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About HBW
Leadership
Our History
Sustainability
Community Outreach
Expertise
Budgets & Estimating
Scheduling
Project Management
Job Site Management
Quality Control
HBW Services
Market Sectors
Projects
Blog
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Careers
Contact Us
Subcontractor Qualification Form
HBW Construction
>
Subcontractor Qualification Form
HBW Construction - Subcontractor Qualification Form
Step
1
of
3
33%
1. Subcontractor Identity
Areas of Expertise
Company Name
Address
Phone Number
Email
Contact Person(s)
Type of Company
Sole Proprietorship
Corporation
Partnership
Union
Yes
No
Wage Scale Project Experience
Yes
No
Date Company Formed
Number of Employees (Office)
Number of Employees (Field)
States in which the company is legally qualified to do business:
States in which the company is legally qualified to do business:
Names and titles of key people in company:
Names and titles of key people in company:
Has the company operated under any other name in the past five years?
Has the company operated under any other name in the past five years?
Yes
No
Previous Company Name
2. MBE/WBE/SBE CERTIFICATION
Is the company a certified Minority Business Enterprise (MBE), Women Business Enterprise (WBE), Small Business Enterprise (SBE), or any other type of certified business enterprise?
Is the company a certified Minority Business Enterprise (MBE), Women Business Enterprise (WBE), Small Business Enterprise (SBE), or any other type of certified business enterprise?
Yes
No
What Type?
Certifying Agency:
3. Financial Information
Does the company have a line of credit from any lending institution?
Does the company have a line of credit from any lending institution?
Yes
No
Give Details
Lender’s Name/Address Lending Officer’s Name/Phone #
Do you have bonding?
Do you have bonding?
Yes
No
Bonding Name Company
Bonding Name Address
Give Details
4. SAFETY RECORD
In the past five years, has your company or any of its key people been investigated for or found to have committed a serious OSHA violation?
In the past five years, has your company or any of its key people been investigated for or found to have committed a serious OSHA violation?
Yes
No
Give Details
Please provide your Workman’s Compensation MOD rate for the past 3 years:
Please provide your Workman’s Compensation MOD rate for the past 3 years
Max. file size: 64 MB.
Do you have a written employee safety policy and program?
Do you have a written employee safety policy and program?
Yes
No
Do you have a designated company safety officer?
Do you have a designated company safety officer?
Yes
No
Safety officer name and phone number
Do you have a hazardous communications program, and are you able to provide SDS for any hazardous products you may use?
Do you have a hazardous communications program, and are you able to provide SDS for any hazardous products you may use?
Yes
No
Do you conduct project safety inspections?
Do you conduct project safety inspections?
Yes
No
Who conducts the inspection (name and title) and how often?
Your most recent OSHA 300 Log.
Please attach a copy of your most recent OSHA 300 Log.
Max. file size: 64 MB.
Your most recent Safety Program
Please attach a copy of your most recent Safety Program.
Max. file size: 64 MB.
Are there any other open or aggregate liability claims that would impair your ability to insure any project?
Are there any other open or aggregate liability claims that would impair your ability to insure any project?
Yes
No
Explain
5. OTHER INFORMATION
Has your company or any of its Owners been a party to a bankruptcy or reorganization proceeding?
Has your company or any of its Owners been a party to a bankruptcy or reorganization proceeding?
Yes
No
Please give date
During the past five years, have any liens been filed against you by any of your subcontractors or suppliers?
During the past five years, have any liens been filed against you by any of your subcontractors or suppliers?
Yes
No
Please give details for any liens over $5,000.
Have you ever failed to complete a contract, been defaulted, or had a contract terminated?
Have you ever failed to complete a contract, been defaulted, or had a contract terminated?
Yes
No
Please give details
In the past five years, has your company or any of its key people been involved in any lawsuits arising from construction projects?
In the past five years, has your company or any of its key people been involved in any lawsuits arising from construction projects?
Yes
No
Please give details
6. US CITIZENS
How many office employees are US Citizens?
How many field employees are US Citizens?
Project Reference Sheet
*
We'll need a project reference sheet. Please choose from the following choices:
Fill out a new reference sheet
Attach your own
Your project reference sheet
Max. file size: 64 MB.
Signed:
I hereby certify that to the best of my knowledge all of the information on this form is correct
Date:
Title:
PROJECT REFERENCE SHEET
1. Completed Projects
Summarize representative projects completed in past 5 years
Include Name of Project, Scope of Work, Contract Amount, Completion Date, and Contact Name/#
2. Current Projects (Work in Progress)
Include Name of Project, Scope of Work, Contract Amount, Completion Date, and Contact Name/#
3. Trade References
List three of your subcontractors or suppliers
Include Name, Address, Phone Number, Contact Name
4. Client References
List three clients
Include Name, Phone Number, Fax Number, Contact Name
5. "Green" Construction
How many of your staff are Green Advantage Certified or LEED Accredited? Please list Certified projects where you have provided environmental construction and the level achieved.
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