ATTACHMENT 6 - Contractor Safety - Environmental Record Evaluation Form.docx
DOCX document 13 KB Posted
- Solicitation number
- 36E77620B0005
About this file
This solicitation notice provides details for a renovation construction project at the Robert J. Dole VA Medical Center in Wichita, Kansas. The Department of Veterans Affairs seeks to award a firm-fixed-price contract through a competitive solicitation process to a Service-Disabled Veteran-Owned Small Business for renovations and relocation of the oncology, hematology, and dialysis departments on the first floor. The renovation work includes general construction, alterations, roads, walks, grading, drainage and necessary removal of existing structures. The period of performance is approximately 270 calendar days with the solicitation to be issued in mid to late June 2020 and magnitude of construction is estimated between $2,000,000 to $5,000,000. Questions must be submitted in writing by the specified deadline.
View the file
Other files
Show all 16
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Contractor Safety and Environmental Record Evaluation Form
Information provide below is current and applicable to Solicitation 36E77620B0001 Company Name: ______________________________________________ Address: _____________________________________________________ Telephone: ______________________ Fax: ________________________ Email: _______________________________________________________ Contact: ______________________________________________________ Utilizing your OSHA 300 Forms, please complete the following information:
| Category |
| 2016 |
| 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.
File details come from the government source that posted it. Updated .