36E77618R0097-011.docx
DOCX document 13 KB Posted
- Attached to
- Cath Lab HVAC Design Build Augusta, GA VAMC Federal contract opportunity
- Solicitation number
- 36E77618R0097
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36E77618R0097 Attachment 10 - Contractor Safety and Environmental Record Eval Form.docx
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 36E77618R0097-010.docx | DOCX document | |
| 36E77618R0097-012.pdf | ||
| 36E77618R0097-009.pdf | ||
| 36E77618R0097-015.pdf | ||
| 36E77618R0097-017.docx | DOCX document | |
| 36E77618R0097-003.pdf | ||
| 36E77618R0097-016.pdf | ||
| 36E77618R0097-007.pdf | ||
| 36E77618R0097-001.docx | DOCX document | |
| 36E77618R0097-004.pdf | ||
| 36E77618R0097-008.pdf | ||
| 36E77618R0097-006.pdf | ||
| 36E77618R0097-005.pdf | ||
| 36E77618R0097-002.pdf | ||
| 36E77618R0097-014.pdf | ||
| 36E77618R0097-013.pdf | ||
| 36E77618R0097-000.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 36E77618R0097 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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