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Sub Contractor Details
Jeff Severson
2019-02-07T16:08:27+00:00
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Upload Current Certificate of Insurance
*
Section 1: Basic Information
_________________________________
Company Name
*
Ownership Type
*
Partnership
Corporation
LLC
Sole Proprietor
Year Started / Incorporated / Organized
*
Address
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Federal ID / SS
*
Owner / President's Name
Contact
*
First
Last
Phone
*
Fax
cell
*
Email
*
Email
Confirm Email
Union Affiliation
Merit Shop
Open Shop
Prevailing Rate
Union
States and License
*
List the States your company is Licensed to perform work and License.
Trades Performed
01000: Construction Publications
01140: Scaffolding and Staging
01150: Hoisting / Rigging
01160: Construciton Fencing
01170: Construction Trailers and Rentals
01190: Temp Heat/ Air Dehumidification
01201: Structural Engineers - DESIGN BUILD
01300: Material Testing Companies
01333: Safety Services and Fall Protection
02001: Structural Fill
02002: Erosion Control
02051: Building Moving and Relocation
02052: Demolition Take Down
02053: Selective Demolition
02075: Concrete Cutting/Removal
02076: Blasting
02082: Hazardous Material Abatement
02085: Regulated Soil Disposal
02090: Dewatering
02115: Underground Storage Tank Removal
02200: Sitework
02249: Rock Anchors
022490: Rock Anchors
02250: Underpinning
02255: Shoring Temp Building Support
022890: Traffic Signalization
02300: Soldier Pile and Lagging / Sheeting
02350: Piles & Caissons
02352: Helical Piles Mini Piles
02353: Shotcrete Soil Nail Wall/ Retention
02510: Paving
02515: Unit Pavers
02520: Paving Marking
02520: Retaining Walls
02540: Synthetic Turf Fields
02545: Bituminous Surface Treatment
02613: Rammed Aggregate Pier / Geo Pier/ Ground Improvement
02670: Water Wells
02700: Geothermal Drilling
02800: Site Improvement
02810: Tree Removal/ Prunning
02830: Fencing
02900: Landscaping
02903: Irrigation
04000: Masonry
04200: Masonry Units
04250: Masonry Material Supplies
04300: Cultured Stone Veneer
05100: Steel Erector
05120: Structural Steel
05450: Light Gauge Metal Trusses
05460: LGMF/ Cold Formed Steel/ Panelized Metal Framing
05461: Steel Roof TRUSS
05462: PREFAB METAL STO WALL PANEL
05500: Metal Fabrications
05513: Metal platforms/balconies
05590: Unistrut / Secondary Support
05715: Fabricated Spiral Stairs
05800: Expansion Control
06060: Rough Carpentry Material
06100: Rough Carpentry Labor
06110: Wood Panels
06120: Structural Insulated Panels
06190: Wood Trusses
06200: Finish Carpentry
06210: Finish Carpentry Installation
06215: Finish Carpentry - FABRICATION
06417: Solid Surface Countertops
06600: Plastic Fabrications/ GFRG/ PVC/ GRC/GRG
06611: Custom Wood Doors and Windows
07100: Dampproofing and Waterproofing
07210: Building Insulation
07220: Spray Foam Insulation
07240: Exterior Insulation and Finish Systems (EIFS)
07250: Spray Fireproofing
07310: Asphalt Shingles
07320: Slate/ Tile/ Copper Roofing
07330: Green Roofing
07410: Metal Roof and Wall Panels
07412: Insulated Steel Panels
07430: Aluminum Composite Panels
07450: Siding - Wood/Vinyl/Fiber Cement
07530: Roofing
07710: Roof Accessories
07800: Penetration Firestopping
07900: Joint Sealants
08001: Doors, Frames, and Hardware Supplier
08002: Doors, Frames, and Hardware Installation
08130: Hanger Doors
08300: Custom Wood Doors
08322: Security Doors
08330: Coiling Doors and Grilles
08389: Electronic Lock & Key System
08410: Glass/ Glazing/ Storefront
08430: Shower Doors
08450: Insulated Translucent Fiberglass Wall Panel
08460: Automatic Entrance Doors
08520: Aluminum Windows
08540: Vinyl Windows
08650: Light Shelves
08670: Wood/ Fiberglass Windows
08675: Wood Window Restoration
08900: Glazed Curtain Wall
08950: Skylights
08990: Glass Railings
09201: MODULAR - PATCH GWB/FLOORS
09202: Lath & Plaster
09250: Drywall
09310: Ceramic Tile
09400: Terrazzo
09430: Dimensional Stone Flooring
09500: Acoustical Ceilings
09510: Acoustical Plaster
09520: Sprayed Acoustical Insulation
09550: Wood Flooring
09560: Wood Ceiling
09600: Flooring Resilient/ Carpet/ Tile/ Wood
09710: Sports Flooring
09720: Epoxy Flooring
09750: Floor Prep and Leveling
09900: Painting
10120: Projection Screens and Visual Aid Boards
10160: Toilet Compartments - Metal
10170: Toilet Compartments Solid Surface
10190: Cubicles Curtains and Track
10200: Louvers and Vents
10265: Wall Protection
10270: Access Flooring
10300: Fireplaces And Stoves
10340: Church Steeples & Cupolas
10350: Flagpoles
10360: Hospital/ Nursing Facilities Headwalls
10430: Awnings
10440: Signage
10510: Lockers
10520: Fire Extinguishers
10530: Canopy
10550: Postal Specialties
10605: Wire Mesh Partitions
10650: Operable Partitions
10670: Storage Shelving
10800: Toilet, Bath, and Laundry Accessories
10821: Roof Screens
11015: Overhead Crane and Hoist Equipment
11018: Fire Station Pole
11060: Theatrical Equipment
11110: Commercial Laundry Equipment
11130: Loading Dock Equipment
11150: Parking Controls
11170: Trash Chutes/ Waste Handling Equipment
11190: Detention Equipment
11400: Food Service Equipment
11450: Residential Appliances
11520: Playground Equipment
11650: Athletic & Recreational Equipment
11670: Grandstands & Bleachers
11680: Scoreboard
11770: Radiology Equipment/Radiation Protection
12002: Floor Mat
12345: Laboratory Casework and Equipment
12360: Educational/ Medical Casework
12370: Kitchen Cabinets / Residential Casework
12490: Window Treatments
12560: Institutional Furniture
12610: Fixed Audience Seating
12620: Stage Curtains
12750: Stone Countertop
12760: Stone Resin Counters
12800: Acoustic Wall Panels
13025: Polyresin Track Surface
13060: Controlled Environment Room
13100: Lightning Protection
13120: Pre-engineered Metal Buildings
13126: Athletic Support Buildings
13127: Athletic Fields/Turf Fields
13150: Swimming Pools
13210: Roof Anchors and Davits
13500: Modular Buildings
13501: Modular Finishes
14000: Dumbwaiters
14200: Elevators
14240: HC Lifts
14420: Wheelchair Lifts
14450: Vehicle Parking Lift Equipment
14620: Hoist and Monorail Systems
15300: Fire Protection
15301: Modular Fire Protection
15400: Plumbing
15401: Modular Plumbing
15500: Heating, Ventilating & Air Conditioning
15501: Modular HVAC
15510: HVAC Equipment Manufacturer/ Suppliers
16000: Electrical
16001: Modular Electrical
16500: Lighting
16700: Fire Alarm Nurse Call / Low Voltage
17200: Audio Video Equipment
17300: Security CCTV
Section 2: Experience
_________________________________
1) List 4 Trade References
List Company, Contact, and Phone for each.
Trade Reference 1.
List Company, Contact, and Phone.
Trade Reference 2.
List Company, Contact, and Phone.
Trade Reference 3.
List Company, Contact, and Phone.
Trade Reference 4.
List Company, Contact, and Phone.
2) List Three Projects Presently Under Construction
Project 1: (Project Name/Owner/GC)
*
List Project Name, Owner (name and phone), and GC (name and phone).
Project 1: (Start Date/Finish Date/Contract Amount)
List start date, finish date, and contact amount.
Project 2: (Project Name/Owner/GC)
*
List project name, Owner (name, phone#), and GC (name, Phone)
Project 3: (Start Date/Finish Date/Contract Amount)
*
List start date, finish date, and contract amount)
3) List All Major Projects Completed Within the Past Three Years
Past Projects
List project name, Owner, GC, Contact, Phone, Start and Finish Dates, and Contract amounts.
Section 3: Financial
_________________________________
1) Bank Information
Name of Bank
Contact Person
*
First
Last
Contact
*
Contact Email Address
2. List Your Company's Volume for the Past Three Years:
Private Work (last Year)
List $ volume.
Public Work (last year)
List $ volume.
Private Work (2 yrs ago)
List $ volume.
Public Work (2 yrs ago)
List $ volume.
Private Work (3 yrs ago)
List $ volume.
Public Work (3 yrs ago)
List $ volume.
3. Current Backlog of Work Next 12 Months
List total $ volume.
4. Has your company ever failed to complete a project?
Yes
No
If Yes, Explain Why?
5. Is Your Company Signatory to Any Labor Agreement?
Yes
No
If Yes, List Trades
6. Does Your Company Offer Health Insurance to its Employees?
Yes
No
If Yes, List Number of Employees
7. What are Your Company's Standard Limits of Insurance Coverage?
_________________________________
General Liability
List Insurance Company, Phone, and Limit.
Excess / Umbrella Liability
List Insurance Company, Phone, and Limit.
Auto Liability
List Insurance Company, Phone, and Limit.
Workers Compensation
List Insurance Company, Phone, and Limit.
8. Is Your Company Bondable?
Yes
No
Contact Person
*
First
Last
If Yes, List Single Job Limit
If Yes, List Aggregate Limit
If Yes, List Surety Company
Contact
*
9. Workers Compensation Rating for the Past Three Years (EMR)
_________________________________
EMR (last year)
EMR (2 years ago)
EMR (3 yrs ago)
Certifications
Disadvantaged
HUB Zone
Minority
Veterans
Women
Section 4: OSHA
_________________________________
1. Does Your Company Have a Written Safety Program?
Yes
No
2. Does Your Co. Require Your Field Employees to be OSHA 10 Hour Certified?
Yes
No
If No, please describe the Safety Training that you provide
3. Has Your Co. Been Cited by OSHA Within the Last 5 Years?
Yes
No
If Yes, please Provide an Explanation of Each Incident
Section 5: Other
_________________________________
1. Trade or Business Associations
Please list any that you are a member of.
2. Minimum Size Project Your Company Would Perform
3. Maximum Size Project Your Company Would Perform
4. How would you like to receive Bid Invitations?
Email
Fax
Both
Name of Person Filling out this Form
*
First
Last
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