Responsibility - Contractor Certification Regarding Safety and Environmental.pdf
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- Solicitation number
- 36C26122R0010
About this file
This document outlines requirements for a construction contract solicitation to replace an elevator at a Veterans Affairs medical center. The solicitation will be issued as a request for proposal to award a firm-fixed price contract between $1,000,000 and $2,000,000 for replacing a four story freight elevator. The project includes replacing all mechanical and electrical components, doors, cab, and adding a new shaft penetration. The contract will have a 329 calendar day period of performance. Offerors must be small businesses under NAICS code 238290 for other building equipment contractors with no more than $16.5 million in annual revenue. Proposals are due by November 23, 2021 and the award will be 100% set aside for small businesses.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C26122R0010 0004.docx | DOCX document | |
| Sign-in Sheet for 3rd Site Visit.pdf | ||
| Sign-in Sheet for 1st Site Visit.pdf | ||
| 36C26122R0010 0003.docx | DOCX document | |
| 36C26122R0010--RFI Reposnes--12.21.2021.pdf | ||
| 570-21-800_Good_Faith_Study.pdf | ||
| General Decision Number--CA20210018--12.17.2021.pdf | ||
| 36C26122R0010 0002.docx | DOCX document | |
| 36C26122R0010 0001.docx | DOCX document | |
| REQUEST FOR INFORMATION (RFI) FORM--36C26122R0010.docx | DOCX document | |
| Factor 3 - Past Performance (Questionnaire).docx | DOCX document | |
| Factor 1 - Prime Contractor Project Experience.xlsx | XLSX spreadsheet | |
| General Decision Number CA20210018.pdf | ||
| VHA_DIRECTIVE_1193_D_2021_08_13--Vaccination_Program.pdf | ||
| Specifications--Project Number 570-21-800 02.pdf | ||
| Construction Drawings--Project Number 570-21-800.pdf | ||
| Factor 6 - Divisional Cost Breakdown.xlsx | XLSX spreadsheet | |
| 36C26122R0010_2.docx | DOCX document |
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Text version
CONTRACTOR CERTIFICATION REGARDING SAFETY AND ENVIRONMENTAL
Contractor Certification Regarding Project: 570-21-800
Title: Replace Building 32 Elevator for Safety
PER VHA DIRECTIVE 7715 (06 April 2017): SAFETY & ENVIRONMENTAL RECORD AND
EXPERIENCE MODIFICATION RATE (EMR): 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 bid/proposal:
SAFETY & ENVIRONMENTAL RECORD: A self-certification on company letterhead that the bidder 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. Include the following table and signature block.
2018 2019 2020
Number of serious, willful, or repeat violations from
OSHA within the last 3 years.
Number of serious, willful, or repeat violations from EPA within the last 3 years
Signature: ______________________________________________
Typed Name: ______________________________________________________
Title: ______________________________________________________
EMR: All offerors shall submit information regarding their current EMR. This information shall be obtained from the bidder’s insurance carrier and be furnished on the insurance carrier’s letterhead.
Company’s Current Insurance Experience Modification Rate (EMR) = _____________
(Note: Contractor must support the EMR with a signed letter from Insurance Carrier on their letterhead.)
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