HWH Sub Pre-Qualification Information

Sub Pre-Qualification
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To submit, click "Submit" on the last page, and you will receive a confirmation email with an attachment of the information submitted.

Note: The company’s unique URL form will only be active for 30 days after registration. Please submit all Sub Pre-Qualification information within 30 days in order to prevent losing completed work.

*this form works best when used in the Google Chrome web browser*
General Information
Company Legal Name
DBA (if applicable)
Street Address
City
State
Zip Code
Company Phone Number
Company Type
Number of Employees
Company Date Founded
Primary CSI Division (Trade)
President/Owner Contact
President Contact Name
President Contact Title
President Office Phone
President Email
Have there been any changes in control/management of the Company in the last five (5) years?

YesNo
Please explain the changes in the control/management of the Company
Sub Pre-Qualification Contact
This person will receive the link to continue and a .pdf copy of the submission once complete.
Prequalification Contact Name
Prequalification Contact Title
Prequalification Contact Office Phone
Prequalification Contact Email
Former Names the Company Has Operated Under
Former Company Name 1
Does the Company have a parent Company?

YesNo
Parent Company Name
Parent Company Address
Parent Company Phone
Certificate of Insurance
Please attach a Certificate of Insurance that shows the Companys' current coverage.
Certificate of Insurance Attachment

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Financial Information
Financial Statements
Does the Company have an annual CPA prepared (audit, review or compilation) financial statement?

YesNo
Type of Financial Statement
Please attach the Company's full financial statement for the most recent fiscal year-end. This should include, at a minimum, the Accountant's Report, Balance Sheet, Income Statement, and all Notes.

Failure to provide all requested information may result in Subcontractor's submission being deemed Incomplete.
Financial Statement Attachment

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H.W. Houston will use the information you provide solely for the purpose of evaluating and prequalifying your company and for no other purpose. H.W. Houston agrees to protect and safeguard your confidential information and will not publish, disclose, or release the contents. We realize the sensitivity of providing the company’s sensitive business information and we are diligent in keeping it confidential.

A NONDISCLOSURE AGREEMENT (NDA) is available and will be signed upon request. Please complete the Company information, sign electronically and submit. H.W. Houston will counter-sign and an electronic copy of the executed agreement will be emailed once it has been signed.
Bank Information
Does the Company have a Bank Line of Credit?

YesNo
Name of Bank
Contact Name
Bank Contact Phone Number
Amount of Line of Credit
Balance Currently Available
Line of Credit Expiration Date
Please attach a Line of Credit Verification Letter issued by the company's banking institution. This letter must be dated no later than 90 days from todays date and outline the bank line of credit limit and current outstanding balance.
Line of Credit Verification Letter Attachment

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Backlog (as of today)
Backlog = amount of revenue the Company expects to realize from work to be performed on uncompleted contracts in progress and from contractual agreements on which work has not yet begun.
Amount of Backlog
Number of Projects in Process
Please attach a Work On Hand Schedule, showing the following information: 1. General Contractor Name, 2. Project Name, 3. Contract Value, 4. Location, 5. Percent (%) Complete
Work on Hand (WOH) Schedule Attachment

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Annual Revenue Over the Past Three (3) Years
Please provide the information below starting with the most recent completed year
Most recent completed year
Revenue Earned
Year-End Backlog
Largest Project Completed Contract Amount
Project Name
One year prior
Revenue Earned
Year-End Backlog
Largest Project Completed Contract Amount
Project Name
Two years prior
Revenue Earned
Year-End Backlog
Largest Project Completed Contract Amount
Project Name

Bond and Surety Information
Does the Company have a current bonding program?

YesNo
Name of Surety Company
Surety Contact Name
Surety Contact Number
Name of Surety Brokerage
Broker Contact Name
Broker Contact Number
Length of Relationship (in years)
Bond Rate (%)
Bonding Capacity per Job
Aggregate Bonding Capacity
Largest Bonded Project
Date of Last Bond
Bond Amount
Please provide a Bonding Capacity and Bonding Rate Verification Letter. This letter must be dated no earlier than 90 days from today's date.
Bonding Verification Letter Attachment

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Please list Person or Entities who provide Indemnification for your Surety

References and Completed Projects
Project References
Project Reference 1 - Project Name
Owner/GC Contact Name
Email
Phone Number 1
Contract Value
Year Completed
Project Reference 2 - Project Name
Owner/GC Contact Name
Email
Phone Number 2
Contract Value
Year Completed
Project Reference 3 - Project Name
Owner/GC Contact Name
Email
Phone Number 3
Contract Value
Year Completed
Projects Completed for HW Houston
Has the Company completed projects for HW Houston?

YesNo
Project 1 - Project Name
Owner
Project Manager
Contract Value
Year Completed
Project 2 - Project Name
Owner
Project Manager
Contract Value
Year Completed
Project 3 - Project Name
Owner
Project Manager
Contract Value
Year Completed

Completion and Signature
I certify that all information provided as part of this submission is true and correct to the best of my knowledge. I acknowledge that knowingly providing false information can be considered a fraudulent act. I give my consent to H.W. Houston/GE Johnson to use the information provided.

YesNo
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Sub Pre-Qualification

General Information

President/Owner Contact

Sub Pre-Qualification Contact

Former Names the Company Has Operated Under

Certificate of Insurance

Safety Information

Experience Modification Rate (EMR)

OSHA 300A Information for the Last Three (3) Years

Safety Programs and Policies

Legal Information

Quality Management

Financial Information

Financial Statements

Bank Information

Backlog (as of today)

Annual Revenue Over the Past Three (3) Years

Bond and Surety Information

References and Completed Projects

Project References

Projects Completed for HW Houston

Completion and Signature