2500 E Brannan Way, Denver, CO, Phone: (303) Fax: (303)

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1 2500 E Brannan Way, Denver, CO, Phone: (303) Fax: (303) January 1, 2015 As a valued member of the Brannan project team, the time has come to update you Subcontractor Prequalification Status with Brannan Companies. Participation in this process is mandatory if you wish to continue to be considered as a subcontractor to work on Brannan Companies projects. You only need to complete the portions of the attached document where there has been a material change in your company s status since last year s qualification document was submitted. At a minimum you will need to provide: - a current certificate of insurance - current financials (income statement and balance sheet from the same period; fully year audited or reviewed financial statements are prefered) - Current year s EMR and OSHA 300A copies (if current EMR is greater than 1.0) - Current letter from your bonding company that details the bonding relationship (length of relationship, per project and maximum bonding capacity). - If you previously submitted DBE/MBE/WBE certification documents, you will need to provide evidence that your certification remains current. - Reference list of only those current or completed projects that were begun or completed since your last prequalification submittal. The information provided in this statement will allow Brannan Project Management teams to make sure that your company is offered work on projects that are best suited for your company s abilities. Failure to return the qualification statement or any of the required attachments may result in your subcontractor status with Brannan Companies being placed on hold. If this occurs, no new subcontracts or payments will be released to your company until the hold status is cleared. Should you have any questions regarding this prequalification process, please feel free to contact me by phone at or by at Thank you for your cooperation with this process. Sincerely, The Brannan Companies Cheryl Cheney Contract Administrator

2 Subcontractor s Qualification Statement The Undersigned certifies under oath that the information provided herein is true and sufficiently complete so as not to be misleading. SUBMITTED TO: Brannan Companies ADDRESS: 2500 E Brannan Way, Denver, CO SUBMISSION DATE: SUBMITTED BY: NAME: ADDRESS: PRINCIPLE OFFICE: PHONE: NAME OF PROJECT (if applicable): FAX: Corporation Partnership Individual Joint Venture Other TYPE OF WORK (file separate form for each Classification of Work): General Construction Plumbing Other (please specify) HVAC Electrical

3 1. ORGANIZATION 1.1 How many years has your organization been in business as a Contractor/Subcontractor? 1.2 How many years has your organization been in business under its present name? Under what other or former names has your organization operated? 1.3 Submit a fully completed and executed W-9 (attached). 2. LICENSING 2.1 List jurisdictions and trade categories in which your organization is legally qualified to do business, and indicate registration or license numbers, if applicable. 2.2 List jurisdictions in which your organization s partnership or trade name is filed. 2.3 Is your company qualified by any agency or jurisdiction as a MBE/DBE/WBE? If yes please provide the name of the agency/jurisdiction, your certification number and the expiration date of your certification. Attach copies of your certification documents. 3. EXPERIENCE 3.1 List the categories of work that your organization normally performs with its own forces. 3.2 Claims and suits. (If the answer to any of the questions below is yes, please provide details in an attachment.) Has your organization ever failed to complete any work awarded to it? Are there any judgments, claims, arbitration proceedings or suits pending or outstanding against your organization or its officers? Has your organization filed any law suits or requested arbitration with regard to construc-tion contracts within the last five years?

4 3.3 Within the last five years, has any officer or principal of your organization ever been an officer or principal of another organization when it failed to complete a construction contract? (If the answer is yes, please provide details as an attachment.) 3.4 State total worth of work in progress and under contract as of the date of this submission: 3.5 On a separate sheet, list the major projects your organization has completed in the last five years, giving the name of the project, owner, architect, contract amount, date of completion and percentage of the cost of the work performed with your own forces State average amount of construction work performed during the last five years: 3.6 On a separate sheet, list the construction experience and present commitments of the key individ-uals of your organization. 4. SAFETY 4.1 Does your company employ a full time safety officer? If yes, provide name, title and contact information for this person. 4.2 Does your company have a written safety manual? If yes, can you provide a copy upon request? 4.3 Does your company conduct regular safety inspections at jobsites? If so, how often are they completed and by whom? 5. INSURANCE 5.1 Attach a copy of your current certificate of insurance detailing coverage and limits for General Liability, Automotive Liability, Excess/Umbrella Liability and Workers Compensation/Employers Liability policies (see attached minimum requirements for subcontractors working with Brannan Companies and sample certificate of insurance). 5.2 Provide your company s EMR for the past three years If your EMR for any of the past 3 years exceeds 1.00, please provide copies of your OSHA 300A reports for each year as an attachment.

5 6. REFERENCES 6.1 Trade references (include at least 3 providing company name, address, phone number, fax number, address and contact name): 6.2 Bank References (provide company name, address, phone number, fax number, address and contact name): 6.3 Surety: Name of Bonding Company: Name, Address, Phone Number and Contact Name of Agent: Maximum bonding limits aggregate per project limit 7. FINANCING 7.1 Financial Statement Attach your most recent full year financial statement, preferably audited, including your organization s latest balance sheet and income statement showing the following items: Name and address of firm preparing attached financial statement, and date thereof: Is the attached financial statement for the identical organization named on page one?

6 7.1.4 If not, explain the relationship and financial responsibility of the organization whose financial statement is provided (e.g., parent-subsidiary). 7.2 Does your company have a line of credit? If yes, provide the maximum available credit and the current available credit. 7.3 Will the organization whose financial statement is attached act as guarantor of the contract for construction? 7.4 By executing this document in the space provided below, the organization noted on page one of this document authorizes Brannan Companies to make a complete credit investigation of said organization, including references, credit association and public agencies regarding credit. The undersigned also warrants that he/she is authorized to execute this document on behalf of said organization. 8. SIGNATURE 8.1 Dated at this day of, 20. Name of Organization: Signed: Name and Title: 8.2 being duly sworn deposes and says the information herein is true and sufficiently complete so as not to be misleading. Subscribed and sworn before me this day of, 20. Notary Public: My Commission Expires:

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December 1, 2015. Dear Valued Brannan Companies Subcontractor,

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