Subcontractor Application

• • COMPANY INFORMATION

  • Name of Company*

  • Address 1*

  • Address 2

  • City*

  • State*

  • Office Phone*

  • Cell Phone (Not Required)

  • Email*

  • Website (Not Required)

  • Company Speciality*Architect/Engineers - DesignConsultingInspections and TestingMoving and StorageCleaningTrash & HaulingSanitary Facilities-ToiletsEquipment RentalSurveys and AssessmentsXRAY GPRDemolitionFacilities RemediationConcreteCore Drilling/Cutting and BoringMasonry-Brick & CMUMasonry - StoneworkStructural SteelDecorative and Ornamental MetalsFinish CarpentryArchitectural MillworkWaterproofing and DamproofingCaulking/Joint SealantsThermal and Moisture (Insulation and EIFS)RoofingFire and Smoke Protection-FireproofingDoors, Frames and HardwareSpecialty DoorsEntrances, Storefronts and Curtain WallsGlass and GlazingWindowsLouvres and VentsGWB/Plaster/FRP PanelsTileCeilingsFlooringWall CoveringsAcoustic TreatmentsPaintingDecorative FinishesSignagePartitions & Bathroom AccessoriesExterior Specilaties-Awnings etc.Equipment-RefrigerationWindow TreatmentsCountertopsFurnitureSpecial ConstructionConveying Equipment-Elevators/LiftsScaffolding SystemsFire Suppression & SprinklersPlumbingHVACAutomated ControlsElectricalElectrical Materials OnlyCommunicationsElectronic Safety & SecurityFire Detection & AlarmsEarthworkPavingLandscapingUtilities-Site

  • State Of Formation*

  • Date Formed*

  • Number Of Employees*

  • Business Information

  • • Do you perform services or do business under any other name?*

    • YesNo

  • If yes, what business name?

  • License Information

  • State*

  • License #*

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  ***Please provide all copies of active license.

• • FINANCIAL

  • Average Project Size ($)*

  • Estimated Annual Revenue this year ($)*

  • Current Backlog (jobs committed and not yet started) ($)*

  • Primary Banking Relationship*

  • List (2) Largest Projects (with references)

  • Project Name 1*

  • Dollar Value*

  • General Contractor/Contact*

  • Project Name 2*

  • Dollar Value*

  • General Contractor/Contact*

• • LEGAL AND CLAIM HISTORY

  • • Has your firm ever been to a party to a lawsuit or arbitration with a general contractor or owner in the last 5 years?*

    • YesNo

  • • Has any entity filed a lawsuit or claim in arbitration against your firm for failing to make payments to that entity?*

    • YesNo

  • • Has your firm ever been terminated on any project in the last 5 years?*

    • YesNo

  • • Has your firm ever been supplemented on any project in the last 5 years?*

    • YesNo

• • INSURANCE AND SAFETY QUESTIONS

  • Upload proof of professional Liability insurance. Click here for liability insurance minimum requirements

    ❌

  • • Does your company procure pollution liability insurance?*

    • YesNo

  • OSHA Recordable Incident Rating & Fatalities Rating for most recent year

  • Incident*

  • Fatalities*

  • • Does your company have a written safety program and/or policy?*

    • YesNo

  • • Does your company conduct accident / incident investigations?*

    • YesNo

  • • Do you always have one or more First Aid / CPR certified individual(s) on-site?*

    • YesNo

  • • Does your company have a substance abuse program?*

    • YesNo

• • ACKNOWLEDGEMENTS

  • I hereby certify that the above statements are true and correct to the best of my knowledge.

  • Company Name*

  • Completed By*

  • Signature*

  • Date*

  • A (W-9) must be submitted as one document to billing@pcsgc.com. If not, the Form will not be accepted.

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