Vendor Pre-Qualification

SUBCONTRACTOR QUALIFICATION

Instructions:
Thank you for your interest in Eastman, Cooke & Associates, LLC. Matching your competencies with the right opportunities is vital to the success of delivering projects that satisfy our clients. In an effort to better match your expertise we would like to know about your company.

Please take a moment to fill out this form and then click Submit at the bottom. Please allow enough time to complete it entirely, since you will not be able to save and finish later. We would ask that you focus your attention on the very last section where you can fill out any information that you feel can help Eastman, Cooke & Associates, LLC understand how you differentiate your company from other companies.

    Company Name

    Address

    City

    State

    Zip Code

    Contact First Name

    Contact Last Name

    Phone

    Fax

    Cell

    Email

    Website

    Date of Incorporation

    Number of Employees

    Union Affiliation

    Non-unionPrevailing WageSupplier/ VendorUnion

    Certifications

    MBESBEVBEWBE

    Geographic Areas Willing to Work

    Trades Performed (Control/ Command to select more than one)

    Annual Sales Volume 2018

    Annual Sales Volume 2019

    Does your company have LEED project experience?

    YesNo

    If yes, please list job name and Client contact:

    Key Contact Information

    Principal, President or CEO (List Name, Phone, and Email)

    Lead Field Supervisor (List Name, Phone, and Email)

    Chief Estimator (List Name, Phone, and Email)

    Project References

    (List 2 most recent projects)

    #1 Project Name

    #1 Client or CG Name

    #1 Work Performed

    #1 Contract Amount

    #1 Date of Completion

    #1 Contact Person

    #2 Project Name

    #2 Client or CG Name

    #2 Work Performed

    #2 Contract Amount

    #2 Date of Completion

    #2 Contact Person

    Bank Reference

    Name of Bank

    Address

    City, State, Zip

    Contact Name

    Contact Phone

    Other Info

    Experience Modifier Rate 2018

    Experience Modifier Rate 2019

    Bonding Capacity

    OSHA Citations (if any)

    DUNN # (if any)

    Insurance Certificate (click here for instructions and sample) (please upload)

    Other Misc Upload (Please upload brochure or other helpful doc(s))

    Any other info (Please provide additional information you may find important for Eastman, Cooke & Associates, LLC)