Prequalification Document Checklist B212 2-18-2025.pdf
PDF 88 KB Posted
- Attached to
- B212 and LS212 D&D Planning Sources Sought Federal contract opportunity
- Solicitation number
- B667987
- Issued by
- Department of Energy
About this file
This is a prequalification document checklist for contractors interested in being pre-qualified at Lawrence Livermore National Laboratory (LLNL) for a decommissioning and demolition project. The checklist outlines nine key documentation requirements that contractors must submit: (1) Safety Questionnaire, (2) Experience Modification Rate (EMR) documentation from Workers' Compensation carriers, (3) OSHA Logs/Documentation including Forms 300 and 300A for the past 7 years, (4) Corporate Safety Plan, (5) Staffing verification through E-Verify, (6) Contractor's License, (7) Insurance Requirements including surety information, (8) Experience and References from federal projects completed in the past 3 years, and (9) Capability Statement.
The checklist is associated with a sources sought notice for B212 and LS212 D&D Planning (Solicitation Number B667987) at LLNL, which involves decommissioning and demolition of former accelerator and physics research facilities. Contractors must be U.S. citizens, possess NQA1 (or equivalent) certifications, and demonstrate experience with similar institutions. The work involves waste characterization, removal, and disposition, along with subsurface structure demolition and utilities removal. Documentation must be submitted to Nicholas Michlig at michlig1@llnl.gov, though no specific deadline is mentioned in the document.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Subcontractor Prequalification Safety Questionnaire v2.docx | DOCX document | |
| Supplier Quality Program Information Worksheet Rev 0.pdf | ||
| B667987 B212 LS212 DD Prequal rev1 2142025.pdf | ||
| E-Verify Example and Tips.pdf | ||
| Representations Certifications Form (05-24-2024).docx | DOCX document |
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Text version
Prequalification Document Checklist * Contractors interested in being pre-qualified at LLNL are required to complete and submit this checklist along with supporting documentation identified below to the Prequalification Administrator listed on the
Prequalification Instruction cover letter.
Company Legal Name
Address
Primary Contact Name/Title
Phone / E-Mail ( )
Contractor License Information State: License Number:
Corporate Information DUNS #: Number of US Citizens Employed:
NAICS Code (s)
1. Safety Questionnaire Completed
Submit the completed questionnaire and provide the following documentation as required.
6. Contractor License
☒ Provide a copy of the Contractor’s License.
2. EMR Documentation
☐Provide a letter from Workers’ Compensation (WC) carrier certifying the EMRs identified on the
Questionnaire or a copy of your Workers’ Compensation
Loss Run from your WC carrier.
☐If EMR > 1.0, Provide an explanation of the safety methods being implemented to reduce your EMR rate.
7. Insurance Requirements ☐Surety must be listed on the Department of
Treasury’s Listing of Approved Sureties.
☐Provide a certification from the surety or its agent
3. OSHA Logs/Documentation
☐Provide a copy of OSHA Form 300 and 300A for the last 7 years.
Provide an explanation and describe the corrective actions taken to improve safety in the following cases:
☐Occurrence of any fatalities within the last 3 years
☐Receipt of any OSHA or state OSHA citation within the last five years, if any.
☐If the Days Away or OSHA Recordable Incident Rates for the past 3 years are above the national average found on Table 1 of the Bureau of Labor Statistics site.
identifying (a) the number of times it has completed the contractor’s work in the past 5 years, (b) total bonding capacity in US dollars, and (c) available bonding capacity (in US dollars) at time of the response.
8. Experience and References
Describe any Federal projects or projects demonstrating Contractor’s abilities completed in the past 3 years. Include (a) value of work performed by contractor and (b) contact info for each project identified.
4. Corporate Safety Plan
Injury and Illness Protection Plan
Provide a copy of your company’s corporate safety plan.
5. Staffing
☐ Provide a copy of the Contractor's ‘Company
Information’ page printed directly from the E-Verify
System.
9. Capability Statement
☐ .Provide a copy of your Capability Statement
☐ Do not have a Capability Statement https://www.fiscal.treasury.gov/surety-bonds/list-certified-companies.html https://www.fiscal.treasury.gov/surety-bonds/list-certified-companies.html https://www.bls.gov/iif/oshsum.htm
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