2015-173-E AMS - Racanelli Construction South, Inc. for Cedar Grove Community Center Construction $2,311,900

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DocuSign Envelope ID:29F350EB-C553-4EEB-BD97-898B3775EE03 Contractor's Safety Record Information The Contractor's safety record shall be reviewed and evaluated in addition to other quality and performance criteria as part of bid evaluation process. Failure to provide the requested information and documentation may result in rejection of your bid as non-responsive. Accordingly, all bidders must submit the following information regarding their safety record. The following definitions shall apply to this section: "DART incident rate"—Acronym for"Days Away,Restrictions and Transfers".The DART incident rate may be used to show the relative level of injuries and illnesses within a firm compared to the industry.It is based only on those injuries and illnesses severe enough to warrant"Days Away,Restrictions and Transfers". The DART incident rate is calculated using OSHA's Form 300 and the following formula: ((Number of entries in column H(days away from work)+column I(job transfer or restriction)x 200,000)/(Number of hours worked by all employees)=DART Incident rate. "EW'—Acronym for"Experience Modification Rate,"is an indicator of a contractor's past safety performance,widely used by the insurance industry as an equitable means of determining premiums for workers'compensation insurance.The rating system considers the average workers'compensation losses for a given firm's type of work and amount of payroll and predicts the dollar amount of expected losses to be paid by that employer in a designated rating period,usually three years.The rating is based on comparison of firms doing similar types of work,and the employer is rated against the average expected performance in each work classification. Losses incurred by the employer for the rating period are them compared to the expected losses to develop an experience rating. "OSHA"—Acronym for the Federal Occupational Health and Safety Administration. The term"OSHA"as used in this Policy also refers to any state or local agency having jurisdictional authorization to enforce worker safety requirements and assess fines or warnings for violation of worker safety standards. 1. OSHA DART Incident Rate. Provide the bidder's DART Incident Rate calculated from OSHA's Form 300 for the last three years and the other required information shown in the example table below. The bidder must attach all supporting documentation and calculations including certified OSHA forms.