S02 IFB Attachment - 636A8-26-001 Safety or Environmental Violations and EMR Information - 2 pages.pdf
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- Solicitation number
- 36C26326B0017
About this file
This document is a federal contracting requirement for Safety and Environmental Violations and Experience Modification Rating Information, applicable to Solicitation 36C26326B0017 for Plumbing, Heating, and Air-Conditioning Contractors (NAICS Code 238220).
All bidders/offerors must submit certification of their past safety and environmental record, certifying no more than three serious violations, one repeat violation, or one willful OSHA or EPA violation within the past three years. Bidders exceeding these thresholds must provide detailed explanations of violations and circumstances. Additionally, all bidders must submit current Experience Modification Rate (EMR) information obtained from their insurance carrier on carrier letterhead. If the EMR exceeds 1.0, bidders must provide written explanation from the insurance carrier describing reasons for the elevated rate and anticipated date for reduction to 1.0 or below. Self-insured contractors or those unable to obtain EMR from insurance carriers must obtain ratings from the National Council on Compensation Insurance, Inc. (NCCI) using form ERM-6, or from state-run worker's compensation rating bureaus for California, Delaware, Michigan, New Jersey, North Dakota, Ohio, Pennsylvania, Washington, Wyoming, and Puerto Rico. For contractors lacking insurance history, NCCI may assign a Unity Rating of 1.0, which must be submitted along with carrier confirmation. This requirement applies to all subcontracting tiers, with prime contractors responsible for determining subcontractor responsibility. The document includes a Pre-Award Contractor Safety and Environmental Record Evaluation Form requiring submission of OSHA 300 and 300a forms, man-hour data, DART rates, and violation information for 2023-2025.
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FOR OFFICAL USE ONLY 1 of 2
Safety or Environmental Violations and Experience Modification Rating Information
1. All Bidders/Offerors shall submit information pertaining to their past Safety and Environmental record. The information must contain a certification that the bidder/offeror has no more than three (3) serious, or one (1) repeat or one (1) willful OSHA or any EPA violation(s) in the past three years. If such certification cannot be made, a Bidder/Offeror shall explain why and submit as much information as possible regarding the circumstances of its past safety and environmental record, including the number of EPA violations and/or the number of serious, repeat, and/or willful OSHA violations, along with a detailed description of those violations.
2. All Bidders/Offerors shall submit information regarding their current Experience Modification Rate (EMR). This information shall be obtained from the Bidder’s/Offeror’s insurance carrier and be furnished on the insurance carrier’s letterhead. If a Bidder/Offeror’s EMR is above 1.0, Bidder/Offeror must submit a written explanation of the EMR from its insurance carrier furnished on the insurance carrier’s letterhead, describing the reasons for the elevated EMR and the anticipated date the EMR may be reduced to 1.0 or below.
3. Self-insured contractors or other contractors that cannot provide their EMR rating on insurance letterhead must obtain a rating from the National Council on Compensation Insurance, Inc. (NCCI) by completing/submitting form ERM-6 and providing the rating on letterhead from NCCI. Note: Self-insured contractors or other contractors that cannot provide EMR rating on insurance letterhead from the states or territories of CA, DE, MI, NJ, ND, OH, PA, WA, WY, and PR shall obtain their EMR rating from their state-run worker’s compensation insurance rating bureau.
4. If the NCCI cannot issue an EMR because the Bidder/Offeror lacks insurance history, Bidder/Offeror shall submit a letter indicating so from its insurance carrier furnished on the insurance carrier’s letterhead and include a letter from the NCCI indicating that is has assigned Bidder/Offeror a Unity Rating of 1.0.
5. The above information, along with other information obtained from Government systems, such as the OSHA and EPA online inspection history databases, will be used to make an initial Determination of Responsibility.
6. This requirement is applicable to all subcontracting tiers, and prospective prime contractors are responsible for determining the responsibility of their prospective subcontractors.
Pre-Award Contractor Safety and Environmental Record Evaluation Form
Information provided below is current and applicable to Solicitation 36C26326B0017
Company Name: ______________________________________________
Address: _____________________________________________________
Telephone: ______________________ Fax: ________________________
Email: _______________________________________________________
Contact: ______________________________________________________
1. Utilizing your OSHA 300 Forms, please complete the following information:
Category 2023 2024 2025
Number of man hours (jobsite and office).
Number of cases involving days away from work, restricted activity, or both (Column H and I of OSHA 300).
Days away, restricted, or transferred rate (# of days away, restricted, or transferred cases x
200,000/# of man hours) (DART Rate).
Number of serious, willful, or repeat violations from OSHA within the last 3 years. Please attach explanation for any violations.
Please attach copies of the following documents: OSHA 300 and 300a Forms. These forms can be accessed through the OSHA publications search page:
http://www.osha.gov/pls/publications/publication.html.
2. Provide six-digit North American Industrial Classification System (NAICS) Code for this acquisition: 238220 - Plumbing, Heating, and Air-Conditioning Contractors
3. Who administers your company’s Safety and Health Program?
4. Company’s Insurance Experience Modification Rate (EMR):
| S02 IFB Attachment - Safety or Environmental Violations and EMR Information - 2 pages |
| Contractor EMR Certification Form |
File details come from the government source that posted it. Updated .