EXHIBIT_C_Safety_Data_and_Narrative_Revised.doc

EXHIBIT C

SAFETY DATA & NARRATIVE

SOLICITATION NO: N62473-18-R-5003

Submit Exhibit C (Safety Data Sheet/Safety Narrative) under Tab #3. The offeror shall submit the following information: (For a partnership or JV; the following submittal requirements are required for each offeror who is part of the partnership or joint venture; however, only one safety narrative is required. EMR and DART Rates shall not be submitted for subcontractors.) Exhibit C is mandatory and shall be used to submit safety information. The safety narrative shall be limited to eight (8) 8.5” x 11” pages.

1. Offeror Name:

Name of Joint Venture partner providing the information below (if applicable):

Offeror’s Three Previous (complete) Years of Reported Safety Data:

Only complete year safety data will be considered. Indicate data rates as decimal figures, not whole numbers. NOTE: Blank entries will be considered non-responsive. If you have no established rates, annotate block with “see narrative below.”

3a. Explanation of any extenuating circumstances resulting in any EMRs greater than 1.0 and address any corrective action(s) taken:

3b. Explain any upward EMR trends:

3c. If you do not have an EMR for a given year, state so here and explain why:

4. Insurance Carrier Information:

Insurance Carrier Name:

Agent’s name:

Phone Number:

*For each year, submit a completed copy of U.S. Dept. of Labor, OSHA Form 300A (Summary of Work-Related Injuries and Illnesses), latest version. This information is required regardless of number of employees in the company. Do not leave blank. If you have no established rates, annotate block with “see narrative below.”

6a. Explain any extenuating circumstances resulting in any DART rates 3.0 or greater and address any corrective action(s) taken:

6b. Explain any upward DART rate trends:

6c. If you do not have a DART rate for a given year, state so here and explain why:

EXHIBIT C

SAFETY DATA & NARRATIVE

SOLICITATION NO: N62473-18-R-5003

7. Provide the Technical Approach for Safety using this form. The technical approach to safety narrative shall be limited to eight pages (8.5”x11”). Any additional pages will not be considered.

Technical Approach for Safety:

7a. Describe the plan for safety that will be implemented to evaluate safety performance of potential subcontractors as part of the selection process for all levels of subcontractors:

7b. Submit a narrative that fully describes the safety management system that they will use to oversee the safety compliance and performance of self-performed and subcontractor performed work:

7c. Describe any innovative methods that will employed to ensure and monitor safe work practices at self-performed and/or all subcontractor levels:

7d. Describe their methodology to execute an effective program that facilitates sound mishap prevention techniques and processes, employee reporting of unsafe conditions, unsafe activities, and near-miss mishaps:

Note: Form may be expanded.