Contractor Certification Regarding EMR 02.docx

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Attached to
C1DA--Prepare Site for PET-CT 539-CSI-204
Solicitation number
36C25020B0056
Issued by

About this file

This document contains a federal contract solicitation and contractor certification requirements. The solicitation is for project number 539-CSI204 to prepare a site for PET-CT scanning at the Veterans Administration Cincinnati VA Medical Center. The contract is set aside as a 100% small business opportunity with preference given to service-disabled veteran-owned small businesses. To be eligible, offerors must be registered and verified in the Vendor Information Pages and System for Award Management databases. The project scope includes compliance with VA security requirements. Offerors must certify having no more than three serious, one repeat, or one willful occupational safety and health violations in the past three years, and a current experience modification rate of 1.0 or less. The contract value is between $500,000 and $1,000,000 using North American Industry Classification System code 236220. The duration is a maximum of 180 days from notice to proceed. Performance and payment bonds will be required.

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CLARIFICATION OF BID SUBMISSIONS.docx DOCX document
36C25020B0056 0003.docx DOCX document
539-CSI-204 DRAWINGS ADDENDUM 1.pdf PDF
36C25020B0056 0002.docx DOCX document
Wage Determinations General Decision Number OH20200082.pdf PDF
36C25020B0056 0001.docx DOCX document
539-CSI-204 SPECIFICATION 2020 0127.pdf PDF
539-CSI-204 CD DRAWINGS 0127-2020.pdf PDF
Contractor Certification Regarding EMR.docx DOCX document
RFI Form.docx DOCX document
36C25020B0056_1.docx DOCX document
WAGE DETERMINATIONS.6.23.20.docx DOCX document
539-CSI-204_Brand Name Justification Honeywell Fire Alarm -1851.docx DOCX document
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Text version

Contractor Certification Regarding Project: 539-20-212

2016
2017
2018
2019

Number of serious, willful, or repeat violations from OSHA within the last 3 years. Please attach explanation for any violations. (Four serious, one repeat, or one willful violation could result in being determined non-responsible.)

Company’s Current Insurance Experience Modification Rate (EMR) = _____________ (Note: Contractor must support the EMR with a signed letter from Insurance Carrier on their letterhead.)

Signature: ______________________________________________

Typed Name: ______________________________________________________

Title: ______________________________________________________

File details come from the government source that posted it. Updated .