Subcontractor Prequalification

Company Information
Company Name*
Representative and Title*
Address*
Street Address Address Line 2 City State ZIP Code
Phone Number*
Mobile Number
Email Address*
Website

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Company Work Details
What is your annual work capacity?*
- $0 - $250k
- $251k - $500k
- $501k - $1m
- $1m - $5m
- $5m+
(Choose 1)
What is the largest project you have completed? (Last 3 years)*
What is your bonding capacity?*
Has your Surety ever completed a project of yours?*
- Yes
- No
If yes, please explain
List current Limits of Insurance for:*
General Liability* Automobile* Umbrella Worker’s Compensation*
What is your current worker’s compensation EMR?
List All Minority Certifications
List all Professional Licenses and State/Municipality in which issued*
License State / Municipality

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Type of Shop
- Open
- Merit Shop
- Union
How many employees does your company employ?*
Administrative Supervisory Field/labor
How many years has your organization been in business?*
Please enter a value between 0 and 150.
List which states in which you can legally 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
Has your company or any affiliated company ever filed for bankruptcy, defaulted or been terminated on a contract?*
- Yes
- No
If yes, please explain
Has your company ever been excluded from bidding public work?*
- Yes
- No
If yes, please explain
Has any entity ever filed a claim against you, in a court of law, for defective work or material, non-conforming work or failure to comply with a warranty?*
- Yes
- No
If yes, please explain
Do you have any outstanding Judgments or claims against your company?*
- Yes
- No
If yes, please explain
Please list top 5 contracts you have completed in the last five years
Project Value
Construction revenue for each of the past 3 completed years
Year 1 Year 2 Year 3
Anticipated construction revenue for the current year?*
Current backlog?*
Backlog twelve months ago?
Has your company performed work for Taggart Brown & Associates in the past?*
- Yes
- No
If yes, please explain
Does your company have a written safety and fall protection program?*
- Yes
- No
Does your company have a designated safety manager to oversee your safety program?*
- Yes
- No
Briefly describe your safety training program*
List any OSHA violations with description received in the last five years
Indicate substance abuse screening below
Please select all instances of substance abuse screening*
- Pre-hire
- For cause
- Post accident
- Random
Please describe what differentiates your company from your competition*

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Subcontractor Prequalification

Step 1 of 37

Company Information

Company Work Details

Indicate substance abuse screening below