Attachment 3 - SAFETY _ ENVIRONMENTAL RECORD AND EXPERIENCE MODIFICATION RATE.docx

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Y1JZ--640-22-111 Fisher House 1 Life Safety Corrections
Solicitation number
36C26122R0051
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This document outlines safety and environmental record requirements for a federal construction contract opportunity. To be eligible for consideration, contractors must have no more than three serious or one repeat or one willful OSHA or EPA violations in the past three years, and an Experience Modification Rate (EMR) of 1.0 or below from their insurance carrier. Offerors must submit a self-certification of their safety and environmental record on company letterhead, along with documentation of their current EMR verified by their insurance carrier on carrier letterhead. The EMR documentation must include an explanation if the rate exceeds 1.0 and the anticipated date for reduction. The related federal contract opportunity is solicitation number 36C26122R0051 to perform life safety corrections at Fisher House 1 for the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 21.

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Other files

File Type Posted
Exhibit9_FH1 As-Built for Reference - Copy.pdf PDF
Attachment 1 - 640-22-111_FH1_SOW_FisherHouse1_LSCorrection .pdf PDF
Attachment 6 - AE Release of Claims.docx DOCX document
Attachment 2 - 640-22-111_FH1_Spec_Combined - Copy.pdf PDF
Attachment 5 - Limitations on Subcontracting Construction.pdf PDF
Exhibit3_Fire Curtain Requirement - Copy.pdf PDF
Exhibit1_Fisher House Prototype - Copy.pdf PDF
36C26122R0051_1.docx DOCX document
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Exhibit5_FH1 Finish Plan for Reference - Copy.pdf PDF
Exhibit6_Paint Spec for Reference - Copy.pdf PDF
Exhibit7_Paint Selections for Reference - Copy.pdf PDF
Exhibit4_Finish Spec for Reference - Copy.pdf PDF
Attachment 4 - WD CA20220018.txt TXT text file
Exhibit10_FH2 As-Built for Reference - Copy.pdf PDF
Exhibit2_Fisher House Recommendations - Copy.pdf PDF
Exhibit11_FH1_ICRA - Copy.pdf PDF
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PER VHA DIRECTIVE 7715 (06 April 2017) - SAFETY & ENVIRONMENTAL RECORD AND EXPERIENCE MODIFICATION RATE (EMR):

Contractor Certification Regarding Project:

To be eligible for consideration and award, the contractor shall have no more than three serious, or one repeat, or one willful OSHA or EPA violation(s) in the past 3 years and have an EMR of equal to or less than 1.0.

All Offerors shall submit the following information pertaining to their past Safety & Environmental Record and EMR with their offer.

1. SAFETY & ENVIRONMENTAL RECORD: A self-certification on company letterhead that the contractor has no more than three (3) serious, or one (1) repeat or one (1) willful OSHA or any EPA violation(s) in the past three years.

2. EMR: All Offerors shall submit information regarding their current EMR. This information shall be obtained from the Offerors’s insurance carrier and be furnished on the insurance carrier’s letterhead. If an Offeror’s EMR is above 1.0, Offeror shall submit a written explanation of the EMR from its insurance carrier furnished on the insurance carrier’s letterhead, describing the reasons for the EMR, and the anticipated date the EMR may be reduced to 1.0 or below.

2018
2019
2020

Number of serious, willful, or repeat violations from OSHA within the last 3 years. Please attach explanation for any violations. (Four serious, one repeat, or one willful disqualifies the contractor.)

Number of violations from EPA within the last 3 years. Please attach explanation for any violations.

Company’s Current Insurance Experience Modification Rate (EMR) = (Note: Contractor must support the EMR with a signed letter from Insurance Carrier on their letterhead.)

Signature:

Print Name: _________________________________________________

File details come from the government source that posted it. Updated .