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Sub Contractor Pre-Qualification Form
Ryan Sudnik
2023-10-03T19:00:46+00:00
Mammoth Construction Sub Contractor Pre-Qualification Form
All subcontractors are required to complete this questionnaire. The contents of this questionnaire will be considered and used solely to determine your firm’s qualification to perform work for Mammoth Construction.
PLEASE NOTE: This form must be filled out completely. Missing information may result in disqualification of consideration.
Application Date:
(Required)
Month
Day
Year
Hidden
Date of Prequal Expiration:
Month
Day
Year
Background
Company Name
(Required)
Type of Company
(Required)
Type of Work Performed
(Required)
Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Email Address
(Required)
Phone Number
(Required)
Fax Number
Principal Contact
(Required)
Year Business Established
(Required)
States We Do Work In
(Required)
Union Status
(Required)
Union
Non-Union
Previous Name of Company (If Applicable)
(Required)
Contractor’s License #
(Required)
D&B #
(Required)
Qualified Minority Business?
(Required)
MBE
WBE
DBE
Safety
List your Company’s # of Injuries/Illnesses from your OSHA 300 Logs.
Experience Modification Rate (EMR)
(Required)
Last Year
1st Prior Year
2nd Prior Year
Add
Remove
Total # of Fatalities (From Column G on the OSHA 300 Log)
(Required)
Last Year
1st Prior Year
2nd Prior Year
Add
Remove
Total # of OSHA Recordable Incidents (Total of Columns H, I, and J on the OSHA 300 Log)
(Required)
Last Year
1st Prior Year
2nd Prior Year
Add
Remove
Total # of Lost Work Day Incidents (Column H on the OSHA 300 Log)
(Required)
Last Year
1st Prior Year
2nd Prior Year
Add
Remove
Total # of Other Recordable Cases (Column J on the OSHA 300 Log)
(Required)
Last Year
1st Prior Year
2nd Prior Year
Add
Remove
Total # of Annual Man-Hours Worked
(Required)
Last Year
1st Prior Year
2nd Prior Year
Add
Remove
Please check if your Company implements the following safety controls:
Has a Written Safety Program
(Required)
Yes
No
Has an Implemented Drug Screening Policy for all Employees
(Required)
Yes
No
Performs Safety Orientation & Training for all Employees
(Required)
Yes
No
Performs Continuing Safety Education for all Employees
(Required)
Yes
No
Safety/Health Professional Contact Information:
(Required)
Name
Title
Phone Number
Email Address
Add
Remove
Schedule
Provide summary of three largest projects presently under construction.
(Required)
Location
Start/Completion
Contract Amount
Add
Remove
Provide summary of all projects under consideration for award.
(Required)
Location
Start/Completion
Contract Amount
Add
Remove
Provide the following information regarding your present personnel:
Executives
Full-Time
Part-Time
Contract
Temp
Project Managers
Full-Time
Part-Time
Contract
Temp
Estimators
Full-Time
Part-Time
Contract
Temp
Administrative
Full-Time
Part-Time
Contract
Temp
Add
Remove
Superintendents
Full-Time
Part-Time
Contract
Temp
Foreman
Full-Time
Part-Time
Contract
Temp
Journeymen
Full-Time
Part-Time
Contract
Temp
Laborers
Full-Time
Part-Time
Contract
Temp
Other
Full-Time
Part-Time
Contract
Temp
Employee Totals
(Required)
Total Full-Time Employees
Total Part-Time Employees
Total Contract Employees
Total Temp Employees
Add
Remove
Financial History
Please provide answers to the following questions and attach explanations where necessary:
Are there any judgments, claims, arbitrations, proceedings or suite pending/outstanding against your firm or its officers or principals?
(Required)
Yes
No
Please summarize any judgments, claims, arbitrations, proceedings or suite pending/outstanding against your firm or its officers or principals.
Has your firm ever filed bankruptcy?
(Required)
Yes
No
Please summarize the bankruptcy filing.
Has your firm filed any lawsuits or requested arbitration or mediation with regard to construction contracts within the last three (3) years?
(Required)
Yes
No
Please summarize the event(s) above.
Has your firm or any other organization, with which of the officers or partners were involved during the past three (3) years, ever failed to complete any work awarded? If yes, please provide further details.
(Required)
Yes
No
Please summarize the event(s) above.
Submit a listing of all litigation or formal arbitration to which your organization has been a party involving amounts in excess of $10,000 for the past five years including any unsettled litigation or arbitration.
Max. file size: 50 MB.
Insurance & Bonding
Please read Exhibit E in its entirety.
Does your company currently maintain insurance that meets Mammoth Construction's requirements?
(Required)
Yes
No
Can You Provide a Performance Bond?
(Required)
Bond Rating
(Required)
Bonding Capacity
(Required)
Single Project
(Required)
Aggregate
(Required)
Bond Cost (% or $/1000)
(Required)
Name of Bonding Company
(Required)
Contact Email
(Required)
Phone Number
(Required)
Last Type of Bond Issued
(Required)
Date
(Required)
MM slash DD slash YYYY
Amount ($)
(Required)
References (The below references may be contacted by Mammoth Construction for verification purposes.)
Provide three client references.
Provide three client references.
(Required)
Company Name
Contact Email
Phone Number
Add
Remove
Provide financial references.
Provide financial references.
(Required)
Name of Bank
Contact Email
Phone Number
Add
Remove
Provide three supplier references.
Provide three supplier references.
(Required)
Company Name
Contact Email
Phone Number
Add
Remove
Mammoth Construction will use this documentation to pre-qualify contractors. Therefore, if you intend to continue to service our facilities, it is essential that you return the documentation as requested. This document should not be construed to constitute a commitment, or a request to perform any work.
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