ATTACHMENT 8 CONTRACTOR SAFETY AND ENVIRONMENTAL RECORD EVAL 618-16-101 CONSTRUCT EVIDENCE BASED INPATIENT WARD 2K2H.docx

DOCX document 14 KB Posted

Attached to
Z2DA--Construct Evidence Based Wards (VA-20-00046403) Federal contract opportunity
Solicitation number
36A77620R0004
Issued by
Department of Veterans Affairs Headquarters

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.

View the file

Other files for this federal contract opportunity

Show all 16

On GovTribe

Work with this file on GovTribe

  • 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 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 .