CONTRACTOR CERTIFICATION REGARDING SAFETY AND ENVIRONMENTAL.docx

This is a contractor certification template regarding safety and environmental compliance for a federal construction solicitation. Contractors responding to Solicitation No. 36C26126R0019 (Project No. 662-23-105) to renovate the Sterile Processing Service at San Francisco VA Medical Center must complete this certification as part of their proposal submission. The template requires contractors to disclose the number of serious, willful, or repeat violations from OSHA within the last three years and the number of serious, willful, or repeat EPA violations within the last three years, with explanations attached for any violations. Additionally, contractors must provide their current Insurance Experience Modification Rate (EMR) supported by a signed letter from their insurance carrier on company letterhead. The certification must be signed by an authorized company representative with typed name and title.

The underlying solicitation is a firm-fixed price construction contract valued between $10,000,000 and $20,000,000 for an SDVOSB (Service-Disabled Veteran-Owned Small Business) set-aside. The requirement encompasses extensive demolition, replacement, installation, and commissioning of a sterile processing department at the San Francisco VA Medical Center to comply with current design criteria, including HVAC and water processing systems, along with site preparation and mobile processing trailer rental during interior work. The applicable NAICS code is 236220 (Commercial and Institutional Building Construction) with a small business size standard of $45 million. Award selection will be based on a best-value trade-off evaluation between non-price factors and price, with the government intending to award without discussions unless deemed necessary.