C12_Att_10_Safety_Data_Sheet.docx
DOCX document 24 KB Posted
- Attached to
- Bldg 82 Replace Overhead Coiling Grille and Security Grate Federal contract opportunity
- Solicitation number
- N0025325Q0008
About this file
The document is a Safety Data Sheet template for a federal contract opportunity, requiring offerors to provide comprehensive safety performance data and narrative information. The form requests detailed safety metrics including OSHA Days Away from Work, Restricted Duty, or Job Transfer (DART) rates and Total Recordable Case (TCR) rates for the previous five calendar years (2019-2023), with provisions for explaining missing data or negative safety trends.
The Safety Data Sheet also requires a two-page safety narrative addressing key safety management elements, including: safety management system implementation, management and employee involvement, hazard prevention and control, worksite analysis, safety training, subcontractor selection processes, and methods for overseeing safety compliance throughout contract performance. This document appears to be a mandatory submission component for the related Naval Undersea Warfare Center Division (NUWC) Keyport solicitation (N0025325Q0008) for replacing overhead coiling grille and security grate at Building 82, which is a small business set-aside construction contract valued between $25,000 and $100,000.
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Other files for this federal contract opportunity
| File | Type | Posted |
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| C11b_Att_02_-_WA20250109_20250307_Mod2_Building.pdf | ||
| C11d_Att_07_Past_Performance_References.docx | DOCX document | |
| C12_Att_01_Material_Equipment_In_Place_List.xlsx | XLSX spreadsheet | |
| C12_Att_03_Safety_Requirements_for_Contractors_and_Subcontractors.pdf | ||
| C12_Att_04_Kpt_EV_Guide_for_Contractors_Jan_2025.pdf | ||
| C12_Att_06_Schedule_of_Values.xlsx | XLSX spreadsheet | |
| C12_Att_11_OSHA_Calculating_Injury_and_Illness_Incident_Rate.pdf | ||
| C11_N0025325Q0008.pdf | ||
| C12_Att_05_OPSEC_Guide_for_Defense_Contractors.pdf | ||
| C12_Att_08_Bid_Form.xlsx | XLSX spreadsheet | |
| C12_Att_09_PPI_Form.docx | DOCX document |
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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 .