ATTACHMENT 7 - Contractor Safety _ Env Record Form.docx
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- Solicitation number
- 36E77620R0050
About this file
This document includes an attachment requesting contractor safety and environmental records for a solicitation, along with details of the related federal contract opportunity. The solicitation number is 36E77620R0050 and seeks proposals for the design-build renovation of Mental Health Wards 1L, 1H and 1K at the Minneapolis Veterans Affairs Medical Center. Offerors must furnish all labor, materials, tools and equipment for demolition, construction and installation of general, structural, civil, mechanical, plumbing, electrical and low voltage systems. The period of performance is approximately 790 calendar days with a magnitude of construction between $10-20 million. The solicitation will be issued on February 4, 2020 as a request for proposal conducted according to FAR Parts 15, 19 and 36 and evaluated as described within. The opportunity is a total SDVOSB set-aside for the Department of Veterans Affairs.
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Contractor Safety and Environmental Record Evaluation Form
Information provide below is current and applicable to Solicitation 36E77621R0050 Company Name: ______________________________________________ Address: _____________________________________________________ Telephone: ______________________ Fax: ________________________ Email: _______________________________________________________ Contact: ______________________________________________________ Utilizing your OSHA 300 Forms, please complete the following information:
| Category |
| 2017 |
| 2018 |
| 2019 |
| 2020 |
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 .