Subcontractor Pre-Qualification Form

Is company a DBA? YesNo


Please enter a direct number if different from general company phone number


Please enter a direct number if different from general company phone number


Please enter a direct number if different from general company phone number



Please Attach a copy of your W-9 Form (required)
Accepted file types: PDF/DOC/DOCX/JPG

Please Attach a copy of your current business license
Accepted file types: PDF/DOC/DOCX/JPG

If company holds multiple licenses, please attach the license that includes your headquarter's location.



Insurance

Is the company insured? (required) YesNo

Please Attach Current Insurance Certificate(s) (required)
Accepted file types: PDF/DOC/DOCX/JPG


This Business Qualifies As A (check all that apply):

Large Business (a major corporation with more than 500 employees)Women-Owned Small Business (a business at least 51% of which is owned by one or more women who are found to be disadvantaged and whose management and daily operations are controlled by such individuals)Veteran-Owned Small Business (a business at least 51% of which is owned by one or more Veterans and whose management and daily operations are controlled by such individuals)Service-Disabled Veteran-Owned Small Business (a business at least 51% of which is owned by one or more Veterans who have a service-connected disability that has been determined by the Department of Veterans Affairs or Department of Defense and whose management and daily operations are controlled by such individuals)Minority-Owned Small Business (a business at least 51% of which is owned by one or more minority individuals or other individuals found to be disadvantaged and whose management and daily operations are controlled by such individuals)


Do you have experience with LEED/green buildings? (required) YesNo

You do NOT have to be LEED certified to answer yes.



What is your workers comp EMR (experience modification rate) for the past three (3) years?

     

     

     



Provide Three (3) Client References

Please list three clients who you have recently worked with and can attest to your expertise.

        

        

        



I hereby certify that all of the information provided above is true and accurate.