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Sub-contractor/Supplier Pre-qualification Questionnaire
Fields marked with
*
are required
Company Name
*
Address:
*
City:
*
State
*
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Zip:
*
Phone Number:
*
Fax Number:
Email:
*
Your Website:
Organization
How many years has your organization been in business as a Contractor?
years
Date of Organization/Incorporation:
How many years has your organization been in business under its present business name?
years
Has your organization operated under any other name(s)? (If yes, please explain)
Yes
No
Please explain:
How are you organized?
Corporation
Partnership
Sole Proprietorship
Other (Please Explain)
Other, please explain:
If incorporated, State incorporated in:
List Officers/Partners/Owners (Name and Title; One per line)
Licenses
Type of License:
State
Number:
Type of License:
State
Number:
Type of License:
State
Number:
Type of License:
State
Number:
Experience
List the categories of work that your organization performs with its own forces. (One per line)
Do you employ union trade labor?
Yes
No
Has your organization ever failed to complete any work awarded to it? (If yes, please explain)
Yes
No
Please explain:
Are there any judgements, claims, arbitration proceedings or suits pending or outstanding against your organization or its officers? (If yes, please explain)
Yes
No
Please explain:
Has your organization filed any lawsuits or requested arbitration with regard to construction contracts within the last five years? (If yes, please explain)
Yes
No
Please explain:
Within the last five years, has any Officer or Principal of your organization ever been an Officer or Principal of another organization when it failed to complete a construction contract? (If yes, please explain)
Yes
No
Please explain:
Additional comments:
*
The undersigned warrants and represents that all the statements are true and correct and hereby authorizes verification of the information through all available means including, but not limited to, obtaining a consumer credit report on existing businesses Owner/Officers and other reports as maintained by the City, County, State and Federal Law Enforcement Agencies. Applicant agrees to furnish additional credit references upon request and/or supplementary proof of financial responsibility. Further, Applicant understands that this is a Pre-Qualification Questionnaire and does not constitute an awarding of a job in a whole or in part.
Signature:
*
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