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CONTRACTOR’S PRE-QUALIFICATION FORM
Please complete the following form providing us with a general description of work experience.
The undersigned certifies that the information provided herein is true and sufficiently complete so as not to be misleading.
All information will be securely submitted to Argo Building Co Inc.
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Employer Identification Number
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Your answer
Company Name
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Your answer
Previously Worked with Argo Building Co Inc?
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Yes
No
Street Address
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Your answer
Phone Number
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Your answer
Fax Number
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Your answer
Contact Email Address
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Your answer
Company Website Address
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If none - please write none.
Your answer
Submitted by:
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Your answer
Principal Office:
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Your answer
Type of Work
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Subcontractor
Vendor
Manufacturer
Consultant
Other
Type of Company
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Corporation
Partnership
Individual
Joint Venture
Other
How many years has your organization been in business as a Contractor?
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Your answer
How many years has your organization been in business under its present business name?
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Your answer
Under what other or former names has your organization operated?
Your answer
2.3 If your organization is a corporation, answer the following: Date of incorporation, State of incorporation, Company Officers: (Name and Tile/Position)
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Your answer
If your organization is a partnership, answer the following: Date of organization, Type of partnership (if applicable), Name(s) of general partner(s)
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If this does not apply - put N/A
Your answer
If your organization is individually owned, answer the following: Date of organization, Name of owner
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If this does not apply - put N/A
Your answer
If the form of your organization is other than those listed above, describe it and name the principals:
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If this does not apply - put N/A
Your answer
Describe your safety program. Provide any information on any particular safety issues you would anticipate on this project and how your company would handle them.
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Your answer
Provide worker compensation experience modification rate for the past five (5) years
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Your answer
Provide number of OSHA Citations for the past five (5) years
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Your answer
Provide Loss Time Incident Rates for the past five (5) years
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Your answer
Provide Recordable Incident Rates for the past five (5) years
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Your answer
Provide Employee Hours Worked for the past five (5) years
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Your answer
List jurisdictions in which your company’s partnership or trade name is filed.
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Your answer
Please identify states in which your company pursues work
Your answer
Please check each of the following that applies to your company
Minority
Woman Owned
Disadvantaged
Veteran
Small Buisness
Other
List the categories of work that your company normally self performs:
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Separate by commas.
Your answer
Has your company ever failed to complete any work awarded to it?
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No
Yes
If you answered yes to the above question - explain why.
Your answer
Are there any judgments, claims, arbitration proceedings or suits pending or outstanding against your company or its officers?
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Your answer
Has your company filed any lawsuits or requested arbitration with regard to construction contracts within the last five (5) years?
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Your answer
Within the last five (5) years, has any officer or principal of your company ever been an officer or principal of another company when it failed to complete a construction contract?
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(If the answer is yes, please explain in the box. If the answer is no, please write no.)
Your answer
List major construction projects your organization currently has in progress:
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Your answer
State the current total value of work under contract and the value of work under contract that is remaining to be completed:
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Answer in the form of $100 total $25 remaining.
Your answer
State your projected revenues for the next 12 months
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Your answer
List the major projects your organization has completed in the past five (5) years
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Separate by commas.
Your answer
List your company’s annual volume for the past five (5) years
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Your answer
List your company’s largest contract to date:
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Your answer
Please enter the project value range for the scope of work that your company is interested in pursuing.
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Your answer
Briefly list the construction experience and present commitments of the key individuals in your company.
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Your answer
Bank References
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Separate by commas.
Your answer
Trade References
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Separate by commas.
Your answer
State the name and rating of your bonding company
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Your answer
Please provide the following: Last two fiscal year-end financial statements to include CPA letter, balance sheet, income statement, cash flow, and any notes to the financial statements. Current interim statements (to include balance sheet and income statement at a minimum) if last fiscal year end is over six months old.
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Your answer
Please Provide the following: Current credit lines; indicate total amounts of lines of credit as well as what is currently outstanding.
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Your answer
List total number of field employees that your company currently employs
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Your answer
List total number of office employees that your company currently employs
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Your answer
What percentage of work does your company perform with its own forces?
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Your answer
If your principle office is located outside the area; Describe how your firm will utilize crafts people and suppliers local to the area.
Your answer
Quality Control – Describe your understanding of quality control and how you propose to successfully attain it.
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Your answer
Has your company ever been disqualified for cause from bidding on any Federal, State or City Agency project?
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Yes
No
Is your company capable of providing a performance bond equal to 100% of the contract and a labor and material payment bond of not less than 100% of the contract?
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Yes
No
Has your company been in the contracting business a minimum of 5 consecutive years under the present name?
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Yes
No
Has your company completed a minimum of 3 projects of similar size and complexity within the last 10 years?
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Yes
No
Is your company able to provide a bid bond to pay, should your firm fail to sign and execute the contract, an amount equal to 5% of your base bid?
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Yes
No
Does your company understand that all qualifications and supporting materials submitted (including all data, material, & documentation originated and prepared for Argo Building Company) shall become the property of Argo Building Co, Inc?
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Yes
No
Does your company understand that all information requested in this form will be considered in the evaluation of your company’s qualification for this work by Argo Building Co, Inc?
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Yes
No
The information provided herein is true and sufficiently complete so as not to be misleading.
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Provide an e-signature that includes Your Name, Your Title, Your Company's Name, and the Date.
Your answer
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