CANA CONSTRUCTION BIDDER INFORMATION AND QUALIFICATION STATEMENT

Transcription

1 CANA CONSTRUCTION BIDDER INFORMATION AND QUALIFICATION STATEMENT This Document is intended to allow CANA to better assess subcontractors capabilities and qualifications, who are submitting bids to CANA for tenders. This information is not to disqualify any bidder but rather to better inform CANA on the capacity, skill, history, and safety record of submitting companies. Sub Contractor Legal Name: Operating as: Address: Primary Business Phone Number: Primary FAX Number: Web Address: Person(s) Submitting this information: Legal Structure of Contractor Year Established: Corporation: Partnership: Registered: Sole Proprietor: Other: Names and titles of Officers, Partners, and Principal(s): Financial References 1. Bank Name: Address / Locattion: 2. Bonding / Surety Company: Location: Able to provide a performance bond? Yes: No: Current Bonding Rate: 50% Performance Bond $ Per $ % Labour & Materials $ Per $ Insurance Carrier Location: Auto Liability Limit $: General Liability Limit: $:

2 Does your firm participate in the Gold Seal program? Yes No Member of the Calgary Construction Association? Yes No Do you currently use the Calgary Construction Association Online Planroom? Yes: No: Personel Number of people employed by firm in past 4 years Management: Office: Field Supervisory: Trades Persons: All Other: Year: Current Year: Year: Year: Please list key personel for the firm. Name: Position: Years with Company Years in Industry Gold Seal: Intern Certified as

3 Safety Information ACSA COR Certificate: Yes No Please attatch a copy Is the firm currently in good standing with the WCB in Alberta? Yes No Health and Safety History: Number of fatalities Number of lost time incidents Number of medical aid injuries Number of other recordable cases Does your company have a written safety policy? Yes No Who is the responsible person for safety on your work sites? Has the firm received any stop work orders or compliance orders from Alberta Workplace Health and Safety, or enviromental protection orders from Alberta Enviroment or equivilant governmentr agencies (federal or provincial) in the last 5 years Yes No Contractual Disputes, Judgements & Status: if you answer yes to any of the below please attach details Is there any current claims against your firm for failure to pay Yes No Have you had a contract terminated on job you had been awarded Yes No Has a surety completed any contract you where awarded Yes No Bid Invitations Please provide a list of contacts that invitations to bid should be adressed to. Contact Phone Scope of work covered Please list all Divisions Scopes of work that you would like to be invited to bid on:

4 Project Experience Annual Value of construction work for the past 5 years Year Value Year Value $ $ $ $ $ Number of projects completed in previous 5 years in contract value: Under $50,000 $ 50,001 to $ 100,000 $ 100,001 to $ 250,000 $ 250,001 to $ 500,000 $ 500,001 to $ 1,000,000 $ 1,000,001 to $ 5,000,000 $ 5,000,001 to $ 10,000,000 $ 10,000,001 to $ 25,000,000 Greater than $ 25,000,000 Number of projects completed in the following fields Hospital/Healthcare Road & Bridgework Hotel/Motel Airside Facilities Sports & Recreation Schools/Institutional Office 1 to 5 Storey Industrial Office 6 to 15 Storey Residential Single Family Office +15 Storey Residential Multifamily/Condo Retail/Mall Data Centres Has your Company worked on any CANA projects in the previous 5 years? Yes: No: List: Project CANA Superintendant

5 Please List Principal Projects in the Past 5 years: (copy sheet if more are needed) I declare the information provided is true and correct to the best of my knowledge X: date: