Subcontractors

Partnering With Eby Construction

Thank you for your interest in partnering with Eby Construction as a subcontractor. Please complete the application for our consideration.

Company Information
Company Legal Name
Address
Street Address Address Line 2 City State ZIP Code
Phone Number
Fax Number
Federal ID Number
Duns & Bradstreet Number
Business Type
- Corporation
- Partnership
- LLC
- Sole Proprietor
- Joint Venture
Parent company, if applicable:
Subsidiaries and Divisions
Year Founded
Website
Number of Field Employees
Number of Office Employees
Number of Field Employees
Number of Non-union Employees
Number of Union Employees
Union Affiliations
Description of Trade/Products Provided
States Where Firm Does Business
Contractor’s License Number(s)
State/City Classification
Does your company subscribe to any vetting services (i.e. ISNetworld, PICS, PEC Premier, etc.)?
- Yes
- No
If yes, please list which ones
Officers/Owners
Name Title Name Title % of Ownership
Has your firm gone through an ownership change in the past 12 months?
- Yes
- No
If yes, please explain
Primary points of contact within your organization:
Department Name Email Phone Fax
Financial Information
Historical financial information (past three years):
Year Ending Revenue Ending Backlog
Current Year Projections
Revenue ($)
Current Backlog ($)
Current Number of Projects in Progress
Average Contract Size
Largest Contract in Past 36 Months
Number of LEED Projects Completed
Provide a recent balance sheet.
Max. file size: 256 MB.
All subcontractor pre-qualification questionnaires and balance sheets are held in strict confidence
Name of primary bank:
Bank contact:
Phone Number
Bank Line of Credit
Unused Portion
Are any assets pledged or collateralized?
- Yes
- No
If yes, how much?
Describe all lawsuits and judgments against your company in the last two years:
Have any of your principals or officers ever filed bankruptcy either personally or for a business they were associated?
- Yes
- No
If yes, please explain
Surety and Bonding
Surety Company
Surety Broker/Agent
Surety Broker/Agent Phone Number
Bonding Capacity
Per Job
Aggregate
Bond Rate
(Per thousand)
Please provide a letter from your surety confirming your capacity and good standing.
Max. file size: 256 MB.
Insurance Information
Does your company meet the insurance requirements?
- Yes
- No
If no, please explain.
Please provide a sample of your certificate of insurance with this form.
Max. file size: 256 MB.
Safety Information
Current
Last Year
Two Years Ago
Have you had any OSHA citations in the last 3 years?
- Yes
- No
If yes, how many?
Provide copies of your OSHA 300 and OSHA 300A logs and EMR letters for the prior three years.
Max. file size: 256 MB.
Do you employ OSHA certified competent person(s)?
- Yes
- No
If yes, please indicate which areas
Work Experience
Has an owner or general contractor terminated your contract for cause in the last 5 years?
- Yes
- No
If yes, please explain.
Has your company failed to complete any construction contracts in the past five years?
- Yes
- No
If yes, please explain.
Provide a list of major construction projects your organization has completed during the past two years or currently in progress. Include name of project, owner, architect, general contractor, contract amount, city/state, and completion date.
Drop files here or
Max. file size: 256 MB.
Provide a list of 5 supplier or financial trade references, including company name, contact name and phone number.
Drop files here or
Max. file size: 256 MB.
Minority Information
Minority Information
- MBE (minority business)
- AABE (African American Business)
- ABE (Asian American Business)
- HBE (Hispanic Business)
- NABE (Native American Business)
- WBE (Women’s Business)
- DBE (Disadvantage Business)
- SBE (Small Business)
- HUB (Historically Underutilized Business)
- None of the above
(Please check all that apply.)
Certification Status
- Not applicable
- Public
- Self
- Private
Address
City State ZIP Code
NMSDC (National Minority Supplier Development Council) Affiliates
Provide a copy of your Minority Certification as an attachment, if applicable.
Max. file size: 256 MB.
Signatures of Subcontractor
Name
Title
Email
Date
MM slash DD slash YYYY
Attachments
Drop files here or
Max. file size: 256 MB.
Attachments Included
- Balance Sheet (reviewed or audited, or most recent internal month-end)
- Surety Reference Letter
- Sample Insurance Certificate
- Current OSHA 300 and 300A Logs
- List of Completed and Active Construction Projects
- Minority Certification
- Form W-9
CAPTCHA

State/City	Classification

Name	Title	Name Title % of Ownership

Department	Name	Email	Phone	Fax

Year Ending	Revenue	Ending Backlog

Subcontractors

Partnering With Eby Construction

Company Information

Financial Information

Current Year Projections

Surety and Bonding

Bonding Capacity

Insurance Information

Safety Information

Work Experience

Minority Information

Signatures of Subcontractor