Experience Modification Rate EMR Insurance Contractor Certification Solicitation 12405B23R0016.docx
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- Attached to
- Replace Photo Period Building Federal contract opportunity
- Solicitation number
- 12405B23R0016
About this file
This federal contract solicitation seeks replacement of an existing photoperiod building. The United States Department of Agriculture Agricultural Research Service Southeast Area Sugarcane Field Station requires demolition of a fire damaged photoperiod house and construction of a new building in the same footprint. Work shall be performed according to the attached Statement of Work. The solicitation number is 12405B23R0016. This is a total small business set-aside with a NAICS code of 236220 and small business size standard of $45 million. Site visits are encouraged and questions must be submitted by July 17th. Proposals are due by July 24th and shall be submitted in MS Word and cost proposals in MS Excel format.
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Text version
EXPERIENCE MODIFICATION RATE (EMR) CERTIFICATION
Contractor Certification Regarding Project: 12405B23R0016 – Replace existing Photo Period Building in accordance with attached Statement of Work (SOW)
| 2019 |
| 2020 |
| 2021 |
| 2022 |
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:
Company Name: ____________________________________________
Title:
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