C7_Att10_Safety_Data_Sheet.docx
DOCX document 24 KB Posted
- Attached to
- KB Dock Piers Ladder Replacement
- Solicitation number
- N0025326Q0009
About this file
This is a Safety Data Sheet template that offerors must complete to provide safety information for evaluation under the KB Dock Piers Ladder Replacement solicitation (N0025326Q0009) issued by Naval Undersea Warfare Center Division (NUWC) Keyport. The form requires submission of five consecutive calendar years (2020–2024) of OSHA safety metrics, specifically Days Away from Work, Restricted Duty, or Job Transfer (DART) rates and Total Recordable Case (TRC) rates, presented as decimal figures. Offerors must explain any missing data for specific years and provide detailed corrective action explanations for any negative trends, defined as DART rates of 3.0 or greater or TRC rates of 4.5 or greater. For Joint Ventures or partnerships, each contractor must submit individual safety data, though only one combined safety narrative is required. Subcontractors are explicitly excluded from DART and TRC rate submission requirements.
The Safety Data Sheet also requires a technical safety narrative not to exceed two pages, which must address the offeror's Safety Management System (SMS) implementation including management and employee involvement, hazard prevention and control, worksite analysis, and safety training standards. Additionally, offerors must describe their process for evaluating and selecting subcontractors and detail their oversight mechanisms for ensuring subcontractor safety compliance throughout contract performance. This safety evaluation component is part of the overall proposal submission for the pier ladder replacement work at NUWC Keyport, Washington and Naval Base Bangor, which is a 100% small business set-aside requiring FOB Destination pricing.
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Other files
| File | Type | Posted |
|---|---|---|
| C7_PPI_Answers_KBDock_Ladders_Complete_List.docx | DOCX document | |
| N0025326Q0009_Amendment_0002.pdf | ||
| C7_Att13_KB_Dock_Keyport_Ladder_Replacement_SoW_Rev2.pdf | ||
| N0025326Q0009_Amendment_0001.pdf | ||
| C7_PPI_Answers_KBDock_Ladders.docx | DOCX document | |
| C7_Att13_KB_Dock_Keyport_Ladder_Replacement_SoW Rev1.pdf | ||
| C7_Att01_Materials_Equipment_In_Place_List.xlsx | XLSX spreadsheet | |
| C7_Att03_Safety_Requirements_for_Contractors.pdf | ||
| C7_Att05_OPSEC_Guide.pdf | ||
| C7_Att06_Schedule_Of_Values.xlsx | XLSX spreadsheet | |
| C7_Att12_Security_Requirements.docx | DOCX document | |
| C7_Att07_Past_Performance_References.docx | DOCX document | |
| C7_Att08_Bid_Form.xlsx | XLSX spreadsheet | |
| C7_Att13_Statement_of_Work_Pier_Ladders.pdf | ||
| C7_N0025326Q0009.pdf | ||
| C7_Att02_Wage_Determination.pdf | ||
| C7_Att04_Contractors_Guide_to_Env_Compliance.pdf | ||
| C7_Att09_PPI_Form.docx | DOCX document | |
| C7_Att11_OSHA_Calculating_Injury_and_Illness_Incident_Rate.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 .