Contractor Pre-Qualification Questionnaire
Company Information
Company Name
Year Established
Business Address
Contact Name
Contact Phone
Contact Email
Website
Company Details
Type of Organization
Corporation
Partnership
Sole Proprietor
LLC
Other
License(s) Held
Trade(s) Performed
Geographic Areas Served
Financial Information
Annual Sales/Revenue
Number of Employees
Bank Reference
Surety/Bonding Company
Insurance
Insurance Provider
General Liability Limit
Workers’ Compensation
Experience & References
Major Projects Completed (last 3 years)
Client References (name & contact)
Health & Safety
Do you have a written Safety Program?
Yes
No
OSHA Recordable Incidents (last 3 years)
EMR Rate (last 3 years)
Additional Information
Other Relevant Information