ATTACHMENT 8 CONTRACTOR SAFETY AND ENVIRONMENTAL RECORD EVAL 618-16-101 CONSTRUCT EVIDENCE BASED INPATIENT WARD 2K2H.docx
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- Attached to
- Z2DA--Construct Evidence Based Wards (VA-20-00046403) Federal contract opportunity
- Solicitation number
- 36A77620R0004
About this file
This document contains a contractor safety and environmental record evaluation form and details of a federal contract opportunity notice for construction services. The contractor evaluation form requests safety and environmental record information over the past four years, including man hours, OSHA-reported injuries, days away from work rates, and any serious violations.
The related federal contract opportunity is a solicitation notice from the Department of Veterans Affairs for construction of a new evidence-based inpatient ward at the Minneapolis VAMC. The project scope involves renovations and construction with an estimated value between $5-10 million. The solicitation will be issued on July 22, 2020 as a request for proposal for a firm-fixed price contract with a performance period of approximately 390 calendar days. The solicitation is set aside as a total small business opportunity for Service-Disabled Veteran-Owned Small Businesses.
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Text version
Contractor Safety and Environmental Record Evaluation Form
Information provide below is current and applicable to Solicitation 36A77620R0004 Company Name: ______________________________________________ Address: _____________________________________________________ Telephone: ______________________ Fax: ________________________ Email: _______________________________________________________ Contact: ______________________________________________________ Utilizing your OSHA 300 Forms, please complete the following information:
| Category |
| 2014 |
| 2015 |
| 2016 |
| 2017 |
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 .