7-11-Bid Package- Safety Experience IP WATER DAMAGE XX.pdf

This is a Safety Experience form submitted as part of a bid package by the Housing Authority of the City of Alameda, California for work involving water damage. The form requires bidders to provide their firm's interstate Experience Modification Rate (EMR) for the three most recent years (2024, 2025, and 2026), along with injury and illness data from their Cal/OSHA 200 logo for the previous year, including the number of lost workday cases, medical treatment cases, and fatalities. Bidders must also report their total employee hours worked during the last year. The submission certifies that all provided information is current and accurate under penalty of perjury, and authorizes the Housing Authority and its representatives to obtain credit reports and verify the information submitted.

The form serves as a safety qualification document designed to assess bidder competency and workplace safety performance as a prerequisite for contract award. No specific pricing terms, contract duration, renewal options, or funding information is contained within this safety experience questionnaire. The document functions as a standalone qualification requirement rather than a comprehensive bid package component addressing project scope, deliverables, or contract terms.