Electrical Subcontractor Prequalification Form
Company Information
Company Name
Contact Person
Title
Address
City
State
Zip Code
Phone
Email
Website
Business Details
Contractor License Number
Issuing State
Years in Business
Legal Structure
Corporation
Partnership
LLC
Sole Proprietor
Other
Principal(s) Name(s)
Work Experience
Type of Projects Completed
Areas Served
Largest Contract Amount Completed
Recent Projects (Name, Value, Year)
Insurance & Bonding
Insurance Carrier
General Liability Limits
Workers Compensation
Bonding Company
Bonding Capacity
References
Reference #1 (Name, Company, Phone, Email)
Reference #2 (Name, Company, Phone, Email)
Reference #3 (Name, Company, Phone, Email)
Certifications & Safety
Certifications (e.g., OSHA, DBE, MBE, WBE, etc.)
Safety Record / EMR
Any OSHA Violations in Past 5 Years?
No
Yes
If Yes, Details