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DocuSign Envelope ID: 04E136D1 -507C- 4219- BF16- 446F8D2192F8 <br />Orange County Detention Facility, Environment & Agriculture Center & Park Operations Base <br />Request for Qualifications (RFQ #5249) <br />•: r <br />GENERAL <br />CONTRACTORS SAFETY RECORD <br />1. OSHA DART Incident Rate <br />Year Contractor DART <br />Incident Rate <br />2017 0 <br />2016 0 <br />2015 0 <br />2. Experience Modification Rate (EMR) <br />Industry DART Incident <br />Rate <br />Unavailable <br />0.7 <br />0.8 <br />Year Contractor EMR Industry Field and Code <br />2018 0.81 2362 <br />2017 0.98 2362 <br />2016 0.96 2362 <br />Industry Field and Code <br />2632 <br />2362 <br />2362 <br />Name and Contact Info <br />for EMR Information <br />Melanie A. Airington <br />TriSure Corporation <br />mairinaton@trisure.com <br />Melanie A. Airington <br />TriSure Corporation <br />mairington @trisure.com <br />Melanie A. Airington <br />TriSure Corporation <br />mairington @trisure.com <br />3. Answer the following OSHA Specific Questions: <br />(a) Within the last years, has the bidder received any citations classified by OSHA as being (1) serious, (2) willful <br />and /or (3) repeat violations where your company operates? <br />Yes No X <br />(b) Has the bidder experienced any work - related fatalities within the last 5 years? <br />Yes No X <br />(c) Has the bidder has any citations issued by OSHA as a result of work related fatalities within the past 5 years? <br />Yes No X <br />(d) Is the bidder under investigation for any work - related fatalities? <br />Yes No X <br />(e) If your answer is "yes" to 3(b), (c) or (d), provide a copy of the citation(s), list of number(s) of fatalities and <br />documented explanation of the fatality. <br />N/A <br />34 <br />