Subcontractor Prequalification

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Click here to download the PreQualification form in PDF form. Please update this information with us annually. If there are any changes to the information you have provided, please let us know as soon as possible.

*Required Field

SUBCONTRACTOR IDENTITY

Enter the Company Name * * Company name

Address*

* Street Address * City * State * Postal / Zip Code

Contact Name First Last

Contact Email and Tax Id Email Federal Tax ID

Company Type

CorporationPartnershipSole Proprietorship

Date Formed Enter Date Company Was Formed: DD/MM/YYYY

SUBCONTRACTOR WORK HISTORY

Previous Year's Information

Average Project Size $$ Average Work In Place Dollar Amount

Average Project Size

$$ Enter Project Size Dollar Amount

Current Work Information

$$ Work Under Contract Dollar Amount $$ Uncomplete Backlog Dollar Amount

WORK PREFERENCES

Preferred Project Size and Location

$$Preferred Project Size Dollar Amount Preferred location of Project

Average Project Size

$$ Enter Project Size Dollar Amount

ADDITIONAL LOCATION INFORMATION

Does the company have offices or warehouses at other locations

City 1 State 1

City 2 State 2

City 3 State3

TRADES OF WORK

Union Affiliation

Are you a member of any associations or Organizations? (i.e. NFPA, Sprinkler Association)

Are you registered with ORCA/CCR

YesNo

BONDING CAPACITY

Is your firm able to bond projects?

YesNo

Bond Rate %

Project Limits

$$Single Project Limit $$Aggregate Project Limit

Bonding Company Name and Address

Bonding Agent Information

Agent Name Agent Phone: ###-###-####

INSURANCE INFORMATION

Workers’ Compensation Experience Modifier:

Current Experience Modifier % Effective Date: DD/MM/YYYY You are required to verify your current workers’ compensation experience modifier. If your experience modifier is .90 or higher, you may be asked to provide a copy of additional information for up to the past four years.

General Liability Limits:

Liability Limits Per Occurance

Insurance Company Address:

Agent Contact Information

Insurance Agent Name Insurance Agent Phone: ###-###-####

BANK REFERENCE

Bank 1 Information:

Bank Name Contact First Name Contact Last Name Bank Address Contact Phone: ###-###-####

Bank 2 Information:

Bank Name Contact First Name Contact Last Name Bank Address Contact Phone: ###-###-####

Bank 3 Information:

Bank Name Contact First Name Contact Last Name Bank Address Contact Phone: ###-###-####

Bank 4 Information:

Bank Name Contact First Name Contact Last Name Bank Address Contact Phone: ###-###-####

Bank 5 Information:

Bank Name Contact First Name Contact Last Name Bank Address Contact Phone: ###-###-####

Does the company have a line of credit from any lending institution?

YesNo

MBE/WBE/SBE/DBE/DVBE CERTIFICATION

Is the company certified?

Certifying Agency(s)

COMPLETED PROJECTS List four (4) representative projects completed in the last five (5) years.

Completed Project 1 Information:

Project Name Contracting Company Contact First Name Contact Last Name Contact Phone: ###-###-#### $$Contract Amount Completion Date: DD/MM/YYYY

Completed Project 2 Information:

Project Name Contracting Company Contact First Name Contact Last Name Contact Phone: ###-###-#### $$Contract Amount Completion Date: DD/MM/YYYY

Completed Project 3 Information:

Project Name Contracting Company Contact First Name Contact Last Name Contact Phone: ###-###-#### $$Contract Amount Completion Date: DD/MM/YYYY

Completed Project 4 Information:

Project Name Contracting Company Contact First Name Contact Last Name Contact Phone: ###-###-#### $$Contract Amount Completion Date: DD/MM/YYYY

CURRENT PROJECTS List four (4) representative projects currently under construction.

Current Project 1 Information:

Project Name Contracting Company Contact First Name Contact Last Name Contact Phone: ###-###-#### $$Contract Amount Percent Complete

Current Project 2 Information:

Project Name Contracting Company Contact First Name Contact Last Name Contact Phone: ###-###-#### $$Contract Amount Percent Complete

Current Project 3 Information:

Project Name Contracting Company Contact First Name Contact Last Name Contact Phone: ###-###-#### $$Contract Amount Percent Complete

Current Project 4 Information:

Project Name Contracting Company Contact First Name Contact Last Name Contact Phone: ###-###-#### $$Contract Amount Percent Complete

TRADE REFERENCES List three (3) of your subcontractors or suppliers.

Trade Reference 1 Information: