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DocuSign Envelope ID:489DFD84-DFCE-4E07-BB35-5F6A708DFA3A <br /> Sbp��Xx�p� <br /> 15c1s`{a,�?'ih3u�. � f...-�'-°•y .�:� vv <br /> 2014 0 0 1542 <br /> f <br /> 2013 0 0 1542 <br /> 2012 0 0 1542 <br /> I <br /> i <br /> 2. Experience Modification Rate(EMR). Provide the bidder's most recent <br /> Experience Modification Rate(EMR)based on insurance claims history. The bidder <br /> mustprovide the source of the EAM information and contact information of insurer entity <br /> providing the EMR. <br /> r , f <br /> �i' '� <br /> Craft Insurance Group <br /> 2014 .90 1542 Mark McLamb <br /> I 336-375-0600 <br /> ! <br /> i <br /> i <br /> I <br /> 3. Answer the following OSHA Specific Questions: <br /> (a) Within the last 2 years,has the bidder received any citations classified by <br /> OSHA as being(1)serious, (2)willful and/or(3)repeat violations where your <br /> company operates? <br /> i <br /> Yes No <br /> If yes, attach a copy of each such citation and violation. <br /> (b) Has the bidder experienced any work-related fatalities within the last five <br /> years? <br /> Yes No <br />