CLEVELAND HOUSING NETWORK, INC CONSTRUCTION DEPARTMENT GENERAL CONTRACTOR APPLICATION PROCESS

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1 CLEVELAND HOUSING NETWORK, INC CONSTRUCTION DEPARTMENT GENERAL CONTRACTOR APPLICATION PROCESS I. It is the Cleveland Housing Network, Inc. s policy to verify all information given on the application. This includes sending correspondence to verify bank account line of credit, credit history with suppliers and job history with sub-contractors. II. A CHN representative will review the following: a. $25K line of credit or working capital on deposit b. General and Liability Insurance c. Workmen s Compensation Insurance d. General Contractor s License with the City of Cleveland e. 3-5 years General Contracting Experience f. 1 year in operation under current business name g. Active account with Material Suppliers and is in Good Standing h. Active relationship with sub-contractors and is in Good Standing. i. Past and Current work performed by your company. III. Three (3) job references that your company completed within the last 12 months and (3) job reference of construction project(s) your company is currently working on. (refer to the enclosed job reference form). If you cannot provide CHN with access to view your past and current work performance, the approval process will be delayed and/or your application will be rejected. IV. It is anticipated that the review and approval process will take days from the date the application was submitted. *APPLICATIONS SHOULD BE RETURNED TO: Michelle Knox, CHN, 2999 Payne Avenue, 3 rd Floor Cleveland, Ohio or via 1

2 Cleveland Housing Network, Inc. General Contractor Compliance and Participation Reporting Requirements Contractors are required to comply with all compliance requirements which include Fannie Lewis Worker Hours, Section 3 reporting as well as MBE/FBE/CSB Business Utilization. Contractors must use certified MBE, FBE and CSB subcontractors to meet the goals set in accordance to all contracts awarded. A. Contractors must also meet the goals of hiring 20% City of Cleveland residents and 4% of the 20% to LOW INCOME individuals. SMALL BUSINESS REQUIREMENTS MBE - 15% FBE - 7% CSB - 8% RESIDENT EMPLOYEMENT LAW REQUIREMENTS City of Cleveland Residents 20% of total project hours LOW INCOME 4% of 20% Minority Females 16.1% of total project hours 6.9% of total project hours SECTION 3 REQUIREMENTS Section 3 10% *Refer to City of Cleveland Office of Equal Opportunity and Department of Community Development on all compliance guidelines. Cleveland Housing Network, Inc. reserves the right to reject any and all bids based upon payment history, quality/timing issues or outstanding unresolved warranty concerns. 2

3 Cleveland Housing Network CONTRACTOR S APPLICATION Name of Business: Business Address: City: State: Zip: Business Phone: ( ) Fax: ( ) Cell Phone: ( ) Owner(s) Name: Address of Owner(s): * is required, CHN communicates with contractors via throughout bidding and contract management* (a) Type of Entity: Corporation Partnership Sole Proprietor Federal ID# - - Social Security # - - (if Sole Proprietor) (b) (c) (d) Date formed: List the number of years the above mentioned Owner(s) have been personally operating a general contracting business? (years) List the legal names of those businesses which you previously owned: (e) (f) State of Incorporation of formation: Are you qualified to do business in the state in which the Project is located? If not, please explain. (g) (h) Number of professional employees: Number of other employees: 3

4 (i) Information concerning officers and directors: Name Position Years of Experience in construction (2) Is this entity the successor to any other entity? If so, state the name of such entity, its date of formation and the reason for the termination of such entity. Is the firm the subject of any current, pending or threatened bankruptcy or receivership proceeding? If so, please describe the proceeding and its status. (3) When did your firm actively begin its current construction practice? (4) List all the professional licenses held by the firm, if any. (5) What is the estimated value of work completed by your firm in each of the last (3) three years? YEAR VALUE 4

5 (6) Is the construction the sole business activity of your firm? If not, please describe generally its other business activities. (7) Is your firm affiliated with any other companies? If so, please name them and their principal line of business activities. 1 (8) Describe the circumstances relating to each instance, if any, in the past three years in which a major claim has been made for benefits under any builder s risk, errors & omissions or liability insurance held by your company. (9) Has there ever been, in the last five (5) years, or is there now, pending or threatened, any litigation involving the construction or operation of any work which your firm has undertaken in which your firm was or is a party or in which your firm s performance and/or work was or is now being questioned? If so, please describe. (10) In addition to litigation referred to in the preceding paragraph, is there any litigation now pending or threatened to which your firm is a party or which might otherwise affect the 1 For purposes of this Questionnaire, the term Affiliate shall mean any person that directly or indirectly, through one or more intermediaries, is in any way related to the person specified. For example, and not by way of limitation, in the case of a corporation, Affiliates would include the corporation s officers, directors, shareholders and subsidiaries in which the corporation holds an interest. Similarly, in the case of a partnership, Affiliates would include all partners. 5

6 capacity of your firm to perform with respect to your involvement with the Project, whether or not it concerns other work which you have undertaken? If so, please describe. (11) Has your firm (or its Principals, Predecessors, or Affiliates) been involved in any of the following types of proceedings within the last (5) five years or currently? If the answer to any parts of this question is Yes please give details on a separate sheet of paper. (a) Is your firm currently debarred from participation in Federal/State/Local programs? Yes No (b) Any action, audit or investigation brought by any federal government agency or authority or by any state or local public body? Yes No (c) Any criminal proceeding, whether felony or misdemeanor (excluding traffic violations and other minor offenses)? Yes No (d) Any local, state or federal proceeding or sanction pending, threatened or imposed at any time against you and/or your Affiliates in any jurisdiction with respect to any aspect of the real estate industry? Yes No (e) Any proceeding under any bankruptcy or insolvency law or any appointment of a Receiver, Fiscal Agent or similar Officer against you and/or your Affiliates? If so, please identify the proceedings, the court or governmental body and the date such proceeding began. Yes No (f) Any federal income tax audit of you and/or your Affiliates or of any enterprise in which you and/or your Affiliates served as controlling persons? If so, please set forth the year of the audit, the fiscal year of the tax return audited, the type of investment (if relevant), a general description of the audit issues and the disposition of the audit. Yes No (g) Any past or present litigation involving claims in excess of $10,000 with respect to the construction or operation of any project which you or your Affiliates managed in which you or your Affiliates were (are) a party to or in which you or your Affiliates performance was (is) questioned. Yes No 6

7 (12) List the gross annual receipts of Your Business for the past three years: *2007 *2008 *2009 *Please ensure that these figures are consistent with your income tax returns. (13) List two (2) financial institutions with whom your business has either lines of credit or working capital on deposit. Lender Address Phone Contact Person Balance Note: Be sure that you complete the Financial Verification Form attached to this Application for each f the 2 lenders listed. (14) Given a payment schedule of up to 45 days, what size contract can you enter into while performing on-time? up to $100,000 $100,000 to $250,000 $250,001 to $500,000 $500,001 to $750,000 $750,001 to $1,000,000 over $1,000,000 (15) List three (3) major material suppliers with whom your business has established a credit relationship with to purchase construction materials: SUPPLIERS ADDRESS PHONE CONTACT PERSON NOTE: be sure that you complete the Material Suppliers Verification form for each for the 3 suppliers listed above. (16) Is your business in a financial position to provide a twelve (12) month warranty on all labor and materials? Yes No (17) List three (3) major sub-contractors with whom your business is currently using in your capacity as a general contractor: 7

8 TRADE COMPANY OWNER ADDRESS PHONE 1. HVAC 2. Electrical 3. Plumbing Refer to the enclosed Job Reference Form. (18) Is your business currently licensed as a General Contractor with the City of Cleveland? Yes No *Please attach a copy of your contractor s license** (19) Does your business currently carry General Liability Insurance? yes no **Please attach a copy of certificate** (20) Is your General Liability Insurance coverage at $1,000,000 or above? yes no Note: Please attach a copy of certificate, Cleveland Housing Network, Inc must be listed as Additional Insured (21) Does your business carry Workers Compensation insurance on its employees? yes no **Please attach a copy of certificate** (22) How do you feel your company would operate under winter conditions? Please explain. (23) Please list Ohio communities where you have completed construction work: Cleveland (24) Contractor is interested in: (Check all that apply) Renovation Work Single-House Contracts New Construction Work Contracts that include a Minimum of Homes (25) A) Are you a state licensed lead abatement contractor? Yes No Please attach evidence 8

9 B) Do you have supervisors and/or workers that have attended day-long courses on lead-safe work practices? Yes No (27) Is your company an: MBE, certified by FBE, certified by Section 3 contractors, certified by Please enclose a copy of the relevant certificates. This Application will be reviewed and all information verified. Please ensure that your verification forms are complete. I, the undersigned, attest that all information provided above is true under penalty of law and that no information on company ownership or referrals has been omitted. Date: Name of Firm: By: Name: Title: AVOIDANCE OF CONFLICT OF INTEREST I, undersigned, certify that neither I nor any company principal has a legal, financial or familial relationship to any employee of CHN or a CHN member group. Signature of Owner Date 9

10 REQUEST FOR VERIFICATION OF FINANCIAL ACCOUNTS/LINE(S) OF CREDIT NOTE TO FINANCIAL INSTITUTION: The undersigned applicant has applied to become a General Contractor with the Cleveland Housing Network, Inc. in doing so, this individual/business has listed your institution as providing certain financial services and/or credit lines which they utilize to operate the said business. We ask that you furnish our agency with requested information below, and return this in the self-addressed envelope. This information is for the confidential use of our agency only. A. NAME, ADDRESS OF THE APPLICANT/CONTRACTOR: Individual: Business: Phone: Address: City:,OH Zip: B. NAME, ADDRESS OF FINANCIAL INSTITUTION NAME OF COMPANY: ADDRESS: CITY: STATE: ZIP: CONTACT PERSON: C. FINANCIAL SERVICES VERIFICATION: (LENDER ONLY) (1) EXISTING LINE(S) OF CREDIT: $ (2) AVAILABLE BALANCE ON LINE(S) $ (3) CHECKING ACCOUNT # BAL. $ (4) SAVINGS ACCOUNT # BAL. $ D. SIGNATURE OF FINANCIAL INSTITUTION The above information is furnished as an accurate account of the Applicants financial relationship with the institution. The information is also being presented in strict confidence, in response to your request. DATE SIGNATURE TITLE APPLICANT S AUTHORIZATION I HEREBY AUTHORIZE YOUR COMPANY TO RELEASE ANY AND ALL OF THE ABOVE REQUESTED INFORMATION TO THE CLEVELAND HOUSING NETWORK. APPLICANT S SIGNATURE DATE 10

11 REQUEST FOR VERIFICATION FOR MATERIAL SUPPLIERS ACCOUNTS/LINE(S) OF CREDIT NOTE TO MATERIAL SUPPLIER COMPANY The undersigned applicant has applied to become a General Contractor with the Cleveland Housing Network, Inc. in doing so, this individual/business has listed your company as providing certain material accounts in which to operate their said business. We ask that you furnish our agency with requested information below, and return this in the self-addressed stamped envelope. This information is for the confidential use of our agency only. A. NAME, ADDRESS OF THE APPLICANT/CONTRACTOR: Individual: Business: Phone: Address: City:, OH Zip: B. NAME, ADDRESS OF THE MATERIAL SUPPLIER: NAME OF COMPANY: ADDRESS: CITY: STATE: ZIP: CONTACT PERSON: C. MATERIAL SUPPLIER VERIFICATION: (1) DATE APPLICANT OPENED ACCOUNT: / / (2) AMOUNT OF CREDIT AVAILABLE ON APPLICANT S ACCOUNT: $ (3) TERMS ON APPLICANT S ACCOUNT: 30 days 60days 90 days (4) HAS A LIEN EVER BEEN FILED AGAINST CONTRACTOR: YES NO (5) IS THE APPLICANT S ACCOUNT IN GOOD STANDING/CURRENT: YES NO D. SIGNATURE OF MATERIAL SUPPLIER The above information is furnished as an accurate account of the Applicants Material purchasing relationship with this company. The information is also being presented in strict confidence, in response to your request. DATE SIGNATURE TITLE APPLICANT S AUTHORIZATION I HEREBY AUTHORIZE YOUR COMPANY TORELEASE ANY AND ALL OF THE ABOVE REQUESTED INFORMATION TO THE CLEVELAND HOUSING NETWORK. APPLICANT S SIGNATURE DATE 11

12 REQUEST FOR VERIFICATION FROM SUB-CONTRACTOR The undersigned applicant has applied to become a General Contractor with the Cleveland Housing Network, Inc. in doing so, this individual/business has listed your company as providing certain material accounts in which to operate their said business. We ask that you furnish our agency with requested information below, and return this in the self-addressed stamped envelope. This information is for the confidential use of our agency only. A. NAME, ADDRESS OF THE APPLICANT/CONTRACTOR: Individual: Business: Phone: Address: City:, OH Zip: B. NAME, ADDRESS OF SUBCONTRACTOR: NAME OF COMPANY: ADDRESS: CITY: STATE: ZIP: CONTACT PERSON: PHONE: C. PAYMENT VERIFICATION: (1) TERMS OF PAYMENT: (2) WHERE PAYMENTS MADE ON TIME: YES NO (3) DID YOU EVER FILE A LIEN ON ANY PROJECT: (4) NAME OF LAST PROJECT AWARDED BY GENERAL CONTRACTOR: D. SIGNATURE OF COMPANY OWNER AND/OR REPRESENTATIVE The above information is furnished as an accurate account of the Applicants financial relationship with this institution. The information is also being presented in strict confidence, in response to your request. DATE SIGNATURE TITLE APPLICANT S AUTHORIZATION I HEREBY AUTHORIZE YOUR COMPANY TO RELEASE ANY AND ALL OF THE ABOVE REQUESTED INFORMATION TO THE CLEVELAND HOUSING NETWORK. APPLICANT S SIGNATURE DATE 12

13 REQUEST FOR VERIFICATION FOR MATERIAL SUPPLIERS ACCOUNTS/LINE(S) OF CREDIT NOTE TO MATERIAL SUPPLIER COMPANY: The undersigned applicant has applied to become a General Contractor with the Cleveland Housing Network, Inc. in doing so, this individual/business has listed your company as providing certain material accounts in which to operate their said business. We ask that you furnish our agency with requested information below, and return this in the self-addressed stamped envelope. This information is for the confidential use of our agency only. A. NAME, ADDRESS OF THE APPLICANT/CONTRACTOR: Individual: Business: Phone: Address: City:, OH Zip: B. NAME, ADDRESS OF THE MATERIAL SUPPLIER: NAME OF COMPANY: ADDRESS: CITY: STATE: ZIP: CONTACT PERSON: PHONE: C. MATERIAL SUPPLIER VERIFICATION: (1) DATE APPLICANT OPENED ACCOUNT: / / (2) AMOUNT OF CREDIT AVAILABLE ON APPLICANT S ACCOUNT: $ (3) TERMS ON APPLICANT S ACCOUNT: 30 days 60days 90 days (4) IS THE APPLICANT S ACCOUNT IN GOOD STANDING/CURRENT: YES NO D. SIGNATURE OF MATERIAL SUPPLIER The above information is furnished as an accurate account of the Applicants material purchasing relationship with this company. The information is also being presented in strict confidence, in response to your request. DATE SIGNATURE TITLE APPLICANT S SIGNATURE I HEREBY AUTHORIZE YOUR COMPANY TO RELEASE ANY AND ALL OF THE ABOVE REQUESTED INFORMATION TO THE CLEVELAND HOUSING NETWORK. APPLICANT S SIGNATURE DATE 13

14 Cleveland Housing Network, Inc Construction Department Date: JOB REFERENCE FORM General Contractor: Completed by: Signature: Please list (3) jobs your firm has completed in the past 8 months. Client Name Phone Number City Building Permit #s Specify Trade Site Address Description of Work Contract Amount Start Date Completion Date $ $ $ Please list (3) jobs your firm is currently working on. Client Name City Phone Number Building Permit #s Specify Trade Site Address Description of Work Contract Amount Start Date Completion Date $ $ $ Internal Office Use Approved Disapproved Reviewed by: Title: Date: Comments: 14

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