36E77618R0085-024.docx
DOCX document 13 KB Posted
- Attached to
- Sepulveda Solar PV Design Build Federal contract opportunity
- Solicitation number
- 36E77618R0085
About this file
36E77618R0085 Attachment 23 - Contractor Safety and Environmental Record Eval Form.docx
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 36E77618R0085-0002000.docx | DOCX document | |
| 36E77618R0085-0001000.docx | DOCX document | |
| 36E77618R0085-001.docx | DOCX document | |
| 36E77618R0085-014.pdf | ||
| 36E77618R0085-012.pdf | ||
| 36E77618R0085-015.pdf | ||
| 36E77618R0085-009.pdf | ||
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| 36E77618R0085-010.pdf | ||
| 36E77618R0085-017.pdf | ||
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| 36E77618R0085-013.pdf | ||
| 36E77618R0085-020.pdf | ||
| 36E77618R0085-008.pdf | ||
| 36E77618R0085-022.pdf | ||
| 36E77618R0085-006.pdf | ||
| 36E77618R0085-005.pdf | ||
| 36E77618R0085-021.pdf | ||
| 36E77618R0085-003.pdf | ||
| 36E77618R0085-004.pdf | ||
| 36E77618R0085-011.pdf | ||
| 36E77618R0085-002.pdf | ||
| 36E77618R0085-018.pdf | ||
| 36E77618R0085-023.docx | DOCX document | |
| 36E77618R0085-019.pdf | ||
| 36E77618R0085-025.pdf | ||
| 36E77618R0085-016.pdf | ||
| 36E77618R0085-000.docx | DOCX document |
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Text version
Contractor Safety and Environmental Record Evaluation Form
Information provide below is current and applicable to Solicitation 36E77618R0085 Company Name: ______________________________________________ Address: _____________________________________________________ Telephone: ______________________ Fax: ________________________ Email: _______________________________________________________ Contact: ______________________________________________________ Utilizing your OSHA 300 Forms, please complete the following information:
| Category |
| 2014 |
| 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.
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