Attachment 3 - Contractor Safety and Environmental Record Evaluation Form.docx
DOCX document 13 KB Posted
- Attached to
- 5680--657-21-710JC EHRM Cerner Admin Space Support Construction - John Cochran Federal contract opportunity
- Solicitation number
- 36C77621B0015
About this file
This document contains a contractor safety and environmental record evaluation form as well as details of a federal contract solicitation for construction support services. The evaluation form requests safety and environmental performance metrics from contractors over the past four years, including total man hours, OSHA recordable incidents, DART rates, and serious violations. The related solicitation, to be issued in July 2021, is for construction support at the John Cochran VA Medical Center in St. Louis, Missouri as part of an electronic health record modernization project. Contractors are directed to submit any questions by email to the point of contact provided.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 36C77621B0015 0004.docx | DOCX document | |
| Attachment 8 - EHRM John Cochran - Technical Questions Tracking Spreadsheet.pdf | ||
| 36C77621B0015 0003.docx | DOCX document | |
| Attachment 7 - Drawings Full Set.pdf | ||
| Attachment 6 - Full Specifications.pdf | ||
| 36C77621B0015 0002.docx | DOCX document | |
| 36C77621B0015 0001.docx | DOCX document | |
| Attachment 1 - Final SOW.pdf | ||
| Attachment 5 - Site Map.pdf | ||
| Attachment 2 - VA NOTICE OF LIMITATIONS ON SUBCONTRACTING.docx | DOCX document | |
| 36C77621B0015_1.docx | DOCX document | |
| Attachment 4 - DBA Wage Rates.pdf |
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Text version
Contractor Safety and Environmental Record Evaluation Form
Information provide below is current and applicable to Solicitation 36C77621B0009 Company Name: ______________________________________________ Address: _____________________________________________________ Telephone: ______________________ Fax: ________________________ Email: _______________________________________________________ Contact: ______________________________________________________ Utilizing your OSHA 300 Forms, please complete the following information:
| Category |
| 2018 |
| 2019 |
| 2020 |
| 2021 |
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 .