C12_Att_10_Safety_Data_Sheet.docx
DOCX document 23 KB Posted
- Attached to
- Bldg. 514 Epoxy Floor Coatings
- Solicitation number
- N0025325Q0010
About this file
This Safety Data Sheet is a document for potential contractors to provide comprehensive safety performance information for a naval construction project. The form requires detailed reporting of OSHA safety metrics including Days Away from Work, Restricted Duty, or Job Transfer (DART) rates and Total Recordable Case (TCR) rates for the past five years (2020-2024). Contractors must explain any safety rate trends above moderate risk and provide a two-page narrative detailing their Safety Management System, including management leadership, employee involvement, hazard prevention and control, worksite analysis, and safety training processes.
The related federal contract opportunity is a small business set-aside solicitation (N0025325Q0010) issued by the Naval Undersea Warfare Center Division at Keyport, WA, seeking quotes to replace epoxy flooring at Building 514. The project is classified under NAICS code 238190 with a small business size standard of $19.0 Million, and has a government estimated value between $75,000 and $175,000. The target award date is July 14, 2025, and the solicitation will be evaluated using Low Price Technically Acceptable factors. Offerors must be registered in the System for Award Management (SAM) and can submit inquiries to specified Navy contract contacts.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| C24_N0025325Q00100001.pdf | ||
| C26_WA20250109_20250606_Mod3.pdf | ||
| C12_Att_11_OSHA_Calculating_Injury_and_Illness_Incident_Rate.pdf | ||
| C12_Att_08_Bid_Form.xlsx | XLSX spreadsheet | |
| C12_Att_06_Schedule_of_Values.xlsx | XLSX spreadsheet | |
| C11d_Att_07_Past_Performance_References.docx | DOCX document | |
| C11b_Att_02_WA20250109_03072025.pdf | ||
| C12_Att_05_OPSEC_Guide_for_Defense_Contractors.pdf | ||
| C12_Att_03_Safety_Requirements_for_Contractors_and_Subcontractors.pdf | ||
| C12_Att_01_Material_Equipment_In_Place_List.xlsx | XLSX spreadsheet | |
| C12_Att_09_PPI_Form.docx | DOCX document | |
| C11_N0025325Q0010.pdf | ||
| C12_Att_04_Kpt_EV_Guide_for_Contractors_Jan_2025.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
| 2020 |
| 2021 |
| 2022 |
| 2023 |
| 2024 |
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
| 2020 |
| 2021 |
| 2022 |
| 2023 |
| 2024 |
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 .