MACC_SOW_Atch_4_-_Contractor_HAZMAT_Reporting_Form.pdf
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- Attached to
- Mountain Home AFB MACC Federal contract opportunity
- Solicitation number
- FA4897-19-R-A004
About this file
This notice provides details for a Multiple Award Construction Contract opportunity at Mountain Home Air Force Base. The contract will have a total ceiling of $90 million and be awarded to up to six contractors to provide new construction, renovation, alteration, demolition, and repair work at various facilities both on and off base. Task orders will range from $2,000 to $15 million and be awarded on a firm fixed price basis. The North American Industry Classification System code is 236220 and the annual size standard is $36.5 million. The solicitation is expected to be released on May 21, 2019 via www.fbo.gov and will remain open until the specified closing date and time. This pre-solicitation notice does not constitute a guarantee of any future contract award.
MACC SOW Attachment 4
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Text version
MHAFB Contractor’s Hazardous Materials Reporting Form
1. Company Information
2. Project Name/Govt Contract Number
3. Contract Start/End Dates
4. Submission Date
5. On-site Project POC Name/Cell Phone # 6. Govt QAE Name/Phone # 7. HAZMART Account #
8. Project On-Base Location
9. Manufacturer and Product Name/Description
(ex: Sherwin Williams gloss white latex paint)
10. NSN/Part #/ID #
(if applicable)
11. Container Type (can, tube, drum, bag, etc)
12. Container Size (LB, OZ, GL,PT,QT, LT, KG )
13.
Projected Total Quantity
Page_____ of _____
MHAFB Contractors Hazardous Materials Reporting Form
- Continuation Sheet -
1. Company Information
2. Project Name/Govt Contract Number
3. HAZMART
Account Number
4. Submission Date
9. Manufacturer and Product Name/Description
(ex: Sherwin Williams gloss white paint)
10. NSN/Part #/ID #
(if applicable)
11. Container Type (can, tube, drum, bag, etc)
12. Container Size (LB, OZ, GL,PT,QT, LT, KG )
13. Projected Total Quantity
Page_____ of _____
MHAFB CONTRACTOR’S HAZARDOUS MATERIALS REPORTING FORM INSTRUCTIONS
1. Company name, address and telephone number.
2. Project name or identifying description and government contract number.
3. As written.
4. Date that this form was submitted to the QAE or HAZMART.
5. Name and phone, or cell number of the contractor’s on-site project manager, foremen, or contact person.
6. Name and phone, or cell number of government Quality Assurance Evaluator (QAE) assigned to the project.
7. HAZMART account number – assigned by the HAZMART once an account is established for this project.
8. Location, or nearest location or building number where the actual work is to take place.
9. Manufacturer’s name and product description of the hazardous material being reported.
10. National Stock Number (NSN) from MSDS, part number, or a number or code identifying the container or material.
11. As written.
12. Container sizes for the product reported: LB = pound, OZ = ounce, GL = gallons, PT = pint, QT = quart, LT = liter, KG = kilogram. Ounces is the most preferred.
13. Known or projected total quantity or amount of this material expected to be used in this project.
Additional Information
A manufacturer-specific Material Safety Data Sheet (MSDS) is required for each item listed on this form and must be turned in with this form.
For additional guidance, refer to the MHAFB HAZMAT Monitor’s Handbook available from 366 FW A6 7/A7IE HAZMAT Manager, at COM: (208) 828-1684, or DSN: 728-1684.
Contact Information
366 FW A6 7/A7IE Hazardous Materials Program Manager Cory Mikita (208) 828-1684
HAZMART Pharmacy Michael Szafranski (208) 828-2360/2690
| MHAFB Contractor’s Hazardous Materials Reporting Form |
| MHAFB Contractors Hazardous Materials Reporting Form |
File details come from the government source that posted it. Updated .