ATTACHMENT_D_-_Safety.docx

ATTACHMENT D

PAST PERFORMANCE WORKSHEET FOR SAFETY

OFFEROR:

FACTOR 3: Offerors are required to provide the following information for safety and health programs:

(1) OSHA Total Recordable Case (TRC) Rate for five previous complete calendar years:

For the five (5) [2014, 2013, 2012, 2011, and 2010] previous complete calendar years, submit your OSHA Total Recordable Case (TRC) Rate, as defined by the U.S. Department of Labor, Occupational Safety and Health Administration. If you cannot submit an OSHA TRC Rate, affirmatively state so, and explain why. Any extenuating circumstances that affected the OSHA TRC Rate data should be addressed as part of this element. OSHA TRC rates above 4.0, in any of the previous five years, will be considered UNACCEPTABLE, unless an adequate explanation is provided to address the extenuating circumstances that affected the rate.

(2) OSHA Days away from work, restricted duty or job transfer (DART) rate for five previous complete calendar years:

For the five (5) [2014, 2013, 2012, 2011, and 2010] previous complete calendar years, submit your OSHA Days Away from Work, Restricted Duty, or Job Transfer (DART) Rate, as defined by the U.S. Department of Labor, Occupational Safety and Health Administration. If you cannot submit an OSHA DART Rate, affirmatively state so, and explain why. Any extenuating circumstances that affected the OSHA DART Rate data should be addressed as part of this element. OSHA DART rates above 3.0, in any of the previous five years, will be considered UNACCEPTABLE, unless an adequate explanation is provided to address the extenuating circumstances that affected the rate.

Use the following table to provide information for the above criteria.

SAFETY AND HEALTH PROGRAM ACCIDENT AND INJURY STATISTICS

OSHA TRC Rate

OSHA DART Rate

Technical approach

(3) Technical approach for safety :

Describe the plan that the Offeror will implement to qualify, evaluate, select and oversee its potential subcontractors. The Safety narrative shall be limited to one page. Offerors must submit both (1) a plan to include the safety performance of subcontractors in the selection process for all levels of subcontractors and (2) a plan to monitor the safety of those subcontractors during contract performance, highlighting what specific management practices will be in place for providing deliberate safety program management and mishap prevention support to those sub-contractors whose EMR is greater than 1.0, whose TRC is greater than 4.0 and whose DART rate is greater than 3.0. Offerors who fail to submit either of these will be rated UNACCEPTABLE.

AMENDMENT 0005