6 - Attachment C_Contractor Certification RE Safety and EMR.docx
DOCX document 16 KB Posted
- Attached to
- CFA Kitchen Renovation
- Solicitation number
- 36C26124R0081
About this file
This document is an attachment to a federal contract opportunity, specifically a Contractor Certification Regarding Safety and Environmental Record and Experience Modification Rate (EMR).
The key details are:
- The contractor must have no more than three serious, one repeat, or one willful OSHA or EPA violations within the past 3 years, and an EMR of 1.0 or less to be eligible for consideration and award.
- Offerors must submit a self-certification on company letterhead providing the number of violations within the past 3 years, and a signed letter from their insurance carrier providing their current EMR.
- The federal contract opportunity is for the CFA Kitchen Renovation, Solicitation Number 36C26124R0081, issued by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 21.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 3 - 459-24-001 CFA Kitchen_IFC_Drawings.pdf | ||
| 9 - Site Visit Map.pdf | ||
| 7 - Pre_Bid RFI.docx | DOCX document | |
| 5 - Price Proposal Breakdown.pdf | ||
| 1 - 36C26124R0081.docx | DOCX document | |
| 4 - RFI FORM CFA Kitchen Renovation.docx | DOCX document | |
| 2 - 459-24-002 CFA Kitchen_IFC_Specifications.pdf | ||
| 8 - P07 WAGE DETERMINATION HI202400001 05.17.24.pdf |
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Text version
ATTACHMENT C
CONTRACTOR CERTIFICATION REGARDING SAFETY AND ENVIRONMENTAL
Contractor Certification Regarding Project: 459-24-002 36C26124R0081 Center for Aging (CFA) Kitchen Renovation PER VHA DIRECTIVE 7715 (06 April 2017): SAFETY & ENVIRONMENTAL RECORD AND EXPERIENCE MODIFICATION RATE (EMR): To be eligible for consideration and award, the contractor shall have no more than three serious, or one repeat, or one willful OSHA or EPA violation(s) within the past 3 years and have an EMR of equal to or less than 1.0.
All Offerors shall submit the following information pertaining to their past Safety & Environmental Record and EMR with their bid/proposal:
SAFETY & ENVIRONMENTAL RECORD: A self-certification on company letterhead that the Offeror has no more than three (3) serious, or one (1) repeat or one (1) willful OSHA or any EPA violation(s) within the past three years. Include the following table and signature block.
| 2021 |
| 2022 |
| 2023 |
Number of serious, willful, or repeat violations from OSHA within the last 3 years.
Number of serious, willful, or repeat violations from EPA within the last 3 years
Signature: ______________________________________________ Typed Name: ______________________________________________________ Title: ______________________________________________________
EMR: All Offerors shall submit information regarding their current EMR. This information shall be obtained from the Offeror’s insurance carrier and be furnished on the insurance carrier’s letterhead.
Contractor’s Current Insurance Experience Modification Rate (EMR) = _____________ (Note: Contractor must support the EMR with a signed letter from Insurance Carrier on their letterhead.)
File details come from the government source that posted it. Updated .