TRADE CONTRACTOR'S PREQUALIFICATION STATEMENT
For prequalification with Holder-Moody-Sovereign-Davis, JV for the ATL South Parking Deck Phase 2 Project
NOTE: Hitting "enter" will submit this form. Refrain from hitting "enter" until all fields in this form are completed.
Submitted To: Holder-Moody-Sovereign-Davis, JV
Submitted By (Contacts Name)
Date
/
Month
/
Day
Year
Date
COMPANY INFORMATION
Company Name
*
Company Address
*
Street Address
Street Address Line 2
City
Please Select
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
State
Zip Code
Company Phone
*
Format: (000) 000-0000.
Scopes of Work
*
MAIN POINT OF CONTACT
For project opportunities
Main Point of Contact Name
*
Main Point of Contact Title
*
Main Point of Contact Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Main Point of Contact Cell Phone
*
Format: (000) 000-0000.
Main Point of Contact Email
*
example@example.com
PROJECT TYPE EXPERIENCE
Such as Aviation, Office, Retail, Hospitality, etc
Market Types
*
Aviation
Office
Retail
Hospitality
Data Center
Residential
Other
FIRM PROFILE
Type of Firm
*
Corporation
Partnership
Individual
Other
Parent Company (if Applicable)
Years in Business as Contractor under present firm name
*
License Number
*
States in which your company is licensed to do Business
States in which your company is licensed to do Business
*
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
Union Affiliations (if any)
How did you hear about this Project Opportunity?
Phone Call from HMSD
Newspaper Advertisement
Industry Networking
Outreach Event
Other
FIRM SIZE
Provide information which would indicate the size and capacity of your organization, including the number of permanent employees engaged in (do not count the same employee twice):
Estimating
*
Field Supervision
*
Clerical and Accounting
Management
*
Tradespeople
*
EBO INFORMATION
Is your organization certified with the City of Atlanta's EBO Program?
*
Yes
No
If yes, which category of EBO?
WBE
MBE
If so, please list certification number
OTHER INFORMATION
Is your organization currently registered with Dun & Bradstreet?
*
Yes
No
If yes, what is your D & B number?
Has your firm ever failed to complete a contract or been assessed schedule related damages?
*
Yes
No
Are there any judgments, claims, liens, or suits pending or outstanding against your firm?
*
Yes
No
Has your firm been a party to any lawsuits, arbitration, or mediation with regard to construction Projects in the last five (5) Years?
*
Yes
No
Has your firm worked at H-JAIA in the past 5 years?
*
Yes
No
Is anyone employed by your firm badged at H-JAIA?
*
Yes
No
Has your firm previously signed a contract with Holder, Austin, Moody, or Bryson?
*
Yes
No
SAFETY INFORMATION
Has your firm had any fatalities in the last five (5) years?
*
Yes
No
If yes, please provide summary and OSHA Incident Number.
Date of Last Company Safety Manual Revision:
What is your organization's Experience Modification Rate (EMR)?
*
2025 Experience Modification Rate (EMR)
*
2024 Experience Modification Rate (EMR)
*
2023 Experience Modification Rate (EMR)
*
2022 Experience Modification Rate (EMR)
2025 Total Recordable Incident Rate (TRIR)?
*
2024 Total Recordable Incident Rate (TRIR)?
*
2023 Total Recordable Incident Rate (TRIR)?
*
2022 Total Recordable Incident Rate (TRIR)?
BILLING INFORMATION / REVENUE PROFILE
2025 Projected Billing
*
2024 Billing
*
2023 Billing
*
2022 Billing
*
2021 Billing
*
2020 Billing
*
2019 Billing
*
2018 Billing
*
RELEVANT PROJECT EXPERIENCE AND REFERENCES
Project experience in aviation and/or at HJAIA
References
Rows
General Contractor
Project Name
Contact Name
Contact Number
Contract Value
Project 1
Project 2
Project 3
Project 4
LARGEST PROJECTS IN FIRM HISTORY
Five (5) Largest Projects Completed in the Last 5 Years by your Contract Amount
*
Rows
General Contractor
Project Name
Trades Performed
Contract Value
Project 1
Project 2
Project 3
Project 4
Project 5
YOUR LARGEST PROJECTS UNDER CONSTRUCTION
Your Five (5) Largest Projects Under Construction
*
Rows
General Contractor
Project Name
End Date
% Complete
Contract Value
Project 1
Project 2
Project 3
Project 4
Project 5
PROJECTS IN PURSUIT
Projects in Pursuit
*
Rows
General Contractor
Project Name
Trades Performed
Date Start
Contract value
Project 1
Project 2
Project 3
Project 4
Project 5
TYPICAL PROJECT SIZE (TRADE CONTRACT)
Typical Size ($)
*
Largest ($)
*
Smallest ($)
*
BONDING INFORMATION
What is your Bond Rate as Percentage?
*
Aggregate Bonding Limit
*
Single Project Bonding Limit
*
Who is your Bonding Agent?
Bonding Agent Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Bonding Agent Contact Name
First Name
Last Name
Bonding Agent Contact Email
SURETY INFORMATION
Surety Name
Surety Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
ATTEST
The answers to the foregoing questions and all statements herein contained are true and correct to the best of the applicants knowledge:
Name
*
Company Position
*
Office Location:
*
Submit
Should be Empty: