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Holder Construction Company

Trade Contractor’s Prequalification Statement

Submitted To:

Contact’s Name

Submitted By:

Contact’s Name

Date:

Date




Holder Construction Company - Atlanta

3333 Riverwood Parkway, SE Suite 400

Atlanta, GA  30339

Telephone:  770-988-3000



Company & Location Information:

Firm:

Company Legal Name

Address:

Office Address

Holder Construction Company - Charlotte

2359 Perimeter Pointe Parkway, Suite 250

Charlotte, NC 28208

Telephone:  704-357-4200



City:

City

State:

State

Zip:

Zip

Holder Construction Company - Dallas

4600 Fuller Drive, Suite 375

Irving, TX  75038

Telephone:  972-870-4260



Phone:

Phone

Main Preconstruction Contact Person:

Name:

Name

Holder Construction Company - Washington DC

2355 Dulles Corner Boulevard, Suite 501

Herndon, VA  20171

Telephone:  703-796-4400



Title:

Title

Office Phone:

Office Phone

Extension:

Office Phone Extension

Holder Construction Company - Phoenix

2325 East Camelback Road, Suite 520

Phoenix, AZ  85016

Telephone:  602-224-5050



Cell:

Cell

Email:

Email




Holder Construction Company - San Jose

2033 Gateway Place, 5th Floor

San Jose, CA 95110

Telephone:  408-516-4401





References: Please list four different general contractors for whom you have performed similar scopes of work regarding similar facilities.

1.

Project







2.

Project




(Project)










(Project)




General Contractor










General Contractor




(General Contractor)










(General Contractor)




GC’s Project Manager Name and Phone Number










GC’s Project Manager Name & Phone Number




(GC’s Project Manager Name & Phone Number)










(GC’s Project Manager Name & Phone Number)




Approximate Contract Value










Approximate Contract Value




(Approximate Contract Value)










(Approximate Contract Value)

3.

Project







4.

Project




(Project)










(Project)




General Contractor










General Contractor




(General Contractor)










(General Contractor)




GC’s Project Manager Name & Phone Number










GC’s Project Manager Name & Phone Number




(GC’s Project Manager Name & Phone Number)










(GC’s Project Manager Name & Phone Number)




Approximate Contract Value










Approximate Contract Value




(Approximate Contract Value)










(Approximate Contract Value)



Company Information:

Self-Performed Scopes of Work:

Scopes of Work

Subcontracted Scopes of Work:

Scopes of Work

Type of Firm:

Corporation



Partnership



Individual



Other

Other

Parent Company:

Same



Name:

Name

Years in business as Contractor under present firm name:

Years

License Number:

License Number.

States in which your company will do business:

List out all States.

Is your organization union?

Yes



No






If so list the affiliation(s) and local(s):

Affiliation(s) and Local(s)

Provide information which would indicate the size and capacity of your organization, including the number or permanent employees engaged in (do not count the same employee twice):

Estimating:

Number

Field Supervision:

Number

Tradespeople:

Number

Clerical / Accounting:

Number

Management:

Number




Is your organization a registered DBE contractor?

Yes



No






If so list certification type / number / body:

Click here to enter text.

Is your organization currently registered with Dun & Bradstreet?

Yes



No






If yes, what is your D & B number?

D & B Number

What is your organization’s Experience Modification Rate (EMR)?

Modification Rate

If over 1.0, attach past three (3) years OSHA 300 logs.

Has your firm ever failed to complete a contract or been assessed schedule related damages?



Yes



No



Has your firm had any subcontractors fail to complete a contract in the last five years

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 years?

Yes



No



*(If answer to any of the above questions is yes, please attach explanation to this form)




Annual Billing:

This year’s projected billing:

$

Billing

Three Years Ago - Billing:

$

Billing

Last Years - Billing:

$

Billing

Four Years Ago - Billing:

$

Billing

Two Years Ago - Billing:

$

Billing

Five Years Ago - Billing:

$

Billing



Five Largest Projects Completed in the Last Five Years:

Project




General Contractor, Contact and Phone Number




Contract Amount

Project




General Contractor, Contact and Phone Number

$

Contract Amount

Project




General Contractor, Contact and Phone Number

$

Contract Amount

Project




General Contractor, Contact and Phone Number

$

Contract Amount

Project




General Contractor, Contact and Phone Number

$

Contract Amount

Project




General Contractor, Contact and Phone Number

$

Contract Amount

Major Projects Under Contract:

Project




% of Contract Complete




Completion Date




Contractor







Total Contract Value

Project




% Complete




Date




Contractor




$

Click here to enter text.

Project




% Complete




Date




Contractor




$

Click here to enter text.

Project




% Complete




Date




Contractor




$

Click here to enter text.

Project




% Complete




Date




Contractor




$

Click here to enter text.

Project




% Complete




Date




Contractor




$

Click here to enter text.

Total value of projects under contract: (including those not listed above)




$

Click here to enter text.

Percent of negotiated / bid contracts




%

% Negotiated / % Bid



Current Pursuits: Current projects you are current a candidate for. (Indicate size and schedule)

Project




Start Date




Contractor







Total Contract Value

Project




Date




Contractor




$

Click here to enter text.

Project




Date




Contractor




$

Click here to enter text.

Project




Date




Contractor




$

Click here to enter text.

Project




Date




Contractor




$

Click here to enter text.

Project




Date




Contractor




$

Click here to enter text.



Bonding Information










What is your bond rate for this project (as a percentage)

%

Rate




Aggregate Limit:

$

Aggregate Limit




Single Project Limit:

$

Single Project Limit

Please list the names of your bonding agent and surety:

Bonding Agent




Surety

(Bonding Agent)




(Surety)

Street Address




Street Address

(Street Address)




(Street Address)

City, State, Zip




City, State, Zip

(City, State, Zip)




(City, State, Zip)



The answers to the foregoing questions and all statements herein contained are true and correct.

Reviewer’s Position




Reviewer’s Position

(Reviewer’s Name)




(Reviewer’s Position)

* Holder Construction reserves the right to request Audited Financials which is defined as a Balance Sheet, and Income Statement, an Auditor’s Report and Footnotes.



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