EXHIBIT E - FACTOR 3 SAFETY.docx
DOCX document 37 KB Posted
- Attached to
- Regional 8(a) Janitorial Services
- Solicitation number
- N40080-25-R-2233
About this file
This is an evaluation form template for the Safety factor in the Regional 8(a) Janitorial Services solicitation (N40080-25-R-2233) issued by the Naval Facilities Engineering Command. The form requires offerors to submit five years of safety performance data across three calendar years (2022, 2023, and 2024), specifically the U.S. Department of Labor OSHA Days Away from Work, Restricted Duty, or Job Transfer (DART) Rate and the Experience Modification Rate (EMR). Offerors must provide DART rates and EMR figures as decimal values and include explanations for any rates meeting or exceeding specified thresholds: DART rates of 3.0 or greater, and EMR rates of 4.5 or greater. The form applies to the prime contractor and, when applicable, Joint Venture members, partnership entities, first-tier small business subcontractors, and custodial subcontractors using Sub-annex 1503010; however, subcontractor DART and EMR data are not required for submission.
Offerors must also explain any negative trends in safety performance and corrective actions implemented for improvement, as well as justify any missing safety data for specific years. This form serves as a key evaluation tool for assessing contractor safety performance under the evaluation criteria for this indefinite-delivery/indefinite-quantity performance-based custodial services contract supporting Naval Washington District facilities within a 100-mile radius of Washington, DC.
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Text version
EXHIBIT E
FACTOR 3 SAFETY DATA & NARRATIVE
SOLICITATION NO: N40080-25-R-2233
This form is to be completed by the Offeror. Use this form to provide safety information for the Safety factor.
Days Away from Work, Restricted Duty, or Job Transfer (DART) Rates and Experience Modification Rate (EMR) shall not be submitted for subcontractors.
Joint Venture (JV) or Partnership: Complete Blocks 1 through 3 for each business entity that is part of the JV or partnership.
For Offerors utilizing Sub-annex 1503010 – Custodial Subcontractor experience: Complete Blocks 1 – 3 for the Offeror and the Sub-annex 1503010 – Custodial Subcontractor.
1. Offeror Name:
Name of JV member, partner, first-tier Small Business subcontractor, or Sub-annex 1503010 – Custodial Subcontractor providing the information below (if applicable):
Offeror’s Five 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. U.S. Dept. of Labor, OSHA Days Away from Work, Restricted Duty, or Job Transfer (DART) Rate |
| 2022 |
| 2023 |
| 2024 |
Instructions for calculating the DART rate can be found in the solicitation.
2a. For DART Rates of 3.0 or greater, explain any extenuating circumstances and corrective actions taken:
2b. Explain any negative DART Rate trends and any corrective actions taken for improvement:
2c. If you do not have a DART Rate for a given year, state so here and explain why:
| 3. U.S. Dept. of Labor, OSHA Experience Modification Rate (EMR) | |
| 2022 | |
| 2023 | |
| 2024 | |
| 2024 |
Instructions for calculating the EMR can be found in the solicitation.
3a. For EMR of 4.5 or greater, explain any extenuating circumstances and corrective actions taken:
3b. Explain any negative EMR trends and any corrective actions taken for improvement:
3c. If you do not have an EMR for a given year, state here and explain why:
File details come from the government source that posted it. Updated .