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CUI//FEDCON [when filled in] Source Selection Information - See FAR 2.101 & 3.104 [when filled in]

Maintenance Services on Supervisory Control and Data Acquisition System (SCADA) at U.S. Naval Hospital (USNH), Camp Foster, Okinawa, Japan N40084-23-R-2005

ATTACHMENT 5 - Safety Plan Sheet

Name of Offeror:

SAFETY PLAN SHEET

The purpose of this form is to provide supporting safety plan for Factor 2 Safety. This form is to be completed by the Offeror.

(a) The offeror’s method for selecting a subcontractor with a safe performance record:

(b) The offeror’s plan to monitor and oversee the safety compliance and performance of self‐performed and subcontractor performed work:

(c) The offeror’s methodology to execute an effective program that facilitates accident prevention techniques and processes, and employee reporting of unsafe conditions and unsafe activities.

CUI//FEDCON [when filled in] Source Selection Information - See FAR 2.101 & 3.104 [when filled in]

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