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Y S - <br /> i r �� ` �, �' 'e : <br /> ✓, <br /> �;.�,, f � y� �`;' <br /> ..�.f �:.:�f �ijr k.s"i <br /> Ouesdons about comaliance with safetv, workers comnensation, <br /> arevailine waee and soorenticeshio laws. These puestions aonlv to the aroaosed Qeneral <br /> contractor. <br /> (11 questions) <br /> 1. Has CAL OSHA cited and assessed penalties against your firm for any "serious," <br /> "willful" or "repeaY' violaHons of its safety or health regulations in the past five years? <br /> Note: If you have filed an appeal of a citation and the Occupadonal Safety and <br /> Health Appeals Board has not yet ruled on your appeal, you need not include <br /> information about it. <br /> ❑ Yes ❑ No <br /> If the ftrm's average gross revenues for the last three years was less tkan $50 million, <br /> scoring is as fo[[ows: <br /> S points for either "No" or "Yes" indicating 1 such instance. <br /> 3 points for "Yes" indicating 2 suck instances. <br /> 0 points for "Yes" if more than 2 such instances. <br /> If the firm's average gross revenues for the last three years was more than $50 mi[lion, <br /> scoring is as fo[lows: <br /> 5 points for either "No" or "Yes" ixdicating 1, 2, or 3 such instances. <br /> 3 points for "Yes" indicating either 4 or S such instances. <br /> 0 points for "Yes" if more than 5 such instance� <br /> 2. Has the federal Occupational Safety and Health Administration cited and assessed <br /> penalries against your firm in the past five years? <br /> Note: If you have filed an appeal of a citation and the appropriate appeals Board has not <br /> yet ruled on your appeal, you need not include information about it. <br /> ❑ Yes ❑ No <br /> If yes, attach a separate signed page describing each citation. <br /> If the firm's average gross revenues for the last three years was less than $SO mi[lion, <br /> scoring is as follows: <br /> S poinfs for either "No" or "Yes" indicating 1 such instance. <br /> 3 points for "Yes" indicating 2 such instances. <br /> 0 points for "Yes" or if more than 2 such instanceS <br /> Ijthe frrm's average gross revenues for the last three years was more than $50 <br /> million, scoring is as follows: <br /> Page 19 M 28 <br />