Subcontractors

Prequalification Form - FL

Section 1: General Information

Company Address
Is this address the
Mailing Address (if different from above)
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Parent Company Address
Experience with Cutler

Section 2: Job Experience

Indicate the size of project you are most competitive in performing (enter 1). Show in preference order (2,3 ...) other size projects you are capable of performing:
 
Check all building types on which your Company has worked









Design Build Capability
In-House
What is the largest contract your company has completed?
What is the largest dollar volume job you expect to do during this year?
 
What is the expected annual volume this year?
What was the average annual volume of work performed over the past 5 years:
 
 
 
     
   
 
 
   
       
Only Drywall & MEP subcontractors need to fill out the fields below, other contractors skip to Section 3.
     
Please list 5 HealthCare Projects, and their size, (SF, $) completed in the past 3 years

Section 3: License Information

Is Your Company
(Please attach all copies of certifications.)

Section 4 Financial Information

How many people does your company currently employ?
How many people did your Company employ on average in the last 3 years?

Section 5: Bonding

Bondable
Bonding Company
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Bonding Capacity:
   
 

Section 6: Insurance

Do you have at least the insurance limits as
indicated in Exhibit 1
Upload:
Upload:
List your firm's Worker's Compensation Interstate or PA Intrastate Experience Modifier Rate for the three most recent years:
 
 
 
     
Have you been cited by OSHA in the past three years?
Are all of your employees OSHA 10-hour certified?
Do you have a written safety program?
Do you have a written hazard communications program?
Do you have a full-time safety person?

Section 7 References

Please list 3 of your major subcontractors:
Name Street City State Zip Code Contact Telephone Number
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Please list 3 contractors that you do business with:
Name Street City State Zip Code Contact Telephone Number
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Section 8: Attachments

Attach a list of current major projects giving name of project, address, owner, architect, general contractor, contract amount, scope of work and scheduled completion. (Include contact people and phone numbers):
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Attach a list of completed major projects giving name of project, address, owner, architect, general contractor, contract amount, and scope of work. (Include contact people and phone numbers):
Upload:
Attach a copy of your latest audited financial statement. (Your financial statement is strictly for Cutler's Purchasing Department use and will be treated confidentially):
Upload:
We have attempted to answer all questions in a full and complete manner to assure that our answers are not in any respect misleading, either by expressing ourselves in a misleading or ambiguous manner or omitting information. We recognize that Cutler will be relying on the accuracy of the information and our responses in this questionaire in deciding whether to permit us to bid and in awarding work to our Company.
 
(print name)
 
(must be an officer of the company)