DS-4319 Activity Risk Assessment for 19AJ2024Q0023.docx
DOCX document 907 KB Posted
- Solicitation number
- 19AJ2024Q0023
- Issued by
-
Department of State US Embassy Baku
About this file
This document is an Activity Risk Assessment for a federal contract opportunity related to the renovation of a guard post at the U.S. Embassy in Baku, Azerbaijan.
The key details are as follows: The contract opportunity solicitation number is 19AJ2024Q0023 for the Renovation of Guard Post at the Chancery, U.S. Embassy Baku, Azerbaijan. The U.S. Department of State, U.S. Embassy Baku is the contracting agency. The contractor must complete a risk assessment to identify and control all risks and hazards associated with the renovation work, which includes drilling penetrations in the ceiling, installing new AC units, and other construction activities. The risk assessment requires the contractor to describe the task/activity, identify hazards, assess initial risk levels, develop controls, determine who will implement the controls, and assess the residual risk levels. The overall residual risk level is to be the highest remaining risk level. The solicitation has a pre-proposal conference scheduled for August 15, 2024, and quotes are due by August 29, 2024. The U.S. Government intends to award a contract/purchase order to the responsible company submitting the lowest acceptable quote, without holding discussions, although discussions may be held if needed.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 2024_08_12_RFQ19AJ2024Q0023.pdf |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Statement of Work Renovation walls and replace floor tiles at Post 2 at the Chancery in Baku, Azerbaijan 23 July 2024
Exhibit A: DS-4319 Activity Risk Assessment Instructions: Complete the following form using the instructions on page 4. The subtask in cell 4a.1 below is only an example. The Contractor must complete their own assessment to identify and control all risks and hazards.
| 1. | |
| Task/Activity Description: | |
| 2. | Date: (DD/MM/YYYY) |
| 3. | |
| Prepared By: | |
| 3b. | Title/Position |
| 4. |
| Five Steps of Risk Management: (1) Identify the hazards (2) Assess the hazards (3) Develop controls (4) Implement controls (5) Supervise and evaluate |
See risk assessment matrix on page 3 for risk classification guidance.
| 4a. |
| Subtask in Activity |
| 4b. Hazard |
| 4c. Initial Risk Level |
| 4d. Control |
| 4e. Who Will Implement |
| 4f. Residual Risk |
| 1. |
| Drill penetrations in the ceiling and install brackets to mount new AC units |
| Complicated work from heights, dust, noise |
| High |
| Build temporary scaffolding, use dust masks, hearing protection |
| Insert on-site supervisor name |
| Medium |
2.
3.
4.
5.
| 4a. |
| Subtask in Activity |
| 4b. Hazard |
| 4c. Initial Risk Level |
| 4d. Control |
| 4e. Who Will Implement |
| 4f. Residual Risk |
6.
7.
8.
9.
10.
11.
12.
| 5. | |||
| Overall Residual Risk Level (Highest remaining residual risk level in block 4f.) | |||
| Extremely High | High | Medium | Low |
Risk Assessment Matrix
Probability of Occurrence
Improbable:
(Very Unlikely to Occur) Seldom:
(Not Likely to Occur) Occasional:
(Sporadic or Intermittent Occurrences) Probable:
(Likely to Occur Multiple Times) Frequent:
(Regular or Continuous Occurrence)
Severity
Negligible:
No Injury or Damage
| Low |
| Low |
| Low |
| Low |
| Medium |
Moderate:
Minor Injury or Damage
| Low |
| Low |
| Medium |
| Medium |
| High |
Critical:
Major Injury or Damage
| Low |
| Medium |
| High |
| High |
| Extremely High |
Catastrophic:
Death, Permanent Disability, or Interrupted Operations
| Medium |
| High |
| High |
| Extremely High |
| Extremely High |
6. Additional Comments:
U.S. Department of State Bureau of Overseas Buildings Operations, OPS/SHEM, SA-6 Washington, DC 20522-0611 Activity Risk Assessment U.S. Department of State
Activity Risk Assessment
U.S. Department of State
Activity Risk Assessment Instructions Page. For information or questions please contact the Office of Safety, Health, and Environmental Management (SHEM) at SHEM-MRSAdmin@state.gov.
| 1. Task/Activity Description: Briefly describe the overall Task or Activity for which the risk assessment is being conducted. This form is not intended to replace job specific JHAs rather to provide a tool for managing non-routine activity risk. |
| 4d. Control: Identify risk mitigation resources/controls to abate or reduce risk for all hazards in block 4b (i.e., removal of hazards, administrative controls, training, PPE, etc.) |
| 2. Date (DD/MM/YYYY): Self explanatory. |
| 4e. Who Will Implement: The name of the individual that has primary responsibility for control implementation. |
| 3. Prepared By: The individual conducting the risk assessment. |
| 4f. Residual Risk Level: After controls are implemented, determine resulting probability, severity, and residual risk level (use the risk assessment matrix on page 3) |
| 4a. Subtask in Activity: Briefly describe all subtasks or different parts of the activity that warrant risk management. Keep it as simple as possible, but with enough information to identify the task. |
| 5. Overall Residual Risk Level: Assign an overall residual risk level after controls are implemented. This is the highest residual risk level (from block 4f). |
4b. Hazard: Specify hazards related to the subtask in block 4. A common mistake is to refer to a hazard as the actual harm or the health effect it caused rather than the hazard. If the task was mopping the floor, the hazard is the wet floor not the potential harm caused e.g. fall / cut knee. If no hazards exist, the task still needs to be listed
| 4c. Initial Risk Level: Using the risk assessment matrix (page 3), determine level of risk for each hazard specified. Use the probability, severity, and associated Risk Level and write the highest level |
| 6. Additional Comments: Additional comments, remarks, or information to support the risk assessment. |
image1.jpg image2.jpeg
File details come from the government source that posted it. Updated .