ATTACHMENT 8 - Contractor Safety and Environmental Record Evaluation Form.docx

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Y1BG--757-22-1-344-0002 EHRM Infrastructure Upgrades - Columbus, OH - Tier 1 (VA-21-00085439)
Solicitation number
36C77622B0048
Issued by

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This solicitation is for an infrastructure upgrades project at a Veterans Affairs medical facility in Columbus, Ohio. Key details include:

  • The project involves upgrades to the EHRM infrastructure at the Columbus VA facility.

  • The solicitation is set aside 100% for Service-Disabled Veteran-Owned Small Businesses. Bids will only be considered from SDVOSBs verified in the VA's Vendor Information Portal database.

  • The bid submission deadline is August 5, 2022. A pre-bid site visit will be held on July 28, 2022.

  • In addition to pricing, bidders must provide safety and environmental records, experience modification rates, and certify the number of OSHA and EPA violations over the past three years.

  • The apparent low bidder will be subject to a determination of responsibility review prior to award. This will include a review of OSHA and EPA inspection histories.

  • The awarded contractor must be registered in the System for Award Management database and the Contractor Performance Assessment Reporting System.

  • The project is under the Department of Veterans Affairs Technology Acquisition Center in Austin.

View the file

Other files

File Type Posted
36C77622B0048 0002.docx DOCX document
36C77622B0048 0001.docx DOCX document
ATTACHMENT 11 EHRM Tier 1 Design Drawings - 2 of 3.pdf PDF
36C77622B0048_2.docx DOCX document
ATTACHMENT 7 - RELEASE OF CLAIMS.docx DOCX document
Attachment 6 DBA 2022 Franklin County OH 2 8 2022.gov.pdf PDF
ATTACHMENT 1 -757-21-701 Specifications.pdf PDF
ATTACHMENT 5 -05 757 21 701 Narrative_Technology.pdf PDF
ATTACHMENT 10 EHRM Tier 1 Design Drawings - 1 of 3.pdf PDF
ATTACHMENT 4 - 05 757 21 701 Narrative_Electrical.pdf PDF
ATTACHMENT 2 - QUALITY CONTROL PLAN REQUIREMENTS.docx DOCX document
ATTACHMENT 12 EHRM Tier 1 Design Drawings - 3 of 3.pdf PDF
Attachment 9 - HEFP SEP Design Alerts 1-8.pdf PDF
ATTACHMENT 3 -02 757 21 701_Narrative_Civil.pdf PDF
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Contractor Safety and Environmental Record Evaluation Form

Information provide below is current and applicable to Solicitation 36E77620R0003-1 Company Name: ______________________________________________ Address: _____________________________________________________ Telephone: ______________________ Fax: ________________________ Email: _______________________________________________________ Contact: ______________________________________________________ Utilizing your OSHA 300 Forms, please complete the following information:

Category
2016
2017
2018
2019

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 .