36E77620R0001-016.docx

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Attached to
650-332 New Mental Health Building - Phase 1 (VA-19-00104660)
Solicitation number
36E77620R0001
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This document provides details for a federal construction solicitation for a new mental health building project. The Department of Veterans Affairs seeks to award a firm-fixed-price contract to provide all supervision, labor, materials, equipment, transportation and infrastructure required to complete construction of a new three-story, approximately 15,300 square foot freestanding mental health building on the Providence VA Medical Center campus. The project includes site preparation, demolition, building construction and corresponding site and utility work. The solicitation will be a service-disabled veteran-owned small business set-aside issued on or about December 20, 2019 via a request for proposal evaluated according to the procedures in the solicitation. The period of performance is expected to be approximately 600 calendar days from notice to proceed, and the magnitude of construction is estimated between $10-20 million.

36E77620R0001 Attachment 15 - Contractor Safety and Environmental Record Evaluation Form.docx

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Contractor Safety and Environmental Record Evaluation Form

Information provide below is current and applicable to Solicitation 36E77620R0001 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 .