Date of Submission: General Company Name: Address: Contact Info: Additional Contact Info: Type of Business: CorporationPartnershipJoint VentureIndividualOther If "Other" please specify: Labor Relations: UnionNon-Union Please list the trade(s) your company performs: Please check which industries where your company has worked in the past 5 years. ResidentialHigh-rise buildingMid-rise BuildingSports Stadium University/Higher EducationHospitalFederal BuildingsIndustrial Schools K-12Apartment ComplexOther If Other: Size of work performed by your company: under $100,000$100,000-$200,000$200,000-$500,000$500,000-$1,000,000 $1,000,000-$3,000,000$3,000,000-$6,000,000$6,000,000-$9,000,000 $9,000,000-$12,000,000$12,000,000-$15,000,000$15,000,000-$20,000,000 over $20,000,000 How many years has your company been in business as a contractor? Number of employees: BONDING Current bonding capacity of company: Aggregate: Single Project: INSURANCE PLEASE PROVIDE A CERTIFICATE/LETTER FROM YOUR INSURANCE PROVIDER VERIFYING ALL LIMITS, EMR AND PROJECT REQUIREMENTS. Experience Modification Rating (EMR) for the last three years: SAFETY PLEASE PROVIDE COPIES OF OSHA 300A LOGS FOR THE LAST THREE COMPLETE YEARS. Does your company have a written Safety Program? YesNo (If "yes", please provide a copy of your Safety Program) Does your company have a disciplinary program for safety violations? YesNo Does your company have a Substance Abuse Program? YesNo Please list the type of safety training provided for all employees: Does your company have a safety officer or qualified person within your company? YesNo Please list their qualifications: Has your company had any OSHA citations within the last three years? YesNo If "yes", please provide details: Has your company had any jobsite fatalities in the last three years? YesNo If "yes", please provide details: Please remember to send in the following: Insurance EMR verification OSHA 300A logs for the last 3 complete years Company Safety Program Please send additional documents to: Bidding@OnealConstruction.com