Subcontractor/Vendor Prequalification Statement

Subcontractor Application Form 2023

Company Name (as shown on your income tax return)

Other DBA Name

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Fax

Website

Type of Company (other)

Federal ID #

Date Established

Contractor's License #

Expiration Date

Estimating Contact Name

Title

Phone

Contract Signer Contact Name

Title

Phone

Work Specialization/Trades of Interest (please list)

Geographical Areas in Which You Work (please list)

Trade Association Memberships (please list)

List all the trades you normally perform with your own forces

What percentage of the Company’s work is normally subcontracted? (%)

What trades do you normally subcontract? (please list)

What is the largest contract your Company has completed?

Largest Contract Amount ($)

Year

Project name and scope:

What is the largest dollar volume job you expect to do during this year?

Largest Contract this Year Amount ($)

Project name and scope:

How many projects to you expect to complete this year?

How many people does your Company presently employ?

Home Office Employees

Field Supervisory Employees

Trades People Employees

Project References

Please list current major projects:

A. Project Scope/s

Subcontract Amount ($)

Start Date

Est. Date of Completion

B. Project Scope/s

Subcontract Amount ($)

Start Date

Est. Date of Completion

C. Project Scope/s

Subcontract Amount ($)

Start Date

Est. Date of Completion

Please list completed major projects:

A. Completed Project Scope/s

Subcontract Amount ($)

Date of Completion

B. Completed Project Scope/s

Subcontract Amount ($)

Date of Completion

C. Completed Project Scope/s

Subcontract Amount ($)

Date of Completion

List three (3) General Contractors that you do business with:

A. General Contractor

Contact Person

Phone

B. General Contractor

Contact Person

Phone

C. General Contractor

Contact Person

Phone

Insurance Information

Can your General Liability, Auto and Umbrella policies name General Contractor and Owner as Additional Insured?

Yes

Can your GL, WC and Umbrella policies give Waiver of Subrogation to Contractor and Owner?

Yes

Do you have Workers' Compensation Insurance?

Yes

We have attempted to answer all questions in a full and complete manner to assure that our answers are not in any respect misleading either by expressing ourselves in a misleading or ambiguous manner or omitting information. We recognize that Minardos Group will be relying on the accuracy of the information and our responses in this questionnaire in deciding whether to permit us to bid and in awarding work to our Company.

Dated

Completed By

Title