Subcontractor Pre-Bid

* indicates required field

General Information

*Legal Name of Bidder:

*Physical Address of Company:
*City:
*State:
*Phone:
Fax:
*Email:
Website:
*Current License Numbers:
*Principal Name:
*FED ID #:

Corporate Information

*Legal form of entity?
Current Experience Rate (EMR):
Date Business Started:
*What is your average job size?
*Latest single job?
*Approximate dollar volume under contract?
*Location:
*Date Completed:
*What type of jobs do you normally do?
*What states are you able to work in?
*What type of employees do you employ?
*Does the company employ direct employees or contract workers?

Financial Information

*Have you ever filled for bankruptcy or receivership proceeding?

If Yes, explain:

*What is the largest project you have done?
*Unbonded or Bonded?

*Have any lawsuits been filed against you in the last three years?

If Yes, explain:

Please provide the following reference information:

Suppliers:

(1.)
*Name:

*Contact:
*Phone:
*Email:
*Account #:

(2.)
*Name:

*Contact:
*Phone:
*Email:
*Account #:

(3.)
*Name:

*Contact:
*Phone:
*Email:
*Account #:
Insurance:

*Name:

*Contact:
*Phone:
*Email:
*General Liability Limits:
Bonding:

Name:

Contact:
Phone:
Email:
Financial Institution:

Bank Name:

Contact:
Phone:
Email:
Account #: