QUALIFICATION FORM
SUBCONTRACTOR / MATERIAL SUPPLIER

Your E-Mail Address (REQUIRED)

PROJECT NAME

GENERAL INFORMATION

Company Name

Mailing Address

Street Address

Telephone

Mobile

Fax Number

Pager

Contact Name

Title

Is your company a: SELECT ONE Corporation Partnership Join Venture Sole Proprietorship Other

Date of Incorporation/Organization:

List names of officers/partners and indicate the number of years of construction/experience with your company:

Is this business a subsidiary of another business? SELECT ONE Yes No
If so, fill out a second Qualification Form on the parent company.

Is the parent company a subsidiary of another business? SELECT ONE Yes No

PROJECT ORGANIZATION & INFORMATION

1. Is your company licensed in the County and State of the project under consideration for your category of work? SELECT ONE Yes No
   
   
2. Indicate your certification
   license #
   
   or registration #
   
   
   
3. Name of the project superintendent to be assigned to this project is:
   
   If available, attach a resume. Otherwise, answer the following:
   Number of years/months the superintendent has been with your company:
   
   Length of time as a superintendent:
   
   
   
4. Attach a list of the last four (4) projects your superintendent has worked on and indicate the position on the project. List the project name, size, type of building, contract amount, type of work performed, name of general contractor, name of general contractor’s project manager, general contractor’s phone number, name of owner, name of owner’s representative and phone number.
   
   
   
5. Name of the project manager you would assign to this project is:
   
   If available, attach a resume. Otherwise, answer the following:
   Number of years/months the project manager has been with your company:
   
   Length of time as a project mgr.
   
   
   
6. Attach a list of the last four (4) projects your project manager has worked on, indicate the position on the project and list the project name, etc. (same as in Question #4).
   
   
   
7. List the categories of work your company would self perform:
   
   
   
8. List the categories of work your company will subcontract:
   
   
   
9. Attach a list of subcontractor(s) you will be using, the category of work they will perform, whether or not your company has used them before and on what project, name of general contractor for the project, the general contractor’s phone number and their project manager’s name.
   
   Rate the subcontractor’s performance: SELECT ONE Excellent Good Fair Poor
   
   Provide any additional comments if applicable.
   
   
   
10. Does your company pay its tradesmen: SELECT ONE by the hour by piece
    

 

EXPERIENCE

Attach a list of all projects your company has completed in the last three (3) years and all projects currently underway. Include the project name, project size, type of work performed, general contractor’s name and phone, project manager’s name and phone, owner’s name, phone and representative’s name, completion or proposed date and the contract amount. Highlight any and all projects similar to the project for which your company is under consideration.

FINANCIAL

1. Is your company now, or has it within the last ten (10) years been in bankruptcy?
   SELECT ONE Yes No
   
   
2. Have any of your officers or principles been in a position with another company within the last ten
   (10) years that failed to complete a contract?
   SELECT ONE Yes No
   If so, attach a detailed explanation.
   
   
   
3. Are there any law suits, arbitrations or judgements pending against your company?
   SELECT ONE Yes No
   If so, attach a detailed explanation.
   
   
   
4. Has your company, within the past three (3) years, been sued by, or had a lien claim by any supplier, subcontractor, general contractor or owner?
   SELECT ONE Yes No
   If so, attach a detailed explanation.
   
   
   
5. Can your company provide a bond for the project presently under consideration?
   SELECT ONE Yes No
   What is the cost of that bond?
   $
   
   
6. If no to #5, can you provide some alternative form of performance and payment security (ie: letter of credit, back-up guarantee, etc.)?
   SELECT ONE Yes No
   If so, describe:
   
   
   
7. List the name, address, phone number and contact person of your bonding company:
   
   
   
8. List the name, address, phone number and contact person of your bonding agent:
   
   
   
9. Fax your company’s most recent audited financial statement and your company’s most recent interim unaudited financial statement. (863) 680-2443
   

REFERENCES

Attach a list of at least two (2) trade references and one (1) bank reference. Include the name and phone number of the contact person.