Attachment 4 Contractor Certification Regarding EMR.docx

13 KB Posted

Attached to
IDIQ Fire Protection - North
Solicitation number
12805B22R0001
Issued by

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Other files

File Type Posted
Sol_12805B22R0001_Amd_0003.pdf PDF
Solicitation_12805B22R0001-0003.pdf PDF
Questions and Answers to 12805B22R0001.pdf PDF
Solicitation_12805B22R0001-0002.pdf PDF
Sol_12805B22R0001_Amd_0002.pdf PDF
Sol_12805B22R0001_Amd_0001.pdf PDF
Attachment 10 Upfront Questions and Answers from USDA.pdf PDF
Attachment 6 SAM Reps and Certs Form.docx DOCX document
Attachment 9 General Conditions Specifications 01 01 00.pdf PDF
Attachment 1 Bid Schedule Fire Protection.xlsx XLSX spreadsheet
Attachment 2 Scope of Work - Plains Area Fire Protection IDIQ.doc DOC document
Attachment 7 ARS Facilities Design Standards ARS-242.1.pdf PDF
Attachment 5 Pre-Award Survey Form.doc DOC document
Attachment 8 ARS Map Fire Protection.pdf PDF
Solicitation_12805B22R0001.pdf PDF
Attachment 3 Request for Task Order Proposal (RTOP) Example.docx DOCX document
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Contractor Certification Regarding Project: Plains Area Roofing IDIQ

2017
2018
2019
2020

Number of serious, willful, or repeat violations from OSHA within the last 4 years. Please attach explanation for any violations. (Four serious, one repeat, or one willful violation could 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:

File details come from the government source that posted it. Updated .