SOLICITATION NOTICE
Z -- Repair Roads, Sidewalks, and Parking Areas 515-21-110
- Notice Date
- 3/8/2022 12:30:47 PM
- Notice Type
- Solicitation
- NAICS
- 237310
— Highway, Street, and Bridge Construction
- Contracting Office
- 250-NETWORK CONTRACT OFFICE 10 (36C250) DAYTON OH 45428 USA
- ZIP Code
- 45428
- Solicitation Number
- 36C25022B0016
- Response Due
- 3/15/2022 9:00:00 AM
- Archive Date
- 05/18/2022
- Point of Contact
- William E Krienke, Contract Specialist
- E-Mail Address
-
William.Krienke@va.gov
(William.Krienke@va.gov)
- Awardee
- null
- Description
- Pre-Award Contractor Experience Modification Rate (EMR) Form Information regarding your EMR is being sought in conjunction with your offer applicable to Solicitation 36C25022B0016 to assist in making an initial determination of responsibility for any potential awardee in accordance with FAR 9.104-1(e) which states that to be determined responsible, a prospective contractor must have the necessary organization, experience, accounting and operational controls, and technical skills including safety programs applicable to materials to be produced or services to be performed by the prospective contractor and subcontractors. Company Name: ______________________________________________ Address: _____________________________________________________ Telephone: ______________________ Fax: ________________________ Email: _______________________________________________________ Contact: ______________________________________________________ 1. Utilizing your OSHA 300 Forms, please complete the following information for the past three calendar years: Category 2018 2019 2020 2021 Number of man hours (jobsite and office). Number of cases involving days away from work, restricted activity, or both (Column H and I of OSHA 300). Days away, restricted, or transferred rate (# of days away, restricted, or transferred cases x 200,000/# of man hours) (DART Rate). Number of serious, willful, or repeat violations from OSHA within the last 3 years. Please attach explanation for any violations. 2. Please attach copies of the following documents: a)2020 OSHA 300 and 300a Forms. These forms can be accessed through the OSHA publications search page: http://www.osha.gov/pls/publications/publication.html. b)Letter from insurance carrier stating current EMR rate. 3. Provide six-digit North American Industrial Classification System (NAICS) Code for this acquisition: __________________________________ 4. The name and title of the person who administers your company s Safety and Health Program? ____________________________. 5. Your company s Insurance Experience Modification Rate (EMR): ______
- Web Link
-
SAM.gov Permalink
(https://sam.gov/opp/f608bab1078246e8b2d9e58b48d223bc/view)
- Record
- SN06260246-F 20220310/220308230100 (samdaily.us)
- Source
-
SAM.gov Link to This Notice
(may not be valid after Archive Date)
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