C12_Att_10_-_Safety_Data_Sheet.docx

DOCX document 27 KB Posted

Attached to
Building 33 Facility Renovation Federal contract opportunity
Solicitation number
N0025324Q0041
Issued by
Department of the Navy Naval Sea Systems Command

About this file

This document is a Safety Data Sheet that is to be completed by the offeror for a federal contract opportunity. The Safety Data Sheet requires the offeror to provide their insurance carrier information and the previous five years of reported safety data, including their OSHA Days Away from Work, Restricted Duty, or Job Transfer (DART) rate and Total Recordable Case (TCR) rate. The offeror is also required to provide a safety narrative that describes their approach to implementing and executing a Safety Management System, their process for selecting subcontractors, and how they will oversee the safety compliance of subcontractors.

The related federal contract opportunity is for the renovation of Building 33 at the Naval Undersea Warfare Center Division (NUWC) Keyport in Keyport, WA. The project will require the contractor to demolish walls, remove abandoned piping, repair flooring, and paint the interior. This requirement is being solicited for non-commercial services in accordance with FAR Parts 13 and 36, utilizing Low Price Technically Acceptable evaluation factors. The government estimate of the magnitude of the requirement is $100,000.00 to $250,000.00, and the target award date is about 04 November 2024. The solicitation will be 100% set aside for small businesses.

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C12_Att_01_-_Material_Equipment_In_Place_List.xlsx XLSX spreadsheet
C12_Att_06_-_Schedule_of_Values.xlsx XLSX spreadsheet
C11b_Att_02_-_WD_WA20240109.pdf PDF
C12_Att_11_-_OSHA_Calculating_Injury_and_Illness_Incident_Rate.pdf PDF
C12_Att_03_-_Safety_Requirements_for_Contractors_and_Subcontractors.pdf PDF
C12_Att_04_-_Contractors_Guide_to_Env_Compliance.pdf PDF
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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

2019
2020
2021
2022
2023

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

2019
2020
2021
2022
2023

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 .