6-Contractor Qualification Statement.pdf

T H E A M E R I C A N I N S T I T U T E O F A R C H I T E C T S

AJA Document A305

Contractor's Qualification Statement

1986 EDITION

This form is approved and recommended by The American Institute of Architects (AJA) and The Associated General Contractors of America (AGC)for use in evaluat ing the qualifications of contractors. No endorsement of the submitting party or verification of the information is made by the AJA or AGC.

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

SUBMITTED TO:

ADDRESS:

SUBMITTED BY: Corporation 0

NAME: Partnership 0

ADDRESS: Individual 0

PRINCIPAL OFFICE: Joint Venture 0

Other 0

NAME OF PROJECT (if applicable):

TYPE OF WORK (file separate form for each Classification of Work):

General Construction

Plumbing Other _

(please specify)

HVAC

Electrical

Copyright 1964, 1969, 19"'9, ©1986 by The American Institute of Architects, P35 New York Avenue, NY'., Washing ton, D.C. 20006. Reproduction of the material herein or substantial quotation of its provisions without written permission of the AJA violates the copyright laws of the United States and will be subject to legal prosecution.

AIA DOCUMENT A305 • CONTRACTOR'S QUALIFICATION STATEMENT • 1986 EDITION • AIA" • © 1986 THE AMERICAN INSTITUTE OF ARCHITECTS, I :"35 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006

WARNING: Unlicensed photocopying violates U.S. copyright laws and is subject to legal prosecution.

A305-1986 1

1. ORGANIZATION

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

1.2 How many years has your organization been in business under it present business name?

1.2. 1 Under what other or former names has your organization operated?

1.3 If your organization is a corporation, answer the following:

1.3.1 Date of incorporation:

1.3.2 State of incorporation:

1.3.3 President's name:

1.3.4 Vice-president's name(s):

1.3.5 Secretary's name:

1.3.6 Treasurer's name:

1.4 If your organization is a partnership, answer the following:

1.4.1 Date of organization:

1.4.2 Type of partnership (if applicable):

1.4.3 Name(s) of general partner(s):

1.5 If your organization is individually owned, answer the following:

1.5.1 Date of organization :

1.5.2 Name of owner:

AIA DOCUMENT A305 • CONTRACTOR'S QUALIFICATION STATEMENT • 1986 EDITION • AJA® • ·D l986 THE AMERICAN INSTITUTE OF.\RCHITECTS, 1-;-35 NEW YORK AVENUE, N.\11 ., "ASHINGTON, D.C. 20006 A305-1986 2

WARNING: Unlicensed photocopying violates U.S. copyright laws and Is subject to legal prosecution.

1.6 If the form of your organization is other than those listed above, describe it and name the principals:

2. LICENSING

2.1 List jurisdictions and trade categories in which your organization is legally qualified to do business, and indicate registration or license numbers, if applicable.

2.2 List jurisdictions in which your organization's partnership or trade name is filed.

3. EXPERIENCE

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

3.2 Claims and Suits. (If the answer to any of the questions below is yes, please attach details.)

3.2.1 Has your organization ever failed to complete any work awarded to it?

3.2.2 Are there any judgments, claims, arbitration proceedings or suits pending or outstanding against your organization or its officers?

3.2.3 Has your organization filed any law suits or requested arbitration with regard to construc tion contracts within the last five years?

3.3 Within the last five years, has any officer or principal of your organization ever been an officer or principal of another organization when it failed to complete a construction contract? (If the answer is yes, please attach details.)

AIA DOCUMENT A305 • CONTRACTOR'S QUALIFICATION STATEMENT 1986 EDITION • AIA• • © 1986 THE AMERICANINSTITUTE OF ARCHITECTS, 1"35 NEW YORK AVENUE, N.'-'., WASHINGTON, D.C. 200o6 A305-1986 3

WARNING: Unlicensed photocopying violates U.S. copyright laws end Is subject to legal prosecution.

3.4 On a separate sheet, list major construction projects your organi7.ation has in progress, giving the name of project, owner, architect, contract amount, percent complete and scheduled completion date.

3.4.1 State total worth of work in progress and under contract:

3.5 On a separate sheet, list the major projects your organization has completed in the past five years, giving the name of project, owner, architect, contract amount, date of completion and percentage of the cost of the work performed with your own forces.

3.5.1 State average annual amount of construction work performed during the past five years:

3.6 On a separate sheet, list the construction experience and present commitments of the key individ uals of your organization.

4. REFERENCES

4.1 Trade References:

4.2 Bank References:

4.3 Surety:

4.3.1 Name of bonding company:

4.3.2 Name and address of agent:

AIA DOCUMENT A305 • CONTRACTOR'S QUALIFICATION STATEMENT • 1986 EDITION • AJA® • © 1986 THE AMERICANINSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 A305-1986 4

5. FINANCING

S.1 Financial Statement.

S.1.1 Attach a financial statement, preferably audited, including your organization's latest balance sheet and income statement showing the following items:

Current Assets (e.g., cash, joint venture accounts, accounts receivable, notes receivable, accrued income, deposits, materials inventory and prepaid expenses);

Net Fixed Assets;

Other Assets;

Current Liabilities (e.g., accounts payable, notes payable, accrued expenses, pro vision for income taxes, advances, accrued salaries and accrued payroll taxes);

Other Liabilities (e.g., capital, capital stock, authorized and outstanding shares par values, earned surplus and retained earnings).

S.1.2 Name and address of firm preparing attached financial statement, and date thereof:

5.1.3 3 Is the attached financial statement for the identical organization named on page one?

5.1.4 If not, explain the relationship and financial responsibility of the organization whose financial statement is provided (e.g., parent-subsidiary).

5.2 Will the organization whose financial statement is attached act as guarantor of the contract for con struction?

AIA DOCUMENT A305 • CONTRACTOR'S QUALIFICATION STATEMENT • 1986 EDITION • AIA® • © 1986 THE AMERICAN INSTITUTE OF ARCHITECTS, I'.'j5 NEW YORK AVENUE, N.W. , WASHINGTON , D.C. 20(Xl6 A305·1986 5

6. SIGNATURE

6.1 Dated at this day of

Name of Organization:

By:

Title:

6.2

M being duly sworn deposes and says that the information provided herein is true and sufficiently complete so as not to be misleading.

Subscribed and sworn before me this day of

Notary Public:

My Commission Expires:

r.ffl CAUTION: You should use an original AIA document which has this caution printed in red.

WW An original assures that changes will not be obscured as may occur when documents are reproduced.

AIA DOCUMENT A305 • CONTRACTOR'S QUALIFICATION STATEMENT • 1986 EDITION • AIA® • ©1986 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., W ASHINGTON, D.C. 2D006 A305-1986 6

WARNING: Unlicensed photocopying violates U.S. copyright laws and is subject to legal prosecution.

5. FINANCING