CONTRACTOR PRE-QUALIFICATION FORM Company Overview Question Title * 1. Company Information First Name Last Name Title Email Phone Company Name Street Address City Zip Code Phone Website DUNS Number Federal EIN Question Title * 2. Year Established Question Title * 3. Type of Trade (s) performed? Question Title * 4. Number of Employees Administrative/Office Shop Field Question Title * 5. What type of labor is your firm capable of providing? Union Prevailing Wage Open Shop Question Title * 6. If union or prevailing wage, can you provide certified payroll reports to comply with local law? Yes No Question Title * 7. Certification Type Woman Owned Business (WBE) Minority Owned Business (MBE) Question Title * 8. Certifiying Agency The Port Authority of NY & NJ New York State Empire Development (ESD) NYC Department of Small Business Services (SBS) Other Certifying Agency Question Title * 9. Please list your insurance limits for the following policies General Liability (per occurrence, aggregate and umbrella) Workers Compensation Bonding Capacity Question Title * 10. What was your annual contract volume for the last 3 years? 2021 2020 2019 Question Title * 11. Are there any judgements, claims or pending suits or outstanding liens against you or your company? Yes No Question Title * 12. What is the largest size contract you are interested in performing? Question Title * 13. What is the largest size contract you have ever performed? Question Title * 14. What areas (locations) do you primarily operate within New York Metro Area (All Boros and New Jersey) Bronx Manhattan Queens Brooklyn Staten Island Question Title * 15. Attach Capability Statement Question Title * 16. Provide three references: provide at least one for each trade Done
