Technical Exhibit 01_Garrison Accident Report.pdf

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Attached to
HVAC/DUCT Cleaning Service Cp Humphreys
Solicitation number
W91QVN24R0112
Issued by

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This document is a Technical Exhibit containing an Accident Report for the USAG-Humphreys installation. The report details the procedures to be followed in the event of an injury, illness, or property damage incident, including notifying emergency services, supervisors, and the USAG-H Safety Office. It provides contact information for key personnel to be notified after normal duty hours.

The related federal contract opportunity is a solicitation (W91QVN24R0112) for HVAC/DUCT Cleaning Service at Camp Humphreys. The solicitation is being issued by the Department of the Army Materiel Command Army Contracting Command. No additional details about the required services, response dates, award information, or other salient contract terms are provided in the materials presented.

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Type of Accident: Injury Illness Property Damage

WHO - Name & Organization

OTHER DETAILS:

Reporting Procedures as Follows:

DEPARTMENT OF THE ARMY

US ARMY INSTALLATION MANAGEMENT COMMAND

USAG-Humphreys

UNIT #15228

APO AP 96271-5228

7-W Initial Mishap Report

POC / Phone #. Filing Report Person Making Notification WHAT - help is needed WHEN & WHAT Time Notification Made:

WHY - Did it happen (brief synopsis)

WHERE - Location of Incident WHEN - Date & Time (HH:MM) WHAT - Happened RANK/GRADE: GS, NAF, KGS, KWB, CTR, etc.

SUBMITS TO

SAFETY & DPTMS

Taken to Emergency Room Taken to Hospital (BDAACH/Off-Post)

1. Notify 911 if Applicable

2. Notify your immediate Supervisor of the incident

3. Notify the Safety Office ASAP – 755-2664 / 2663 / 2660

After Normal Duty Hours:

a. Mr. Turnage – 010-8465-3590

b. Mr. Harman – 010-9828-5109

c. Mr. Kang – 010-5449-1224

4. Complete the above information and send to the USAG-H Safety Office

5. Safety Office Date Received Report:____________________________

1277033956.LN

Cross-Out

DEPARTMENT OF THE ARMY
APO AP 96271-5228
WHO – Person / Patient Name
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Group1: Off
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Group3: Off
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