Prus Subcontractor Prequalification

At Prus Construction, we are constantly on the lookout for qualified subcontractors to partner with us on our projects. To be eligible, we require each company to complete the Prequalification Questionnaire below to ensure all vendors have the right skills, operational expertise, workforce, and financial background to be successful. If you have questions, please feel free to send an email to estimating@prus.us.

GENERAL INFORMATION

Company Name

Federal Tax ID

Address

Company Phone #

Company Fax#

Contact Name

Contact Phone #

Contact Email

List of Executive Officers' Names & Titles (I.e: President, CEO, Vice President, CFO)

COMPANY HISTORY

Date Company Began Under Present Name

Former Company Name

Years performing under current name

Company Type (i.e: Corporation, Limited Liability, Joint-Venture)

Any Affirmative Action Violations in the past 5 years? If yes, attach details below.

If yes, attach details below.

Yes

CERTIFICATIONS

Please list any MBE, WBE, EDGE, DBE, SBE, or Other Certifications below and attach certificate(s) at the bottom of this form.

FINANCIAL INFORMATION

Bank Company Name

Bank Phone #

Bank Contact (If Applicable)

Balance Sheet from Previous Year

Expected Volume for This and Prior 3 Years

Current Revenue Backlog

What bank do you use for a line of credit?

SURETY & INSURANCE INFORMATION

Surety Company Name

Surety Agent Contact

Surety Agent Phone

Insurance Company Name

Insurance Agent Contact

Insurance Agent Phone

Total Bonding Capacity

Current Bonded Amount

Has your Surety Made Payments in Last 5 Years?

STATEMENT OF EXPERIENCE

Key Construction Personnel for Project (Name, Title, Phone#, Email, Experience)

Past (5) completed projects relevant to this project.

Please provide the following for each: project name, owner, start date, completion date, total amount of project. Attach files below if necessary.

Current (3) Projects

Please provide the following for each: project name, owner, start date, completion date, total amount of project. Attach files below if necessary.

In the past three (3) years, has your company defaulted, been terminated for cause or failed to complete a construction contract awarded to it?

Yes

In the past three (3) years, has any officer, partner, joint venture or proprietor of your company ever failed to complete a construction contract awarded to that person or entity in their name or on behalf of another organization?

Yes

In the past five (5) years, has your company been charged liquidated damages because of your inability to meet the contractual schedule requirements?

Yes

If you answered "Yes" to any of the last three (3) questions, please give a brief description why.

Describe all litigation arising from your company’s active projects or projects worked on within the last three years.

Annual Construction Volume

Merit-Shop?

Please note this pre-qualification is for a project which requires prevailing wage rates be administered to all employees on site.

Yes

Union Affiliations?

Geographical Areas

Trades

REFERENCES

Please List (2) General Contractor/Construction Manager References

Include Company Name, Address, Contact, Phone #

Please List (2) Material Supplier References

Include Company Name, Address, Contact, Phone #

Please List (2) Business References

Include Company Name, Address, Contact, Phone #

SAFETY PROGRAM

Safety Officer Name

Safety Officer Phone #

Safety Officer Email

Do You Have a Written Safety Program?

If "Yes", please attach your program below.

Yes

Do You Have a Drug & Alcohol Testing Policy?

If "Yes", please attach your policy below.

Yes

List Workers Compensation Experience Modification Rate (EMR) for the Current Year

Last Year EMR

Two Years Ago EMR

Three Years Ago EMR

List Total Recordable Incident Rate (TRIR) for Last Year

OTHER INFORMATION

Within the past three (3) years, has your company or any of the individuals identified as the Executive Officers and/or Key Personnel has/have been the subject of any criminal indictment or judgment of conviction for any business-related conduct constituting a crime under state or federal law?

Yes

If "Yes", give a brief description why.

Has your company, or any of the individuals identified as the Executive Officers and/or Key Personnel has/have been the subject of any bankruptcy proceeding within the last three years?

Yes

If "Yes", give a brief description why.

Within the past three (3) years, has your company or any of the Executive Officers and/or Key Personnel been the subject of any formal proceeding or consent order with a state or federal environmental agency involving a violation of state or federal environmental laws?

Yes

If "Yes", give a brief description why.

Within the past three (3) years, has your company or any of the Executive Officers and/or Key Personnel been the subject of any federal or state suspension or disbarment?

Yes

If "Yes", give a brief description why.

Attachments

Please attach:

W-9
Workers Comp.
Certificate of Insurance indicating current limits
EEO Certificate of Compliance
Proof of current licenses to perform associated work
Audited or reviewed financial statements (PY Balance Sheet, Income Statement & WIP)
Letter from surety indicating per project and aggregate bonding limits and amount currently in use
OHSA 300 and 300 A for last three years
Additional documents deemed necessary

Drop your files here

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