Contractor Certification Regarding Safety and Environmental.docx
DOCX document 13 KB Posted
- Attached to
- Z1DA--Replace Perimeter Fence 610-21-212 Federal contract opportunity
- Solicitation number
- 36C25022B0059
About this file
This document contains a contractor certification form and details of a related federal contract opportunity for replacement of perimeter fencing. The certification form requests information on any OSHA violations from the past three years and the contractor's current insurance EMR rating, to be supported by a letter from their carrier.
The related federal contract opportunity is solicitation number 36C25022B0059 to provide all labor, equipment, materials and supervision necessary to remove and replace fencing and gates as specified at the VA Northern Indiana Health Care facility in Marion, Indiana. The work also includes specified landscaping. The contracting agency is the Department of Veterans Affairs Veterans Health Administration VISN 10.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Bid Schedule.pdf | ||
| 36C25022B0059 Amendment A00003.pdf | ||
| Amendment 36C25022B0059 A00002.pdf | ||
| 610-21-212 Replace Perimeter Fence - Sign In Sheet.pdf | ||
| Amendment 36C25022B0059 A0001.pdf | ||
| 36C25022B0059 Solicitation.pdf | ||
| Flu Directive.pdf | ||
| Drawings.pdf | ||
| RFI Form.doc | DOC document | |
| Specifications.pdf | ||
| Wage Determination.pdf |
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Text version
Contractor Certification Regarding Project: 610-21-212
| 2019 |
| 2020 |
| 2021 |
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 .