8-Attachment E - Safety Documents.pdf
PDF 315 KB Posted
- Solicitation number
- 26RFP032
- Issued by
- Travis County, Austin City, Texas
About this file
This is a Safety Documents attachment for the Austin Independent School District (AISD) Request for Proposals regarding custom serving line upgrades at Akins and Bowie High School kitchens in Texas. The document outlines mandatory safety record submission requirements that all bidders must fulfill as part of their proposal response. Vendors are required to submit OSHA 300 Logs and 300A Form Summary Logs for the last three completed calendar years, with the 300A Summary Form required for every year even if no recordable injuries occurred. Additionally, bidders must provide a loss run (statement of claims) from their workers' compensation insurance carrier covering the most recently completed policy year, printed no more than 60 calendar days before the bid due date. The attachment specifies that insurance carrier or agency names must be clearly legible on all documents, and claimant names may be redacted.
Beyond the loss run requirement, vendors must submit a loss ratio document from their workers' compensation insurance carrier corresponding to the most recent completed policy year, also printed within 60 calendar days of the bid deadline. Bidders are also required to provide their current experience modifier from their workers' compensation insurance premiums, obtained from their insurance carrier, insurance agency, or rating agency with the applicable year clearly indicated and printed within the same 60-day timeframe. All loss ratio and experience modifier documents must originate from official insurance carriers or agencies rather than being internally prepared. If no losses are recorded on the loss run, a separate zero percent loss ratio document is not required. These safety documentation requirements must be met for bid consideration.
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Attachment E
1. Safety Record Please provide the following information in connection with your organization’s safety record.
1.1. Your organization's OSHA (Occupational Safety and Health Administration) 300 Logs and 300A Form Logs for the last three completed Calendar (3) years.
-- If there are no recordable injuries on the OSHA 300 log(s) FOR A SPECIFIC YEAR, the 300 log(s) FOR THAT SPECIFIC YEAR will not be required to be submitted. However, the OSHA 300A Summary Form Log must still be submitted FOR EVERY YEAR.
-- OSHA 300 A Summary Form log must be completed signed and dated. If no accidents, record "0" in appropriate column totals.
1.2. Loss run from your organization's insurance carrier or insurance agency covering your organization's workers' compensation insurance coverage. (Loss run is also referred to as "statement of claims" or SOC.) A loss analysis/loss summary may be submitted as long as it contains individual claims descriptions.
-- Loss run must be provided by your organization’s insurance carrier or insurance agency.
Insurance carrier’s company name or insurance agent (Agency) must be clearly legible on documents provided.
-- Names of claimants on loss run may be redacted/blacked out.
-- If there have been no losses, provide Document from your firm’s insurance carrier stating no losses.
-- Loss Run/Loss Analysis/Loss Summary must be from the most recently completed policy year.
-- This Document must be printed 60 calendar days or less before the bid due date. Date printed must be clearly indicated on the Document.
1.3. Loss ratio from your organization’s insurance carrier or insurance agency covering your organization’s workers’ compensation insurance coverage.
-- Loss ratio must be provided by your organization’s insurance carrier or insurance agency.
Insurance carrier’s company name or insurance agent) Agency_ must be clearly legible on documents provided.
-- Time period corresponding to loss ratio must be provided for the most recent completed policy year.
Attachment B
-- Typed or handwritten information concerning loss ratio prepared by your firm WILL NOT be accepted.
-- Experience rating documents WILL NOT be accepted for this section.
-- If your Loss Run/Loss Analysis/Loss Summary for the most completed policy period indicates no losses, then a separate document showing 0% loss ratio will not be required.
-- This Document must be printed 60 calendar days or less before the bid due date. Date printed must be clearly indicated on the Document.
1.4. Your organization’s current experience modifier from your organization’s workers’ compensation insurance premiums provided by your organization’s insurance carrier, insurance agency or rating agency.
-- Experience modifier must be provided by your organization’s insurance carrier, insurance agent or rating agency. Insurance carrier’s company name or insurance agent (agency) must be clearly legible on documents provided.
-- Experience modifier must clearly indicate time period/year covered for the current experience modifier.
--Typed or hand-written experience modifiers prepared by your firm WILL NOT be accepted.
-- Experience rating documents indicating a calculated experience modifier will be accepted provided there is a final calculated experience modifier with applicable year indicated.
-- This Document must be printed 60 calendar days or less before the bid due date. Date printed must be clearly indicated on the Document.
Attachment B
SAFETY RECORD QUICK SUMMARY:
OSHA 300 Logs and 300A Form Logs
• The last three (3) completed Calendar years
• OSHA 300A Summary Form Log must be completed signed and dated. If not accidents, record “0” in appropriate column totals.
Loss Run
• Also referred to as “statement of claims” or SOC
• Insurance agency must be clearly labeled
• Must be from the most recent completed policy year
• Must be printed 60 calendar days or less before bid due date.
• Date printed must be clearly indicated on the Document
Loss Ratio
• Insurance agency must be clearly labeled
• Must correspond to most recent completed policy year
• If your Loss Run indicated no losses a separate document showing
0% loss ratio will not be required.
• Must be printed 60 calendar days or less before bid due date.
• Date printed must be clearly indicated on the Document
Experience Modifier
• Insurance agency must be clearly labeled
• Must be printed 60 calendar days or less before bid due date.
• Date printed must be clearly indicated on the Document
• Your organization’s current workers’ compensation insurance premiums provided by your organization’s insurance carrier, insurance agency, or rating agency
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