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r <br /> 27 <br /> YEAR CONTRACTOR INDUSTRY INDUSTRY FIELD AND CODE <br /> DART DART <br /> INCIDENT RATE INCIDENT RATE <br /> 2-0Z1> d I 1�1A 1G5 - 239210 <br /> 2vz`T' 0 I AlAIcy- Z3gz10 <br /> 2c)Z3 L1. 9 NAIC5 - 238210 <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 /> must provide the'source of the EAR information and contact information of insurer entity <br /> providing the EAMI <br /> YEAR CONTRACTOR INDUSTRY FIELD AND NAME AND CONTACT <br /> EMR CODE INFO FOR EMR <br /> INFORMATION <br /> ale,. Ho, V o <br /> 202-J 2Z- 'd0 704-662' 9533 <br /> a Iexe hoodhar�e� !,� <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 /> Yes No t� <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 />