Attachment 4 Contractor Certification Regarding EMR.pdf
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- Attached to
- Critical Upgrades to Install Lighting at Children's Nutrition Research Center in Houston, Texas
- Solicitation number
- 12805B24R0008
About this file
This document contains a certification form and details of a federal contract opportunity for critical upgrades to lighting at a children's nutrition research center. The United States Department of Agriculture will issue a firm fixed price construction contract valued between $1,000,000 to $5,000,000 to upgrade lighting fixtures at the Children's Nutrition Research Center in Houston, Texas. The contractor shall provide all labor, equipment, and materials to perform the work in accordance with the plans and specifications. The NAICS code is 236220 for commercial and institutional building construction. Interested parties should monitor the sam.gov website where the request for proposal will be posted on or around February 7, 2024 under contract opportunities. Offerors must be registered in the System for Award Management to be considered.
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Text version
ATTACHMENT 4
Contractor Certification Regarding Project: 12805B24R0007
2018 2019 2020 2021 Number of serious, willful, or repeat violations from OSHA within the last 4 years. Please attach explanation for any violations. (Three serious, one repeat, or one willful violation shall result in being determined non-responsible.)
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:
Typed Name:
Title:
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