S02 - Attachment 7 - Contractor Safety and Environmental Record Evaluation Form.docx
DOCX document 13 KB Posted
- Solicitation number
- 36E77620R0025
About this file
This document contains a solicitation for a federal construction contract opportunity with the Department of Veterans Affairs. The solicitation seeks proposals for a design-build project to correct water infiltration issues and perform renovation work at buildings 1, 3, 60 and an adjacent modular building at the Veterans Affairs North Texas Health Care System campus in Dallas, Texas. The project scope involves investigating and correcting all avenues of water entry into the connecting corridor, which may include repairs or additions to gutters, downspouts and drains. Interior and exterior waterproofing will also be done. All work must be completed within 270 calendar days from the notice to proceed with a budget between $1 million and $2 million. The solicitation will be set aside for Service-Disabled Veteran-Owned Small Businesses and issued on or around March 20, 2020.
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Contractor Safety and Environmental Record Evaluation Form
Information provide below is current and applicable to Solicitation 36E776208R0025 Company Name: ______________________________________________ Address: _____________________________________________________ Telephone: ______________________ Fax: ________________________ Email: _______________________________________________________ Contact: ______________________________________________________ Utilizing your OSHA 300 Forms, please complete the following information:
| Category |
| 2015 |
| 2016 |
| 2017 |
| 2018 |
Number of man hours (jobsite and office).
Number of cases involving days away from work, restricted activity, or both (Column H and I of OSHA 300).
Days away, restricted, or transferred rate (# of days away, restricted, or transferred cases x 200,000/# of man hours) (DART Rate).
Number of serious, willful, or repeat violations from OSHA within the last 3 years. Please attach explanation for any violations.
File details come from the government source that posted it. Updated .