ATTACHMENT 4-Contractor Certification Regarding EMR.pdf

This document contains a contractor certification form and details of a related federal contract opportunity. The contractor certification form requests information on any OSHA violations from the past three 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 36C25022B0004 to replace ozone depleting equipment at the Cincinnati VA Medical Center. The project scope includes replacing various HVAC units containing R-22 or other refrigerants throughout the hospital and requires general contracting, electrical, controls, and mechanical work to be completed over a 360 day period of performance. The contracting agency is the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 10.