Holder Construction Company
TRADE CONTRACTOR’S PREQUALIFICATION STATEMENT
Submitted To: Contact’s Name
Submitted By:
Contact’s Name
Holder Construction Company - Atlanta
3333 Riverwood Parkway, SE Suite 400
Atlanta, GA 30339
Telephone: 770-988-3000
Company & Location Information:
Firm:
Company Legal Name
Address:
Office Address
Holder Construction Company - Charlotte
2359 Perimeter Pointe Parkway, Suite 250
Charlotte, NC 28208
Telephone: 704-357-4200
City:
City
State:
State
Zip:
Zip
Holder Construction Company - Dallas
4600 Fuller Drive, Suite 375
Irving, TX 75038
Telephone: 972-870-4260
Phone:
Phone
Date:
Date
Main Preconstruction Contact Person:
Name:
Name
Holder Construction Company - Washington DC Title:
Title
2355 Dulles Corner Boulevard, Suite 501
Office Phone: Office Phone
Herndon, VA 20171
Telephone: 703-796-4400
Extension:
Office Phone Extension
Holder Construction Company - Phoenix
2325 East Camelback Road, Suite 520
Phoenix, AZ 85016
Telephone: 602-224-5050
Cell:
Cell
Email:
Email
Holder Construction Company - San Jose
2033 Gateway Place, 5th Floor
San Jose, CA 95110
Telephone: 408-516-4401
References: Please list four different general contractors for whom you have performed similar scopes of work regarding
similar facilities.
1. Project
2. Project
(Project)
(Project)
General Contractor
General Contractor
(General Contractor)
(General Contractor)
GC’s Project Manager Name and Phone Number
GC’s Project Manager Name & Phone Number
(GC’s Project Manager Name & Phone Number)
(GC’s Project Manager Name & Phone Number)
Approximate Contract Value
Approximate Contract Value
(Approximate Contract Value)
(Approximate Contract Value)
3. Project
4.
Project
(Project)
(Project)
General Contractor
General Contractor
(General Contractor)
(General Contractor)
GC’s Project Manager Name & Phone Number
GC’s Project Manager Name & Phone Number
(GC’s Project Manager Name & Phone Number)
(GC’s Project Manager Name & Phone Number)
Approximate Contract Value
Approximate Contract Value
(Approximate Contract Value)
(Approximate Contract Value)
Holder Construction
Version 04/16/2013
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Holder Construction Company
TRADE CONTRACTOR’S PREQUALIFICATION STATEMENT
Company Information:
Self-Performed
Scopes of Work:
Scopes of Work
Subcontracted
Scopes of Work:
Scopes of Work
Type of Firm:
Corporation
☐
Partnership
☐
Parent Company:
Same
☐
Name: Name
Years in business as Contractor under present firm name:
Years
List out all States.
Is your organization union?
Yes
☐
Other Other
License Number:
States in which your company will do business:
If so list the affiliation(s) and local(s):
☐
Individual
License Number.
☐
No
Affiliation(s) and Local(s)
Provide information which would indicate the size and capacity of your organization, including the number or permanent
employees engaged in (do not count the same employee twice):
Estimating: Number
Field Supervision: Number
Clerical / Accounting: Number
Management: Number
Is your organization a registered DBE contractor?
If so list certification type / number / body:
Yes
☐
No
☐
Click here to enter text.
Is your organization currently registered with Dun & Bradstreet?
If yes, what is your D & B number?
Tradespeople: Number
Yes
☐
No
☐
D & B Number
What is your organization’s Experience Modification Rate (EMR)?
Modification Rate
If over 1.0, attach past three (3) years OSHA 300 logs.
Yes
☐
No
☐
Has your firm had any subcontractors fail to complete a contract in the last five years
Yes
☐
No
☐
Are there any judgments, claims, liens, or suits pending or outstanding against your firm?
Yes
☐
No
☐
Has your firm been a party to any lawsuits, arbitration, or mediation with regard to
construction projects in the last five years?
Yes
☐
No
☐
Has your firm ever failed to complete a contract or been assessed schedule related damages?
*(If answer to any of the above questions is yes, please attach explanation to this form)
Annual Billing:
This year’s projected billing:
$
Billing
Three Years Ago - Billing:
$ Billing
Last Years - Billing:
$
Billing
Four Years Ago - Billing:
$ Billing
Two Years Ago - Billing:
$
Billing
Five Years Ago - Billing:
$ Billing
Five Largest Projects Completed in the Last Five Years:
Project
General Contractor, Contact and Phone Number
Contract Amount
Project
General Contractor, Contact and Phone Number
$ Contract Amount
Project
General Contractor, Contact and Phone Number
$ Contract Amount
Project
General Contractor, Contact and Phone Number
$ Contract Amount
Project
General Contractor, Contact and Phone Number
$ Contract Amount
Project
General Contractor, Contact and Phone Number
$ Contract Amount
Holder Construction
Version 04/16/2013
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Holder Construction Company
TRADE CONTRACTOR’S PREQUALIFICATION STATEMENT
Major Projects Under Contract:
Project
% of Contract
Complete
Completion
Date
Contractor
Total Contract Value
Project
% Complete
Date
Contractor
$ Click here to enter text.
Project
% Complete
Date
Contractor
$ Click here to enter text.
Project
% Complete
Date
Contractor
$ Click here to enter text.
Project
% Complete
Date
Contractor
$ Click here to enter text.
Project
% Complete
Date
Contractor
$ Click here to enter text.
Total value of projects under contract: (including those not listed above)
$ Click here to enter text.
Percent of negotiated / bid contracts
% % Negotiated / % Bid
Current Pursuits: Current projects you are current a candidate for. (Indicate size and schedule)
Project
Start Date
Contractor
Total Contract Value
Project
Date
Contractor
$ Click here to enter text.
Project
Date
Contractor
$ Click here to enter text.
Project
Date
Contractor
$ Click here to enter text.
Project
Date
Contractor
$ Click here to enter text.
Project
Date
Contractor
$ Click here to enter text.
Bonding Information
What is your bond rate for this project (as a percentage)
Aggregate Limit:
$
Aggregate Limit
%
Rate
Single Project Limit:
$
Single Project Limit
Please list the names of your bonding agent and surety:
Bonding Agent
Surety
(Bonding Agent)
(Surety)
Street Address
Street Address
(Street Address)
(Street Address)
City, State, Zip
City, State, Zip
(City, State, Zip)
(City, State, Zip)
The answers to the foregoing questions and all statements herein contained are true and correct.
Reviewer’s Position
Reviewer’s Position
(Reviewer’s Name)
(Reviewer’s Position)
* Holder Construction reserves the right to request Audited Financials which is defined as a Balance Sheet, and
Income Statement, an Auditor’s Report and Footnotes.
Holder Construction
Version 04/16/2013
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