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DocuSign Envelope ID:A9CF8A9E-4CDB-4BB9-A678-D4AD80CD1393 <br /> Contractor's Safety Record Information <br /> The Contractor's safety record shall be reviewed and evaluated in addition to other quality and <br /> performance criteria as part of bid evaluation process. Failure to provide the requested <br /> information and documentation may result in rejection of your bid as non-responsive. <br /> Accordingly, all bidders must submit the following information regarding their safety record. <br /> The following definitions shall apply to this section: <br /> "DART incident rate"—Acronym for"Days Away,Restrictions and Transfers".The <br /> DART incident rate may be used to show the relative level of injuries and illnesses within <br /> a firm compared to the industry. It is based only on those injuries and illnesses severe <br /> enough to warrant"Days Away,Restrictions and Transfers". The DART incident rate is <br /> calculated using OSHA's Form 300 and the following formula: <br /> ((Number of entries in column H(days away from work)+column I(job transfer or <br /> restriction)x 200,000) (Number of hours worked by all employees)=DART Incident <br /> rate. <br /> "EMR"—Acronym for"Experience Modification Rate,"is an indicator of a contractor's <br /> past safety performance,widely used by the insurance industry as an equitable means of <br /> determining premiums for workers'compensation insurance.The rating system considers <br /> the average workers'compensation losses for a given firm's type of work and amount of <br /> payroll and predicts the dollar amount of expected losses to be paid by that employer in a <br /> designated rating period,usually three years.The rating is based on comparison of firms <br /> doing similar types of work,and the employer is rated against the average expected <br /> performance in each work classification.Losses incurred by the employer for the rating <br /> period are then compared to the expected losses to develop an experience rating. <br /> "OSHA"--Acronym for the Federal Occupational Health and Safety Administration, <br /> The term"OSHA"as used in this Policy also refers to any state or local agency having <br /> jurisdictional authorization to enforce worker safety requirements and assess fines or <br /> warnings for violation of worker safety standards. <br /> 1. OSHA DART Incident Rate. Provide the bidder's DART Incident Rate <br /> calculated from OSHA's Form 300 for the last three years and the other required <br /> information shown in the example table below. The bidder must attach all supporting <br /> documentation and calculations including certified OSHAforms. <br />