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									Qwest Local Network Questionnaire for
OUTSIDE PLANT Contractors




OSP Contractor,


Attached you will find the Qwest® Local Network Questionnaire for OUTSIDE PLANT CONTRACTORS. Prior to
completing the Questionnaire, ask yourself these two questions:


         Are you completing this Questionnaire on behalf of your company or as an individual? If your answer is
          “Company”, proceed. If your answer is “Individual”, this Questionnaire will not meet your needs. Return
          to www.Qwest.com/Careers and click on the link titled, “Qwest Job Search”.


         What type of work does your company offer? Outside Plant work activities includes: Digging, trenching,
          construction, boring, traffic barricades, locating, and engineering (see work activities below). Inquiries for
          all other departments (Real Estate, Fleet Management Procurement, Staffing, Business outside the 14
          state region, etc.) must be directed to those departments through the supplier help desk at
          www.qwest.com/about/company/business. Click on the link titled, “Become a Qwest Supplier”.


Forward the completed package and copies of the required documents to:

        Qwest Corporation
        Contract Administration/Registration
        Attn: Louise Berquist
        700 W. Mineral, WY L3416
        Littleton, CO 80120


All qualification packages received in this office are reviewed carefully and not all will be registered. Some of the
reasons your company may not be qualified are, but not limited to:

     * Failure to return a complete registration package, including an audited company financial statement with
       balance sheet
     * Low liquidity ratios
     * Low net worth — companies must have the financial strength to handle the size of a corporate contract
       without it accounting for more than 25 percent of your company's total income
     * No previous construction work for utility (specifically telecommunications) companies
If after review, your company is registered, your company will be placed on the Qwest Qualified Contractors Bid
List. This may allow you the opportunity to bid on upcoming contracts the areas and for the work you are
registered to do. Being on the Qwest Qualified Contractors Bid List is not a guarantee of work, nor a guarantee
that your company will receive an invitation to bid.
If your company is certified as a minority, women, or disabled veteran owned business, you must provide a copy
of your state or other agency MWDVBE certification.

Qwest reserves the right to not register any contractor for any reason.

Should you have any questions regarding this Outside Plant packet, please contact Louise Berquist at
Louise.Berquist@qwest.com.

Thank you for your interest in Qwest.




OSP Construction
Qwest Local Network Questionnaire for
OUTSIDE PLANT Contractors



                                                         (Please print or type)
Company Legal Name:
Business Address:              Street
                               City
                               State                         ZIP Code
Telephone:                                                   Fax Number:
Name of Contact:                                             E-mail of Contact:
Remit to Address (if different from Business Address):


1.  How do you operate? As a(n):             Individual              Partnership             Company
    If a company, which type? (corporation, limited liability company, etc)*
    In what state is your organization registered?
2. Federal Tax Identification Number:
          Failure to provide a correct taxpayer identification number may result in our withholding Federal income tax of
          20 percent from payments made to you. This withholding requirement is included in the Tax Equity and Fiscal
          Responsibility Act of 1982, and generally applies to payments that are required to be reported on Form 1099
          to the IRS.
3. a) Is your company a wholly owned subsidiary?               Yes       No If yes, by whom?
    b) If yes, what other subsidiaries are owned by the parent firm?
    c) Does your company own any subsidiaries?                 Yes       No If yes, name:
4. Does the company (subsidiaries and/or parent) supply materials or equipment to Qwest?                      Yes*        No
    If yes, what type?
5. Is your company registered as a minority, woman, disabled veteran owned business?                          Yes*        No
            A list of national and state agencies is provided in Attachment B.
6. Has your company been sited for OSHA violations?                                                           Yes*        No
7. Does your company report to Dun and Bradstreet?                                                            Yes         No
    If yes, what is the file number?
8. Does your company (subsidiaries and/or parent) have outstanding claims with Qwest
    Corporation, f/k/a U S WEST Communications, Inc.?                                                         Yes         No
    If yes, name state(s) and explain:
9. Our general contract contains an "on call" provision. You may be required to perform work
    within 24 hours of notification. Are you available, willing and able to perform the
    required work under this type of contract?                                                                Yes         No
10. Number of full-time employees:
11. Are your employees affiliated with a union(s)?                                                            Yes         No
    If yes, list the union(s):
1. In what areas of Qwest are you interested in bidding on projects (please choose only the ones that apply). This packet
    deals ONLY with the states listed below:


         Arizona**               Iowa**                  Nebraska                     Oregon**                  Washington**
         Colorado                Minnesota               New Mexico**                 So. Dakota                Wyoming
         Idaho                   Montana**               No. Dakota**                 Utah



* Documentation is required. See page 3, Required Documents
** These states require contractor and/or business licenses in order to work. See Attachment A, Contractor Licensing for additional
information. Copies will be required. Also see page 3, Required Documents


OSP Construction
Qwest Local Network Questionnaire for
OUTSIDE PLANT Contractors



                                                         Work Activities
The following is a list of construction and engineering functions and other types of work that are currently being performed by
contractors for Qwest. Please mark the box next to the activity you have performed, thus verifying that you are experienced
and proficient in all necessary methods and procedures to carry out the work with the proper equipment.

 Qualified?        Category                  Function                                          Work Activities
 Yes      No
                 Broadband          Broadband                    Engineering studies, construction system input module, splicing coaxial
                                                                 cable, test and turn up, loop electronic (LEIM), pole test and treatment


                 Cable Locating     Locating                     In association with construction work, in association with cable repair
                 Cable Repair       Excavation and Restoration   General
                                    Repair and Maintenance       Cable
                 Construction       Cable Placement              Aerial, buried trench, buried plow, in conduit, lowering cable
                                    Drop Wire Placement          Aerial, buried trench, buried plow
                                    Conduit Placement            Conduit construction, lowering and maintenance, precast manholes, cast-
                                                                 in-place manholes, general evacuation, augering and jacking (1" - 10")
                                    Boring                       Small - less than 24", Large – greater than 24"
                                    Pole / Anchor Placement      Company, joint use, open wire rehabilitation
                                    Manhole Placement            Buried, underground blasting Aerial, buried, underground, contract work
                                                                 inspection, core drilling (manhole, or vault wall)
                 Maintenance        Cutting and Restoration      Asphalt, concrete
                                    Sprinkler Repair             Make ready aerial rearrangement
                                    CATV
                                    Air Pressurization
                 Engineering        Planning                     Long range OSP Planning (LROPP), Facilities Analysis Plan (FAP)
                                    Feeder Administration        Documentation, data gathering, route layout preparation and maintenance,
                                                                 pair group display
                                    Design Engineering           Conduit, underground cable, buried cable, aerial cable and plan, subscriber
                                                                 loop electronics (SLE), Trunk and Toll (T-Carrier), detailed distribution area
                                                                 plan (DDAP), outside plant records, mapping (aerial photography), general
                                                                 drafting, manhole detailing
                                    Assignment                   Assignment records, rural addressing
                 Installation       Installation (Hookup)        Inside wire (all types), cable television, on line – internet, telephone


                                    Equipment Installation       CO power systems, CO switch, CO common systems
                 Other              Other                        Plumbing, electrical, consultant, environmental impact, potholing,
                                                                 compaction testing, fiber optic, Construction and engineering, submarine
                                                                 cable placement, painting telephone plant, mobile unit repair radio/beeper),
                                                                 staking, computer aid design, saw cutting/concrete, rail plowing, bridge
                                                                 attachment, manhole cleaning, asbestos removal
                 Traffic Controls   Barricades                   Traffic control/barricades
                 Right of Way       Specialized Eng. Support     Surveying and Right of Way, Archeological Study


                 Restoration        Restoration                  Includes Paving, General Landscape, and Tree Trimming


                 Directional        Boring                       AIR/VAC/ directional boring
                 Boring




OSP Construction
Qwest Local Network Questionnaire for
OUTSIDE PLANT Contractors




OSP Construction
Qwest Local Network Questionnaire for
OUTSIDE PLANT Contractors




                                                  References
Please provide three letters of references from three different companies for which current and/or previous work
has been performed during the last two years. The letters should include responses to the following questions:


                                 Question                                                    Response
What type of work did the contractor do for you?
How long has this contractor been doing business with you?
What is the quality of their work?
Was the work completed as per specifications?
How was the clean-up, if any?
Were there any complaints from your people or the public?
Did the contractor perform the work in a proper, safe, and secure manner?
Did the contractor meet deadlines?
What is the condition of their equipment?
Would you hire this contractor again?
Other comments:

For verification purposes, list the contact information of the persons providing letters of references and contract
amounts.


         Company Name                         Reference Name               Telephone Number         Contract Amount
                                                                                                   $
                                                                                                   $
                                                                                                   $


If your company is interested in becoming registered for directional boring, please provide one additional letter
of reference from a company you have performed a cumulative minimum of five miles (26400 linear feet) of
directional boring activity. The letter should include responses to the questions listed above and the additional
questions below:


                                 Question                                                    Response
What was the length of the bore?
What was the soil type(s)?

For verification purposes, list the contact information of the person providing the letter of reference and contract
amount.

         Company Name                         Reference Name               Telephone Number         Contract Amount

                                                                                                   $




OSP Construction
Qwest Local Network Questionnaire for
OUTSIDE PLANT Contractors




                                       Required Documents

Provide the documentation listed below with your registration packet. Please do not send original
documents or certificates (documentation will not be returned). Incomplete applications will delay and
may prevent processing.


1. Company Formation              ARTICLES OF ORGANIZATION or ARTICLES OF INCORPORATION

2. MWDVBE Certification           This is certificate/license is only required if you checked the box on Page 1
                                  called "Minority Women/Disabled Veteran Business Enterprise". A list of
                                  qualifying agencies is provided in Attachment B.

3. OSHA Violation                 Records are required if you checked the box on Page 1 called "6. Has your
                                  company been sited for OSHA violations?”

4. Brief History of your          Please provide a paragraph describing the history of your company. You
Company                           may substitute the typed paragraph with a brochure or flyer.

5. Equipment List                 Please supply a list of all applicable equipment for the activities desired.
                                  This list should include excavation and/or trenching equipment as well as
                                  equipment applicable to the Engineering activities. You may supply other
                                  data if you desire.

6. State Licenses                 The following states require registration. If you desire to work in one or more
                                  of these states, copies of the certificates must be provided. Your company
                                  will not be registered in these states without this information!

                                  Arizona, Iowa, Montana, New Mexico, North Dakota, Oregon,
                                  Washington

                                  Please refer to Attachment B for information on state licensing departments

7. Proof of Insurance             If awarded a Contract, Qwest requires contractors to provide sufficient types
                                  and amounts of insurance to protect both the Contractor and Qwest from any
                                  and all claims and suits for personal injury and property damage. Please
                                  have your carrier provide a Certificate of Insurance (ACORD form).
                                  Contractors applying for registration need not carry this limit, only provide
                                  proof that you can obtain this limit of insurance (i.e., letter from insurance
                                  carrier). Enclose a copy of the current insurance certificate for your
                                  company. Your application will not be processed without this information.

                                  Note: General contracts awarded in large metropolitan areas may require higher
                                  limits

8. Balance Sheet and Income       Please provide copies of an independently audited Income Statement and
Statement                         Balance Sheet for the most recent fiscal year. Your application will not be
                                  processed without this information.

9. Letters of Reference           Please provide 3 letters of reference (4, if directional bore).


OSP Construction
Qwest Local Network Questionnaire for
OUTSIDE PLANT Contractors




                                                   Sign Off

   The matters set forth in the foregoing are true and correct to the best of my knowledge. Permission
is hereby granted to Qwest Corporation, its employees and agents to make inquiries regarding the
foregoing matters and all matters relevant thereto. If Qwest offers a contract to the Contractor and later
determines that any statement or information provided by Contractor under this application, or in any
subsequent information provided to Qwest by the Company is untrue, Qwest may revoke such offer, or
if a Contract has been executed by Qwest and the Contractor, Qwest shall have the right to cancel
such contract, pursuant to the terms therein.

Failure to complete any questions pertinent to your firm may result in disqualification from placement on
Qwest's Contractor Bid List.




                Company:
                Signature:
                Title:
                Date:

                Seal (if a corp.):




This questionnaire, along with all supporting information, should be sent to Qwest at this address:

                Qwest Corporation
                Contract Administration / Registration
                700 W. Mineral, NE J30.1
                Littleton, CO 80120

Do not send registered mail.




OSP Construction
Qwest Local Network Questionnaire for
OUTSIDE PLANT Contractors




                                 Attachment A - Contractor Licensing
The following states require contractor's licensing:
         If your company desires work in any of these states, licensing is required upon application.

ARIZONA                                                               NORTH DAKOTA
Arizona Register of Contractors                                       Secretary of States Office
800 West Washington Street, 6th Floor                                 600 E. Boulevard Avenue
Phoenix, AZ 85007                                                     Bismarck, ND 58505-0500

Phone: 602-542-1525                                                   Phone: 701-328-3665

IOWA                                                                  OREGON
Licensing and Registration                                            Business Info. Center
1000 E. Grand Avenue                                                  Public Service Bldg, Ste 151
Des Moines, IA 50319-0209                                             255 Capitol Street NE
                                                                      Salem, OR 97310-1327
Phone: 515-242-5871
                                                                      Phone: 503-731-4073

MONTANA                                                                      WASHINGTON
                                                                      WASHINGTON
One-Stop Licensing Office                                             Master License Services
c/o Montana Dept of Revenue                                                      P.O. Box Bldg P.O. Box 9034
                                                                      405 Black Lake Blvd,8003 #2
Helena, MT 59604                                                      Olympia, WA 98507-9034
                                                                      Phone: 360-664-1400
Phone: 406-444-7734

NEW MEXICO
Construction Industries Division
Regulation and Licensing Dept.
725 St. Michael's Drive
Santa Fe, NM 87505

Phone: 505-827-7030


Notes: Engineering consultants are not required to be licensed as a contractor, however, may be required to
obtain business registration or business licensing. Right-of-Way companies are not required to be licensed as a
contractor, however, may be required to obtain business registration or business licensing. Check with individual
cities and counties where work is desired for city and county requirements.




OSP Construction
       Qwest Local Network Questionnaire for
       OUTSIDE PLANT Contractors




                                      Attachment B - MWDVBE Certification
       This list contains agencies approved by Qwest for MWDVBE certification. Qwest prefers Minority Business Enterprise (MBE)
       certifications for affiliates of the National Minority Suppliers Development Council (NMSDC)* and Women's Business
       Enterprise (WBE) certifications from affiliates of the Women's Business Enterprise National Council (WBENC)** and Disabled
       Veteran Enterprise certifications from the Association of Disabled Veterans listed below.

       Qwest accepts pre-existing certification from other agencies provided they are in keeping with Qwest's definition of Minority-
       Owned Business and Woman-Owned Business and Disabled Veteran-Owned Business. Please understand that Qwest does
       not accept self-certification as a valid MWDVBE certification.


National           National Minority Supplier Development Council (HQ)           Office of Small Business Certification & Resources
                   Phone: 202-944-2430                                           Phone: 916-322-5060

                   Women's Business Enterprise National Council (HQ)             National Assoc. of Women Bus. Owners (NAWBO)
                   Phone: 202-872-5515                                           Phone: 561-848-5066

                   Assoc. for Disabled Veterans                                  Small Business Administration SBA 8(a) Program
                   Phone: 202-543-1942                                           Phone: 303-844-0500

Alabama            South Region Minority Business Council                Nebraska          Great Plains Minority Supplier Dev. Council
                   Phone: 334-471-6380                                                     Phone: 402-346-5000
Arizona            Grand Canyon Minority Supplier Dev. Council           Nevada            Nevada Minority Purchasing Council, Inc.
                   Phone: 602-495-9950                                                     Phone: 415-894-0022
Arkansas           AK Regional Minority Supplier Dev. Council            New Mexico        Rocky Mt. Minority Supplier Dev. Council
                   Phone: 501-374-7026                                                     Phone: 303-623-3037
California         CA Regional Purchasing Council                        New York          NY/NJ Minority Purchasing Council
                   Phone: 213-380-7114                                                     Phone: 202-582-2334
                   No. CA Supplier Development Council                   North             Carolinas Minority Dev. Council, Inc.
                   Phone: 415-894-0022                                   Carolina          Phone: 704-536-2884
Colorado           Rocky Mt. Minority Supplier Dev. Council              Ohio              Cincinnati Minority Supplier Dev. Council
                   Phone: 303-623-3037                                                     Phone: 513-579-3137
Connecticut        Connecticut Minority Supplier Dev. Council                              Cleveland Regional Minority Purchasing
                   Phone: 203-787-3993                                                     Council
                                                                                           Phone: 216-621-3300
DC                 Natl. Minority Supplier Dev. Council                                    Columbus Regional Minority Purchasing
                   Phone: 212-944-2430                                                     Council
                                                                                           Phone: 614-225-6959
Florida            NMSDC of Florida, Inc. Orlando                                          Greater Dayton Minority Purchasing Council
                   Phone: 407-859-3901                                                     Phone: 937-226-8265
Georgia            Georgia Minority Supplier Dev. Council                Oklahoma          OK Minority Supplier Dev. Council
                   Phone: 404-589-4929                                                     Phone: 405-528-6732
Idaho              NW Minority Supplier Dev. Council                     Oregon            NW Minority Supplier Dev. Council
                   Phone: 206-441-9558                                                     Phone: 206-441-9558
Illinois           Chicago Minority Business Dev. Council                Pennsylvania      Pittsburgh Regional Minority Purchasing
                   Phone: 312-263-0105                                                     Council
                                                                                           Phone: 412-391-4423
Indiana            IN Regional Minority Supplier Dev. Council            So. Carolina      Carolinas Minority Development Council, Inc.
                   Phone: 317-923-2110                                                     Phone: 704-536-2884
Iowa               Wisconsin Supplier Dev. Council                       So. Dakota        Minnesota Economic Development Assoc.
                   Phone: 608-241-5858                                                     (MEDA)
                                                                                           Phone: 612-332-6332
Kentucky           Kentucky Minority Supplier Dev. Council               Tennessee         Tennessee Minority Purchasing Council
                   Phone: 502-625-0135                                                     Phone: 615-259-4699
Louisiana          Gulf South Minority Supplier Dev. Council, Inc.       Texas             South Texas Minority Business Council


       OSP Construction
     Qwest Local Network Questionnaire for
     OUTSIDE PLANT Contractors



                Phone: 504-523-7110                                          Phone: 512-472-8048
Maryland        MD/DC Minority Supplier Dev. Council                         Dallas/Ft. Worth Minority Business Dev. Council
                Phone: 410-997-7599                                          Phone: 214-630-0747
Massachusetts   New England Minority Purchasing Council                      Houston Minority Business Council
                Phone: 617-578-8900                                          Phone: 713-271-7805
Michigan        Michigan Minority Business Dev. Council         Utah         Rocky Mountain Minority Supplier Dev.
                Phone: 313-873-3200                                          Phone: 303-623-3037
Minnesota       Minnesota Economic Dev. Assoc. (MEDA)           Virginia     Tidewater Regional Minority Purchasing Council
                Phone: 612-332-6332                                          Phone: 757-62-8471
                Women's Business Educational Consortium, Inc.                Virginia Regional Minority Supplier Dev. Council
                Phone: 414-466-2911                                          Phone: 804-780-2322
Missouri        Minority Supplier Council                       Washington   NW Minority Supplier Development Council
                Phone: 816-931-9672                                          Phone: 206-441-9558
                St. Louis Minority Business Council             Wisconsin    Wisconsin Supplier Development Council
                Phone: 314-241-1143                                          Phone: 608-241-5858
Montana         NW Minority Supplier Dev. Council               Wyoming      Rocky Mountain Minority Supplier Dev. Council
                Phone: 206-441-9558                                          Phone: 303-623-3037




     OSP Construction

								
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