S02 SAFETY AND ENVIRONMENTAL RECORD.docx
DOCX document 16 KB Posted
- Attached to
- Y1DA-- Replace Generator Pumps and Above Ground Storage Tank Federal contract opportunity
- Solicitation number
- 36C24226Q0238
About this file
This is a Safety and Environmental Record submission requirement document for bidders and offerors on a Department of Veterans Affairs contract to replace generator pumps and above ground storage tank at Veterans Integrated Service Network 2.
All bidders and offerors must submit certification and documentation demonstrating compliance with safety and environmental standards, specifically confirming no more than three serious OSHA or EPA violations, or one repeat or willful violation within the past three years. Bidders must also provide current Experience Modification Rate (EMR) documentation equal to or less than 1.0, obtained from their insurance carrier on letterhead or, for self-insured contractors or those in designated states (CA, DE, MI, NJ, ND, OH, PA, WA, WY, and PR), from the National Council on Compensation Insurance, Inc. (NCCI) or their respective state worker's compensation insurance rating bureau. The Government will conduct a Determination of Responsibility for the apparent awardee using the submitted documentation and verification through OSHA and EPA online inspection history databases. Failure to provide this information or affirm compliance with these guidelines will result in a non-responsibility determination and ineligibility for award. This requirement applies to all subcontracting tiers, making prime contractors responsible for verifying the responsibility of prospective subcontractors. The document includes a certification statement requiring authorized company representatives to sign and date confirming compliance with subcontracting limitations and contract terms.
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| 36C24226Q0238 0001.docx | DOCX document | |
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| S02 NY Tax Exempt Form.pdf | ||
| S02 ADDITIONAL INSERTS.pdf | ||
| VAAR 852.219-75 VA NOTICE OF LIMITATIONS ON SUBCONTRACTING Certificate of Compliance (1).docx | DOCX document | |
| WAGE DETERMINATION 1-2-2026.pdf | ||
| FAR 52.225-2 BUY AMERICAN CERTIFICATE.pdf | ||
| S02 PARTICIPATION FOR MINORITIES AND FEMALES.pdf | ||
| 36C24226Q0238_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: ____________________________________________________________
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