Exhibit C Safety Data Sheet.docx
DOCX document 18 KB Posted
- Attached to
- Alert Facility and Alert Apron Federal contract opportunity
- Solicitation number
- N69450-20-R-0129
About this file
This document contains a safety data sheet template and information about a federal contract opportunity for construction services. The safety data sheet template requests safety information for evaluation, including experience modification rates, days away from work rates, and total recordable case rates for the past three years. Offerors must provide a safety narrative describing how they will evaluate and monitor safety performance of subcontractors.
The federal contract opportunity is a solicitation to construct an alert facility and apron at a naval air station. The project scope includes construction of aircraft shelters, alert quarters, and an alert apron, along with associated site work and utilities. The contract type is firm-fixed-price, and the period of performance is 1300 calendar days from award. The contract value is estimated between $25-100 million. The solicitation is unrestricted and open to all responsible sources. One or more items are subject to World Trade Organization and free trade agreements. The contracting agency is the Naval Facilities Engineering Command.
View the file
Other files for this federal contract opportunity
Show all 50
Alert Facility and Alert Apron has more files on GovTribe.
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 C
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): |
| 2018 |
| 2017 |
| 2016 |
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 |
| 2018 |
| 2017 |
| 2016 |
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 |
| 2018 |
| 2017 |
| 2016 |
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 C (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 .