CONTRACTOR CERTIFICATION REGARDING SAFETY AND ENVIRONMENTAL.docx
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- Solicitation number
- 36C26126R0049
About this file
This is a Contractor Certification form regarding safety and environmental compliance for Solicitation No. 36C26126R0049, which covers the renovation of Building 1, 1st Floor Acute Respiratory Clinic at Fresno VA Medical Center (Project No. 570-23-223). The form requires contractors to disclose the number of serious, willful, or repeat violations from OSHA and EPA within the last three years, with explanations required for any violations cited. Contractors with four or more serious violations, one repeat violation, or one willful violation are automatically disqualified. Additionally, contractors must provide their current Experience Modification Rate (EMR) from their insurance carrier and support this figure with a signed letter on the carrier's letterhead. The certification must be signed by an authorized company representative with their typed name and title.
This firm-fixed-price construction requirement is a total service-disabled veteran-owned small business (SDVOSB) set-aside under NAICS Code 236220 with a small business size standard of $45 million. The solicitation closes on June 15, 2026, at 2:00 P.M. PDT, with performance scheduled for 224 calendar days after Notice to Proceed at the Fresno VA Medical Center location in California. A pre-proposal site visit is scheduled for May 20, 2026, at 11:00 A.M. PDT, and written requests for information must be submitted by May 28, 2026, at 10:00 A.M. PDT. Bid bonds, payment bonds, and performance bonds are required submissions with proposals.
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CONTRACTOR CERTIFICATION REGARDING SAFETY AND ENVIRONMENTAL
Contractor Certification: Solicitation No. 36C26126R0049, Project No. 570-23-223, Renovate Building 1, 1st Floor Acute Respiratory Clinic at Fresno VA Medical Center
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| 2026 |
Number of serious, willful, or repeat violations from OSHA within the last 3 years. Please attach explanation for any violations.
Number of serious, willful, or repeat EPA violations within the last 3 years. Please attach explanation for any violations.
(Four serious, one repeat, or one willful violation 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 .