Attachment D Safety Data Sheet Safety Narrative.docx
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- Attached to
- NORTHWEST MULTIPLE AWARD CONSTRUCTION CONTRACT (NW MACC) Federal contract opportunity
- Solicitation number
- N4425521R4000
About this file
This document contains an attachment for a safety data sheet and narrative as well as details of the related federal contract opportunity. The safety data sheet attachment requests safety information from offerors, including OSHA DART and TCR rates for the past five years along with explanations for any rates above thresholds or negative trends.
The associated federal contract opportunity is a solicitation for an indefinite delivery/indefinite quantity multiple award construction contract to provide new construction, renovation, alteration, demolition and repair work for facilities located primarily in the Naval Facilities Engineering Systems Command Northwest area of responsibility, including states such as Washington, Oregon and Alaska. Services include administrative, industrial, housing and other facility construction. The NAICS code is 236220 for commercial and institutional building construction and the annual size standard is $36.5 million. The solicitation is a partial small business set-aside.
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Text version
ATTACHMENT D
SAFETY DATA SHEET / SAFETY NARATIVE
ATTACHMENT D
SAFETY DATA SHEET
N44255-21-R-2001
This form is to be completed by the Offeror. Use this form to provide safety information for the Safety factor. DART rates and TCR shall not be submitted for subcontractors, except as noted (in Factor 4 – Safety) for Small Business Offerors utilizing first-tier Small Business subcontractor experience.
Joint Venture (JV) or Partnership: Complete Blocks 1 through 4 for each business entity who is part of the JV or partnership. Small Business Offerors utilizing first-tier Small Business subcontractor experience: Complete Blocks 1 – 4 for the Small Business Offeror and each first-tier Small Business subcontractor.
1. Offeror Name:
Name of JV member, partner, or first-tier Small Business 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 |
| 2016 |
| 2017 |
| 2018 |
| 2019 |
| 2020 |
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 Total Case Rate (TCR) | |
| 2016 | |
| 2017 | |
| 2018 | |
| 2019 | |
| 2020 |
Instructions for calculating the TCR can be found in the solicitation.
3a. For TCR of 4.5 or greater, explain any extenuating circumstances and corrective actions taken:
3b. Explain any negative TCR trends and any corrective actions taken for improvement:
3c. If you do not have a TCR for a given year, state so here and explain why:
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