SUBCONTRACTOR PREQUALIFICATION FORM

SUBCONTRACTOR  PREQUALIFICATION  FORM

Company Name
SubcontractorSupplier
Street Address
City
State
Zip
Telephone
Fax
Email Address
Other Office Locations
Organization
CorporationPartnershipIndividualJoin Venture
State
Date Established
Are you currently DBE Certified through the City and County of Denver?YesNo
Is your company currently registered as any type of historically underutilized business or participate in any small business minority programs?
YesNo
SBE
MBE
WBE
VOSB
Other category, please explain:
General Scope Of Work:
Division 1:
Construction FacilitiesTemporary ConstructionVehicular Access and PavingTemporary Barriers and Enclosures
Division 2:
SurveyingDemolitionSite RemediationContaminated Site Material Removal
Division 3:
Concrete FormingCast-In-Place ConcreteConcrete FinishingPrecast ConcreteTilt-Up Concrete
Division 4:
Concrete Unit MasonryStone AssembliesUnit MasonryRefractory Masonry
Division 5:
Structural Metal FramingCold-Formed Metal FramingMetal FabricationDecorative Metal
Division 6:
Rough CarpentryFinish CarpentryArchitectural WoodworkStructural Composites
Division 7:
Thermal ProtectionRoofing and Siding PanelsFlashing and Sheet MetalFire and Smoke Protection
Division 8:
Doors and FramesEntrances and StorefrontsGlazingLouvers and Vents
Division 9:
Plaster and Gypsum BoardFlooringAcoustic TreatmentPainting and Coatings
Division 10:
SpecialtiesInterior SpecialtiesSafety SpecialtiesExterior Specialties
Division 11:
Vehicle & Pedestrian Equip.Commercial EquipmentFood-service EquipmentOther Equipment
Division 12:
FurnishingsCaseworkFurnitureMultiple Seating
Division 13:
Special Facility ComponentsSpecial StructuresIntegrated ConstructionSpecial Instrumentation
Division 14:
Conveying EquipmentElevatorsEscalators and Moving WalksScaffolding
Division 21:
Fire SuppressionFire Extinguishing SystemsFire PumpsFire-Suppression Water Storage
Division 22:
PlumbingPlumbing EquipmentPool and Fountain SystemsGas and Vacuum Systems For laboratory
Division 23:
HVACFacility Fuel SystemsHVAC Piping & PumpsCentral HVAC Equipment
Division 25:
Integrated AutomationNetwork EquipmentFacility ControlsIntegrated Automation Control Sequences
Division 26:
ElectricalElectrical DistributionElectrical ProtectionLightning Protection
Division 27:
CommunicationsStructured CablingData CommunicationDistributed Communications
Division 28:
Electronic Safety / SecurityElectronic SurveillanceElectronic Detection I AlarmElectronic Monitoring and Control
Division 31:
EarthworkSite ClearingShoring and UnderpinningTunneling and Mining
Division 32:
Exterior ImprovementsBases, Ballasts. and PavingSite ImprovementsIrrigation / Planting
Division 33:
UtilitiesWater UtilitiesStorm Drainage UtilitiesElectrical utilitiesNatural Gas or LP Utilities
Specialty Scope of Work
Geographical areas of service
Type of InsuranceGeneral LiabilityWorkers Compensation
Bonding capabilities:
AggregatePer ProjectBonding Rate
Does the organization currently have active liens or lawsuits?
YesNo
If so, please explain
Does the company have any recent OSHA violations?YesNo
If so, please explain

PLEASE BE ADVISED FAILURE TO DISCLOSE ANY LIENS, LAWSUITS, JUDGMENTS, AND/OR CLAIMS COULD LEAD
TO DISQUALIFICATION OF BIDDING AND/OR CONSIDERATION FOR CONTRACT.


Please list 5 references:

1st Reference
Name:
Address:
Phone:
Email:
2nd Reference
Name:
Address:
Phone:
Email:
3rd Reference
Name:
Address:
Phone:
Email:
4th Reference
Name:
Address:
Phone:
Email:
5th Reference
Name:
Address:
Phone:
Email:

List of 5 recent projects completed in the past 5 years:

1st Project
Project:
Location:
Value:
Owner/General Contractor:
2nd Project
Project:
Location:
Value:
Owner/General Contractor:
3rd Project
Project:
Location:
Value:
Owner/General Contractor:
4th Project
Project:
Location:
Value:
Owner/General Contractor:
5th Project
Project:
Location:
Value:
Owner/General Contractor:
Please attached 3 to 5 resumes of key personnel (Only PDF, Doc & Docx files allowed).
Copy of Insurance Certificate
W9form
Is your Organization?
Union
Non-Union
Has your organization completed LEED Certified Projects?YesNo

I certify under penalty of perjury under the laws of the State of Colorado that the information provided on this pre-qualification form is true, correct and to the best of my knowledge. I understand that any falsification of this form, whether willingly or accidentally, is grounds for disqualification of bidding and/or consideration for contract.

I certify by signing below that I am an authorized officer and representative of the company able to provide the information contained herein this form.

Authorized signature
Date
Name
Title