Attachment 7 - DSCC Excavation Permit.pdf

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Attached to
CSC-20019; DSCC BLDG 27 Boiler Conversion Federal contract opportunity
Solicitation number
SP4702-21-R-0018
Issued by
Defense Logistics Agency

About this file

This solicitation is for a full conversion of the boiler system at Building 27 of the Defense Supply Center in Columbus, Ohio. The existing steam boiler system will be removed, demolition and repair work completed, and a new hot water boiler system installed. The procurement is a 100% small business set-aside between $1 million to $5 million as a firm fixed-price contract. Proposals are due by July 15, 2021, and award will be made to the lowest-priced technically acceptable offer with acceptable past performance. A mandatory site visit is scheduled for June 30, 2021, and questions are due by July 6, 2021. Responses must include forms SF1442, a bid form, bid bond, past performance, and a contract management plan with resumes. The Defense Logistics Agency is the contracting agency.

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Text version

DEFENSE SUPPLY CENTER COLUMBUS EXCAVATION PERMIT

PERMIT NUMBER

In case of an emergency, dial 911 from a DSCC phone or call the DSCC Fire Department at (614) 692-2111.

PROJECT NAME DATE

PROJECT START DATE PROJECT END DATE DURATION

PRIME CONTRACTOR SUB-CONTRACTOR / EXCAVATION CONTRACTOR

CONTRACTOR REPRESENTATIVE CONTRACTOR REPRESENTATIVE PHONE NO.

DSCC FACILITIES REPRESENTATIVE DSCC FACILITIES REPRESENTATIVE PHONE NO.

DESCRIPTION OF WORK AND LOCATION

Excavation by Contractor include applicable drawings.

Excavation by Government

Excavation / Trench Depth: Less than 5 ft. Greater than 5 ft. Greater than 20 ft.

Note: If excavation depth is greater than 5 ft., a soil analysis will be required to determine the appropriate Protective System that will be utilized. A Competent Person shall be on site during trenching and/or excavating activities.

SOIL ANALYSIS CONTRACTOR COMPETENT PERSON SOIL ANALYSIS CONTRACTOR PHONE NO.

SOIL ANALYSIS METHOD UTILIZED NAME OF PROFESSIONAL ENGINEER (if excavation is greater than 20 ft.)

SOIL ANALYSIS RESULTS PROVIDED TO FACILITIES: Yes No

CONTRACTOR REVIEWED UTILITY DRAWINGS: Yes No

UNDERGROUND UTILITIES IDENTIFIED: Yes No If no, provide explanation:

INSTRUMENTS UTILIZED TO IDENTIFY UNDERGROUND UTILITIES: Passive or Active Electromagnetic RF Detector

Ground Penetrating Radar

Other (provide type):

UTILITIES CHECKED BELOW WERE IDENTIFIED, AND MARKED ACCORDINGLY AT THE WORK LOCATION

Electrical Water Sewer Compressed Gas Communications* Stormwater

IS PROTECTIVESHORING SYSTEM REQUIRED: Yes No

Shoring Shielding Benching Sloping Not Applicable

REVIEWED BY CONCURRENCES

PRINT SIGN DATE

CONTRACTOR (Required) (Company Name)

SUBMITTED BY

DSCC FACILITIES REPRESENTATIVE

PROFESSIONAL ENGINEER DATE

(if excavation is greater than 20ft.)

COMPETENT PERSON DATE

NOTES: PERMIT SHALL BE KEPT AT THE WORK LOCATION AT ALL TIMES

* If Communications utilities are present Defense Information Systems Agency (DISA) may require 30 Days Advanced Notice prior to excavation c011169 Text Box Attachment 7; SP4702-21-R-0018

PERMIT NUMBER:
PROJECT NAME:
DATE:
PROJECT START DATE:
PROJECT END DATE:
DURATION:
PRIME CONTRACTOR:
SUB-CONTRACTOR / EXCAVATION CONTRACTOR:
CONTRACTOR REPRESENTATIVE:
CONTRACTOR REPRESENTATIVE PHONE NO.:
JPL FACILITIES REPRESENTATIVE:
JPL FACILITIES REPRESENTATIVE PHONE NO.:
Construction Project include applicable drawings: Off
Construction Project include applicable drawings: Off
Excavation / Trench Depth:
Less than 5 ft: Off
Greater than 5 ft: Off
Greater than 5 ft: Off
SOIL ANALYSIS CONTRACTOR:
SOIL ANALYSIS CONTRACTOR PHONE NO.:
SOIL ANALYSIS METHOD UTILIZED:
undefined: Off
undefined: Off
CONTRACTOR REVIEWED UTILITY DRAWINGS: Yes No:
undefined: Off
undefined: Off
Yes: Off
No If no, provide explanation: Off
Passive or Active Electromagnetic RF Detector: Off
Ground Penetrating Radar: Off
undefined: Off
Other (provide type:
Electrical: Off
Water: Off
Sewer: Off
Compressed Gas: Off
Communications: Off
Stormwater: Off
Yes: Off
No If yes, select type below: Off
Shoring: Off
Shielding: Off
Benching: Off
Sloping: Off
Not Applicable: Off
CONTRACTOR (Required) (Company Name):
PROTECTIVE SERVICES (as applicable) DATE:
SUBMITTED BY:
TRANSPORTATION (as applicable) DATE:
FACILITIES (Required):

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