SAFETY - ENVIRONMENTAL RECORD AND EXPERIENCE MODIFICATION RATE.docx

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Z1DA--612A4-19-016 | Renovate Outpatient Pharmacy and HVAC
Solicitation number
36C26126R0036
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About this file

This document is a safety and environmental evaluation criteria sheet for contractor qualification assessment. The file establishes requirements for evaluating contractors' safety performance, environmental compliance records, and experience modification rates (EMR) as part of the bidding process for the Veterans Affairs outpatient pharmacy and HVAC renovation project (Solicitation 36C26126R0036).

The evaluation framework focuses on assessing contractors' historical safety and environmental records to determine their capability to execute the project safely and in compliance with regulatory standards. The document likely outlines specific criteria and scoring methodology for reviewing contractors' safety documentation, including workers' compensation experience modification rates, OSHA recordkeeping history, and environmental compliance certifications. This safety and environmental qualification assessment is a component of the broader evaluation process for contractors submitting proposals for the renovation work at the Department of Veterans Affairs facility under the Veterans Integrated Service Network 21.

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Text version

PER VHA DIRECTIVE 7715 (06 April 2017) - SAFETY & ENVIRONMENTAL RECORD AND EXPERIENCE MODIFICATION RATE (EMR):

Contractor Certification Regarding Project:

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 offer.

1. SAFETY & ENVIRONMENTAL RECORD: A self-certification on company letterhead that the contractor 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.

2. EMR: All Offerors shall submit information regarding their current EMR. This information shall be obtained from the Offerors’s insurance carrier and be furnished on the insurance carrier’s letterhead. If an Offeror’s EMR is above 1.0, Offeror shall submit a written explanation of the EMR from its insurance carrier furnished on the insurance carrier’s letterhead, describing the reasons for the EMR, and the anticipated date the EMR may be reduced to 1.0 or below.

2023
2024
2025

Number of serious, willful, or repeat violations from OSHA within the last 3 years. Please attach explanation for any violations. (Four serious, one repeat, or one willful disqualifies the contractor.)

Number of violations from EPA within the last 3 years. Please attach explanation for any violations.

Company’s Current Insurance Experience Modification Rate (EMR) = (Note: Contractor must support the EMR with a signed letter from Insurance Carrier on their letterhead.)

Signature:

Print Name: _________________________________________________

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