GENERAL INFORMATION
Company Name
Telephone
Fax
Email Address
Website Address
PAYMENT INFORMATION
Address
City
State
Zip
Country
Additional Address
Additional Information
Preferred Project Scope
Preferred Project Size: Please select 3. Under $50K$50K-100K$100K-200K$200K-500K$500K-1M$1M-3M$3M-6M$6M-10M$10M+
ATTACHMENTS
Please attach a copy of your company's certificate of insurance
Please attach a copy of your company's W9
LEGAL
Has your company or any if its principals ever petitioned for bankruptcy, failed in business, defaulted, or been terminated on a contract awarded? If yes, check here and enter explanatory notes.
Have any of the owners, officers, or major stockholders of your company ever been indicted or convicted of any felony or other criminal conduct? If yes, check here and enter explanatory notes.
Has your company or any of the owners, officers, or major stockholders ever been suspended, disbarred, or otherwise precluded from persuing public work or ever been found to be non-responsive to a public agency? If yes, check here and enter explanatory notes.
Has your company ever had a claim made against it for improper, delayed, defective, or non-compliant work or failure to meet warranty obligations? If yes, check here and enter explanatory notes.
Is your company or any of the owners, officers, or major stockholders involved in any arbitration or litigation? If yes, check here and enter explanatory notes.
Does your company have any outstanding judgments or claims against it? If yes, check here and enter explanatory notes.
Has your company or any of the owners, officers, or major stockholders ever been investigated for, or charged with, alleged labor law violations including alleged violations of Immigration Control and Reform Act; state or local laws regarding employment of immigrants; prevailing wage laws; wage and hour laws or other federal, local, or state labor laws? If yes, check here and enter explanatory notes.
CONTACTS
OWNER
Title
Years
Preferred Contact Method
Phone number
Fax number
Email address
ESTIMATOR
ACCOUNTING
SIGNATURE - all fields required
We have attempted to answer all questions in a full and complete manner to assure that our answers are not in any respect misleading, either by expressing ourselves in a misleading or ambiguous manner or omitting information. We recognize that Martin Horn, Inc. will be relying on the accuracy of the information and our responses in this questionnaire in deciding whether to permit us to bid and to award work to our Company.
Name of Company*
Completed by*
Title*
Date*
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