ATTACHMENT 11 - Contractor Safety - Environmental Form.docx
DOCX document 14 KB Posted
- Attached to
- Y1BG--EHRM Infrastructure Upgrades Construction John Cochran Federal contract opportunity
- Solicitation number
- 36C77623B0034
About this file
This document contains a contractor safety and environmental record evaluation form and details of a federal solicitation for construction services. The solicitation seeks a general contractor to construct twenty-four telecommunication rooms at a Veterans Affairs medical center to upgrade the electrical system, HVAC, fiber infrastructure, security systems, and perform hazardous material abatement. Bidders must provide man-hours and OSHA record information for the past four years, including case details, days away from work rates, and explanations for any violations. The solicitation is identified as number 36C77623B0034 and was issued by the Department of Veterans Affairs Technology Acquisition Center located in Austin, Texas.
View the file
Other files for this federal contract opportunity
Show all 32
On GovTribe
Work with this file on GovTribe
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Contractor Safety and Environmental Record Evaluation Form
Information provide below is current and applicable to Solicitation 36C77623B0034 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.
File details come from the government source that posted it. Updated .