Subcontractor Prequalification Form – Optum Construction

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- Subcontractor Prequalification Form

Home
About
Projects
Contact Us
Subcontractors
- Subcontractor Prequalification Form

General Information

Company Name:

Address:

City:

State:

Zip Code:

Contact Information

Primary Contact:

Title:

Email:

Phone:

Cell:

Fax:

Estimating Contact:

Title:

Email:

Phone:

Call:

Fax:

Other Contact:

TItle:

Email:

Phone:

Cell:

Fax:

Company

Type of Entity:

Partnership Sole Proprietorship Corporation LLC

Year Established Under Current Name:

Is company MBE, WBE, DBE, or SBE certified?

Workers' Compensation Experience Modification Rate

Current Year:

Previous Year:

Does company have a written safety program?

Is company able to provide P&P bond if required?

Average annual sales over past three years:

Average project size:

Value:

Square Footage:

List three projects representative of your company, completed in the last five years:

Name of Project:

Contract Value:

Primary/General Contractor:

Contact:

Phone:

Name of Project:

Contract Value:

Primary/General Contractor:

Contact:

Phone:

Name of Project:

Contract Value:

Primary/General Contractor:

Contact:

Phone:

Scope of Work/Trades (Check all that apply)

Geotechnical & Materials Testing Final Cleaning Demolition Soil Treatment Site Development Site Utilities Erosion Control Asphalt Paving Curb & Gutter Striping & Sealcoating Fencing Retaining Walls Landscaping Cast-In-Place Concrete Structural Precast Masonry Cultured Stone Structural Steel Metal Fabrications Rough Carpentry Finish/Trim Carpentry Architectural Millwork/Casework Supply Caulking/Waterproofing Roofing Metal Roofing Insulation EIFS/Stucco Doors/Frames/Hardware Supply Doors/Frames/Hardware Installation Storefront/Glazing Windows Drywall/Acoustical Ceiling Flooring Painting – needs to be added next Specialties Toilet Partitions & Accessories Equipment Furnishings Casework Countertops Pools Metal Building Systems Elevators Fire Protection Plumbing HVAC Electrical Fire Alarm / Security Low Voltage Other

Geographic Area Served (Check all that apply)

Metro Atlanta North Georgia Central Georgia South Georgia Alabama Florida North Carolina South Carolina Other

Market Sectors Served (Check all that apply)

Aviation Government Hospitality Industrial Interiors Office Retail Other

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1974 Delta Drive
Gainesville, GA 30501
770-287-3093
Info@OptumConst.com