Contractor Certification Regarding Safety and Environmental 610-24-509.docx
DOCX document 13 KB Posted
- Attached to
- Install Isolation Filter System 610-24-509
- Solicitation number
- 36C25024B0044
About this file
This document is a Contractor Certification Regarding Safety and Environmental for Federal Contract Opportunity 610-24-509. The certification requires the contractor to disclose any serious, willful, or repeat violations from OSHA within the last 3 years and provide an explanation. The contractor must also provide their current Insurance Experience Modification Rate (EMR) supported by a signed letter from their insurance carrier. The related Federal Contract Opportunity is for installing (34) VA-provided negative/positive pressure isolation units with UV function, Accustat, and EchoPhan blower modules in building 172 at the VA Northern Indiana Health Care - Marion Campus. The work must be completed within 120 calendar days from the notice to proceed. The solicitation number is 36C25024B0044 and only electronic bids are being accepted via email to Colin.Remes@VA.gov.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C25024B0044 Bid Opening Call in Information 0003.docx | DOCX document | |
| 36C25024B0044 0002.docx | DOCX document | |
| RFI part 1.docx | DOCX document | |
| 610-24-509 Site Visit Attendance.pdf | ||
| 610-24-509 - Complete Drawings.pdf | ||
| 36C25024B0044 0001.docx | DOCX document | |
| RFI Form 36C25024B0044.doc | DOC document | |
| 610-24-509 - Specifications.pdf | ||
| EMR 36C25024R0095.docx | DOCX document | |
| RFI Form 36C25024R0095.doc | DOC document | |
| 610-24-509 - SOW.doc | DOC document | |
| IN 2024 Wage Determination.txt | TXT text file | |
| VHA Directive 1192 01.pdf | ||
| IFB 36C25024B0044.pdf |
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Text version
Contractor Certification Regarding Project: 610-24-509
| 2021 |
| 2022 |
| 2023 |
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 .