Subcontractor Qualifier Packet

Section 1 - Company

Company Name:(Required)

Officers & Owners(Required)

Primary Points of Contact

Estimating, Accounting, and Safety

Estimating Name(Required)

Estimating Email(Required)

Estimating Phone(Required)

Estimating Fax(Required)

Accounting Name(Required)

Accounting Email(Required)

Accounting Phone(Required)

Acccounting Fax(Required)

Safety Name(Required)

Safety Email(Required)

Safety Phone(Required)

Safety Fax(Required)

Section 2 - Organization

How many years has your organization been in business?(Required)

How many years has your organization been in business under its present name?(Required)

List any former names your organization has operated under

Is your company a subsidiary or affiliate of another firm?

If your organization is a corporation, to include Limited Liability Corporation; or a Partnership, please provide the following:

Date of Incorporation

State of Incorporation

Name of CEO/President

Key Personnel

Date of Partnership

Type of Partnership

Names of General Partners

If your Organization is individually owned, please provide the Date of Organization and Name of Owner(s)

Section 3 - Licensing

Indicate contractor license number, class and expiration date, for which you are qualified to do business.

State(Required)

License Number(Required)

License Type(Required)

Expiration Date(Required)

Section 4 - Experience

Has your organization within the last five years ever failed to complete any work?(Required)

Are there any judgments, claims or arbitration proceedings or suits pending or outstanding against your organization or its officer within the last five years?(Required)

Has your organization filed any lawsuits or requested arbitration with regard to contracts within the last five years?(Required)

Within the last three years has your company performed any work for David Nice Builders, Inc.? If yes, please provide the Project Name(Required)

Are you familiar with Certified Payroll Projects (Davis Bacon Wage Requirements)?(Required)

Section 5 - References

Provide Two (2) General Contractor and/or Owner References(Required)

To include company name, address, telephone, contact person, and email address

Provide Two (2) Supplier References(Required)

To include company name, address, telephone, contact person, and email address

Section 6 - Safety and Loss Prevention

Please provide a copy of your current Certificate of Insurance (General Liability, Auto, Worker's Compensation and Excess Liability.(Required)

Required coverages found here.

Drop files here or

Max. file size: 50 MB.

Is your firm able to provide a Payment and Performance Bond? (P&P Bond) Attach a signed letter from your bonding agent stipulating current amount of bonding capacity per project, aggregate limit, bond rate and identifying the Surety including A.M. Best Rating

Max. file size: 50 MB.

Have you had any OSHA violations in the last 5 years?(Required)

Please list your company's Experience Modification Rate (EMR) for the last three years(Required)

E.g., 2021, 0.69

Do you have a Safety Policy?

Section 7 - Financial/Operation

What is your current backlog?

Today(Required)

Last Financial Statement(Required)

12 Months Ago(Required)

Phone

This field is for validation purposes and should be left unchanged.

Subcontractor Registration

Subcontractor Qualifier Packet