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

Radius of work from Your Office Location

Geographic Reach

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

File Upload

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