36E77620R0004-025.docx
DOCX document Posted
- Solicitation number
- 36E77620R0004
About this file
This document contains a contractor safety and environmental record evaluation form and details of a federal contract opportunity for replacing patient lift systems. The form requests safety information such as number of man hours, OSHA recordable cases, DART rates, and explanations for violations from 2016 to 2019.
The federal contract opportunity is a service-disabled veteran-owned small business set-aside to design and construct replacement patient lift systems at the Minneapolis VA Medical Center. The project includes replacing 49 ceiling lifts in select exam rooms of the SCI/D building and installing 15 additional lifts in the ED building. The solicitation will be issued as a request for proposal on November 30, 2019 with a period of performance of approximately 275 calendar days. The magnitude of construction is estimated between $1,000,000 to $2,000,000.
36E77620R0004 ATTACHMENT 10 - CONTRACTOR SAFETY-ENV FORM.docx
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| 36E77620R0004-0005000.docx | DOCX document | |
| 36E77620R0004-0005001.docx | DOCX document | |
| 36E77620R0004-0004012.docx | DOCX document | |
| 36E77620R0004-0004013.pdf | ||
| 36E77620R0004-0003001.docx | DOCX document | |
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| 36E77620R0004-017.zip | ZIP file | |
| 36E77620R0004-022.docx | DOCX document | |
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Contractor Safety and Environmental Record Evaluation Form
Information provide below is current and applicable to Solicitation 36E77619R0004 Company Name: ______________________________________________ Address: _____________________________________________________ Telephone: ______________________ Fax: ________________________ Email: _______________________________________________________ Contact: ______________________________________________________ Utilizing your OSHA 300 Forms, please complete the following information:
| Category |
| 2016 |
| 2017 |
| 2018 |
| 2019 |
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 .