Contractor’s Questionnaire Please enable JavaScript in your browser to complete this form.GENERAL BUSINESS INFORMATIONName of FirmWebsiteStreet AddressTelephoneFaxContact Person/TitleEmailYear Business StartedState of IncorpDate of IncorpFed Tax ID No.Form of BusinessSole ProprietorPartnership“C” Corporation“S” CorporationLLCCertifications8A Hub ZoneSDVOSB Fiscal Year End:LIST OF CORPORATE OFFICERS, PARTNERS OR PROPRIETORS OF THE FIRMS:NameSS#Home AddressDate of BirthPosition% Owned Name of SpouseSS#NameSS#Home AddressDate of BirthPosition% OwnedName of SpouseSS# NameSS#Home AddressDate of BirthPosition% OwnedName of SpouseSS#NameSS#Home AddressDate of BirthPosition% OwnedName of SpouseSS#Has your firm or any of it’s principals ever petitioned for bankruptcy, failed in business or defaulted so as to cause a loss to Surety?YesNoIf yes, please attach a separate sheet to fully explain. Click or drag a file to this area to upload. Is your firm or any of its principals or officers currently involved in any litigation?YesNoIf yes, attach summary of the litigation. Click or drag a file to this area to upload. Contracting Specialty: Geographic Area of Operation:LIST ANY SUBSIDIARIES AND AFFILIATES:NameOwnership Type of BusinessNameOwnershipType of BusinessNameOwnershipType of BusinessWhat percentage of the firm’s work is normally for: Government Agencies Private OwnersHow many people does your firm employ?OfficeFieldOn average, how many work crews?What percentage of the firm’s work is normally subcontracted?What trades do you subcontract?Explain the firm’s policy for Bonding back subcontractors:What trades do you normally perform with your own forces?Is your firm Union?If so, which Unions?What is the largest amount of Backlog that the firm had at any one time in the past?Amount of BacklogNo. of ProjectsWhat is the largest project that you expect to do within the next twelve months?What is your average job size?What is your expected annual volume (Sales/Revenues) next year?What is the largest job you have ever completed?LIST THE FIRM’S KEY PERSONNEL — OFFICE AND FIELD:NamePositionYears ExperiencePrevious EmployerName PositionYears Experience Previous EmployerName PositionYears ExperiencePrevious EmployerExplain the firm’s Business Continuity Plan. Who will complete the current projects should something happen to the Owners and/or Key Employees?Is there a buy/sell agreement among the owners of the business?YesNo(Check one)if YES, attach copy Click or drag a file to this area to upload. Is the buy/sell agreement financed by life insurance?YesNo(Check one)FINANCIAL INFORMATIONDo you have a full time accountant on staff?YesNoHow often are financial statements prepared?AnnuallySemi-annuallyQuarterlyMonthlyOn what basis are your Financial statements prepared?CashAccrualCompleted Project% of ProjectAre taxes current?YesNoName of your BankAddressAmount of Line of CreditAttach the letter from the Bank confirming the Credit Agreement. Click or drag a file to this area to upload. What type of Accounting System/Software do you use?BONDING INFORMATIONPrevious Bonding Companies (last five years) List the most current firstYears with this Bonding CompanyBonding AgentPrevious Bonding Companies Years with this Bonding CompanyBonding AgentPrevious Bonding CompaniesYears with this Bonding CompanyBonding AgentHas the firm had major disputes or ever failed to complete a job on schedule?YesNoIf yes, please attach detailsAre there any liens, lawsuits or claims pending on completed or uncompleted?YesNoIf yes, please attach detailsREFERENCE INFORMATION List your three largest completed projects: 1. Description & Location of the WorkOwner/GCContact NameTelephoneEmailGross ProfitFinal Contract PriceYear CompletedBonded?2. Description & Location of the WorkOwner/GCContact NameTelephoneEmailGross ProfitFinal Contract PriceYear CompletedBonded?3. Description & Location of the WorkOwner/GCContact NameTelephoneEmailGross ProfitFinal Contract PriceYear Completed Bonded?List your three of your major Suppliers1. NameContact PersonTelephoneAddress2. NameContact PersonTelephoneAddress3. NameContact PersonTelephoneAddressList three Subcontractors/General Contractors that you do business with1. NameContact PersonTelephoneAddress2. NameContact PersonTelephoneAddress3. NameContact PersonTelephoneAddressThis application consists of this instrument, the financial statement and all indemnity, security, and trust agreement signed by the applicant with regard to the bond or bonds hereby requested such financial statement and agreement being incorporated herein by reference. In addition to routine verification of information pertinent to the bond applied for, if application is by an individual primarily for personal purposes, or, if the application is for bond primarily for the benefit of a corporation and the said application be also executed for the officers of the corporation in a personal not a corporate capacity thereby acting as a CO-guarantor thereof Surety may have an investigative consumer report make including information bearing on the character, general reputation, personal characteristics of mode of living of said individual(s), and, upon written request of said individuals(s) will disclose in writing the nature and scope of the investigation request-ed, if such investigative consumer report is in fact secured. The representations contained in this instrument an in the financial statement are warranted by the applicant to be true. Such representations are made as material inducements to be relied upon by the Surety in issuing the bond or bonds hereby requested.SignatureBy initialing here you authorize this form.Name — Typed of PrintedDateAny persons who, with intent to defraud or knowing that he is facilitating a fraud against an insurer, submits application or files claim containing a false or deceptive statement is guilty of insurance fraud.Submit