brace B is identified by the Phasing Sequencing Notes on GI101. Per Note 5 – Brace A, Brace B, and the Elevator/Building Connection are considered sub-parts of one overall phase and shall be completed simultaneously. Contractor will be required to build temporary partitions to separate the overall phase from adjacent occupied spaces as indicated. Sub-phases completed early may be turned back over to the VA. Any changes to the phasing will need to be coordinated between the VA COR and the contractor.

1. Brace B who is the security provider for the pharmacy for security connection to system for construction?

RESPONSE: Siemens.

1. In pharmacy area, where the alarms are to be connected, please provide types and number of devices the government is requiring to be active, (i.e. Door alarms, Motion sensors, or breaking devices.)

RESPONSE: All devices are required to be active.

1. Please proved the manufacturer of the existing alarm system and who is responsible for its current maintenance in the Pharmacy area.

RESPONSE: Siemens.

1. AD101 Brace N (Corridor 100 and stair 42-2) Where stairwell be closed for construction, will ILSM (interim Life Safety Measures) be required since fire rating of stairwell will be compromised during construction?

RESPONSE: Yes.

1. AD 101 Imaging viewing room, who will be responsible for relocation of radiology viewing stations?

RESPONSE: Please clarify the location of the equipment in question. Provide room number of space housing the radiology viewing stations. If this is in reference to Radiologist BC129 and Chief BC130, the general contractor shall remove and reinstall all wall mounted equipment. Coordinate with other trades for disconnection and reconnection requirements.

1. All HEPA units exhaust to exterior of building, please verify exterior wall type. Is it EIFS or another system?

RESPONSE: Exterior wall type consists EIFS over cementitious board over structural substrates. Exterior partition types are detailed on AI600.

1. In #7 above penetration will require patching, these areas will require repainting or coating. Please provide direction on limits of areas to be repaired and recoated.

RESPONSE: Routing of HEPA filtration exhaust and resultant penetrations required for the exhaust will be determined by the contractor in conjunction with the VA. It will be the responsibility of the contractor to determine the extent of the opening required. At the exterior, openings shall be cut neatly between joints in the EIFS and patched to match adjacent surfaces. Recoat between the nearest vertical and horizontal joints of the existing EIFS system to match existing. Interior, openings shall be cut as required and patched to match existing surfaces. Paint the entire interior wall impacted by the penetration from corner to corner, floor to ceiling.

1. On exterior wall systems, provide any specification on existing system and coating system?

RESPONSE: Exterior wall system is EIFS over cementitious board. Exact system is unknown. Thicknesses vary.

1. On Sheet AI601, remove and repair (or replace) existing handrail and crash rail. Can the government provide existing manufacture and style of existing material?

RESPONSE: The manufacture of the existing material is Impro. The style is product number 1100.

1. Noise generating activities (i.e. Slab demolition and removal) what are the thresholds for excessive limits? Will this work be required for off hours? Some of this work may be in the pharmacy area with work time limited to business hours, how will this be addressed during construction?

RESPONSE: It is likely that slab demolition and removal will be required to be completed during off hours. Restrictions to pharmacy hours and noise generating activities will need to be coordinated during construction. It is anticipated that this work will be completed during off hours and will require the presence of pharmacy representative from the VA. VA to confirm thresholds for excessive limits and pharmacy requirements.

1. Sheet MD401 Note 4 Remove existing oxygen line where in conflict with rework? This is the building backup oxygen piping, what is required from contractor for removal? Will VA be responsible for getting redundant system in operation or contractor to provide alternate route for re-connection during construction? This is on the ground floor level.

RESPONSE: Contractor to provide temporary alternate route during time of shutdown.

QUESTIONS FOR CONTRACTING OFFICER:

1. On page 13 of the Solicitation it states that “Pricing is to be submitted on Page 3 of the Standard Form 1442,” however, there is no 3rd page of the SF 1442 and in Block 17 of the SF 1442 it states that “Pricing to be completed on page 7.” Please clarify where pricing is to be entered.

RESPONSE: page 13 d will be revised to read “Pricing is to be submitted on Pages 6 and 7 of the solicitation. The block 17 of the SF-1442 will be corrected to read “Pricing to be completed on pages 6 and 7” in the amendment to the solicitation.

SUMMARY OF CHANGES – SOLICITATION # 36C25518R0049

(Changes made is highlighted) The Solicitation documents number of pages, first page of SF-1442 has changed from:

PAGE OF PAGES 1 of 111 The Solicitation documents number of pages, first page of SF-1442 has changed to:

PAGE OF PAGES 1 of 114

At Block 17 of the SF-1442 the following has changed from:

See page 7 For Bid Items and Descriptions Pricing to be completed on page 7.

At Block 17 of the SF-1442 the following has changed to:

See pages 6 and 7 For Bid Items and Descriptions Pricing to be completed on pages 6 and 7.

At PROPOSAL SUBMITTAL INSTRUCTIONS changes made as follows:

In page 13, paragraph 2d. PRICE PROPOSAL has changed from:

Pricing is to be submitted on Page 3 of the Standard Form 1442. Offerors must provide a price for each bid item. In addition, offerors shall include a breakdown of material and labor costs, by specification division for each bid item. Overhead, profit and bond costs shall be added after a subtotal of materials and labor costs has been calculated.

Note: It is intended that award will be made on bid items # 1 but in the event the bid exceeds the funds available, a single award will be made to one of the deducts 2-5.

In page 13, paragraph 2d. PRICE PROPOSAL has changed to:

Pricing is to be submitted on Pages 6 and 7 of the solicitation. Offerors must provide a price for each bid item. In addition, offerors shall include a breakdown of material and labor costs, by specification division for each bid item. Overhead, profit and bond costs shall be added after a subtotal of materials and labor costs has been calculated. See Appendix 1.

Note: It is intended that award will be made on bid item # 1 but in the event the bid exceeds the funds available, a single award will be made to the deduct item 2.

In page 14, paragraph 5 (1) has changed from:

1.) All Bidders/Offerors shall submit information pertaining to their past Safety and Environmental record. The information must contain a certification that the bidder/offeror has no more than three (3) serious, or one (1) repeat or one (1) willful OSHA or any EPA violation(s) in the past three years. If such certification cannot be made, a Bidder/Offeror shall explain why and submit as much information as possible regarding the circumstances of its past safety and environmental record, including the number of EPA violations and/or the number of serious, repeat, and/or willful OSHA violations, along with a detailed description of those violations.

In page 14, paragraph 5 (1) has changed to:

1.) All Bidders/Offerors shall submit information pertaining to their past Safety and Environmental record. See Appendix 2. The information must contain a certification that the bidder/offeror has no more than three (3) serious, or one (1) repeat or one (1) willful OSHA or any EPA violation(s) in the past three years. If such certification cannot be made, a Bidder/Offeror shall explain why and submit as much information as possible regarding the circumstances of its past safety and environmental record, including the number of EPA violations and/or the number of serious, repeat, and/or willful OSHA violations, along with a detailed description of those violations.

End of Summary of Changes

PROPOSAL SUBMITTAL INSTRUCTIONS

FOR LOWEST PRICE TECHNICALLY ACCEPTABLE COMPETITION

SOLICITATION: 36C25518R0049

PROJECT: Structural Improvements to Building 42 Project No. 657-343 LOCATION: Department of Veteran Affairs, Marion VAMC, Illinois

1. PREPARATION AND SUBMITTAL OF PROPOSALS

a. GENERAL INFORMATION.

Selection of an offeror for contract award will be made on the basis of an assessment of each offeror’s response to the Request for Proposal (RFP). As a Request for Proposals (RFP) based on Lowest Price Technically Acceptable (LPTA) Source Selection Process, in accordance with Federal Acquisition Regulation (FAR) Part 15.101-2, the VA will make the award based on the lowest evaluated price of proposals meeting or exceeding the acceptability standards for non-price factors. The FOUR (4) evaluation factors for determination of technical acceptability consist of:

See “ DOCUMENTATION OF TECHNICAL ACCEPTABILITY” below:

NOTE: Failure to comply with the RFP submittal requirements will be grounds to eliminate the proposal from further consideration for contract award.

b. THE OFFER.

The submission of the documentation specified below will constitute the Offeror’s acceptance of the terms and conditions of the RFP, including the Plans & Specifications for the construction of this project. These instructions prescribe the format for the proposal, and describe the approach for the development and presentation of proposal data. These instructions are designed to ensure the submission of necessary information to provide for the understanding and comprehensive evaluation of proposals.

c. AWARD BASED ON INITIAL OFFERS.

Pursuant to clause 52.215-1 (included by reference), the Government intends to evaluate proposals and award a contract without discussions with offerors (except clarifications as described in FAR 15.306(a)). Therefore, the offeror’s initial proposal should contain the offeror’s best terms from a price, and technical qualifications standpoint. The VA reserves the right to conduct discussions if the Contracting Officer later determines such discussions to be necessary.

d. NUMBER OF COPIES TO SUBMIT. Offerors shall submit a single package to the address shown in Block 8 of the Standard Form 1442. The package shall include both the originally signed paper hard copies and a separate compact disc (CD) containing copies of the originally signed paper hard copies. The package shall include the following:

Package shall be marked as follows:

ORIGINAL -RESPONSE TO RFP 36C25518R0049

Structural Improvements to Building 42, PROJECT # 657-343 This package is to contain the signed original copies of the documents listed below:

2. DOCUMENTS TO SUBMIT.

Documents to be included in the proposal identified above shall consist of:

The following NON-PRICE Evaluation Factors will be used as the basis for determining Technical Acceptability:

1. Relevant Past Performance of Prime Contractor;

2. Technical Construction Experience of Prime Contractor;

3. Technical Qualifications of Proposed Staffing;

4. Prime Contractor’s Safety Plan.

NOTE: There is a possibility that some offerors may choose to submit the same construction project as a qualifying example for both the past performance and the technical experience evaluation factors. This is not prohibited, but the supporting documentation must demonstrate that the submitted projects absolutely do comply with the specific minimal requirements, identified below, for each separate evaluation factor.

FACTOR 1: RELEVANT PAST PERFORMANCE OF PRIME CONTRACTOR.

To be technically acceptable, Offerors should identify no less than one (1), and no more than FIVE (5), relevant, previously-awarded, and completed construction contracts, which were issued by either: Federal, State, or Local Government Agencies; and/or Private Organizations that demonstrate the Offerors ability to successfully complete this project in an acceptable fashion. To be evaluated as Relevant Past Performance, the construction contracts submitted by offerors must reflect:

A. Construction work, at a hospital or medical facility, as a prime contractor that is similar in scope to the work required under this contract; (NAICS Code: 236220– Commercial and Institutional Building Construction), that was equal to or greater than $6,000,000.00;

B. Work that was 100% completed within a time period of no more than FIVE (5) years prior to the date of submitting this proposal. If the contract/work is incomplete, or was completed more than five years prior to the date of submitting this proposal, it will not be deemed relevant and will not be considered.

C. To be considered Technically Acceptable, relevant past performance must be rated satisfactory or better.

For each of the submitted Relevant Past Performance contracts, provide the following information. :

Factor 1 SPECIAL NOTE 1 for Offerors That May Lack Past Performance Information: In accordance with FAR Part 15.305(a)(2), in the case of an offeror that is without a record of relevant past performance, or for whom information on past performance is not available, the offeror may not be evaluated favorably or unfavorably on past performance. Such offerors may submit relevant past performance information regarding: predecessor companies; key personnel who have relevant experience; or subcontractors that will be performing major or critical aspects of this requirement; provided that such information is relevant to the construction in this solicitation.

Factor 1 SPECIAL NOTE 2 for Offerors that have Past Performance: Offerors may provide information on problems encountered on the identified contracts and the offeror’s corrective actions. The government also reserves the right to consider past performance information from all available sources, in addition to any information submitted by offerors.

FACTOR 2: TECHNICAL CONSTRUCTION EXPERIENCE OF PRIME CONTRACTOR.

To be Technically Acceptable, offerors must provide evidence that they have the technical qualifications and experience needed to meet the technical performance requirements of this project. Offerors must submit no less than TWO (2) and no more than FIVE (5), examples of their successful technical construction experience with projects that involved technical requirements similar to the requirements of this project that were previously-awarded, and completed. The construction project submitted must involve:

D. Work that was of a similar nature to the scope of work for this project. This is defined as work performed at a Patient Care Area of an active and occupied Hospital or Medical Facility. If an offeror chooses to submit experience that was not conducted at Patient Care Area of a Hospital or Medical Facility, they must explain how the nature and complexity of the work conducted involved technical construction requirements equivalent to that described in the Plans & Specifications of this solicitation.

(Note: If submitting as a Prime/Sub teaming arrangement under FAR 9.601(2), the designated prime must meet the specific requirements of Factor 2A and 2B in order for the teaming arrangement to be deemed acceptable. Subcontractor experience will not be considered.)

FACTOR 3: TECHNICAL QUALIFICATIONS OF PROPOSED STAFFING.

To be Technically Acceptable, qualified offerors must submit a detailed resume of each key individual on the Prime contractor’s staff for his project. To promote maximum continuity on this project, key staffing positions are not to be subcontracted out. This factor will be evaluated to determine if they have the appropriate technical training and or previous construction experience to meet the technical requirements of the key staffing positions for a project of this nature. No one individual can perform more than two of the key staffing positions below:

(a) Project Manager – Must have a minimum of 5 years of experience as a project manager and must provide a minimum of 2 projects with similar scope to this project. Provide the name of the construction contract, and the contract ID number; The name of the contracting agency or organization the contract was awarded by; The date of the construction contract award and the contract award amount in dollars; The date of the construction contract completion, and the final contract amount, in dollars; A brief description of the construction contract scope of work; Identification of at least one point-of-contact at the organization that awarded the submitted contract, including: the name of the point-of-contact; their current mailing address; phone number; and email address (if applicable).

b) Quality Control manager –Provide a minimum of 2 projects with similar scope of this project that they have acted as the QC manager. Provide the name of the construction contract, and the contract ID number; the name of the contracting agency or organization the contract was awarded by; and the date of the construction contract award. A brief description of the construction contract scope of work and the QC program that was implemented.; Identify at least one point-of-contact at the organization that awarded the submitted contract, including: the name of the point-of-contact; their current mailing address; phone number; and email address (if applicable).

(c) Safety Officer – Must provide a list of safety training completed by the safety officer, which includes at a minimum; life safety, excavation safety, scaffold safety, OSHA 30, fall protection training, crane/rigging safety (Provide OSHA 30 Training Certificate, proof of other training shall be available upon request). Must have a minimum of 5 years of experience as a safety officer. Provide a minimum of 2 projects with similar scope of this project. Provide the name of the construction contract, and the contract ID number; The name of the contracting agency or organization the contract was awarded by; Provide a brief description of the construction contract scope of work and how the safety program was implemented; Identify at least one point-of-contact at the organization that awarded the submitted contract, including: the name of the point-of-contact; their current mailing address; phone number; and email address (if applicable).

(d) Site Superintendent – Must have minimum of 5 years of experience as a site superintendent and must have OSHA 30 training (provide OSHA 30 Training Certificate). Provide at least 2 projects as a site superintendent with similar scope of this project. Provide the name of the construction contract, and the contract ID number; The name of the contracting agency or organization the contract was awarded by; The date of the construction contract award and the contract award amount in dollars; The date of the construction contract completion, and the final contract amount, in dollars; A brief description of the construction contract scope of work; and Identification of at least one point-of-contact at the organization that awarded the submitted contract, including: the name of the point-of-contact; their current mailing address; phone number; and email address (if applicable).

Special Note: During the period of performance of the Contract, the Contractor shall make NO substitutions of the Staffing unless the substitution is necessitated by illness, death, or termination of employment. The contractor shall notify the contracting officer, in writing, within five (5) calendar days after the occurrence of any of these events. Any replacement of Staffing shall have equal or better qualifications, subject to the approval by the contracting officer.

FACTOR 4: PRIME CONTRACTOR SAFETY PLAN

Offerors must provide a construction safety plan that is deemed acceptable and meets the following requirements:

a. The contractor's Safety Plan shall be evaluated for their compliance with local/State/Federal rules and regulations and the company's consideration of safety of its employees and the general public. The contractor's Safety Plan at the minimum shall address their safety policy, commitment to safety, detailed disciplinary action to be taken with respect to employees violating safety requirements, personnel safety responsibilities, personnel safety training, personal protective equipment, accident / incident reporting procedure and investigations, emergency procedures guidelines.

b. The contractor’s Safety Plan shall address their plan for completing all contract work on and around an active hospital without impacting patient care and completing all work in accordance with all construction documents and all local/State/Federal rules and regulations.

Note: It is intended that award will be made on bid item # 1 but in the event the bid exceeds the funds available, a single award will be made to the deduct item 2.

3. BASIS OF AWARD.

VA will make the award based on the lowest evaluated price of proposals meeting or exceeding the acceptability standards for non-price factors. Note that offers that are not technically acceptable cannot be selected, regardless of price.

4. Special Contract Requirements

SUBSTITUTIONS OF SUBCONTRACTORS AND / OR KEY PERSONNEL

1. When an offeror submits its proposal in response to this Request For Proposals, and key personnel who are proposed to work on the project are required to be submitted, those personnel who are offered will be the same personnel who will actually perform on the project. If, during performance of the contract, it becomes necessary for the contractor to substitute personnel for one of those whose qualifications were the basis for evaluation of the offer and award of the contract, the contractor shall submit to the Contracting Officer the same information that was required in the initial proposal regarding the proposed substitute employee. The Contracting Officer shall have the right to review the qualifications of the proposed substitute employee and to approve or disapprove his or her qualifications. If the proposed substitute employee's qualifications are disapproved by the Contracting Officer, the contractor will propose another employee who does possess equivalent qualifications.

2. When an offeror submits its proposal in response to this Request For Proposals, and the name and experience of a specific subcontractor is a required evaluation factor, then that subcontractor who is offered will be the same subcontractor who will actually perform the specified work on the project. If, during performance of the contract, it becomes necessary for the contractor to substitute a subcontractor for one of those whose qualifications were the basis for evaluation of the offer and award of the contract, the contractor shall submit to the Contracting Officer the same information that was required in the initial proposal regarding the proposed substitute subcontractor. The Contracting Officer shall have the right to review the qualifications of the proposed substitute subcontractor and to approve or disapprove its qualifications. If the proposed substitute subcontractor's qualifications are disapproved by the Contracting Officer, the contractor will propose another subcontractor who does possess equivalent qualifications.

5. ADDITIONAL PRIME CONTRACTOR SAFETY OR ENVIRONMENTAL VIOLATIONS AND EXPERIENCE MODIFICATION RATE See – Contractor Certification Regarding Safety and Environmental

1.) All Bidders/Offerors shall submit information pertaining to their past Safety and Environmental record. See Appendix 2. The information must contain a certification that the bidder/offeror has no more than three (3) serious, or one (1) repeat or one (1) willful OSHA or any EPA violation(s) in the past three years. If such certification cannot be made, a Bidder/Offeror shall explain why and submit as much information as possible regarding the circumstances of its past safety and environmental record, including the number of EPA violations and/or the number of serious, repeat, and/or willful OSHA violations, along with a detailed description of those violations.

2.) All Bidders/Offerors shall submit information regarding their current Experience Modification Rate (EMR). This information shall be obtained from the Bidder’s/Offeror’s insurance carrier and be furnished on the insurance carrier’s letterhead. If a Bidder/Offeror’s EMR is above 1.0, Bidder/Offeror must submit a written explanation of the EMR from its insurance carrier furnished on the insurance carrier’s letterhead, describing the reasons for the elevated EMR and the anticipated date the EMR may be reduced to 1.0 or below.

3.) Self-insured contractors or other contractors that cannot provide their EMR rating on insurance letterhead must obtain a rating from the National Council on Compensation Insurance, Inc. (NCCI) by completing/submitting form ERM-6 and providing the rating on letterhead from NCCI. Note: Self insured contractors or other contractors that cannot provide EMR rating on insurance letterhead from the states or territories of CA, DE, MI, NJ, ND, OH, PA, WA, WY, and PR shall obtain their EMR rating from their state run worker’s compensation insurance rating bureau.

4.) If the NCCI cannot issue an EMR because the Bidder/Offeror lacks insurance history, Bidder/Offeror shall submit a letter indicating so from its insurance carrier furnished on the insurance carrier’s letterhead, and include a letter from the NCCI indicating that is has assigned Bidder/Offeror a Unity Rating of 1.0.

5.) The above information, along with other information obtained from Government systems, such as the OSHA and EPA online inspection history databases, will be used to make an initial Determination of Responsibility.

6.) This requirement is applicable to all subcontracting tiers, and prospective prime contractors are responsible for determining the responsibility of their prospective subcontractors.

END OF PROPOSAL SUBMITTAL INSTRUCTIONS

2.2 CALCULATION OF SELF-PERFORMED/SUBCONTRACTED WORK

CALCULATION OF SELF-PERFORMED/SUBCONTRACTED WORK - Appendix 1

Offerors for General Construction (NAICS code 236220) must provide at least 15 percent (25% for NAICS codes 238210 & 238220) of the cost of the contract performance incurred for personnel will be spent on the concern's employees or the employees of other eligible service-disabled veteran-owned small business concerns. Provide a breakdown of material and personnel costs, by specification division listed for the project. Home Office overhead, profit/fee and bond costs shall be added after a subtotal of personnel and material/Equipment costs has been calculated. Clearly identify the personnel costs you will be performing, and the personnel costs of other eligible service disabled veteran-owned small business concerns. Below is a suggested format.

Division 01

Division 02

Division 03

(Add additional lines as necessary for each Division applicable to this project)

Calculation of self-performed personnel costs:

1. Total personnel costs * both prime and all subcontractors: $_________________

2. Subtract all subcontractor personnel costs* that are not SDVOSB companies that will perform work on this contract: $__________________

3. Remainder is ‘Total amount of work to be self-performed under the Contract’: $__________________

4. Self-performed work = Line 3/Line 1 x 100 = __________%

*personnel costs include labors, mechanics, other tradesmen, and office personnel directly charged to the project (includes project manager, job superintendent, administrative, estimators, etc.)

I certify the above representations are true and correct to the best of my knowledge.

(Title of Authorized Representative)

2.3 CONTRACTOR CERTIFICATION REGARDING SAFETY AND ENVIRONMENTAL

Pre-Award Contractor Safety and Environmental Record Evaluation Form – Appendix 2

Information provided below is current and applicable to Solicitation 36C25518R0049:

Company Name: ______________________________________________

Address: _____________________________________________________

Telephone: ______________________ Fax: ________________________

Email: _______________________________________________________

Contact: ______________________________________________________

1. Utilizing your OSHA 300 Forms, please complete the following information:

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): ____________________________