Attachment 07- Contractor Safety - Environmental Form.pdf
PDF 117 KB Posted
- Solicitation number
- 36C77623B0040
About this file
This document contains a Contractor Safety and Environmental Record Evaluation Form for solicitation number 36C77623B0040 for Y1DA--EHRM Training and Admin Space Construction Support Muskogee. The form requests contact information for the bidding company and utilization data from their OSHA 300 forms for the number of man hours, cases involving days away from work or restricted activity, days away restricted or transferred rate, and any serious, willful, or repeat OSHA violations from the past three years along with an explanation for any violations. Bidders are to provide safety and environmental record information on this form for consideration as part of the solicitation process.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment 1-Technical Questions -Muskogee.docx | DOCX document | |
| Attachment 2- VA Asbestos Abatement Manual.pdf | ||
| 36C77623B0040 0003.docx | DOCX document | |
| EHRM TASS Muskogee Site Visit Sign In.pdf | ||
| 36C77623B0040 0002.docx | DOCX document | |
| Parking Plan 2023.pdf | ||
| Site Visit Instructions - 2023 July 7-Revised.docx | DOCX document | |
| 36C77623B0040 0001.docx | DOCX document | |
| Attachment 02- Drawings - EHRM TASS- Muskogee.pdf | ||
| Attachment 06- Site Map.pdf | ||
| 36C77623B0040_1.docx | DOCX document | |
| Attachment 04- Limitations on Subcontracting - Construction.docx | DOCX document | |
| Attachment 01-Specifications - EHRM TASS-Muskogee.pdf | ||
| Attachment 03- Wage Determination Muskogee 6.20.pdf | ||
| Attachment 05- Site Visit Instructions.docx | DOCX document |
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Text version
Contractor Safety and Environmental Record Evaluation Form
Information provide below is current and applicable to Solicitation 36C77623B0040_1
Company Name: ______________________________________________
Address: _____________________________________________________
Telephone: ______________________ Fax: ________________________
Email: _______________________________________________________
Contact: ______________________________________________________
Utilizing your OSHA 300 Forms, please complete the following information:
Category 2019 2020 2021 2022
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.
Contractor Safety and Environmental Record Evaluation Form
File details come from the government source that posted it. Updated .