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CONTACT INFORMATION
Company Name
Company Email
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Title
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Phone Number
Address
Street Address
City
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U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Suite No.:
EXPERIENCE
Please check the CSI Codes applicable to your business:
02 00 00 Existing Conditions
02 20 00 Assessment
02 30 00 Subsurface Investigation
02 40 00 Demolition And Structure Moving
02 50 00 Site Remediation
02 60 00 Contaminated Site Material Removal
02 70 00 Water Remediation
02 80 00 Facility Remediation
03 00 00 Concrete
03 10 00 Concrete Forming And Accessories
03 20 00 Concrete Reinforcing
03 30 00 Cast-In-Place Concrete
03 40 00 Precast Concrete
03 50 00 Cast Decks And Underlayment
03 60 00 Grouting
03 70 00 Mass Concrete
03 80 00 Concrete Cutting And Boring
04 00 00 Masonry
04 20 00 Unit Masonry
04 40 00 Stone Assemblies
04 50 00 Refractory Masonry
04 60 00 Corrosion-Resistant Masonry
04 70 00 Manufactured Masonry
05 00 00 Metals
05 10 00 Structural Metal Framing
05 20 00 Metal Joists
05 30 00 Metal Decking
05 40 00 Cold-Formed Metal Framing
05 50 00 Metal Fabrications
05 70 00 Decorative Metal
06 00 00 Wood, Plastics, And Composites
06 10 00 Rough Carpentry
06 20 00 Finish Carpentry
06 40 00 Architectural Woodwork
06 50 00 Structural Plastics
06 60 00 Plastic Fabrications
06 70 00 Structural Composites
06 80 00 Composite Fabrications
07 00 00 Thermal And Moisture Protection
07 10 00 Waterproofing
07 20 00 Thermal Protection
07 25 00 Weather Barriers
07 30 00 Steep Slope Roofing
07 40 00 Roofing And Siding Panels
07 50 00 Membrane Roofing
07 60 00 Flashing And Sheet Metal
07 70 00 Roof And Wall Specialties
07 80 00 Fire And Smoke Protection
07 90 00 Joint Protection
08 00 00 Openings
08 10 00 Doors And Frames
08 30 00 Specialty Doors And Frames
08 40 00 Curtain Walls
08 50 00 Windows
08 60 00 Roof Windows And Skylights
08 70 00 Hardware
08 80 00 Glazing
08 90 00 Louvers And Vents
09 00 00 Finishes
09 20 00 Plaster And Gypsum Board
09 30 00 Tiling
09 50 00 Ceilings
09 60 00 Flooring
09 70 00 Wall Finishes
09 80 00 Acoustic Treatment
09 90 00 Painting And Coating
10 00 00 Specialties
10 10 00 Information Specialties
10 20 00 Interior Specialties
10 30 00 Fireplaces And Stoves
10 40 00 Safety Specialties
10 50 00 Storage Specialties
10 70 00 Exterior Specialties
10 80 00 Other Specialties
11 00 00 Equipment
11 10 00 Vehicle And Pedestrian Equipment
11 15 00 Security, Detention & Banking Equip.
11 20 00 Commercial Equipment
11 30 00 Residential Equipment
11 40 00 Food Service Equipment
11 50 00 Educational And Scientific Equipment
11 60 00 Entertainment Equipment
11 65 00 Athletic And Recreational Equipment
11 70 00 Healthcare Equipment
11 80 00 Collection And Disposal Equipment
11 90 00 Other Equipment
12 00 00 Furnishings
12 10 00 Art
12 20 00 Window Treatments
12 30 00 Casework
12 40 00 Furnishings And Accessories
12 50 00 Furniture
12 60 00 Multiple Seating
12 90 00 Other Furnishings
13 00 00 Special Construction
13 10 00 Special Facility Components
13 20 00 Special Purpose Rooms
13 30 00 Special Structures
13 40 00 Integrated Construction
13 50 00 Special Instrumentation
14 00 00 Conveying Equipment
14 10 00 Dumbwaiters
14 20 00 Elevators
14 30 00 Escalators And Moving Walks
14 70 00 Turntables
14 80 00 Scaffolding
14 90 00 Other Conveying Equipment
21 00 00 Fire Suppression
21 10 00 Water-Based Fire-Suppression Systems
21 20 00 Fire-Extinguishing Systems
21 30 00 Fire Pumps
21 40 00 Fire-Suppression Water Storage
22 00 00 Plumbing
22 10 00 Plumbing Piping And Pumps
22 30 00 Plumbing Equipment
22 40 00 Plumbing Fixtures
22 50 00 Pool And Fountain Plumbing Systems
22 60 00 Gas And Vacuum Systems
23 00 00 HVAC
23 10 00 Facility Fuel Systems
23 20 00 HVAC Piping And Pumps
23 30 00 HVAC Air Distribution
23 40 00 HVAC Air Cleaning Devices
23 50 00 Central Heating Equipment
23 60 00 Central Cooling Equipment
23 70 00 Central HVAC Equipment
23 80 00 Decentralized HVAC Equipment
25 00 00 Integrated Automation
26 00 00 Electrical
26 10 00 Medium Voltage Electrical Dist.
26 20 00 Low Voltage Electrical Distribution
26 30 00 Electrical Power Generating
26 40 00 Electrical & Cathodic Protection
26 50 00 Lighting
27 00 00 Communications
27 10 00 Structured Cabling
27 20 00 Data Communications
27 30 00 Voice Communications
27 40 00 Audio-Video Communications
27 50 00 Distributed Communications
28 00 00 Electronic Safety And Security
28 10 00 Electronic Access Control
28 20 00 Electronic Surveillance
28 30 00 Electronic Detection And Alarm
28 40 00 Electronic Monitoring & Control
31 00 00 Earthwork
31 10 00 Site Clearing
31 30 00 Earthwork Methods
31 40 00 Shoring And Underpinning
31 50 00 Excavation Support & Protection
31 60 00 Special Foundations
31 70 00 Tunneling And Mining
32 00 00 Exterior Improvements
32 10 00 Bases, Ballasts, And Paving
32 30 00 Site Improvements
32 70 00 Wetlands
32 80 00 Irrigation
32 90 00 Planting
33 00 00 Utilities
33 10 00 Water Utilities
33 20 00 Wells
33 30 00 Sanitary Sewerage Utilities
33 40 00 Storm Drainage Utilities
33 50 00 Fuel Distribution Utilities
33 60 00 Hydronic & Steam Energy Utilities
33 70 00 Electrical Utilities
33 80 00 Communications Utilities
34 00 00 Transportation
34 10 00 Guideways/Railways
34 20 00 Traction Power
34 50 00 Fare Collection Equipment
34 80 00 Bridges
Please list Licenses & License Numbers you hold:
License Type:
License Number:
State:
Check the building type and size your company has experience with:
Less than $100,000
Over $250,000
Over $500,000
Federal
Airports
Healthcare
Educational
Office
Retail
Please indicate the highest construction value your company wishes to be considered for (Keep in mind you must be able to bond the amount indicated below)
$0,00 - $25,0000
$150,000 - $250,000
$25,000 - $50,000
$250,000 - $500,000
$50,000 - $150,000
Over $500,000
List the 3 most important projects your company has completed in the past 3 years
Project Name
Cost
End Date
Owner
List the 3 most important projects your company has in progress at the moment:
Project Name
Cost
End Date
% Complete
Owner
Indicate the Total $ Amount of Uncompleted work:
CORPORATE & FINANCIAL INFO
How long has your company been in operations?
0 - 5 years
5 - 10 years
over 10 years
How is your company organized:
Sole Proprietorship
Partnership
Corporation
Joint Venture
If applicable, State of Incorporation:
What is your Federal Tax ID Number:
List the names of the 3 top officers in your company:
Name
Title
Does your company operate under any other name:
Is your company affiliated with any other company?
Name
Address
Phone Number
Relationship
Surety Information
Surety Company
Bonding Agent
Name
Phone Number
Single Capacity
Aggregate Capacity
Insurance Information
Insurance Company
Insurance Agent
Name
Phone Number
Check your Company’s Areas of Operations:
South Florida
Central Florida
All Florida
South East US
Other
Other Company’s Areas of Operations
Check the Categories that Apply to your firm:
Large Business
Small Business
8(a)
HUB Zone
Women-Owned Business
Service-Disabled Veteran
Alaska-Native
MDC CSBE Level 1
MDC Level 2
CSBE Level 3
Florida DBE
Other
Other Categories that Apply to your firm
Please indicate which type of work does your firm Self-Perform:
Electrical
Mechanical
Fire Protection
Sheet Metal
Roofing
Earthwork
Demolition
Asphalt
Masonry
Drywall
Painting
Other
Other Self-Perform
What percentage of the work do you typically Self-Perform:
Please indicate the number of people your company currently employs:
Office
Field
Have you ever failed to complete any project awarded to you?
Yes
No
Indicate the yearly volume of work awarded to your firm for the past 3 years
2019
2020
2021
Please include the following Financial Information
Date of Statement
Retained Earnings
Current Assets
Net Worth
Current Liabilities
REFERENCES
List 3 Trade References
Contact Name/Title
Company
Phone Number
E-mail Address
Provide 1 Banking Reference
Contact Name/Title
Bank Name
Phone Number
E-mail Address
SAFETY RECORD & PROGRAM
Indicate you EMR (Experience Modification Rate) for the past 3 years:
2020
2021
2022
Do you conduct Safety Inspections?
Yes
No
Who conducts the safety inspections?
How Often?
Do you have a written Safety Program?
Yes
No
Do you have a safety orientation program for new employees in place?
Yes
No
Do you have a Drug & Alcohol Policy in place?
Yes
No
Do you conduct “Toolbox” Safety Meetings?
Yes
No
How Often?
Consent
All information submitted is held in strict confidence. By clicking in the box you hereby certify that all the foregoing statements contained herein are true and correct.
Name
This field is for validation purposes and should be left unchanged.