New Vendor Prequalification Form

New Vendor Prequalification Form

**Please allocate sufficient time to complete this form or keep tab open - form will not autosave**

BUSINESS INFORMATION

Please upload the following documents found on website to the File Upload box at the bottom of this form:

1) Exhibit A Minimum Insurance Coverage (Please view & upload)

2) Copy of Safety Manual (Please upload)

Company Name*

Phone *

Phone

Company Email

Please list the names and emails of company Officers/Owners.*

Please list primary company contacts with phone numbers / emails.*

Include contacts for Operations, Project Management, & Estimating departments

Please list the address of your company's primary office.*

Where are your other offices located? (If any)

Company Type*

Select

Company Federal ID*

Company Age*

Company Web Address*

Please list your company's social media names or addresses.*

Are you an MBE, WBE, DVBE, DBE, Etc. business?*

Select

Please select your company's primary trade.*

Select

What's the smallest contract your company has worked on in the last 2 years?*

What's the largest contract your company has worked on in the last 2 years?*

Please list the number of Superintendents in your company:*

Foremen:*

Tradesmen / Field Staff:*

Project Managers:*

Estimators:*

Administrators:*

INSURANCE & BONDING

Please list the name of your insurance company / agent.*

Lingo requires subcontractors to be insured for the requirements listed in Exhibit A linked at the top of this form. Confirm below that your company's coverage meets or exceeds the listed minimum requirements.

If yes, please upload certificate in file section at the bottom of the form.

Select

Are you willing to bond projects?*

Select

Please provide the name of your bonding company.

What is your company's payment and performance bonding rate?

What is your single job bonding limit capacity?

What is your total bonding capacity?

Have you performed work on Title 61 Projects?*

Select

Please list the Title 61 Projects you have worked on and the associated years:*

RELIABILITY

Have you ever failed to complete a contract, been removed from a project, or received a notice of default under any company held by the current owners of the applicant company?*

Select or enter value

Please explain:*

Have the company owners ever filed for bankruptcy?*

Select

Please explain:*

Have you had any litigation in the last 3 years?*

Select

Please explain:*

SAFETY

What's your experience with Experience Modification Rate (EMR) been for the last 3 years? Please list the rates and the associated years.*

What has your OSHA / lost workday incident rate been for the last 3 years? Please list the rates and the associated years.*

Do you have a safety program?*

Select

If awarded a project, could you provide a copy of your safety policy and /or safety manual?

Please upload safety policy / manual at bottom of form.

Select

List safety contact person -*

First and Last Name -*

Phone Number -*

Email Address -*

PROJECT REFERENCES

Please provide three (3) references for contractors on current or recently completed projects within the last year that we may contact.

COMPANY #1*

Company Name

Company Address*

Contact Name*

Contact Phone*

Phone

Contact Email*

Project Name*

Contract Value*

COMPANY #2*

Company Name

Company Address*

Contact Name*

Contact Phone*

Phone

Contact Email*

Project Name*

Contract Value*

COMPANY #3*

Company Name

Company Address*

Contact Name*

Contact Phone #*

Phone

Contact Email*

Project Name*

Contract Value*

TRADE REFERENCES

Please provide references for three (3) suppliers or subcontractors whom you regularly use.

COMPANY #1*

Company Name

Company Address*

Contact Name*

Contact Phone*

Phone

Contact Email*

Last Date of Sale*

Payment Terms *

Are balances "Current" or "Overdue?" If overdue, please explain.*

Company #2*

Company Address*

Company Contact*

Contact Phone*

Phone

Contact Email*

Last Date of Sale*

Payment terms*

Are balances "Current" or "Overdue?" If overdue, please explain.*

Company #3*

Company Address*

Company Contact*

Company Phone*

Phone

Company Email*

Last Date of Sale*

Payment terms*

Are balances "Current" or "Overdue?" If overdue, please explain.*

Please upload documents Here:*

Please upload the following documents found on website to the File Upload box at the bottom of this form:

1) Exhibit A Minimum Insurance Coverage (Please view & upload)

2) Copy of Safety Manual (Please upload)

Drag and drop files here or

Send me a copy of my responses

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