Attachment 8 - Contractor Safety and Environmental Record Evaluation Form.docx
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- Attached to
- Y1DZ-- Renovate Sterile Processing Service Project # 598-18-108 NRM Construction - Little Rock, AR
- Solicitation number
- 36C77621R0035
About this file
This solicitation describes a construction project to renovate sterile processing service areas at a Department of Veterans Affairs medical center in Little Rock, Arkansas. The project includes renovating approximately 14,903 gross square feet of interior space on the ground floor and 860 gross square feet of interior space on the fifth floor. General contractors will be responsible for renting sterilization trailers to be used during renovations. The solicitation will be issued as a request for proposal on March 4, 2021, with a period of performance of approximately 365 calendar days from the notice to proceed. The estimated value is between $5-10 million. The solicitation is a total service-disabled veteran-owned small business set-aside, and offers will only be accepted from SDVOSBs. Questions must be submitted in writing by the specified deadline.
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Contractor Safety and Environmental Record Evaluation Form
Information provide below is current and applicable to Solicitation 36C77621R0035 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 .