CONTRACTOR CERTIFICATION REGARDING SAFETY AND ENVIRONMENTAL.docx
DOCX document 14 KB Posted
- Attached to
- 3960--654-22-1-6059-0005 Replace Elevators Building 1. Please Federal contract opportunity
- Solicitation number
- 36C26122R0018
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, as more than one serious, willful, or repeat violation would disqualify the contractor from the project. It also asks for the contractor's current insurance Experience Modification Rate and requires a supporting letter from the contractor's insurance carrier.
The related federal contract opportunity is solicitation number 36C26122R0018 to replace elevators in Building 1. The opportunity was posted by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 21. The solicitation provides details on the required work to replace elevators and requests proposals be sent to the Contracting Officer Charee Harris.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| B1 1945 D1-26 Arch Grd Flr Plan.pdf | ||
| S02 - Past Performance Questionnaire Elevators.docx | DOCX document | |
| S02 Price Breakdown by Division.docx | DOCX document | |
| 01.45.00 Quality Control.docx | DOCX document | |
| 01.35.26 Safety Requirements.docx | DOCX document | |
| PG 18-10 - Elevator Design Manual.pdf | ||
| 01.57.19 Temporary Environmental Controls.doc | DOC document | |
| Appendix 1.docx | DOCX document | |
| 01.32.16-16 Network Analysis Schedules.docx | DOCX document | |
| 36C26122R0018.docx | DOCX document | |
| 01.00.00 General Requirments.pdf | ||
| Key Personnel Attachment for Evaluation 02.docx | DOCX document | |
| 01.42.19 Reference Standards.docx | DOCX document | |
| 01.33.23.submittals.docx | DOCX document | |
| Checklist QC Plan Review.pdf | ||
| Wage Determination NV20210040 12.03.21.pdf | ||
| S02 - RFI FORM.docx | DOCX document |
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Text version
CONTRACTOR CERTIFICATION REGARDING SAFETY AND ENVIRONMENTAL
Contractor Certification Regarding Project: 640-21-300 Patient Privacy
| 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 .