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U.S. Subcontractor Qualification

US Subcontractor Qualification

  • Please provide the following information relative to your firm's safety performance and program:
  • Certificate of Liability Insurance AND Experience Modification Rate (EMR)

    Please obtain from your insurance agent a Certificate of Liability Insurance showing the general liability, auto (if applicable) and workers compensation coverages. The certificate must list the above selected company's name as a certificate holder as well as an additional insured. Please attach the certificate to this form.
  • Insurance Requirements:
    General Liability: $2,000,000
    Automobile Liability: $1,000,000
    Umbrella/Excess: $5,000,000 each occurrence
    Workers Compensation: $1,000,000

  • Sample Certificate of Insurance:

  • Please obtain from your insurance agent (or state fund, if applicable) your interstate EMRs for the last three rating periods. If you do not have an interstate rating, obtain your intrastate EMRs. Then complete the following data:
  • We require backup for the above information. Please furnish a letter from your insurance agent, insurance carrier, or state fund (on their letterhead) verifying the EMR data listed above.
  • OSHA Recordable Incidents
  • Furnish a copy of your firm’s OSHA Forms 300 and 300A from the past three (3) years. It is unlikely we can qualify your company to bid work without these forms.
  • Some firms are not required to complete the OSHA 300 Log because they have too few employees (less than ten at any time during the calendar year) or are exempted by virtue of the services they perform. If you don’t complete an OSHA 300 Log, is it because your firm:
  • The answers you provide in this section may determine whether you will be permitted to bid work. You are responsible and accountable for providing accurate information. Using your past three years OSHA Logs, provide the following injury and illness information. Provide the information whether or not you are required to keep a Log per OSHA recordkeeping guidelines:
  • Enter details for Year 1
  • Enter details for Year 2
  • Enter details for Year 3

    Attach the following documents: 2MB MAXIMUM TOTAL FILE SIZE ACCEPTED

  • Safety Program
  • Do you hold safety meetings for: Field Supervisors?
  • Do you hold safety meetings for: Employees?
  • New hires? Orientation
  • Subcontractors?
  • Do you conduct job safety inspections?
  • Irex Risk Management will email notification to you upon approval. You must receive approval prior to work.

    Irex Corporation
    Risk Management Dept
    PO Box 1268
    Lancaster, PA 17608 USA
    Donna Ridinger: