Attachment 8 - Contractor Safety and Environmental Record Eval Form.pdf

70 KB Posted

Attached to
6210--596A4-24-102 - Replace Obsolete Lighting
Solicitation number
36C24924R0035
Issued by

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This solicitation is for electrical lighting replacement services at a Veterans Affairs medical campus. The contractor will remove approximately 9,300 existing ballast lamp fixtures and install new LED fixtures according to VA specifications. The contractor must provide all labor, materials, equipment, and construction services for this project. The expected completion time is 270 calendar days from notice to proceed. The solicitation includes safety and environmental record evaluation forms for contractors to submit, as well as project background, scope of work details, and general contract conditions regarding items like qualifications, supervision, security, parking, and records management requirements.

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Other files

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36C24924R0035 0007.docx DOCX document
36C24924R0035 0006.docx DOCX document
36C24924R0035 0005.docx DOCX document
A0004 - Replace Obsolete Lighting - Questions and Answers.pdf PDF
Amendment 0004 - 36C24924R0035 .pdf PDF
36C24924R0035 0003.pdf PDF
36C24924R0035 0002.pdf PDF
ATTACHMENT 1- Price Schedule - Sample Template revised.xlsx XLSX spreadsheet
Attachment 12 - UEI TAX ID.docx DOCX document
Attachment 11 - RFI Form.docx DOCX document
36C24924R0035 0001.pdf PDF
Attachment 10 - Wage Determination Fayette Co. KY20240090 01-05-2024.pdf PDF
36C24924R0035_1.docx DOCX document
Attachment 5 - Lighting Design Manual.pdf PDF
Attachment 1 - Pricing Schedule.xlsx XLSX spreadsheet
Attachment 10 - WD Fayette County Building KY20230090 dated 12012023.pdf PDF
Attachment 4 - 265100 Specification - Interior Lighting.pdf PDF
Attachment 2 - 017419 Specification - Construction Waste Management.pdf PDF
Attachment 9 - Past Performance Questionnaire.pdf PDF
Attachment 7 - Calc. of Self Performed Work General Contractor.xlsx XLSX spreadsheet
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Attachment 3 - 262726 Specification - Wiring Devices.pdf PDF
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Pre-Award Contractor Safety and Environmental Record Evaluation Form

Information provided below is current and applicable to Solicitation 36C24924R0035

Company Name:

Address:

Telephone:

Email:

Contact:

1. Utilizing your OSHA 300 Forms, please complete the following information:

Category 2020 2021 2022

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.

Please attach copies of the following documents: OSHA 300 and 300a Forms. These forms can be accessed through the OSHA publications search page:

http://www.osha.gov/pls/publications/publication.html.

2. Provide six-digit North American Industrial Classification System (NAICS) Code for this acquisition: 238210 – Electrical Contractors and Other Wiring Installation

Contractors.

3. Who administers your company’s Safety and Health Program?

4. Company’s Insurance Experience Modification Rate

(EMR):

http://www.osha.gov/pls/publications/publication.html

File details come from the government source that posted it. Updated .