8 - Attachment C - EMR Sheet.docx
DOCX document 16 KB Posted
- Solicitation number
- 36C26124R0085
About this file
This document is an attachment related to a federal contract opportunity. It contains information regarding contractor safety and environmental records, as well as Experience Modification Rates (EMR), required for consideration and award of the contract.
The key details are:
- Contractors must have no more than three serious, one repeat, or one willful OSHA or EPA violations in the past 3 years.
- Contractors must have an EMR of 1.0 or less. If the EMR is above 1.0, the contractor must provide a written explanation from their insurance carrier on the reasons and anticipated date for reduction to 1.0 or below.
- Contractors must provide this safety, environmental, and EMR information with their offer for the contract opportunity.
The related federal contract opportunity is for updating accessible parking at Palo Alto Lots 100 North and South, with the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 21 as the procuring agency.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 4 - Reference Drawing Post Detail.pdf | ||
| 7 - Attachment B - Price Breakdown Sheet.docx | DOCX document | |
| 1 - 36C26124R0085.docx | DOCX document | |
| 9 - RFI FORM.docx | DOCX document | |
| 3 - Reference Drawings Parking Lot.pdf | ||
| 6 - Wage Determinations.pdf | ||
| 2 - Combined Specs Parking Lot.pdf |
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Text version
PER VHA DIRECTIVE 7715 (06 April 2017) - SAFETY & ENVIRONMENTAL RECORD AND EXPERIENCE MODIFICATION RATE (EMR):
Contractor Certification Regarding Project:
To be eligible for consideration and award, the contractor shall have no more than three serious, or one repeat, or one willful OSHA or EPA violation(s) in the past 3 years and have an EMR of equal to or less than 1.0.
All Offerors shall submit the following information pertaining to their past Safety & Environmental Record and EMR with their offer.
1. SAFETY & ENVIRONMENTAL RECORD: A self-certification on company letterhead that the contractor has no more than three (3) serious, or one (1) repeat or one (1) willful OSHA or any EPA violation(s) in the past three years.
2. EMR: All Offerors shall submit information regarding their current EMR. This information shall be obtained from the Offerors’s insurance carrier and be furnished on the insurance carrier’s letterhead. If an Offeror’s EMR is above 1.0, Offeror shall submit a written explanation of the EMR from its insurance carrier furnished on the insurance carrier’s letterhead, describing the reasons for the EMR, and the anticipated date the EMR may be reduced to 1.0 or below.
| 2021 |
| 2022 |
| 2023 |
| 2024 |
Number of serious, willful, or repeat violations from OSHA within the last 3 years. Please attach explanation for any violations. (Four serious, one repeat, or one willful disqualifies the contractor.)
Number of violations from EPA within the last 3 years. Please attach explanation for any violations.
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:
Print Name:
File details come from the government source that posted it. Updated .