PER VHA DIRECTIVE 7715 EMR.docx
VHA Directive DOCX document 16 KB Posted
- Attached to
- Menlo Park Replace Nurse Call Bldg. 331 and 360
- Solicitation number
- 36C26124R0009
About this file
This document outlines safety and environmental record requirements for contractors bidding on a federal project to replace nurse call systems at two buildings at the Menlo Park VA Medical Center. To be eligible for award, contractors must have no more than three serious, one repeat, or one willful OSHA or EPA violations in the past three years and an Experience Modification Rate (EMR) of 1.0 or below from their insurance carrier. Contractors must submit a letter certifying their safety and environmental record and violations in the past three years, as well as an EMR letter from their insurance carrier. If the EMR is above 1.0, contractors must provide an explanation from their insurance carrier describing reasons for the high rate and anticipated date for reduction.
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| File | Type | Posted |
|---|---|---|
| 36C26124R0009 0003.pdf | ||
| 36C26124R0009 0002.pdf | ||
| NURSE CALL_MERGED SET.pdf | ||
| 000000 Specs Merged NEW.pdf | ||
| Wage Determination San Mateo.pdf | ||
| ICRA MPD Nurse Call Replacement_ complete.pdf | ||
| 36C26124R0009.pdf | ||
| S02 - RFI FORM.docx | DOCX document | |
| Cost Breakdown.pdf |
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Text version
PER VHA DIRECTIVE 7715 (06 April 2017) - SAFETY & ENVIRONMENTAL RECORD AND EXPERIENCE MODIFICATION RATE (EMR):
Contractor Certification Regarding Project:
To be eligible for consideration and award, the contractor shall have no more than three serious, or one repeat, or one willful OSHA or EPA violation(s) in the past 3 years and have an EMR of equal to or less than 1.0.
All Offerors shall submit the following information pertaining to their past Safety & Environmental Record and EMR with their offer.
1. SAFETY & ENVIRONMENTAL RECORD: A self-certification on company letterhead that the contractor has no more than three (3) serious, or one (1) repeat or one (1) willful OSHA or any EPA violation(s) in the past three years.
2. EMR: All Offerors shall submit information regarding their current EMR. This information shall be obtained from the Offerors’s insurance carrier and be furnished on the insurance carrier’s letterhead. If an Offeror’s EMR is above 1.0, Offeror shall submit a written explanation of the EMR from its insurance carrier furnished on the insurance carrier’s letterhead, describing the reasons for the EMR, and the anticipated date the EMR may be reduced to 1.0 or below.
| 2021 |
| 2022 |
| 2023 |
Number of serious, willful, or repeat violations from OSHA within the last 3 years. Please attach explanation for any violations. (Four serious, one repeat, or one willful disqualifies the contractor.)
Number of violations from EPA within the last 3 years. Please attach explanation for any violations.
Company’s Current Insurance Experience Modification Rate (EMR) = (Note: Contractor must support the EMR with a signed letter from Insurance Carrier on their letterhead.)
Signature:
Print Name: _________________________________________________
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