S02 - Contractor Safety - Environmental Form.docx
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- Attached to
- Y1DA--568A4-21-702 EHRM Infrastructure Construction - Hot Springs, SD Federal contract opportunity
- Solicitation number
- 36C77622B0032
About this file
This document contains a solicitation for a federal construction contract opportunity. The Hot Springs VA Medical Center is seeking a general contractor to completely refresh the data cable infrastructure at its facility. The scope of work includes demolishing phone lines and abandoned hardware; upgrading electrical panels and generators; renovating and replacing HVAC, plumbing, and fire systems; expanding and renovating office space; migrating IT closets to TRs and upgrading cabling from 50 closets to 29 rooms; upgrading the data center; implementing physical security upgrades; conducting asbestos abatement; upgrading the campus ground vault system; and phasing the work to minimize disruptions to hospital operations. The project involves buildings 1 through 8, 11 through 14, 17 through 20, 23, 29, 43, 65, and 66. Completion will be difficult due to the need for phasing across areas and departments.
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Text version
Contractor Safety and Environmental Record Evaluation Form
Information provide below is current and applicable to Solicitation 36C77622B0032 Company Name: ______________________________________________ Address: _____________________________________________________ Telephone: ______________________ Fax: ________________________ Email: _______________________________________________________ Contact: ______________________________________________________ Utilizing your OSHA 300 Forms, please complete the following information:
| Category |
| 2018 |
| 2019 |
| 2020 |
| 2021 |
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 .