Attachment 4 Contractor Certification Regarding EMR.docx

This document contains a contractor certification form and details of a related federal contract opportunity for construction services. The contractor certification form requests information on any OSHA violations in the past four years and the contractor's current insurance experience modification rate, to be supported by a signed letter from their insurance carrier.

The related federal contract opportunity is solicitation number 12805B22R0013 to build a shade structure at a USDA Agricultural Research Service facility in Clay Center, Nebraska. The contractor will provide all labor, equipment, materials and transportation to perform the work in accordance with the plans and specifications for adding the shade structures. The magnitude of the construction project is between $1 million to $5 million. The soliciting agency is the USDA Agricultural Research Service Plains Area.