About this file

This is a Safety Narrative submission form for an Indefinite Delivery/Indefinite Quantity (IDIQ) Custodial, Pest Control, and Grounds Maintenance Service Contract at U.S. Marine Corps Air Station (MCAS) Iwakuni, Japan, issued by the Department of the Navy Naval Facilities Engineering Command under Solicitation Number N4008426R1026.

The form requires offerors to submit a one-page (double-sided) or two-page (single-sided) safety narrative addressing four key areas. First, offerors must provide five years of labor hours and injury data (2021–2025) in a standardized table format, including fatalities, lost workday cases, and no-lost workday cases, with detailed explanations required for any fatalities during the period. Second, offerors must describe their Safety Management System (SMS) implementation, covering management and leadership involvement, employee involvement, hazard prevention and control, worksite analysis, and safety and health training, along with the standards used for benchmarking. Third, offerors must explain their evaluation process for selecting subcontractors. Fourth, offerors must describe their processes for overseeing safety compliance of subcontractors and their own employees throughout contract performance. The form is marked as source selection information and must be completed by all offerors, with joint ventures required to submit only one combined narrative.

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RFP N4008420R0405

RFP N4008420R0405

CUI [when filled in] RFP N4008426R102, Exhibit C Source Selection Information – See FAR 2.101 and 3.104 [when filled in]

SAFETY NARRATIVE

Use this form to provide the Safety Narrative. Individual blocks on this form may be expanded; however, total length shall not exceed one (1) double-sided page (or two (2) single-sided pages). For Joint Ventures, only one safety narrative is required. Additional pages will not be considered.

OFFEROR NAME:

1. Submit the numbers of Labor Hours (Hrs) and Fatality (death), Lost Work Day (Lost D) and No-Lost Work Day (No- Lost D) cases using the table below. Fill in highlighted boxes below.
Calendar Year (Jan-Dec)
2021
2022
2023
2024
2025
① Labor Hrs
Hrs _______
Hrs ________
Hrs ________
Hrs ________
Hrs _______
② Fatality
case(s) _______
case(s) _______
case(s) _______
case(s) _______
case(s) _______
③ Lost D
case(s) _______
case(s) _______
case(s) _______
case(s) _______
case(s) _______
④ No-Lost D
case(s) _______
case(s) _______
case(s) _______
case(s) _______
case(s) _______

a. If the Offeror has no data, for any year, affirmatively state so and explain why.

b. Any fatalities (death cases) experienced within this 5-year period must be explained in detail to include root cause and corrective actions.

2. Describe the Offeror’s approach to implementing and executing a Safety Management System (SMS) including 1) Management/Leadership involvement, 2) Employee involvement, 3) Hazard prevention, 4) Hazard control, 5) Worksite analysis, and 6) Safety and health training, to include the standard(s) used to benchmark the SMS.

3. Describe the evaluation process used to select potential subcontractors.

4. Describe the processes of how the Offeror will oversee safety compliance of subcontractors at all levels throughout performance of the contract (to include the Offeror’s own employees).

CUIwhen filled in] Source Selection Information – See FAR 2.101 and 3.104 [when filled in]

File details come from the government source that posted it. Updated .