36E77620R0006-008.docx
DOCX document Posted
- Attached to
- VISN 23 Project 636A8-17-001 "Modernize A Bank Elevators" Federal contract opportunity
- Solicitation number
- 36E77620R0006
About this file
This document contains a contractor safety evaluation form and details of a federal contract solicitation. The safety evaluation form requests contractors provide man-hour and OSHA record data from 2015 to 2018, including number of days away from work, restricted activity cases, and serious violations.
The federal contract solicitation is for modernizing five elevators and one service elevator at the Iowa City VA Medical Center. The project scope includes replacing and modifying elevator equipment and components as well as interior finishes. The solicitation will be issued as an RFP in November or December 2019 in accordance with FAR Parts 15, 19, and 36. It is a total SDVOSB set-aside with a 323 day period of performance. The magnitude of construction is estimated between $2 million to $5 million. Questions must be submitted in writing to the specified contracting officer by email.
36E77620R0006 ATTACHMENT 7 - CONTRACTOR SAFETY AND ENVIRONMENTAL RECORD EVALUATION FORM.docx
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 36E77620R0006-0004000.docx | DOCX document | |
| 36E77620R0006-0003001.doc | DOC document | |
| 36E77620R0006-0003000.docx | DOCX document | |
| 36E77620R0006-0003002.pdf | ||
| 36E77620R0006-0002001.pdf | ||
| 36E77620R0006-0002003.pdf | ||
| 36E77620R0006-0002002.pdf | ||
| 36E77620R0006-0002000.docx | DOCX document | |
| 36E77620R0006-0002004.docx | DOCX document | |
| 36E77620R0006-0002005.pdf | ||
| 36E77620R0006-0001000.docx | DOCX document | |
| 36E77620R0006-001.docx | DOCX document | |
| 36E77620R0006-009.docx | DOCX document | |
| 36E77620R0006-004.pdf | ||
| 36E77620R0006-002.docx | DOCX document | |
| 36E77620R0006-003.pdf | ||
| 36E77620R0006-006.pdf | ||
| 36E77620R0006-007.docx | DOCX document | |
| 36E77620R0006-005.pdf |
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Text version
Contractor Safety and Environmental Record Evaluation Form
Information provide below is current and applicable to Solicitation 36E77618R0051 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 .