ATTACHMENT E - EMR.pdf
PDF 77 KB Posted
- Attached to
- Y1DA--FY23: NRM-Tier 1 (PROJ: 548-20-106) BB - Replace Emergency Generators and Paralleling Gear
- Solicitation number
- 36C24823R0005
About this file
This document contains a pre-award contractor evaluation form and information on a related federal contract opportunity for generator replacement services. The evaluation form requests safety and health information from bidders, including OSHA recordable incident rates for the past three years, explanations for any serious violations, insurance experience modification rates, and safety program administration details. Bidders must also provide their six-digit NAICS code and attach copies of recent OSHA forms. The related federal opportunity is a solicitation from the Department of Veterans Affairs to replace emergency generators and paralleling gear at the West Palm Beach VA Medical Center in Florida. Interested contractors must meet the evaluation criteria to qualify for the work of completely preparing the site and furnishing all labor, materials, and services to install new emergency generators and transfer switches.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Award Notice for SAM 36C24824C0014_1.pdf | ||
| 36C24823R0005 0002.docx | DOCX document | |
| Contractors Inquiry - Questions and Answers - Follow Up Questions.docx | DOCX document | |
| 36C24823R0005 0001.docx | DOCX document | |
| Contractors Inquiry Questions with Answers.pdf | ||
| 36C24823R0005_1.docx | DOCX document | |
| ATTACHMENT C - Submittal Register.xlsx | XLSX spreadsheet | |
| ATTACHMENT F - Contractors Inquiry.pdf | ||
| ATTACHMENT A - Combined Specs.pdf | ||
| ATTACHMENT G - Price Matrix.xlsx | XLSX spreadsheet | |
| ATTACHMENT D - Past Performance Questionnaire.pdf | ||
| ATTACHMENT B - Drawings.pdf | ||
| ATTACHMENT H - Experience Information Sheet.docx | DOCX document |
Show all 13
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
EMR FORM FOR BIDDER/OFFEROR TO COMPLETE & SUBMIT WITH PROPOSAL
Pre-Award Contractor Evaluation Form Company Name:
Address: _____________________________________________________
Telephone: ______________________ Fax: ________________________
Email: _______________________________________________________
Contact: ______________________________________________________
1. Utilizing your OSHA 300 Forms, please complete the following information:
Category 2019 2020 2021 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. (Four serious, one repeat, or one willful disqualifies the contractor.)
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 your six-digit North American Industrial Classification System (NAICS) Code for this acquisition: __________________________________
3. Who administers your company’s Safety and Health Program?
4. Company’s Insurance Experience Modification Rate (EMR) for the past 3 years (an EMR of greater than 1.0 disqualifies the contractor): _____________
File details come from the government source that posted it. Updated .