CONTRACTOR CERTIFICATION REGARDING SAFETY AND ENVIRONMENTAL.docx
DOCX document 13 KB Posted
- Solicitation number
- 36C26120B0018
About this file
This document contains a contractor certification form and details of a related federal contract opportunity. The contractor certification form requests information on any OSHA violations from the past three years and the contractor's current insurance EMR. It must be signed and include the signer's title.
The related federal contract opportunity is solicitation number 36C26120B0018 to install fire sprinklers at the Sunnyvale Campus for the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 21. The opportunity type is a solicitation and the description provided is to install fire sprinklers. No further details are included on response dates, award dates, pricing or terms, or set asides.
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Other files
| File | Type | Posted |
|---|---|---|
| Fire Alarm Reference Docs.pdf | ||
| 36C26120B0018.docx | DOCX document | |
| RFI FORM SUNNYVALE FIRE SPRINKLERS.docx | DOCX document | |
| 010010-Contractor Quality Control.doc | DOC document | |
| Fire Protection Specifications.pdf | ||
| Fire Protection Bid Set.pdf |
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Text version
CONTRACTOR CERTIFICATION REGARDING SAFETY AND ENVIRONMENTAL
Contractor Certification Regarding Project: 640-16-121 Sunnyvale Fire Sprinkler
| 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 disqualifies the contractor.)
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 .