Attachment 4 - EMR Attachment.pdf
PDF 111 KB Posted
- Solicitation number
- 36C25020B0064
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 36C25020B0064 0003.docx | DOCX document | |
| RFI 8.pdf | ||
| RFI 9.pdf | ||
| 36C25020B0064 0002 - Attachment.pdf | ||
| 36C25020B0064 0002.docx | DOCX document | |
| 36C25020B0064 0001.docx | DOCX document | |
| Closet - 2.jpg | JPG image | |
| Staging and Dumpster Designated Area.png | PNG image | |
| Pre-Bid RFI 7_Response.pdf | ||
| Pre-Bid RFI 3_Response.pdf | ||
| Pre-Bid RFI 6_Response.pdf | ||
| JA - ARJO.pdf | ||
| 539-19-101 ADDENDUM 1 2020.0818.pdf | ||
| Pre-Bid RFI 2_Response.pdf | ||
| 539-19-101 ADDENDUM 1 DRAWINGS 2020.08.pdf | ||
| Pre-Bid RFI 1_Response.pdf | ||
| Closet - 3.jpg | JPG image | |
| Pre-Bid RFI 5_Response.pdf | ||
| Closet - 1.jpg | JPG image | |
| Closet - 4.jpg | JPG image | |
| Pre-Bid RFI 4_Response.pdf | ||
| Attachment 3 - RFI Form.pdf | ||
| 36C25020B0064_1.docx | DOCX document | |
| Attachment 1 - SPECIFICATIONS.pdf | ||
| Attachment 5 - DBA WD - OH20200082.pdf | ||
| Attachment 2 - DRAWINGS.pdf |
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Text version
Pre-Award Contractor Safety and Environmental Record
Evaluation Form Information provided below is current and applicable to Solicitation # 36C25020B0064.
Company Name: ______________________________________________
Address: _____________________________________________________
Telephone: ______________________ Fax: ________________________
Email: _______________________________________________________
Contact: ______________________________________________________
1. Utilizing your OSHA 300 Forms, please complete the following information:
Category 2017 2018 2019
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.
Please attach copies of the following documents: OSHA 300 and 300a Forms. These forms can be accessed through the OSHA publications search page:
http://www.osha.gov/pls/publications/publication.html.
2. Provide six-digit North American Industrial Classification System (NAICS) Code for this acquisition: __________________________________
3. Who administers your company’s Safety and Health Program?
4. Company’s Insurance Experience Modification Rate (EMR):
http://www.osha.gov/pls/publications/publication.html
File details come from the government source that posted it. Updated .