Exhibit B Safety Data Sheet.docx
DOCX document 18 KB Posted
- Solicitation number
- N69450-20-R-0012
About this file
This document provides details for a federal solicitation seeking proposals for design-build and design-bid-build construction services in the Jacksonville, Mayport, and Orlando areas of Florida. The Naval Facilities Engineering Command Southeast is soliciting proposals for indefinite-delivery/indefinite-quantity multiple award construction contracts with a total aggregate value not to exceed $99 million over five years. The planned seed project involves building two paint storage and mixing enclosures at Naval Station Jacksonville. Offerors must be HUBZone certified small businesses with experience in general building construction such as industrial, airfield, administrative, and community facilities projects ranging from $150,000 to $6 million. The solicitation will result in awards to approximately five contractors through a two-phase best value source selection evaluating technical and price factors, with the seed project being awarded to the best value proposal. A pre-proposal conference will be held for phase two participants. The period of performance is a five-year ordering period beginning from award date.
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Other files
| File | Type | Posted |
|---|---|---|
| N69450-20-R-0012-0003.pdf | ||
| N69450-20-R-0012-0002.pdf | ||
| N69450-20-R-0012-0001.pdf | ||
| Exhibit A Construction Experience Project Data Sheet.docx | DOCX document | |
| N69450-20-R-0012.pdf | ||
| Exhibit D ProjNet How-To Guide.pdf | ||
| Exhibit C Past Performance Questionnaire.docx | DOCX document |
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Text version
Exhibit B
SAFETY DATA SHEET
This form is to be completed by the Offeror. Use this form to provide safety information for the Safety factor. EMR, DART and TRC rates shall not be submitted for subcontractors.
Joint Venture (JV) or Partnership: Provide a Safety Data Sheet for each contractor who is part of the JV or partnership; however, only one safety narrative is required.
1. Offeror Name:
Name of JV partner providing the information below (if applicable):
Offeror’s Three Previous Complete Calendar Years of Reported Safety Data:
Only complete year safety data will be considered. Indicate data rates as decimal figures, not whole numbers.
| 2. Experience Modification Rate (EMR): |
| 2019 |
| 2018 |
| 2017 |
2a. Explain any extenuating circumstances resulting in any EMRs greater than 1.0:
2b. Explain any upward or downward EMR trends:
2c. If you do not have an EMR for a given year, state so here and explain why:
3. Insurance Carrier Information:
Insurance Carrier Name:
| Agent’s name: |
| Phone No.: |
| Email: |
| 4. U.S. Dept. of Labor, OSHA Days Away from Work, Restricted Duty, or Job Transfer (DART) Rate |
| 2019 |
| 2018 |
| 2017 |
4a. Explain any extenuating circumstances resulting in any DART Rates of 3.0 or greater:
4b. Explain any upward or downward DART Rate trends:
4c. If you do not have a DART Rate for a given year, state so here and explain why:
| 5. Total Recordable Case (TRC) Rate |
| 2019 |
| 2018 |
| 2017 |
5a. Explain any extenuating circumstances resulting in any TRC Rates of 4.5 or greater:
5b. Explain any upward or downward TRC Rate trends:
5c. If you do not have a DART Rate for a given year, state so here and explain why:
Exhibit B (Continuation)
SAFETY NARRATIVE
6. Technical Approach for Safety: Provide the Safety Narrative using this form. Do not exceed 2 pages. Any additional pages will not be considered.
Describe the plan that the Offeror will implement to evaluate safety performance of potential subcontractors, as a part of the selection process for all levels of subcontractors:
Describe any innovative methods that the Offeror will employ to ensure and monitor safe work practices at all subcontractor levels:
File details come from the government source that posted it. Updated .