Exhibit D Safety Data.docx

EXHIBIT “E”

SAFETY DATA SHEET

N62473-19-R-2436

This form is to be completed by the Offeror. Use this form to provide safety information for the Safety factor. EMR, DART, and TRC rates shall not be submitted for subcontractors.

Joint Venture (JV) or Partnership: Complete Blocks 1 through 8 for each contractor who is part of the JV or partnership. Only one safety narrative (Block 9) is required.

1. Offeror Name:

Name of JV partner providing the information below (if applicable):

Offeror’s Three Previous Complete Calendar Years of Reported Safety Data:

Only complete year safety data will be considered. Indicate data rates as decimal figures, not whole numbers.

3a. For EMRs greater than 1.0, explain any extenuating circumstances and corrective actions taken:

3b. Explain any negative EMR trends:

3c. If you do not have an EMR for a given year, state so here and explain why:

4. Insurance Carrier Information:

Insurance Carrier Name:

Instructions for calculating the DART rate can be found at http://www.bls.gov/iif/osheval.htm.

6a. For DART Rates of 3.0 or greater, explain any extenuating circumstances and corrective actions taken:

6b. Explain any negative DART Rate trends:

6c. If you do not have a DART Rate for a given year, state so here and explain why:

Note: Form may be expanded.

EXHIBIT “E” (continuation)

SAFETY DATA SHEET

N62473-19-R-2436

Instructions for calculating the TRC rate can be found at http://www.bls.gov/iif/osheval.htm.

8a. For TRC Rates of 4.5 or greater, explain any extenuating circumstances and corrective actions taken:

8b. Explain any negative TRC Rate trends:

8c. If you do not have a TRC Rate for a given year, state so here and explain why:

Note: Form may be expanded.

Exhibit “E” – Safety Data Sheet/Safety Narrative, Page 2 of 2

(Rev 07/17)