EXHIBIT A CONTRACTOR EVALUATION FORM CONSTRUCTION SAFETY.pdf
PDF 57 KB Posted
- Attached to
- Z2DA--Design/Build Project: 629-29-114 Correct Inaccessible Fire Dampers Federal contract opportunity
- Solicitation number
- 629-29-114
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.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 36C25621R0033_1.pdf | ||
| RESEARCH 3rd Mech Plan Drawing.pdf | ||
| INP L01 Drawing.pdf | ||
| 629-20-114 Inaccessible Fire Damper Scope and Locations 71620.pdf | ||
| Specs.pdf | ||
| 36C25621R0033_1.pdf | ||
| RESEARCH 2nd Mech Plan Drawing.pdf | ||
| 629-20-114 Overall Campus Damper Location Drawings.pdf | ||
| General Decision LA 20200041 10-09-2020.pdf | ||
| RESEARCH 4th Mech Plan Drawing.pdf | ||
| INP L04 Drawing.pdf | ||
| Concourse L1.pdf | ||
| VA Master Specs Table of Contents.pdf |
Show all 13
On GovTribe
Work with this file on GovTribe
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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 .