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SUBCONTRACTOR PREQUALIFICATION FORM
Subcontractor Information
Contact Person for Application
(Required)
Contact Person Email
(Required)
Address
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Classification(s)
Specify one or more construction classification codes from the following list in which the subcontractor is applying for Prequalification. Please note the required license:
Construction Classification Codes & Required License:
(Required)
CS/SD: Construction Services and Site Development (General Contractor/Building Contractor)
HV: HVAC Services (Mechanical Contractor or A/C Contractor - Class A or B)
DS: Demolition Services (General Contractor)
PS: Painting Services (Palm Beach County Certificate of Competency)
ES: Electrical Services (Electrical Contractor)
RS: Roofing Services (Roofing Contractor)
FA: Fire Alarm System Services (Electrical Contractor or Alarm System Contractor
UU: Utility and Underground Excavation Services (Underground Utility Contractor)
PS: Painting Services (Palm Beach County Certificate of
Competency)
RS: Roofing Services (Roofing Contractor)
UU: Utility and Underground Excavation Services
(Underground Utility Contractor)
Type of Organization
Corporate Name
(Required)
Type of Organization (check one below)
(Required)
Corporation
LLC
Partnership
Sole Proprietor
State of Incorporation
(Required)
Date of Incorporation
(Required)
MM slash DD slash YYYY
FEIN No
(Required)
Name and Title of Principal Officers
(Required)
Name/Title
Email
Add
Remove
Banking Information
(Required)
Name of Bank
Lines of Credit
Add
Remove
Bonding Capacity
Is the organization able to bond projects over 100 K?
Yes
No
Please provide bonding capacity amount:
List other Public Agencies the Applicant is currently certified and provide proof of current prequalified status (letter, certificate, etc.)
(Required)
Agency Name
Trade in which qualified E
Expiration Date
Amount Approved
Add
Remove
Experience
Applicant may provide additional experience on separate sheets and attached to this form but MUST include all of the information in the same format as below.
Project Reference #1
Project Name
(Required)
Type of Project
(Required)
Project Location (Address)
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Contact Name
(Required)
Contact Email
(Required)
Contact Phone Number
(Required)
Extension
(Required)
Contract Dollar Value
(Required)
Architect Name
(Required)
Type(s) of Work Performed (name disciplines, scope of work, etc.)
Project Reference #2
Project Name
(Required)
Type of Project
(Required)
Project Location (Address)
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Contact Name
(Required)
Contact Email
(Required)
Contact Phone Number
(Required)
Extension
(Required)
Contract Dollar Value
(Required)
Architect Name
(Required)
Type(s) of Work Performed (name disciplines, scope of work, etc.)
Supplier References
List
(Required)
Name
Contact Info
Add
Remove
Is the applicant certified as an SBE OR M/WBE?
(Required)
Yes
No
Attach a copy of the certificate
(Required)
Max. file size: 100 MB.
Please identify M/WBE designation
(Required)
African American
Hispanic American
Asian American
Native American
Woman Owned or Service Disabled Veteran
