EMR 1 Page.pdf

This document is a Pre-Award Contractor Evaluation Form that must be completed and submitted with proposals for federal contract opportunities. The form requires bidders and offerors to provide company identification information including name, address, telephone, fax, email, and primary contact person.

The form mandates completion of four evaluation categories based on OSHA 300 Forms covering a four-year period (2022-2025): number of man hours worked at jobsite and office locations; number of cases involving days away from work, restricted activity, or both; days away, restricted, or transferred rate (DART Rate) calculated as the number of such cases multiplied by 200,000 divided by total man hours; and number of serious, willful, or repeat violations from OSHA within the last three years, with explanations required for any violations. The form specifies that four serious violations, one repeat violation, or one willful violation disqualifies the contractor. Additionally, contractors must provide their six-digit North American Industrial Classification System (NAICS) Code, identify the individual or entity administering the company's Safety and Health Program, and submit their Insurance Experience Modification Rate (EMR) for the past three years, noting that an EMR greater than 1.0 disqualifies the contractor. Copies of OSHA 300 and 300a Forms must be attached to the submission, accessible through the OSHA publications search page.