SUBCONTRACTOR'S QUALIFICATION SHEET

The contents of this statement are CONFIDENTIAL.

Complete all sections as completely as possible.
Fill out Schedule A (attached) if your organization is currently bidding a project.

The Undersigned certifies under oath that the information provided herein is true and sufficiently
complete so as not to be misleading.

Name of Organization:
Your Name: Title:
Address:
City: State: Zip Code:
Telephone: Fax:
Email: Website:

Trades that your organization provides:

Choose One: Union Shop Open Shop Union and Open Shop
If Union, Which Affiliations:

1. GENERAL COMPANY INFORMATION

Type of Organization

Corporation Partnership Sole Proprietorship

Date of Incorporation / Partnership:
State of Incorporation / Partnership:
Minority Owned (specify):

How many years has your organization been in business as a subcontractor?

Please list previous name(s) of company, if applicable:

If a previous name of company was applicable, how many years has your organization been in business under its present name?
Number of full time employees: In Shop In Field In Office

2. EXPERIENCE

Work Type / Category

List the categories of work that your organization normally performs with its own forces.

Please select the work types that your company will do:
Commercial Institutional Industrial Restaurant Retail
Multi-Family, Residential Single-Family, Residential

Current Projects

Summarize current projects and provide, at least, the following information. If more writing space is needed, provide information in the note area below.
Name of Project 1:
GC or Client Name:
Contact: Telephone#:
Scope of Work:
Contract Amount: Completion Date:

Current Project 1 Note Pad:

Name of Project 2:
GC or Client Name:
Contact: Telephone#:
Scope of Work:
Contract Amount: Completion Date:

Current Project 2 Note Pad:

Name of Project 3:
GC or Client Name:
Contact: Telephone#:
Scope of Work:
Contract Amount: Completion Date:

Current Project 3 Note Pad:

Past Projects

Name of Past Project 1:
GC or Client Name:
Contact: Telephone#:
Scope of Work:
Contract Amount: Completion Date:

Past Project 1 Note Pad:

Name of Past Project 2:
GC or Client Name:
Contact: Telephone#:
Scope of Work:
Contract Amount: Completion Date:

Past Project 2 Note Pad:

Name of Past Project 3:
GC or Client Name:
Contact: Telephone#:
Scope of Work:
Contract Amount: Completion Date:

Past Project 3 Note Pad:

3. BANK / SALES / TRADE REFERENCES

Federal Employer ID Number:

Bank Reference


Contact:
Bank Location:
Telephone #:

Annual Sales Volume

2008:
2007:
2006:

Trade References [list five]


4. BONDING COMPANY

Can your company provide a bond if necessary? Yes No
Bonding Company Name:
Address:
Contact Name: telephone#:
Single Project Limit: Aggregate Limit:

5. SAFETY

Describe the permanent safety program you maintain within your organization.

6. SIGNATURE

I hereby certify the above to be the truth to the best of my knowledge.

Dated this day of 20
Name of Organization:
By: Title:

SCHEDULE A

complete this schedule if your organization is currently bidding a project for Martins Construction.

Project Name:
Project Manager who will be assigned to this project.
Name: Years with company: Years in construction:
Prior positions and experience:

List this Project manager's other commitments at this time:

Who prepares and processes submittals?
Who estimates change orders?
What is the % markup on change orders?
List hourly rates to be used to add or deduct work:
Foreman: Mechanic: Helper:
List equipment rates.

Check here to test this without sending it off.