Vendor/Subcontractor Qualification Statement

Jollay Masonry believes in creating partnerships with our subcontractors and suppliers, and in this effort, we look for companies who hold the same values of quality and fairness that we do. We work in an industry that has demanding needs, and with this in mind, we know we are better suited for success when we assemble a team who shares a like-minded approach to business. If you are interested in doing business with our company, we invite you to fill out the form below.

The Undersigned certifies under oath that the information provided herein is true and sufficiently complete so as not to be misleading.

Submitted To *

Address *

Submitted By *

Address *

Name *

If other, please specify

Name of Project (if applicable)

Type of Work

1. Organization

1.1) How many years has your organization been in business as a Contractor? *

1.2) How many years has your organization been in business under its present business name? *

1.2.1) Under what other or former names has your organization operated?

1.3) If your organization is a corporation, answer the following:

1.3.1) Date of incorporation:

1.3.2) State of incorporation:

1.3.3) President’s name:

1.3.4) Vice-president’s name(s):

1.3.5) Secretary’s name:

1.3.6) Treasurer’s name:

1.4) If your organization is a partnership, answer the following:

1.4.1) Date of organization:

1.4.2) Type of partnership (if applicable):

1.4.3) Name(s) of general partner(s):

1.5) If your organization is individually owned, answer the following:

1.5.1) Date of organization:

1.5.2) Name of owner:

1.6) If the form of your organization is other than those listed above, describe it and name the principals:

2. Licensing

2.1) List jurisdictions and trade categories in which your organization is legally qualified to do business, and indicate registration or license numbers, if applicable.

2.2) List jurisdictions in which your organization’s partnership or trade name if filed.

3. Experience

3.1) List the categories of work that your organization normally performs with its own forces.

3.2) Claims and Suits. (If the answer to any of the questions below is yes, please explain.)

3.2.1) Has your organization ever failed to complete any work awarded to it?

3.2.2) Are there any judgments, claims, arbitration proceedings or suits pending or outstanding against your organization or its officers?

3.2.3) Has your organization filed any law suits or requested arbitration with regard to construction contracts within the last five years?

3.3) Within the last five years, has any officer or principal of your organization ever been an officer or principal of another organization when it failed to complete a construction contract? (If yes, please explain.)

3.4) List major construction projects your organization has in progress:

Project name

Owner

Architect

Contract amount

% complete

Scheduled completion

Project name

Owner

Architect

Contract amount

% complete

Scheduled completion

Project name

Owner

Architect

Contract amount

% complete

Scheduled completion

Project name

Owner

Architect

Contract amount

% complete

Scheduled completion

Project name

Owner

Architect

Contract amount

% complete

Scheduled completion

Project name

Owner

Architect

Contract amount

% complete

Scheduled completion

Project name

Owner

Architect

Contract amount

% complete

Scheduled completion

Project name

Owner

Architect

Contract amount

% complete

Scheduled completion

3.4.1) State total worth of work in progress and under contract:

3.5) List major projects your organization completed in the past five years:

Project name

Owner

Architect

Contract amount

% performed by own forces

Completed

Project name

Owner

Architect

Contract amount

% performed by own forces

Completed

Project name

Owner

Architect

Contract amount

% performed by own forces

Completed

Project name

Owner

Architect

Contract amount

% performed by own forces

Completed

Project name

Owner

Architect

Contract amount

% performed by own forces

Completed

Project name

Owner

Architect

Contract amount

% performed by own forces

Completed

Project name

Owner

Architect

Contract amount

% performed by own forces

Completed

Project name

Owner

Architect

Contract amount

% performed by own forces

Completed

Project name

Owner

Architect

Contract amount

% performed by own forces

Completed

Project name

Owner

Architect

Contract amount

% performed by own forces

Completed

3.5.1) State average annual amount of construction work performed during the past five years:

3.6) List the construction experience and present commitments of the key individuals of your organization:

Name

Experience

Present commitments

Name

Experience

Present commitments

Name

Experience

Present commitments

Name

Experience

Present commitments

Name

Experience

Present commitments

4. References

4.1) Trade references

4.2) Bank references

4.3) Surety:

4.3.1) Name of bonding company

4.3.2) Name and address of agent

5. Additional Information

Use this to upload additional information (PDF or JPG)

Maximum upload size: 10MB

6. Digital Signature

I understand that by completing the form section below I certify that all of the above information is true: *

Yes

Name of organization *

Name of person completing form *

Title of person completing form *

Date *

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