Attachment 3 Contractor Safety Environmental Form.docx

This document contains a contractor safety and environmental record evaluation form and details of a federal contract opportunity for design-build infrastructure upgrades.

The evaluation form requests a contractor provide information including number of man hours, OSHA recordable cases, days away from work rates, and serious violations for the years 2017 through 2020. The related federal contract opportunity is a solicitation from the Department of Veterans Affairs for a design-build project to relocate or remodel approximately 13 telecommunications rooms and one data center at the VA Pacific Islands Health Care System in Honolulu, Hawaii. The solicitation will be a request for proposal conducted under FAR Part 36.3 for two-phase design-build selection. The opportunity is set aside as a total SDVOSB and will be evaluated according to procedures in the solicitation. The NAICS code is 236220 with a size standard of $39.5 million. The period of performance is approximately 540 calendar days from notice to proceed for a project magnitude between $10 million and $20 million.