36C25618R0173-005.docx
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- Construction IDIQ - Overton Brooks VAMC AWARD NOTIFICATIONS MADE JUNE 28, 2019 Federal contract opportunity
- Solicitation number
- 36C25618R0173
About this file
This document provides details for an Indefinite-Delivery Indefinite-Quantity construction contract opportunity with the Department of Veterans Affairs. The contract will make multiple awards for construction services across four locations in Veterans Integrated Service Network 16, including medical centers and outpatient clinics in Louisiana, Mississippi, Florida, and Texas. Services will include non-recurring maintenance, repair, and new construction. The 100% small business set-aside is for Service-Disabled Veteran-Owned Small Businesses. The anticipated contract value is $25 million per award over five years. A request for proposals will be issued on April 16, 2018 with bids due on May 18, 2018. Awards are expected 45 days later.
36C25618R0173 EXHIBIT D CONTRACTOR EVALUATION FORM CONSTRUCTION SAFETY.docx
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FOR OFFICIAL USE ONLY
Source Selection Sensitive Information—See FAR 2.101 & 3.104 Indefinite-Delivery Indefinite-Quantity (IDIQ) Construction Contract 36C25618R0173 Exhibit D Contractor Evaluation Form Construction Safety
Company Name:
Address:
Telephone: Fax:
Email:
Contact:
1. Utilizing your OSHA 300 Forms, please complete the following information:
| Category |
| 2015 |
| 2016 |
| 2017 |
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. (Four serious, one repeat, or one willful disqualifies the contractor.)
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. Who administers your company’s Safety and Health Program?
3. Company’s current insurance Experience Modification Rate (EMR):__________________________
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