Attachment_8_Safety_Data_Sheet.docx
DOCX document 22 KB Posted
- Attached to
- Bldg. 894 - Create Bldg. Security Boundary Federal contract opportunity
- Solicitation number
- N0025324R5002
About this file
The provided document is a Safety Data Sheet that must be completed by an offeror for a federal contract opportunity. It requests information on the offeror's insurance carrier, OSHA Days Away from Work, Restricted Duty, or Job Transfer (DART) rates and Total Recordable Case (TCR) rates for the past five calendar years, as well as a technical approach for implementing and executing a Safety Management System, evaluating potential subcontractors, and overseeing subcontractor safety compliance. This Safety Data Sheet is required as part of the proposal submission for the federal contract opportunity to upgrade Building 894 to create a secure building boundary, which is a 100% small business set-aside solicitation issued by the Department of the Navy Naval Sea Systems Command.
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Text version
SAFETY DATA SHEET
This form is to be completed by the offeror. Use this form to provide safety information for the Safety factor. DART and TRC rates shall not be submitted for subcontractors.
Joint Venture (JV) or Partnership: Provide a Safety Data Sheet for each contractor who is part of the JV or partnership; however, only one safety narrative is required.
1. Offeror Name:
Name of JV partner providing the information below (if applicable):
2. Insurance Carrier Information:
Insurance Carrier Name:
Agent’s name:
Phone No.:
Email:
Offeror’s Five Previous Complete Calendar Years of Reported Safety Data:
Only complete year safety data will be considered. Indicate data rates as decimal figures, not whole numbers.
3. OSHA Days Away from Work, Restricted Duty, or Job Transfer (DART) Rate
| 2016 |
| 2017 |
| 2018 |
| 2019 |
| 2020 |
3a. If you do not have a DART Rate for a given year, affirmatively state so here and explain why:
3b. Explain any negative trend above moderate risk (DART Rates of 3.0 or greater), an acceptable/detailed explanation is required that includes any corrective actions taken for improvement:
4. Total Recordable Case (TCR) Rate
| 2016 |
| 2017 |
| 2018 |
| 2019 |
| 2020 |
4a. If you do not have a TCR Rate for a given year, affirmatively state so here and explain why:
4b. Explain any negative trend above moderate risk (TCR Rates of 4.5 or greater), an acceptable/detailed explanation is required that includes any corrective actions taken for improvement:
SAFETY DATA SHEET (Continuation)
5. Technical Approach for Safety: Provide the Safety Narrative using this form. Do not exceed 2 pages. Any additional pages will not be considered.
a. Describe the Offeror’ s approach to implementing and executing a Safety Management System (SMS) including Management/Leadership involvement, Employee involvement, Hazard prevention, Hazard control, Worksite analysis, and Safety and health training, to include the standard(s) used to benchmark the SMS.
b. Describe the evaluation process used to select potential subcontractors.
c. Describe the processes of how the Offeror will oversee safety compliance of subcontractors at all levels throughout performance of the contract (to include the Offeror’s own in-house workforce).
File details come from the government source that posted it. Updated .