Trade Partner Qualification Form

Trade Partner Qualification Form

Please fill out form completely. If a question does not apply, select or type 'N/A'.
Please select company type*

Trade SubcontractorArchitect/EngineerConsultantSupplierOther
General Company Information
Business Name*
Business Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Phone Number (Main)*
Please enter a valid phone number.
Website*
EIN/Tax ID #*
Company Type*
Year Founded*
State of Incorporation

Street Address

Street Address Line 2

CityState

Zip Code
Is Company a certified small, minority or disadvantaged business?*

YesNo
If yes, provide details*
Does Company have any business licenses*

YesNo
If yes, provide details*
Provide license and jurisdiction
Does your company hold ISO certification for quality management, such as ISO 9001, or other relevant ISO certifications?*

YesNo
If yes, provide details (Certification, Expiration date)*
Company Contacts
Provide main company contacts (Project Management, Estimating, Accounting, etc.)*
Services Provided

Please indicate field staff labor affiliations*

UnionOpen ShopN/AOther
If Union, provide details
Provide employee information*

Rows Management Non-Management

EMPLOYEE HEADCOUNT

Rows	Management	Non-Management
EMPLOYEE HEADCOUNT

Safety
Provide your Worker’s Compensation Insurance Modifier (EMR) for the past three years:*

This does not apply to me

Provide number of staff with OSHA 30 and OSHA 10 Certification*

Number of OSHA recordable incidents over the last three years:*
In the past three years, have you been cited for any serious OSHA safety violations? (If yes, please provide explanation including the dates, violation types, description and inspection number of each violation. Attach pages if necessary.)*

YesNo
If yes, please explain
Do all employees receive safety training?*

YesNo
Do you have a written safety plan? (If yes, please provide)*

YesNo
Please provide your safety plan*

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Do you have a written drug policy?*

YesNo

Insurance & Bonding
Insurance Company Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Insurance Agent

First NameLast Name
Please provide a Certificate of Insurance with current limits.*

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Can you obtain performance and payment bonds if required?*

YesNo
What is your current bonding capacity (single project limit and aggregate limit)?
Who is your current surety/bonding company?
Provide Name and Contact
What is your current bond rate (typically expressed as cost per $1,000 of contract value)?
Financial Capacity
Please provide your current IRS form W-9*

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Annual Volume ($)*

Rows	Self-Perform	Subcontract	N/A
Structural Steel Erection
Modular Panel Installation
Metal Stud Framing
Gypsum Wall Board
Heat Welded PVC Wall Liner
Heat Welded PVC Flooring
Epoxy Flake / Quartz Flooring
Mechanical Rigging / Lifting
HVAC Equipment Install
HVAC Ducting
Duct / Piping Insulation
Power Distribution Panels
Load Side Wiring
HVAC Control Systems
Door Interlock Wiring
Fire Alarm System Wiring
Security Interlock Wiring
Data / Network Wiring
Environmental Monitoring Equipment
Hydronic Piping
Domestic Water and Sanitation
Process Gas Piping
Fire Sprinklers
PW / WFI Piping
Liquid N2 Piping
Construction Particle Cleaning
Biological Decontamination Cleaning
HVAC Testing Adjusting & Balancing
HEPA Filter Integrity Testing
Process Equipment Installation
Furniture Installation

Rows	In-House	Subcontracted	N/A
TOTAL EMPLOYEE HEADCOUNT
Licensed Architects
Licensed Structural Engineers
Licensed Mechanical Engineers
Architectural Designers
Mechanical Designers
Project Managers
Superintendents
Lead Installers
Installers/Laborers

Rows	Project Name	Scope	Contract Amount	Reference Contact (Name, Phone, Email)
1
2
3

General Company Information