S02 SAFETY AND ENVIRONMENTAL RECORD.docx

DOCX document 16 KB Posted

Attached to
Y1DA-- 630A4-26-404 Sewage Ejector Pump replacement Federal contract opportunity
Solicitation number
36C24226Q0095
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 2

About this file

This document is a Safety and Environmental Record requirement for a federal contract opportunity. The file mandates that bidders/offerors submit detailed documentation about their safety performance, specifically requiring: (1) certification of no more than three serious, one repeat, or one willful OSHA/EPA violations in the past three years, and (2) an Experience Modification Rate (EMR) equal to or less than 1.0. Contractors must obtain their EMR rating from their insurance carrier, NCCI, or state-run worker's compensation insurance rating bureau, depending on their insurance status.

The contract opportunity is associated with the Department of Veterans Affairs Veterans Health Administration, with solicitation number 36C24226Q0095, and appears to involve a sewage ejector pump replacement. The document emphasizes that a Determination of Responsibility will be conducted using the submitted safety information, and failure to comply with the guidelines or submission of negative safety records will result in contractor ineligibility. Bidders must complete a certification acknowledging their compliance with subcontracting limitations, including being responsible for verifying their subcontractors' compliance with these safety requirements.

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Other files for this federal contract opportunity

Other files attached to Y1DA-- 630A4-26-404 Sewage Ejector Pump replacement, newest first.
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36C24226Q0095 0001.docx DOCX document
S02 AUTODESK Contractors Access Instructions.pdf PDF
S02 ADDITIONAL INSERTS.pdf PDF
P11 GREEN PROCUREMENT MEMORANDUM.docx DOCX document
S02 Privacy Training for Personnel without Access to VA Computer.pdf PDF
P07 WAGE DETERMINATION 1032025.pdf PDF
S02 PARTICIPATION FOR MINORITIES AND FEMALES.pdf PDF
36C24226Q0095_1.docx DOCX document
S02 VA ID PACKAGE UPDATED 10-29-2025.pdf PDF
FAR 52.225-2 BUY AMERICAN CERTIFICATE.pdf PDF
S02 LIMITATION ON SUBCONTRACTING.docx DOCX document
VAAR 852.219-75 VA NOTICE OF LIMITATIONS ON SUBCONTRACTING Certificate of Compliance (1).docx DOCX document
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Text version

SAFETY AND ENVIRONMENTAL RECORD

All Bidders/Offerors shall submit the following information pertaining to their past Safety and Environmental record. The information shall contain, at a minimum, a certification that the bidder/offeror 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. All Bidders/Offerors shall submit information regarding their current Experience Modification Rate (EMR) equal to or less than 1.0. This information shall be obtained from the bidder’s/offeror’s insurance company and be furnished on the insurance carrier’s letterhead. Self-insured contractors or other contractors that cannot provide their EMR rating on insurance letterhead must obtain a rating from the National Council on Compensation Insurance, Inc. (NCCI) by completing/submitting form ERM-6 and providing the rating on letterhead from NCCI. Note: Self-insured contractors or other contractors that cannot provide EMR rating on insurance letterhead from the states or territories of CA, DE, MI, NJ, ND, OH, PA, WA, WY, and PR shall obtain their EMR rating from their state-run worker’s compensation insurance rating bureau. A Determination of Responsibility will be accomplished for the apparent awardee prior to processing the award. The above information, along with other information obtained from Government systems, such as the OSHA and EPA online inspection history databases will be used to make the Determination of Responsibility. Failure to affirm being within the guidelines above or submit this information will result in a determination of “Non-Responsibility” for the bidder/offeror. NOTE: Any information received by the Government that would cause a negative Determination of Responsibility will make the bidder/offeror ineligible for award. This requirement is applicable to all subcontracting tiers, and prospective prime contractors are responsible for determining the responsibility of their prospective subcontractors.

Certification:

I hereby certify that if awarded the contract, COMPANY NAME will comply with the limitations on subcontracting specified in this clause and in the resultant contract. I further certify that I am authorized to execute this certification on behalf of COMPANY NAME.

Printed Name of Signee: _____________________________________

Printed Title of Signee: ________________________________________

Signature: ___________________________________________________

Date: _______________________________________________________

Company Name and Address: ____________________________________________________________

File details come from the government source that posted it. Updated .