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j � _ <br /> �-.: i'r � ' <br /> 4 <br /> i1 E: ' �� � �_ <br /> �' , � r �_ .` r i <br /> �� �� � . � i <br /> Yeaz prior to previous year: <br /> If your EMK far any of these tFuee yeazs is or was 1.00 or higher, you may, if you wish, <br /> attach a letter of explanation. <br /> 5 points for three year average EMR of.95 or less <br /> 3 points for three year average of EMR of more than .95 but no more than 1.00 <br /> 0 points for any other EMR <br /> 6. Within the last five years, has there ever been a period when your firm had employees but <br /> was without workers' compensation insurance or state-approved self-insurance? <br /> ❑ Yes ❑ No <br /> S points for either "No" or "Yes" indicating 1 such insiance. <br /> 0 poiats for any other answer. <br /> 7. Has there been more than one occasion during the last five years on which your firm was <br /> required to pay either back wages or penalries for your own firm's failure to comply with <br /> the state's prevailing wage laws? <br /> ❑ Yes ❑ No <br /> NOTE: This question refers only to your own Firm's violation of prevailing wage <br /> laws, not to violations of the prevailing wage laws by a subcontractor. <br /> If your firm's average gross revenues for the last three years was less than $50 million, <br /> scoring is as follows: <br /> 5 points for either "No," or "Yes" indicating eitker 1 or 2 such instance. <br /> 3 points for "Yes" indicating 3 such instances. <br /> 0 points for "Yes" and more than 3 such instances. <br /> Ifyour ferm's average gross revenues for the last three years was more than $50 million, <br /> scoring is as follows: <br /> 5 points for either "No" or "Yes" indicating no more than 4 suck instances. <br /> 3 points for "Yes" indicating either 5 or 6 such instances. <br /> 0 points for "Yes" and more than 6 such instances. <br /> 8. During the last five years, has there been more than one occasion on which your own firm <br /> has been penalized or required to pay back wages for failure to comply with the federal <br /> Davis-Bacon prevailing wage requirements? <br /> ❑ Yes ❑ No <br /> Ijyour ftrm's average gross revenues for tke last three years was less than $SO million, <br /> scoring is as follows: <br /> Pags 21 d 78 <br /> `:i�. <br />