EXHIBIT A CONTRACTOR EVALUATION FORM CONSTRUCTION SAFETY.pdf

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Attached to
Z2DA--Design/Build Project: 629-29-114 Correct Inaccessible Fire Dampers Federal contract opportunity
Solicitation number
629-29-114
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16

About this file

This document contains an evaluation form for contractor safety performance and a federal contract opportunity notice for a design-build project. The evaluation form requests safety-related information from contractors over the past three years, including man-hours worked, OSHA recordable incidents, rates of days away from work, and documentation of any serious violations. It inquires about the administrator of the company's safety program and current experience modification rate.

The federal contract opportunity is a two-phase design-build acquisition to make all inaccessible fire, smoke, and fire/smoke dampers accessible for inspection and maintenance at the Southeast Louisiana Veterans Health Care System campus. Phase I is open to all qualified SDVOSB offerors to submit for evaluation and selection to Phase II. Phase II offerors will then submit full proposals. The project scope includes relocating, constructing access structures, and modifying spaces to reach all inaccessible dampers, inspecting and repairing those previously inaccessible, investigating walls for required dampers, and providing design and installation of any new dampers. All work must comply with building codes, NFPA standards, ASME, UL, VA requirements and TJC.

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Other files for this federal contract opportunity

Other files attached to Z2DA--Design/Build Project: 629-29-114 Correct Inaccessible Fire Dampers, newest first.
File Type Posted
36C25621R0033_1.pdf PDF
RESEARCH 3rd Mech Plan Drawing.pdf PDF
INP L01 Drawing.pdf PDF
629-20-114 Inaccessible Fire Damper Scope and Locations 71620.pdf PDF
Specs.pdf PDF
36C25621R0033_1.pdf PDF
RESEARCH 2nd Mech Plan Drawing.pdf PDF
629-20-114 Overall Campus Damper Location Drawings.pdf PDF
General Decision LA 20200041 10-09-2020.pdf PDF
RESEARCH 4th Mech Plan Drawing.pdf PDF
INP L04 Drawing.pdf PDF
Concourse L1.pdf PDF
VA Master Specs Table of Contents.pdf PDF
Show all 13

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Text version

Exhibit A Contractor Evaluation Form

Construction Safety

Company Name:

Address:

Telephone: Fax:

Email:

Contact:

1. Utilizing your OSHA 300 Forms, please complete the following information:

Category 2017 2018 2019

Number of man hours (jobsite and office).

Number of cases involving days away from work, restricted activity, or both (Column H and I of OSHA 300).

Days away, restricted, or transferred rate (# of days away, restricted, or transferred cases x 200,000/# of man hours)

(DART Rate).

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 will lower technical rating of offeror significantly.)

Please attach copies of the following documents: OSHA 300 and 300a Forms. These forms can be accessed through the OSHA publications search page:

http://www.osha.gov/pls/publications/publication.html.

2. Who administers your company’s Safety and Health Program? ______________________

3. Company’s current insurance Experience Modification Rate (EMR):___________________ http://www.osha.gov/pls/publications/publication.html

File details come from the government source that posted it. Updated .