Contractor Safety Record Form Summary

This is a Contractor Safety Record Form for Tree Trimming and Stump Removal Services for the Pennsylvania Department of Transportation (PennDOT) in Washington County, designated as District 12. The form requires bidders to submit documentation of their safety performance and programs as part of the competitive bidding process for tree trimming and stump removal services across State Routes, PennDOT facilities, and other areas under the department's responsibility within Washington County. Work includes the removal and disposal of waste materials such as chips, mulch, leaves, and branches, with fly chipping available upon specific project instructions. Bidders must submit responses electronically through the PA Supplier Portal via the Commonwealth's electronic SRM system.

Bidders are required to complete and upload three critical safety documentation components: the last three years of OSHA 300A logs with personnel information redacted to identify accident trends, completed tables documenting Total Recordable Case (TRC) rates and Days Away, Restricted, or Transferred (DART) incidence rates for the preceding three calendar years as defined by the U.S. Department of Labor, and a copy of the bidder's current safety program. Failure to complete and upload this form will result in the bid being deemed non-responsive. This procurement is restricted to DGS-certified small businesses only under Pennsylvania's Small Business Procurement Initiative established by Executive Order 2011-09, limiting competition to qualified small business entities.