Vendor Prequalifications (PART 1)

Please complete the following information as part of our Vendor Prequalification process. All information submitted on this form is kept in a secure/confidential manner & will only be used for evaluation purposes by Meyer Najem Risk Management Staff. Welcome to working with Meyer Najem.

General Company Information

Company Name*

Address*

City*

State*

Zip Code*

Phone Number*

Scope of Work*
Please enter your primary scope(s) of work or trade performed:

Company/Firm Register as*

Diverse Business Classification*

Diverse Business Classification Comments
If you selected Other from above, please use this field to add any additional Diverse Business Classifications or comments.

Years in Business*

Full-Time Employees*

Company Contacts

Accounting Contact*

Accounting Contact email*

Estimating Contact*

Estimating Contact email*

Company Details

Current Year Volume ($)*

Previous Yr Volume ($)

2 Yrs Ago Volume ($)

Current EMR*

Previous Year EMR

2 Yrs Ago EMR

Judgements/Liens*

Judgement/Liens Comments

Company Project Experience

Completed Project Name 1*

Completed Project 1 General Contractor Name*

Completed Project 2

Completed Project 2 General Contractor Name

Completed Project 3

Completed Project General Contractor Name

References
Please use the boxes below to list company references.

Reference Company 1*

Reference Name 1*

Reference Phone 1*

Reference Company 2

Reference Name 2

Reference Phone 2

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Email address