Attachment 5 - Contractor Safety - Environmental Form.docx
DOCX document 14 KB Posted
- Attached to
- Y1DA--EHRM Infrastructure Updates - Data Center Construction - Grand Junction. CO (VA-22-00087706)
- Solicitation number
- 36C77623B0027
About this file
This document contains a contractor safety and environmental record evaluation form and details of a related federal contract opportunity for data center construction services. The evaluation form requests information on a contractor's man-hours, OSHA recordable incidents, days away from work rates, and any serious violations over the past four years to evaluate the firm's safety and environmental performance.
The related federal contract opportunity is solicitation number 36C77623B0027 from the Department of Veterans Affairs for data center construction services at its facility in Grand Junction, Colorado. The opportunity type is a solicitation and the requirement is to provide EHRM infrastructure and data center construction for the VA location. No further details are provided on response dates, award dates, pricing terms, or other contract information.
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Other files
| File | Type | Posted |
|---|---|---|
| RFI Attachment 5- B34 Record Dwg 2014.pdf | ||
| RFI Attachment 3-Instructions to AE.docx | DOCX document | |
| Grand Junction RFIs.docx | DOCX document | |
| 36C77623B0027 0003.docx | DOCX document | |
| RFI-Attachment 1- Specifications.pdf | ||
| RFI Attachment 2- Hazmat Asbestos Report.pdf | ||
| RFI Attachment 4-B34-1st-HOT-Contiguous-Bldg.pdf | ||
| RFI-Attachment 6 -B34-1st-HOT-Samples.pdf | ||
| 36C77623B0027 0002.docx | DOCX document | |
| Site Visit Sign in Sheet 4-28.pdf | ||
| 36C77623B0027 0001.docx | DOCX document | |
| 36C77623B0027.docx | DOCX document | |
| Attachment 6 - Construction Wage Rate Mesa County.pdf | ||
| Attachment 4 - Limitations on Subcontracting - Construction.docx | DOCX document | |
| Attachment 1 - Specifications.pdf | ||
| Attachment 8 - Site Visit Map.pdf | ||
| Attachment 7 - Site Visit Instructions.docx | DOCX document | |
| Attachment 3 - Construction SOW.docx | DOCX document | |
| Attachment 2 -Drawings.pdf |
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Text version
Contractor Safety and Environmental Record Evaluation Form
Information provide below is current and applicable to Solicitation 36C77623B0027 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 .