B514_Att_10_Safety_Data.docx
DOCX document 31 KB Posted
- Attached to
- Bldg. 514 Subfloor Removal & Epoxy Coating
- Solicitation number
- N0025326Q0005
About this file
This is a Safety Data Sheet template required as part of the solicitation N0025326Q0005 for Building 514 Subfloor Removal & Epoxy Coating at Naval Undersea Warfare Center (NUWC) Division, Keyport. Offerors must complete this form to provide safety information that will be evaluated as part of the Safety factor in the proposal evaluation.
The template requires offerors to submit five previous complete calendar years of OSHA safety data, specifically DART (Days Away from Work, Restricted Duty, or Job Transfer) rates and TCR (Total Recordable Case) rates for 2021 through 2025. Offerors must explain any negative safety trends with DART rates of 3.0 or greater or TCR rates of 4.5 or greater, including corrective actions taken. Additionally, offerors must provide insurance carrier information and a safety narrative not exceeding two pages that describes their Safety Management System implementation, approach to subcontractor evaluation, and processes for overseeing subcontractor safety compliance throughout contract performance. The narrative should address management and leadership involvement, employee involvement, hazard prevention and control, worksite analysis, safety and health training, and benchmarking standards. For joint ventures or partnerships, each contractor must submit a Safety Data Sheet, though only one consolidated safety narrative is required.
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Other files
| File | Type | Posted |
|---|---|---|
| B514_Att_13_PPI_Answers.pdf | ||
| B514_N0025326Q00050001.pdf | ||
| B514_Att_06_Schedule_of_Values.xlsx | XLSX spreadsheet | |
| B514_Att_12_SOW.pdf | ||
| B514_Att_02_Wage_Det.pdf | ||
| B514_Att_03_Guide_Safety.pdf | ||
| B514_Att_09_PPI_Form.docx | DOCX document | |
| Solicitation - N0025326Q0005.pdf | ||
| B514_Att_05_Guide_OPSEC.pdf | ||
| B514_Att_07_Past_Performance.docx | DOCX document | |
| B514_Att_01_Material_Equip.xlsx | XLSX spreadsheet | |
| B514_Att_04_Guide_Environmental.pdf | ||
| B514_Att_08_Bid_Form.xlsx | XLSX spreadsheet | |
| B514_Att_11_OSHA.pdf |
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Text version
N0025326Q0005 Safety Data Sheet
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
| 2021 |
| 2022 |
| 2023 |
| 2024 |
| 2025 |
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
| 2021 |
| 2022 |
| 2023 |
| 2024 |
| 2025 |
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 .