S02_RFP Attachment EMR 1 page.pdf

This is a Pre-Award Contractor Evaluation Form (EMR Form) that bidders and offerors must complete and submit with their proposals.

The form requires contractors to provide company identification information including name, address, telephone, fax, email, and primary contact person. Contractors must complete OSHA 300 Forms data for four years (2023-2026), including the number of man hours worked at jobsite and office locations, number of cases involving days away from work or restricted activity, the Days Away, Restricted, or Transferred (DART) rate calculated using the formula of cases multiplied by 200,000 divided by man hours, and the number of serious, willful, or repeat violations from OSHA within the past three years with required explanations. Contractors must also provide their six-digit North American Industrial Classification System (NAICS) Code, identify who administers the company's Safety and Health Program, and submit their Insurance Experience Modification Rate (EMR) for the past three years. A disqualifying criterion is an EMR greater than 1.0 or four serious violations, one repeat violation, or one willful violation from OSHA within the evaluation period. Contractors are required to attach copies of OSHA 300 and 300a Forms, which are available through the OSHA publications search page.