Steel Erection Subcontractor Prequalification Form
Company Information
Company Name
Address
City
State
Zip Code
Phone
Email
Website
Business Details
Type of Business
Year Established
State(s) Licensed To Work
Number of Employees
Safety Information
EMR (Experience Modification Rate) for past 3 years
OSHA Citations (past 3 years)
Has your company ever had a fatality?
Yes
No
If yes, please explain
Insurance & Bonding
Insurance Carrier
Contact Name
Contact Phone
Bonding Capacity
Bonding Company
Relevant Project Experience
List Sample Projects Completed (include project name, location, GC, value):
References
References (name, company, phone, email):
Additional Information
Comments or Other Relevant Information: