36E77619R0061-006.docx
DOCX document 13 KB Posted
- Solicitation number
- 36E77619R0061
About this file
36E77619R0061 S02 - Attachment 5 - Contractor Safety and Environmental Record Evaluation Form West Haven.docx
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 36E77619R0061-001.docx | DOCX document | |
| 36E77619R0061-008.docx | DOCX document | |
| 36E77619R0061-003.zip | ZIP file | |
| 36E77619R0061-005.zip | ZIP file | |
| 36E77619R0061-002.doc | DOC document | |
| 36E77619R0061-009.docx | DOCX document | |
| 36E77619R0061-007.pdf | ||
| 36E77619R0061-004.zip | ZIP file | |
| 36E77619R0061-000.docx | DOCX document |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Contractor Safety and Environmental Record Evaluation Form
Information provide below is current and applicable to Solicitation 36E77619R0061 Company Name: ______________________________________________ Address: _____________________________________________________ Telephone: ______________________ Fax: ________________________ Email: _______________________________________________________ Contact: ______________________________________________________ Utilizing your OSHA 300 Forms, please complete the following information:
| Category |
| 2015 |
| 2016 |
| 2017 |
| 2018 |
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.
File details come from the government source that posted it.