KMC Corporation

   

Subcontractors Pre-Qualification Form

Please complete the form below to pre-qualify with KMC Corporation.

You may also download the PDF Version of the form

Click Here for PDF Form


All highlited fields listed below are required!

Business Section
Legal Business Name:

 Project, if applicable:
Street Address:
 Street Address 2:
City: City 2:
State: Zip: State 2: Zip 2:
Principal Contact:
 Years in Business:
# Employees:
Phone:
    Fax: 		Business Type:
Sole Proprietor Corporation Partnership
LLC/LLP Other
Contact Email:
 Company Website:
Have you failed to complete awarded work or been terminated for cause? Do you have any judgements, claims, arbitrations, suits or liens currently against your organization? Had any bankruptcies or reorganizations?

If yes, please explain below:
   
Safety Section  
Enter your Experience Modification Rate(EMR) for the last three years:
2007 (EMR) Rate: Number of OSHA Recordable incidents over the prior threee years:
2006 (EMR) Rate:
2005 (EMR) Rate: (Data available at www.osha.gov)
Do you have a written safety program?
   
Project Information Section  
Enter data from three most recent completed fiscal years:
Year: Max. Contract Value Completed Annual Company Revenue Current Year Company Workload
 
List license numbers in jurisdictions in which you company is legally qualified to work:
State License Number Expiration
   
Insurance and Bonding Section
Do you currently carry, or can you obtain the following insurance coverage?
Worker's Compensation Statuatory Maximum at Project Site Location:
General Liability $1,000,000 :
Automobile Liability $1,000,000 :
Employer Liability $1,000,000 :
Bonding Company Total Bonding Capacity Current Available Bonding Capacity
$ $
   
Reference Section
Project References (Within Last Three Years)
Project Name Project Location (City, State) Completion Date (MM/YY)
Your Firms Approximate Contract Amount Project General Contractor GC Contact and Telephone Number
Briefly Describe Work Performed By Your Firm:
Project Name Project Location (City, State) Completion Date (MM/YY)
Your Firms Approximate Contract Amount Project General Contractor GC Contact and Telephone Number
Briefly Describe Work Performed By Your Firm:
Project Name Project Location (City, State) Completion Date (MM/YY)
Your Firms Approximate Contract Amount Project General Contractor GC Contact and Telephone Number
Briefly Describe Work Performed By Your Firm:
 
Scope Of Work Section
(Scopes Of Work That Your Company Performs)
General Conditions Thermal & Moist. Protection Special Construction
Sitework Doors & Windows Conveying Systems
Concrete Finishes Mechanical
Masonrys Specialties Electrical
Metals Equipment Security
Wood & Plastics Furnishing  
 
 
 

Confidential Note:

The information supplied by the undersigned in this document is intended only for the use of KMC Corporation.

The undersigned certifies that the information provided herein is a clear and accurate representation of this orginization. Information Supplied by:

Name Title Date
 
 
   

KMC Corporation is a service driven, multi-dimensional construction corporation. Because we are developer/owners we understand the challenges owners and their representatives face every day. The KMC Team views every project from the owner's perspective. We sit in this seat every day. The KMC Team has combined experience spanning 40 million square feet and over 120 years. KMC has a comprehensive suite of in-house divisions. These in-house divisions ensure we control the process. These divisions represent a stark departure from most companies in our industry who outsource or subcontract all of the core aspects of the completed construction project. In areas outside of our in-house divisions, we utilize professional relationships and long standing alliances in substantive disciplines, such as engineering, architecture, design and geo-technical. KMC Corporation meets your needs at Every Stage of Construction.

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