36E77619R0091-009.docx
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- Attached to
- Abate Asbestos Crawlspace 523-19-123 Federal contract opportunity
- Solicitation number
- 36E77619R0091
About this file
This document contains a contractor safety and environmental record evaluation form and information on a related federal contract opportunity. The evaluation form requests information from contractors such as number of man hours, OSHA injury cases, DART rates, and OSHA violations for the years 2015 through 2018. It relates to solicitation 36E77619R0091 to abate asbestos in a VA facility crawlspace located at 523-19-123. The solicitation is for an indefinite delivery/indefinite quantity contract with a one year base period and four one-year options to be awarded by the Department of Veterans Affairs Headquarters.
36E77619R0091 ATTACHMENT 8 - Contractor Safety and Environmental Record Evaluation Form.docx
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Text version
Contractor Safety and Environmental Record Evaluation Form
Information provide below is current and applicable to Solicitation 36E77619R0091 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. Updated .