SOW Attach 6_AHA Form.docx
DOCX document 25 KB Posted
- Attached to
- Bldg 1000 Lab Server Rooms Cooling Units Federal contract opportunity
- Solicitation number
- N6449821R4037
About this file
This Activity Hazard Analysis (AHA) template outlines safety requirements and procedures for a federal construction project. The contractor must identify hazards, controls, and a Risk Assessment Code for each work sequence. Training and inspection requirements are also specified. A signature log must be maintained to confirm all employees reviewed the AHA before starting work.
The related federal contract opportunity is a solicitation to remove existing temporary cooling units and install new Computer Room Air Conditioning units in three server rooms at the Naval Surface Warfare Center in Philadelphia. The contractor shall return the portable A/C units and must use an authorized Automated Logic installer. Work is to be performed on weekdays from 0700 to 1600 with a period of performance of 120 days after the notice to proceed.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| N6449821R4037-Amendment 0001.pdf | ||
| Brand Name Justification Bldg 1000 Lab Server Room--1_Redacted.pdf | ||
| SOW Attachment (11) COVID Questionnaire.pdf | ||
| SOW Attach 5_Mobile Equipment Check List.pdf | ||
| PPQ (Attachment 13).doc | DOC document | |
| SOW Attach 7_Photographs B-1000 Lab Server Room CRAC units installation_rev01.docx | DOCX document | |
| SOW Attach 4_Contractor Lift Plan Form.pdf | ||
| Construction Cost Estimate (Attachment 12).xlsx | XLSX spreadsheet | |
| SOW Attachment (10) Contract Progress Report.pdf | ||
| SOW Attach 1_SiteMap PNBC.pdf | ||
| SOW Attach 9_Power Riser Diagram.pdf | ||
| SOW Attach 3_Contractor Production Report Form.doc | DOC document | |
| SOW Attach 2_NSWCPD ENTRY SCREENING ASSESSMENT.pdf | ||
| SOW Attach 8_PPE Lab Rm 410.pdf | ||
| N6449821R4037.pdf |
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Text version
Contractor Name ( Performing the Work):
Overall Risk Assessment Code (RAC) (Use highest code )
Foreman Signature (Pe r forming the Wor k):
AHA Prepared by (Name/Title):
| Activity/Work Task: |
| Risk Assessment Code (RAC) Matrix |
AHA Signature Log #
Probability
| Contract Number: |
| Severity |
| Frequent |
| Likely |
| Occasional |
| Seldom |
| Unlikely |
| Date Prepared: |
| Catastrophic |
| E |
| E |
| H |
| H |
| M |
| Project Location: |
| Critical |
| E |
| H |
| H |
| M |
| L |
| PRIME CONTRACTOR SECTION: REV IEW ED BY: SIGNATUR E REQUIRED |
| Marginal |
| H |
| M |
| M |
| L |
| L |
| SSHO Signature: |
| Negligible |
| M |
| L |
| L |
| L |
| L |
| QC Manager Signature: |
| Step 1: Review each Hazard with identified |
"Controls". Determine RAC (see above).
Prime Superintendent Signature:
RAC CHART
| Notes: |
| Probability: Likelihood the activity will cause a Mishap (Near Miss, Incident, or Accident). Identify as Frequent, Likely, Occasional, Seldom or Unlikely |
E = Extremely High Risk
| Identify as Catastrophic, Critical, Marginal, or Negligible |
| H = High Risk |
Step 2: Identify the RAC (probability vs. severity) as E, H, M, or L for each "Hazard" on AHA.
Annotate the overall highest RAC at the top of the AHA
M= Moderate Risk
L = Low Risk
| Job Steps (Work Sequences) |
| Specific Anticipated Hazards |
| Controls |
| RAC |
EM385-1-1 (30NOV14) UFGS 103526 11/15
Activity Hazard Analysis (AHA)
SOW ATTACHMENT 6
Sheet 3 of 3
| Job Steps (Work Sequences) |
| Specific Anticipated Hazards |
| Controls |
| RAC |
| Equipment to be used |
| Training Requirements & Competent or Qualified Personnel Name(s) |
| Inspection Requirements |
UFGS 013526 11/15 1.9 Government reserves the right to require the Contractor to revise and resubmit the AHA if it f ails to ef f ectively identif y the w ork sequences; specific anticipated hazards, site conditions, equipment, materials, personnel and the control measures to be implemented.
UFGS 013526 1.9.1 Review the AHA list periodically (at least monthly) at supervisory safety meetings, update w hen procedures, scheduling or hazards change.
UFGS 013526 1.9.2 Each employee perf orming w ork...must review the AHA and sign a signature log f or that AHA prior to starting w ork. The SSHO must maintain a signature log on site f or every AHA
File details come from the government source that posted it. Updated .