Subcontractor Qualification Form

Submitted by admin on Wed, 2011-06-01 14:06

Company Name: *

Address: *

City: *

State: *

Zip Code: *

Phone: *

Fax: *

Contact Person for Estimating: *

E-mail Address: *

Primary Trades Performed by Company: *

Union/Non-union: *

Year Established: *

Which states would your company work in: *

List the last 5 Hospitality projects you have completed: *

List any judgements or Law Suits against your company within the last three (3) years: *

Price range of work your company is best able to undertake: *

Contract value of work accomplished by your organization in the last three (3) years: *

What is the largest contract value that your company has completed: *

Amount of current backlog: *

General Contractor: List three (3) references along with contact person and phone number: *

Suppliers: List three (3) references along with contact person and phone number: *

Name and address of Insurance Agent: *

Name and address of Insurance Company: *

Please indicate your limits of

Commercial General Liability: *

Automobile General Liability: *

Personal & Adv. Injury: *

Each Occurence: *

Excess Liability/Umbrella: *

I certify that the information provided in this application is accurate and complete as of the date of this
certification.

Owner/Officer: *

Title: *

Date of Certification: *