36C25520R0007-0002001.pdf

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Attached to
589-CA3-369, Renovate Emergency Room Phase 2 B
Solicitation number
36C25520R0007
Issued by

About this file

This document includes a federal solicitation for construction services to renovate an emergency room at a Veterans Affairs medical center. The Department of Veterans Affairs, VISN 15 is seeking to renovate approximately 1,250 square feet of existing space at the Kansas City VA Medical Center to include 3 new treatment rooms, a nourishment room, bio-med closet, shower/toilet facility, and electrical room. The scope of work involves general construction, alterations, finishes and necessary removal/replacement of existing structures. The contractor will be required to provide in-wall, in-ceiling or other supports for furniture, medical equipment, and miscellaneous items. Additional work includes electrical, mechanical, plumbing, fire protection demolition and new work. The project cost is estimated between $500,000 to $1,000,000 and will be set aside for Service-Disabled Veteran-Owned Small Businesses. Proposals are due on or about January 17, 2020. The contract type will be firm fixed price with a performance period of 180 calendar days from notice to proceed.

36C25520R0007 0002 Contractor Certification Regarding Safety and Environmental FY 16 to FY 19.pdf

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36C25520R0007-0003000.docx DOCX document
36C25520R0007-0002000.docx DOCX document
36C25520R0007-0001001.pdf PDF
36C25520R0007-0001000.docx DOCX document
36C25520R0007-004.pdf PDF
36C25520R0007-006.pdf PDF
36C25520R0007-007.pdf PDF
36C25520R0007-003.pdf PDF
36C25520R0007-002.pdf PDF
36C25520R0007-005.pdf PDF
36C25520R0007-001.docx DOCX document
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Information provided below is current and applicable to Solicitation 36C25520R0007:

Company Name: ______________________________________________ Address: _____________________________________________________ Telephone: ______________________ Fax: ________________________ Email: _______________________________________________________ Contact: ______________________________________________________

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

Category 2016 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): ____________________________

http://www.osha.gov/pls/publications/publication.html http://www.osha.gov/pls/publications/publication.html

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