Subcontractor Qualification

Interested in Working with Crosslands as a Sub Contractor?

Start here by filling out this form and we’ll get in touch with you and see if we might be able to work together

Name of Business*
Address*
Street Address Address Line 2 City State ZIP Code
Office Phone*
Website
Specialties*
use the "+" symbol to add as many specialties as you like (Maximum 10)
Experience
Please tell us about your company and your experience.
Employees*
Start with the current year, then use the "+" symbol to add the previous two years.
Year # of Field Employees # of Office Employees # of Total Employees
Labor Unions - Signatory*
Use the "+" symbol to add additional Labor Unions
Contact for Bidding*
Phone*
Contact for Billing*
Phone*
Dunn & Bradstreet #
Organization
Type*
(Corporation, S-Corporation, etc)
Date Founded*
mm/yyyy
Years in Business
Enter number of years
Where Incorporated?
State where incorporated
Owners, Officers and Principals*
Use the "+" symbol to add additional people
Name Title Percent Ownership
Licenses*
Use the "+" symbol to add additional licenses
Type of License State Number
Legal Information
Has your firm, its officers or principals been involved in any tax liens, bankruptcy or reorganization proceedings, failed to complete any work awarded to them, defaulted, or had a contract terminated for cause within the last five years?*
- Yes
- No
If Yes, Please Explain
Are there any judgements, tax liens, claims, lawsuits, arbitration or mediation proceedings currently pending or outstanding against your firm, its officers or principals?*
- Yes
- No
If Yes, Please Explain
Has your firm, its officers or principals filed any claims, lawsuits, arbitration or meidation proceedings with regards to a construction contract within the last five years?*
- Yes
- No
If Yes, Please Explain
Financials / Revenue
Revenue Projected for This Year*
Actual Revenue for Last Year*
Actual Revenue for Two Years Ago*
Contracts and Previous Work
Largest Individual Contract Completed - This Year*
Job Title
Largest Individual Contract Completed - Last Year*
Job Title
Largest Individual Contract Completed - Two Years Ago*
Job Title
Completed Major Contracts - Last Three Years*
Start with this year, then use the "+" symbol to add last year and then two years ago.
Year Project Name Contractor
Are key supervisory personnel on these projects still with your firm?*
- Yes
- No
If No, Please Explain
Bidding Interest
What work do you normally perform with your own forces?
What work do you normally subcontract to others?
What geographical regions are you interested in bidding?*
- Alabama
- Alaska
- Arizona
- Arkansas
- California
- Colorado
- Connecticut
- Delaware
- District of Columbia
- Florida
- Georgia
- Hawaii
- Idaho
- Illinois
- Indiana
- Iowa
- Kansas
- Kentucky
- Louisiana
- Maine
- Maryland
- Massachusetts
- Michigan
- Minnesota
- Mississippi
- Missouri
- Montana
- Nebraska
- Nevada
- New Hampshire
- New Jersey
- New Mexico
- New York
- North Carolina
- North Dakota
- Ohio
- Oklahoma
- Oregon
- Pennsylvania
- Rhode Island
- South Carolina
- South Dakota
- Tennessee
- Texas
- Utah
- Vermont
- Virginia
- Washington
- West Virginia
- Wisconsin
- Wyoming
- Armed Forces Americas
- Armed Forces Europe
- Armed Forces Pacific
Key Project Personnel*
Use the "+" symbol to add more personnel
Name Role Phone Email
Safety
Workers' Compensation Experience Modification Rate (EMR) for the last five (5) years.*
Year EMR
Who is responsible for safety at your firm?*
Use the "+" symbol to add additional safety personnel if necessary.
Name Title Qualifications Years of Experience
Do you have a written safety program?*
- Yes
- No
What does senior management do to actively promote your safety program?*
Any OSHA (Federal or State) Serious, Willful and or Repeat violations within the last five years?*
- Yes
- No
If Yes, Please Explain
Any EPA (Federal or State) violations within the last five years?*
- Yes
- No
If Yes, Please Explain
Banking, Surety and Insurance
Bank Name*
Branch
Phone*
Since (mm/yyyy)*
Bonding Company*
Bond Limits*
Name of Agent*
Address of Bonding Agent
Street Address Address Line 2 City State ZIP Code
Phone of Bonding Agent*
Since (mm/yyyy)*
Insurance Company*
General Liability, Automotive, Workers Comp and Umbrella Co.:
Contact at Insurance Company*
Phone Number for Insurance Company Contact*
Email for Insurance Company Contact*
Since (mm/yyyy)*
References
Supplier Reference*
Use the "+" symbol to add more references
Name Location (city, state) Contact Name Phone Number
Contractor References*
Use the "+" symbol to add more references
Name Location (city, state) Contact Name Phone Number
Consent*
By typing your name below, the undersigned warrants and represents that the information provided herein is complete and accurate in all respects and explicitly authorizes the references identified herein to provide any additional information requested by the Contractor that it may require to complete its prequalification and evaluation process upon granting of a subcontract to Crosslands Construction Company.
I agree
Company Name*
Officer's Name*
Title*
Date*
Month
Day
Year
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Our Recent Work

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Subcontractor Qualification

Interested in Working with Crosslands as a Sub Contractor?

Organization

Legal Information

Financials / Revenue

Contracts and Previous Work

Bidding Interest

Safety

Banking, Surety and Insurance

References

Our Recent Work

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Year	# of Field Employees	# of Office Employees	# of Total Employees

Name	Title	Percent Ownership

Type of License	State	Number

Year	Project Name	Contractor