Request A Quote Contractor Questionnaire Name of Firm:*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Fiscal Year End:*Phone:*Format: (XXX)XXX-XXXXContracting Specialty:*Contact Person:*Title:*Year Business Started:*Type of Business:* Corp. Part. Prop. Sub. S. Corp. State of Incorporation:*Area of Operation:*List the corporate officers, partners or proprietors of your firm:* *Include Name, Date of Birth, Position, Percent Owned, and Name of Spouse for each person listed.*Will the above individuals and spouses personally indemnify Surety?*YesNoIf no, please explain:*Is there a buy/sell agreement among the owners of the business?*YesNoIs this agreement funded by life insurance?*YesNoCorp. Indemnity?*YesNoCross/Corp. Indemnity?*YesNoHow many people does your firm employ?*How many work crews?*Has your firm or any of its principals ever petitioned for bankruptcy, failed in business or defaulted so as to cause a loss to a Surety?*YesNoIf yes, please explain:* Is your firm or any of its owners currently involvedd in any litigation?*YesNoIf yes, please explain:*What percentage of the firm's work is normally for Government Agencies:*What percentage of the firm's work is normally for Private Owners:*What percentage of the firm's work is normally subcontracted:*Are bonds required of subs?*YesNoWhat trade do you normally subcontract?*What is the largest amount of incompleted work on hand at one time in the past?**Include Amount ($) and Year.*What is the largest job you expect to do during the next year?*( Amount $ )What is the largest incompleted work program expected during the year?*( Amount $ )What trades do you normally undertake with your own forces?*SIC Code:*Do you lease equipment?*YesNoType of lease:*What are the terms of the lease?* Name of your CPA:*Address of CPA:*Phone number of CPA:*Format: (XXX)XXX-XXXXContact Person:*On what basis are taxes paid?* Cash Completed Job Accrual % of Completion On what basis are financial statements prepared?* Cash Completed Job Accrual % Completed On what level of assurance are financial statements prepared?* CPA Audit Review Compilation How often are financial statements prepared?* Annually Semi-annually Quarterly Monthly Do you have a full-time accountant on staff?*YesNoYears of experience?*Are job cost records kept?*YesNoHow often reviewed?How often updated?Do they show detail?YesNoFrequency?Name of your Bank:*Address of bank:*Phone number of bank:*Format: (XXX)XXX-XXXXAmount of line of credit: $*Expiration date:*What is interest rate?*UCC Filing?*YesNoHow is credit secured?*Is your firm union?*YesNoWhat is firm's Dun & Bradstreet number?D & B Rating:Pay record:Date of rating:Previous Bonding Companies:* *Please include Name & Reason for leaving.*List five of your largest contracts:1. Job Name:*Contract Price:*Gross Profit:*Completion Date:*Bonded?*YesNoOwner:*Design Professional:*2. Job Name:*Contract Price:*Gross Profit:*Completion Date:*Bonded?*YesNoOwner:*Design Professional:*3. Job Name:*Contract Price:*Gross Profit:*Completion Date:*Bonded?*YesNoOwner:*Design Professional:*4. Job Name:*Contract Price:*Gross Profit:*Completion Date:*Bonded?*YesNoOwner:*Design Professional:*5. Job Name:*Contract Price:*Gross Profit:*Completion Date:*Bonded?*YesNoOwner:*Design Professional:*List five of your major suppliers:1. Name* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Format: (XXX)XXX-XXXXContact:*2. Name* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Format: (XXX)XXX-XXXXContact:*3. Name* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Format: (XXX)XXX-XXXXContact:*4. Name* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Format: (XXX)XXX-XXXXContact:*5. Name* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Format: (XXX)XXX-XXXXContact:*List five subcontractors (or contractors if you are a subcontractor) that you do business with:1. Name* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Format: (XXX)XXX-XXXXContact:*Job:*2. Name* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Format: (XXX)XXX-XXXXContact:*Job:*3. Name* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Format: (XXX)XXX-XXXXContact:*Job:*4. Name* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Format: (XXX)XXX-XXXXContact:*Job:*5. Name* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Format: (XXX)XXX-XXXXContact:*Job:*List three Architects you have done business with:1. Name* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Format: (XXX)XXX-XXXXContact:*Job:*2. Name First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Format: (XXX)XXX-XXXXContact:*Job:*3. Name* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Format: (XXX)XXX-XXXXContact:*Job:*List key personnel, foreman or supervisors:1. Name First Last Year of BirthPosition:Years of Experience:Previous Employer:2. Name First Last Year of Birth:Position:Years of Experience:Previous Employer:3. Name First Last Year of Birth:Position:Years of Experience:Previous Employer:4. Name First Last Year of Birth:Position:Years of Experience:Previous Employer:5. Name First Last Year of Birth:Position:Years of Experience:Previous Employer:List any life insurance in effect on key personnel:1. Name First Last Beneficiary:Amount: $Cash Value: $Insurance Company:2. Name First Last Beneficiary:Amount: $Cash Value: $Insurance Company:3. Name First Last Beneficiary:Amount: $Cash Value:Insurance Company:List other insurance coverage currently in effect:A. General Liability:BI: $PD: $Carrier:Expiration Date:B. Auto Liability:BI: $PD: $Carrier:Expiration Date:C. Umbrella:BI: $PD: $Carrier:Expiration Date:D. Owner's Protection:BI: $PD: $Carrier:Expiration Date:List any subsidiaries and affiliates of the contraction firm:1. Firm Name:Ownership:Business Type:NANDA Code:2. Firm Name:Ownership:Business Type:NANDA Code:3. Firm Name:Ownership:Business Type:NANDA Code:4. Firm Name:Ownership:Business Type:NANDA Code:5. Firm Name:Ownership:Business Type:NANDA Code:Remarks: Form completed by:*Title:*Date:*