Pre-qualification Form | Epic Construction

Company Details

Company Name *

Company Address *

Country

City

State

Zip code

Company Telephone No. *

Company Website

(If Available, please include http://)

Parent Company Details (If Applicable)

Parent Company Name

Parent Company Address

Apt, suite, etc.

Country

City

State

Zip code

Business & Services

Company Date of Formation *

(Month/Year)

Type of Company *

Corporation

Limited Liability Corporation

Partnership: General, Limited, Limited Liability

If Corporation, in what State?

Tax ID Number *

(You will also be required to submit a W9 as part of the File Upload section below)

Number of Current Employees *

Business Services *

Provide a description of the lines of business/services provided by your company. Please also describe the size/types of projects your company works on.

Self-Perform or Subcontract Work? *

Self-Perform

Subcontract

Annual Revenue

Please provide your annual revenue for the previous 2 years and year-to-date for the current financial year.

Current YTD *

Prior Year *

2 Years Prior *

Legal

Felony Convictions *

Have any of the present or past owners, officers or major stockholders of your Company (holding those positions within the past five years), ever been indicted or convicted of any felony or other criminal conduct?

Yes, please explain below

If Yes, Please Explain

Contract Defaults *

During the past five years, has your firm ever defaulted on a contract or been assessed with liquidated damages?

Yes, please explain below

If Yes, Please Explain

Contact Details

Provide name, phone number and email address for each.

President / Owner

Name *

Phone *

Sr. Project Manager

Name *

Phone *

Billing / AR

Name *

Phone *

Estimating

Name *

Phone *

Primary Contact

Who should bid invites be sent to?

Name *

Email *

References

Please provide the name, address and contact details of two GENERAL CONTRACTORS and two SUPPLIERS who can be used as references.

General Contractor #1

GC Name *

Address

Apt, suite, etc.

Country

City

State

Zip code

Phone *

General Contractor #2

GC Name *

Address

Apt, suite, etc.

Country

City

State

Zip code

Phone *

Supplier #1

Supplier Name *

Address

Apt, suite, etc.

Country

City

State

Zip code

Phone *

Supplier #2

Supplier Name *

Address

Apt, suite, etc.

Country

City

State

Zip code

Phone *

Project Details

Please provide your 4 most recent projects, including project name, location, contract amount and General Contractor.

Project #1

Project Name *

Project Location *

Contract Amount *

GC Name *

Project #2

Project Name *

Project Location *

Contract Amount *

GC Name *

Project #3

Project Name *

Project Location *

Contract Amount *

GC Name *

Project #4

Project Name *

Project Location *

Contract Amount *

GC Name *

Attachments

Current Form W9 *

Please submit a current W9. (PNG, JPEG, GIF and PDF accepted). Maximum size allowed is 8 MB.

Certificate of Insurance *

Please submit a current Certificate of Insurance (General Liability, Workers Compensation and Commercial Vehicle) to match this sample form. (PNG, JPEG, GIF and PDF accepted). Maximum size allowed is 8 MB.

Agreement & Submit

Complete Packages *

I understand that incomplete pre-qualification packages will automatically be rejected.

I Agree

Pay When Paid *

I understand and agree that Epic Construction Inc. is a PAY WHEN PAID contractor, and they withhold the standard 10% retention on all pay applications. Epic also requires a supplier listing from subcontractors on each project, along with supplier lien waivers to be submitted with each draw request.

I Agree