Contractor Qualification Form
Date:
INSTRUCTIONS: You may elaborate on the requested information, or add to it if you think it will be
useful for evaluation of your firm’s capabilities. Simply attach extra information to this form. The
information we receive will be used by (your company’s name) as a basis for
determining bid sources. PLEASE ATTACH TO THIS FORM a copy of your certificate of insurance
indicating current limits and a current financial statement.
Firm: Phone #:
Address: Fax #:
President:
Federal ID#: Contact:
Bank reference: Date Co. began:
Address: Years in trade:
Phone: Value of equipment:
Bonding capacity: Stockholder equity:
Work currently bonded: Percent work done by own workers:
Bonding Co.: Work under contract:
Bonding Co. Best rating: Volume, last year:
Bonding agent phone: Average sales, last 3 yrs.:
Ins. Agent: Merit shop? Yes No
Ins. agent phone: Union affiliation?
Comply with EEO requirements? Yes No
Staff you employ:
Engineers CPM Schedulers Project managers
Purchasing agents Estimators Draftsmen
In-house engineering capacity? Yes No
In-house fabrication capacity? Yes No
Fabrication area square feet
Do you have a safety program? Yes No
Have you been cited for serious OSHA violations? Yes No
If Yes, please explain circumstances separately.
Contractor Qualification Form (cont.)
Qualified as MBE or WBE? Details:
Attach certificates.
Geographic areas where you are interested in bidding work:
Type of work you wish to bid:
REFERENCES
Non-government work done in the past three years:
Customer:
Phone #:
Contract amount:
Description of project:
Completion: On-time Ahead of schedule Late
Customer:
Phone #:
Contract amount:
Description of project:
Completion: On time Ahead of schedule Late
Customer:
Phone #:
Contract amount:
Description of project:
Completion: On time Ahead of schedule Late
Contractor Qualification Form (cont.)
Government work completed in the past three years:
Customer:
Phone #:
Contract amount:
Description of project:
Completion: On-time Ahead of schedule Late
Customer:
Phone #:
Contract amount:
Description of project:
Completion: On time Ahead of schedule Late
Customer:
Phone #:
Contract amount:
Description of project:
Completion: On time Ahead of schedule Late