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48 <br /> YEAR CONTRACTOR INDUSTRY INDUSTRY FIELD AND CODE <br /> DART DART <br /> INCIDENT RATE INCIDENT RATE <br /> o <br /> rLb <br /> 2. Experience Modification Rate (EMR). Provide the bidder's most recent <br /> Experience Modification Rate (EMR)based on insurance claims history. The bidden <br /> must provide the source of the EMR information and contact information of insurer entity <br /> providing the EMR. <br /> YEAR CONTRACTOR INDUSTRY FIELD AND NAME AND CONTACT <br /> EMR CODE INFO FOR EMR <br /> IN,F�ORMATION <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? e /1 <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 /> 72 <br />