Section C - III(D) ICRA Attachment.doc
DOC document 31 KB Posted
- Attached to
- Supply and Install 4 HVAC Units
- Solicitation number
- 75H71324Q00020
About this file
This document is an interim life safety measures condition evaluation form for a federal facility. The form requires identifying the facility, date, description of the project or condition being evaluated, and departments affected. It also requires timeframes and listing life safety features impacted. Questions determine if there is potential safety impact on patients, visitors or staff, and whether the situation warrants implementing interim life safety measures.
The related federal contract opportunity is a solicitation from the Department of Health and Human Services Indian Health Service to supply and install four HVAC units. The solicitation number and opportunity type are provided. No other details are included in the documents.
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Text version
OCAIHS Interim Life Safety Measures Condition/Project
Evaluation Form
| Facility: |
| Current Date: |
Description of Project, Situation, or Condition being evaluated:
Departments and/or buildings that will be, or are affected by Project, Situation, or Condition:
Time frame during which Project, Situation, or Condition exists or will exist (give dates):
Life Safety features which are affected by Project, Situation, or Condition (list below)
1.
2.
3.
Is there potential for any of these conditions to impact the life safety of patients, visitors, or staff?
YES
NO
If No, explain why not?____________________________________________________________
Based on these findings, does this project, situation, or condition warrant the implementation of ILSM?
| YES |
| NO |
Signature of Individual Completing form Date
File details come from the government source that posted it. Updated .