Prequalification Form

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Maud Fitzgerald
5 years ago
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1 1.0 General Information Date: 1.1 Name of Firm _ County Telephone Toll Free Fax Website _ for Bid Purposes: Name Phone 1.2 Legal Identity: Sole Proprietorship Partnership Corporation Limited Liability Corporation Limited Liability Partnership Other (specify) 1.2.a Federal Identification Number _ 1.3 How long has your organization been in business as a contractor under its present name? yrs. 1.3.a. Under what other names has your firm operated? (attach additional sheet, if necessary) from to from _ to _ 1.3.b. How long has your organization been under present management? yrs. Page 1 of 7

2 1.4 Is your firm certified as: Minority Business Enterprise (MBE)? Yes No Woman Owned Business Enterprise (WBE)? Yes No Disadvantaged Business Enterprise (DBE)? Yes No Hub-Zone Small Business (HZSB)? Yes No Forward a copy of your certification with this form, if applicable. 1.5 Labor Relations: Union Non Union Merit Shop Mixed 1.6 Number of Employees: Administrative, Project Management, and General Office Field Superintendents and Foremen Field Craft 2.0 Capabilities 2.1 Business Volume 2.1.a Indicate your annual dollar volume for the past three years (most recent year first): $ $ $ 2.1.b Indicate the dollar volume of the largest project you have completed for each of the past three years (most recent year first): Project Name / Owner 20 $ 20 $ 20 $ 2.1.c Indicate the dollar volume of work for which you presently have contracts, but have not started or completed to date: $ 2.2 Contract 2.2.a Has your firm ever failed to complete a contract? Yes No 2.2.b Has your firm ever been in a lawsuit regarding Yes No project performance, payments, or schedule? Page 2 of 7

3 2.2.c Within the last five years, has any officer or principal of Yes No your firm been an officer or principal of another organization when it failed to complete a construction contract? 2.3 Bonding Name of Bonding Company _ 2.3.a Total Bonding Capacity $ 2.3.b Single Project Capacity $ 3.0 Safety 3.1 From your last year s OSHA 300 log provide the following: List current year to date as of _: Days away from work Days of restricted work activity Injuries without lost work days 3.2 Does your firm have a safety training program for new hires? Yes No 4.0 Financial 4.1 List bank references: (if more than one bank attach additional sheet) Name of Bank 5.0 References 5.1 List three Owner, Construction Manager, or General Contractor references for which you have performed work in the last two years. 5.1.a Company Name Page 3 of 7

4 5.1.b Project Name(s) _ Company Name Project Name(s) _ 5.1.c Company Name Project Name(s) _ 5.2 List three Supplier / Vendor contacts from whom you regularly buy materials and equipment as trade references. 5.2.a Company Name 5.2.b Company Name Page 4 of 7

5 5.2.c Company Name Telephone Fax 6.0 Insurance 6.1 Insurance Company 6.2 Broker / Agent Company 6.3 Agent Telephone An insurance certificate must be provided to Willow Construction, LLC for liability coverage and worker s comp coverage. Willow Construction, LLC must be listed as the Certificate Holder as well as Additional Insured on All Work Performed. Willow Construction, LLC 400 Maryland Avenue P. O. Box 521 Easton, Maryland Please note that some projects may require additional insurance limits. Page 5 of 7

6 Please check the trades that your company currently performs: Clean-Up Temporary Facilities Tools & Equipment Safety Equipment Office Supplies & Equipment Fuel Delivery Trash Removal Photography CPM Schedule Testing and Inspection Survey Services Professional Services Security Welding Hauling & Trucking Material Supplier Asbestos Removal Subsurface Exploration Demolition Site Clearing Dewatering Piling, Sheeting & Shoring Earthwork Pest Control Tunneling Caissions Site Utilities Paving Specialties Curbs & Gutters/Site Concrete Site Improvements Fences and Gates Road & Parking Appurtenances Landscaping Lawns and Grass Maintenance of Traffic Marine Work Railroad Work Formwork Concrete Accessories Concrete Reinforcing Post Tensioning Concrete Slabs Structural Concrete Concrete Finishing Specially Finished Concrete Precast Structural Concrete Precast Architectural Concrete Tilt Up Concrete Cementitious Decks Roof Decks Grout Concrete Sawcut/Core/Joint Supply Masonry Masonry Accessories Stone Materials Refractories Restoration & Cleaning Structural Steel Metal Decking Metal Fabrications Castings Ornamental Metals Rough Carpentry Wood Framing Heavy Timber Construction Millwork Paneling Waterproofing & Dampproofing Building Insulation EIFS Shingles, Tiles & Roof Coverings Metal Roof & Wall Panels Build Up Bituminous Roofing Foam Roofing Flashing & Sheet Metal Roof Specialties & Accessories Applied Fireproofing Metal Doors & Frames Sliding Doors Wood Doors Plastic Doors Overhead Doors Steel Windows Aluminum Windows Skylights Hardware Glass Curtain Wall System Plaster & Stucco Gypsum Board Page 6 of 7

7 09300 Tile Specialty Floors Wood Floors Resilient Flooring Carpet Acoustical Treatments Trades (Continued) Lockers Partitions Louvers Miscellaneous Specialties Toilet Accessories Scales Teller Equipment Theater & Stage Equipment Musical Equipment Audio Visual Equipment Parking Equipment Loading Dock Equipment Solid Waste Handling Equipment Prison & Jail Equipment Water Supply Equipment Fluid Waste Disposal Equipment Food Service Equipment Food Storage Equipment Residential Equipment Dark Room Equipment Athletic Equipment Laboratory Equipment Medical Equipment Miscellaneous Equipment Service Station Equipment Education Equipment Painting and Coatings Toilet Compartments Flagpoles Identification Devices Refrigeration Equipment HVAC Equipment Ductwork Mechanical System Controls Testing & Balancing Electrical Electrical Equipment Supplier Lighting Electrical Special Systems Other: Furnishings & Accessories Rugs & Mats Window Treatments Seating Prefabricated Structures Storage Tanks Special Chimney Construction Miscellaneous Special Construction Computer Floors Dumbwaiters Elevators Conveyors Hoists & Cranes Mechanical Mechanical Insulation Fire Protection Plumbing Fixtures & Equipment Page 7 of 7

LEVEL TWO NUMBERS AND TITLES. Introductory Information. Bidding Requirements. Contracting Requirements. Facilities and Spaces. Systems and Assemblies

LEVEL TWO NUMBERS AND TITLES. Introductory Information. Bidding Requirements. Contracting Requirements. Facilities and Spaces. Systems and Assemblies MasterFormat LEVEL TWO NUMBERS AND TITLES Introductory Information 00001 Project Title Page 00005 Certifications Page 00007 Seals Page 00010 Table of Contents 00015 List of Drawings 00020 List of Schedules