• Initial Pre-Qualification Form

    Initial Pre-Qualification Form

  • SECTION 1:

    COMPANY INFORMATION
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • SECTION 2:

    TYPE OF WORK PERFORMED

  • Select from the drop-down menu below the type of work your company typically performs.  If your company performs work under more than one division or code, please use the additional drop-down menus to select an additional division or code.

  • How do you best classify your company's role?*
  • Is your company primarily union or open shop?*
  • If union, please select the unions that you are signatory with:
  • Please select the type(s) of projects your company typically works on:*
  • Please select the geographic areas that your company services:*

  • SECTION 3:

    SIZE OF COMPANY
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  • SCTION 4:

    BONDING CAPACITY
  • Is your company bondable?*
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  • SECTION 5:

    CLAIMS AND SUITS
  • Has your company ever failed to complete any work awarded to it?*
  • Are there any judgements, claims, arbitration proceedings or suits pending against your organization or its officers?*
  • Has your organization filed any lawsuits, claims, or requested arbitration with regard to contracts within the last two years?*
  • Has your company ever had financial difficulties that resulted in declaring chapter 11?*

  • SECTION 6:

    CLASSIFICATION/CERTIFICATION
  • Does your company qualify for special classification (MBE, DBE, SBE, etc.)?
  • If yes, which of the following certifications does your company hold?

  • SECTION 7:

    EXPERIENCE
  • Has your company ever work with TG Gallagher, Inc.?*

  • SECTION 8:

    SAFETY AND LOSS CONTROL DATA
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  • Does your company have a Safety Program?*
  • Does your company have a full-time Safety Director?*
  • Does your company conduct and document job site Safety Audits?*
  • Does your company conduct and document incident investigations?*
  • Does your company have a Substance Abuse Policy?*
  • Does your company provide Pre-Task Plans (PTP) or Job Hazard Analysis (JHA) for work activities?*
  • Will your company have a designated Safety Officer on-site?*
  • Will your company have a Designated Competent Person on-site?*
  • Will your company have a site specific Safety Manual on-site?*
  • Will your company have a First Aid/CPR Trained Person on-site?*

  • Section 9:

    MISCELLANEOUS
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  • If required, can your company acquire additional staff to appropriately man a project?*
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  • SECTION 10:

    LICENSES
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  • SECTION 11:

    INSURANCE

  • Click to view sample insurance requirements

    TG Gallagher, Inc. Insurance Requirements

    COI Sample

  • Has your company reviewed the attached insurance requirements?*
  • Does your company currently meet or exceed the policy limits within?*
  • Does your company have Professional Liability Insurance?*
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  • Does your company have Pollution Liability Insurance?*
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  • SECTION 12:

    CONTRACT

  • Click to view sample subcontract agreement

    TG Gallagher, Inc. Subcontract Agreement

  • Has your company reviewed the attached Subcontract Agreement?*
  • Does your company agree to the language in the attached Subcontract Agreement with no modifications?*

  • Click to view sample lien waviers

    Lien Waiver Example

    Final Lien Waiver Example

  • Has your company reviewed the sample Lien Waivers and agrees to the terms?

  • SECTION 14:

    BANK / FINANCIAL
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  • The following documents are required to complete your Prequalification Application with TG Gallagher: 

    • 2 years of audited or professionally prepared financial statements-balance sheet, income statement & cash flow statement.
    • A current bonding capacity letter
    • Worker's compensation modification rate verification letter from your current insurance agent.
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  • SECTION 15:

    REFERENCES (TG Gallagher MAY NOT be listed as a Reference)
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