EXHIBIT B - Contractor Qualification Statement - Final.pdf

EXHIBIT B_- CONTRACTOR QUALIFICATION STATEMENT

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

SUBMITED TO:

ADDRESS:

SUBMITTED BY:

NAME:

ADDRESS:

PRINCIPAL OFFICE:

☐ Corporation

☐ Partnership

☐ Individual

☐ Joint Venture

☐ Other: (Specify)

NAME OF PROJECT: (If applicable)

TYPE OF WORK: (File a separate form for each Classification of Work.)

☐ General Construction

☐ HVAC

☐ Electrical

☐ Plumbing

☐ Other: (Specify)

1.0 ORGANIZATION

1.1 How many years has your organization been in business as a Contractor, more specifically in Colorado?

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

1.2.1 Under what other or former names has your organization operated?

1.3 Principle/Project Manager/Contact person with direct phone, number, email address.

1.4 Names, credentials, and responsibilities of principals within your organization.

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

1.5.1 Date of incorporation:

1.5.2 State of incorporation:

1.5.3 President’s name:

1.5.4 Vice-president’s name(s):

1.5.5 Secretary’s name:

1.5.6 Treasurer's name:

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

1.6.1 Date of organization:

1.6.2 Type of partnership, if applicable:

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

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

1.7.1 Date of organization:

1.7.2 Name of owner:

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

2.0 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.

3.0 EXPERIENCE

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

3.2 Fire alarm experience and qualifications

3.3 Claims & Suits

(If the answer to any of the questions below is yes, attach details.)

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

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

3.3.3 Has your organization filed any lawsuits or requested arbitration with regard to construction contracts within the last five years?

3.4 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, attach details.)

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

3.5.1 State total worth of work in progress and under contract

3.6 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.

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

3.7 On a separate sheet, list the construction experience and present commitments of the key individuals of your organization.

4.0 REFERENCES

4.1 Name, contact person and phone number for recent Colorado School Districts your firm has worked for in the past five years.

4.2 Trade references:

4.3 Bank references:

4.4 Surety

4.4.1 Name of bonding company:

4.4.2 Name and address of agent:

5.0 INSURANCE

5.1 Insurance coverages/limits currently in force, policy renewal dates, and agent’s name and telephone number.