Attachment 4 Contractor Certification Regarding EMR.pdf
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- Solicitation number
- 12805B24R0012
About this file
This document contains an attachment requiring contractor certification and an associated federal contract opportunity notice. The attachment requires contractors to disclose any OSHA violations within the last four years and provide an explanation for any serious, willful, or repeat violations. It also requires contractors to disclose their current insurance experience modification rate and provide a signed letter from their insurance carrier to support it.
The associated federal contract opportunity is seeking proposals for critical upgrades to insulation, piping, and HVAC systems at the CNRC facility in Houston, Texas. The opportunity is a 100% total small business set-aside with an estimated value between $1-5 million. The applicable NAICS code is 236220 for commercial and institutional building construction, with an SBA size standard of $45 million. Proposals are due from vendors with active SAM registrations by the specified deadline. The soliciting agency is the US Department of Agriculture Agricultural Research Service Field Research Implementation and Information Delivery Plains Area.
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Text version
ATTACHMENT 4
Contractor Certification Regarding Project: 12805B24R0012
2020 2021 2022 2023 Number of serious, willful, or repeat violations from OSHA within the last 4 years. Please attach explanation for any violations. (Three serious, one repeat, or one willful violation shall 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 .