C12_Att_10_Safety_Data_Sheet.docx
DOCX document 27 KB Posted
- Attached to
- Replace Restroom Doors Federal contract opportunity
- Solicitation number
- N0025325Q0009
About this file
This document is a Safety Data Sheet template for a federal contract opportunity. The form requires offerors to provide comprehensive safety information, 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. Offerors must detail their Safety Management System approach, including management leadership, employee involvement, hazard prevention and control, worksite analysis, and safety training. The form also requires descriptions of subcontractor selection processes and safety compliance oversight.
The associated federal contract opportunity is a Navy solicitation (N0025325Q0009) for replacing two restroom doors and frames at the Naval Undersea Warfare Center Division in Keyport, WA. The solicitation is a small business set-aside with an estimated contract value between $15,000 and $50,000, targeting a June 10, 2025 award date. It is classified under NAICS code 238350 (Finish Carpentry Contractors) and will use a Low Price Technically Acceptable evaluation method. Offerors must be registered in the System for Award Management (SAM) and can submit inquiries to specified Navy contract representatives.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| C24_N0025325Q00090001.pdf | ||
| C26_ SOW_REV1.pdf | ||
| C12_Att_04_Kpt_EV_Guide_for_Contractors_Jan_2025.pdf | ||
| C12_Att_03_Safety_Requirements_for_Contractors_and_Subcontractors.pdf | ||
| C12_Att_05_OPSEC_Guide_for_Defense_Contractors.pdf | ||
| C11b_Att_02_WD_WA20250109_03072025.pdf | ||
| C12_Att_09_PPI_Form.docx | DOCX document | |
| C12_Att_08_Bid_Form.xlsx | XLSX spreadsheet | |
| C11_N0025325Q0009.pdf | ||
| C12_Att_11_OSHA_Calculating_Injury_and_Illness_Incident_Rate.pdf | ||
| C11d_Att_07_Past_Performance_References.docx | DOCX document | |
| C12_Att_06_Schedule_of_Values.xlsx | XLSX spreadsheet | |
| C12_Att_01_Material_Equipment_In_Place_List.xlsx | XLSX spreadsheet |
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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 .