EMR Certification.docx

DOCX document 14 KB Posted

Attached to
PROJECT TITLE: Fenceline Vehicle Access Clearing at USDA/DKI-PBARC Germplasm Repository located at 928 Stainback Hwy in Hilo Hawaii
Solicitation number
12905B20Q0006
Issued by

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Other files

File Type Posted
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FORM ARS 371 CONSTRUCTION PROGRESS AND PAYMENT SCHEDULE.pdf PDF
FORM ARS 372 CONTRACTOR REQUEST FOR PAYMENT TRANSMITTAL.pdf PDF
Calculation of Self Performed Work.xlsx XLSX spreadsheet
HI20200001 07.24.2020.pdf PDF
Past Performance Capability Information.docx DOCX document
Sol_12905B20Q0006.pdf PDF

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Contractor Certification Regarding Project:

2016
2017
2018
2019

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 .