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Subcontractor Pre-Qualification
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Subcontractor Pre-Qualification
Subcontractor Pre-Qualification
ntegrityit
2025-03-20T08:37:48-06:00
Company Information
Company Name
(Required)
Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Point of Contact Name
(Required)
Point of Contact Title
(Required)
Point of Contact Phone
(Required)
Point of Contact Email
(Required)
Year Established
(Required)
UEI Number
(Required)
Cage Code
(Required)
Company Specialties/Type of Work
(Required)
NAICS Code(s)
(Required)
LICENSES
Licenses
License Number
Classification
Issuing State Agency
Add
Remove
SAFETY
Please provide OSHA 300 forms for last three years
OSHA 300 Logs
(Required)
Drop files here or
Select files
Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 512 MB, Max. files: 3.
EMR Ratings for last three years:
(Required)
Interstate: Year
Rating
Add
Remove
Has your company had any OSHA violations in the past three years?
(Required)
Yes
No
If any, please provide a brief explanation
(Required)
Has your company had any fatalities in the past three years?
(Required)
Yes
No
Do you have a written Accident Prevention Plan?
(Required)
Yes
No
Do you have a Safety Manager?
(Required)
Yes
No
Safety Manager's Name
(Required)
QUALITY
Do you have a written Quality Control (QC) Plan?
(Required)
Yes
No
Do you have a QC Manager?
(Required)
Yes
No
QC Manager's Name
(Required)
Has your company even been Terminated for Default from a project?
(Required)
Yes
No
If yes, please provide date and a short description
(Required)
BONDS/INSURANCE/CERTIFIED PAYROLL
Do you currently have bonding capacity?
(Required)
Yes
No
Total bonding capacity
(Required)
Bonding capacity per project
(Required)
Does your company currently carry the following insurance policies?
(Required)
(check all boxes that apply)
Commercial General Liability
Workers Compensation
Business Auto Insurance
PROJECT REFERENCES
Provide references for three major clients for projects performed in the past three years to include.
List
Project Name/Location
Contract Value
Client Reference Name
Title
Phone
Email
Add
Remove
SIGNATURE
By submitting this form, I represent that the information provided is complete and accurate as of the date of this submission.
Authorized Company Representative
(Required)
Phone
This field is for validation purposes and should be left unchanged.
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