Attachment 44 - Contractor Safety - Environmental Form.docx

DOCX document 14 KB Posted

Attached to
Y1DA--EHRM Infrastructure Upgrades Construction Jefferson Barracks Federal contract opportunity
Solicitation number
36C77623R0009
Issued by
Department of Veterans Affairs Technology Acquisition Center Austin

About this file

This document contains a contractor safety and environmental record evaluation form and details of a federal contract opportunity for infrastructure upgrades at the St. Louis Jefferson Barracks VAMC. The evaluation form requests information on a contractor's man hours, OSHA recordable incidents, DART rates, and any serious, willful, or repeat OSHA violations over the past four years. The federal contract opportunity, solicitation number 36C77623R0009, is seeking a general contractor to provide electrical, HVAC, data center, communication, security, and fiber infrastructure upgrades across multiple buildings at the VA medical center campus. The scope of work involves upgrades to electrical panels, power systems, building management systems, data and communication outlets, exterior and interior walls, and hazardous material abatement. The contracting agency is the Department of Veterans Affairs Technology Acquisition Center located in Austin, Texas.

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Other files for this federal contract opportunity

Other files attached to Y1DA--EHRM Infrastructure Upgrades Construction Jefferson Barracks, newest first.
File Type Posted
36C77623R0009 0005.pdf PDF
36C77623R0009 0004.pdf PDF
657-21-701JB - 100 PC - Basis of Design.pdf PDF
329000-05-R1 Sod Certificate.pdf PDF
32 32 23 01R1 - Mechanically Stabilized Earth Wall System RESPONSE.pdf PDF
Attachment 43 - Construction Wage Rates - St. Louis 3-3-23.pdf PDF
36C77623R0009 0003.pdf PDF
36C77623R0009 0002.pdf PDF
Site Visit Sign-in Sheet - St. Louis 2-28-23.pdf PDF
36C77623R0009 0001.pdf PDF
36C77623R0009 - 2-16-23.pdf PDF
Attachment 7 - Drawings Part-6.pdf PDF
Attachment 11 - Drawings Part-10.pdf PDF
Attachment 12 - Drawings Part-11.pdf PDF
Attachment 13 - Drawings Part-12.pdf PDF
Attachment 18 - Drawings Part-17.pdf PDF
Attachment 31 - Drawings Part-30.pdf PDF
Attachment 35 - Envr. Report - Appendix A.pdf PDF
Attachment 38 - Envr. Report - Drawings.pdf PDF
Attachment 42 - Limitations on Subcontracting - Construction.docx DOCX document
Attachment 45 - Site Visit Instructions.pdf PDF
Attachment 4 - Drawings Part-3.pdf PDF
Attachment 10 - Drawings Part-9.pdf PDF
Attachment 14 - Drawings Part-13.pdf PDF
Attachment 20 - Drawings Part-19.pdf PDF
Attachment 21 - Drawings Part-20.pdf PDF
Attachment 25 - Drawings Part-24.pdf PDF
Attachment 26 - Drawings Part-25.pdf PDF
Attachment 28 - Drawings Part-27.pdf PDF
Attachment 29 - Drawings Part-28.pdf PDF
Attachment 32 - Drawings Part-31.pdf PDF
Attachment 39 - ICRA ILSM Tool - MCM 001S-03 Att B.zip ZIP file
Attachment 1 - Specifications.pdf PDF
Attachment 5 - Drawings Part-4.pdf PDF
Attachment 6 - Drawings Part-5.pdf PDF
Attachment 9 - Drawings Part-8.pdf PDF
Attachment 16 - Drawings Part-15.pdf PDF
Attachment 22 - Drawings Part-21.pdf PDF
Attachment 24 - Drawings Part-23.pdf PDF
Attachment 36 - Envr. Report - Appendix B.pdf PDF
Attachment 41 - COVID-19 Safety Protocols 12-14-21.pdf PDF
Attachment 2 - Drawings Part-1.pdf PDF
Attachment 3 - Drawings Part-2.pdf PDF
Attachment 8 - Drawings Part-7.pdf PDF
Attachment 15 - Drawings Part-14.pdf PDF
Attachment 17 - Drawings Part-16.pdf PDF
Attachment 19 - Drawings Part-18.pdf PDF
Attachment 23 - Drawings Part-22.pdf PDF
Attachment 27 - Drawings Part-26.pdf PDF
Attachment 30 - Drawings Part-29.pdf PDF
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Text version

Contractor Safety and Environmental Record Evaluation Form

Information provide below is current and applicable to Solicitation 36C77623R0009 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 .