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SUBCONTRACTOR_VENDOR PRE-QUALIFICATION STATEMENT

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					                                                      Renewal Date:

                                                      Sent By:
                                                                                                                         §
                               SUBCONTRACTOR
          PRE-QUALIFICATION RENEWAL STATEMENT
 Overview: Your pre-qualification has expired, or is about to expire. SubQual, LLC provides prequalification services on
 subcontractors that wish to be included in the bid list of the following general contractors, Sundt Construction, Inc.
 and Summit Builders. It is the policy of these general contractors to prequalify the subcontractors prior to bidding on
 any of their projects. From the information provided, each general contractor will independently establish their
 maximum per project contract limit for subcontractors. Establishment of this maximum subcontract value is a
 requirement of the subcontractor default insurance carrier of these general contractors. (Subcontractor default
 insurance is provided in-lieu of a bond on the subcontractor.). Your prequalification status must be updated annually.
Questions can be directed to our Pre-qualification Department at (800) 407-6192 or E-Mail to prequal@subqual-llc.com.
This statement can be downloaded as a Word document or prepared and submitted on-line in our Subcontractor Portal at
www.subqual-llc.com.

  Please complete as it appears on your State Contractor’s License:
  Legal Name of Firm:

  DBA:

  Address:



                     (city, state, zip)
  State:           License No:                            Class(es):                                  Expiration:
  State:           License No:                            Class(es):                                  Expiration:
  State:           License No:                            Class(es):                                  Expiration:
  State:           License No:                            Class(es):                                  Expiration:

Shipping Address:

           (city, state, zip)
Mailing Address:

           (city, state, zip)
Phone:                                                        Fax:
Web Address :

Provide names and titles of your firm’s principal contacts:
PRINCIPAL CONTACT:                                                                 TITLE:
Phone:                                                        Fax:
E-Mail:

ESTIMATING CONTACT:                                                                TITLE:
Phone:                                                        Fax:
E-Mail:


SubQual, LLC                         Subcontractor Prequalification RENEWAL Web Form, rev. 12/09/09                 Page 1 of 5
INDICATE THE AREA(S) THAT YOU PREFER TO WORK IN:

Northern Arizona (including Phoenix and Casa Grande metro areas)
Southern Arizona (including Tucson and Yuma metro areas)
Northern California (including Sacramento metro areas)
Southern California (including Los Angeles and San Diego metro areas)
Nevada (including Reno metro areas)
Federal Work – list states              ______________________________________________________________
List CSI Divisions/Trades (see page 5):
Are you willing to bid on prevailing wage projects?                   Yes          No
For Arizona subcontractors only, please answer the following two questions:
Do you comply with all federal immigration laws per A.R.S. 41-4401?                           Yes      No
Do you use the E- Verify program (A.R.S. 23-214, subsec. A)?                         Yes          No

Your Company’s Minority Status:
Please check all that may apply and provide proof of certifications*:
County, City, State and Transportation Departments:
      DBE ................... Disadvantaged Business Enterprise*
      DVBE……………Disabled Veterans Business Enterprise*
      MBE ................... Minority Business Enterprise*
      SBE ................... Small Business Enterprise*
      WBE .................. Woman Business Enterprise*
Federal Contracts (DoD) / Small Business Administration:
(Small Disadvantaged Businesses and HubZone Businesses must be certified by the SBA and registered in the CCR /Pro-Net system. For
more information visit www.ccr.gov)
      HBCU/MI .......... Historically Black Colleges Universities/ Minority Institutions*
      HUBZone-SB..... Historically Underutilized Business Zone*
      LB ...................... Large Business
      SB ...................... Small Business*
      SBA 8(a) ............ Small Business Administration 8(a)*
      SDB ................... Small Disadvantaged Business*
      SD-VOSB .......... Service Disabled Veteran Owned Small Business*
      VOSB ................ Veteran Owned Small Business*
      WOSB ............... Women Owned Small Business*
Minority Ownership
      Native American (includes American Indian, Eskimo, Aleut & Native Hawaiian)
      ANC-LB…………Alaskan Native Corporation and Indian Tribes – Large Business
      ANC………...…..Alaskan Native Corporation and Indian Tribes


SubQual, LLC                          Subcontractor Prequalification RENEWAL Web Form, rev. 12/09/09                   Page 2 of 5
                    Annual                Largest Single                                General
    Year            Sales                 Contract Value                               Contractor
    2009       $                      $



Safety: Experience Modification Rate for 2009
Federal Tax ID:
Dunn & Bradstreet Number:

Current Bonding and Banking Information:
Surety Company:                                       Broker:
Contact Person:                                       Phone:

Name of your bank:
Address:
Contact Person:                                Phone:
Line of credit: $                 Unused portion: $                               Expiration date:



        IN ORDER TO BE PRE-QUALIFIED FOR MORE THAN $50,000, THE
               FOLLOWING MUST BE PROVIDED ANNUALLY:

        A letter from your Surety outlining the single project and aggregate amounts
         they will issue a performance and payment bond for (we are not asking for a
         bond).

        A copy of your latest (consolidated) financial statements, i.e., Balance Sheet,
         Income Statement, etc., prepared by an outside accounting firm (Audited,
         Reviewed or Compiled Financial Statements) AND a copy of your most recent
         internal financial statements.




SubQual, LLC                 Subcontractor Prequalification RENEWAL Web Form, rev. 12/09/09          Page 3 of 5
     Please be assured that your financial information will be kept confidential in
      accordance with our Subcontractor Portal Privacy Statement. For more
      information visit www.subqual-llc.com and select Subcontractor Portal.

     Your pre-qualification status cannot be renewed until the pre-qualification
      statement is accurately completed, a letter from your surety is received and the
      necessary financial statements are provided.


By signing the SubQual, LLC Subcontractor Pre-Qualification Statement
(“Statement”) you authorize the release of the submitted information as set forth in the
Statement to Sundt Construction, Inc. (“Sundt”) and Summit Builders (“Summit”). This
information will be used by Sundt and Summit to independently establish their maximum per
project contract limit for your company. Please note, the actual financial statements you
provide to SubQual are kept confidential and are not open to the GC’s or any other party
unless SubQual receives written permission from an officer of your company.

    Completed by:

    Title:

    Phone number:

    Email:

    Date:


If for any reason you do not wish to remain on our bid list, please provide a brief
explanation below. Thank you.

Explanation for removal from bid list:




Submit to:
SubQual, LLC
Attn: Pre-Qualification Department
P.O. Box 80577
San Diego, CA 92138

Or by Confidential Fax: (800) 407-6194
Or by Confidential E-mail: prequal@subqual-llc.com


SubQual, LLC             Subcontractor Prequalification RENEWAL Web Form, rev. 12/09/09   Page 4 of 5
                                                CSI Divisions/Trades:
                        (Please circle or check the trade(s)that your company is interested in bidding)
1000          General Conditions                    5810         Expansion Joint Covers                11130    Audio-Visual Equipment
1140          Survey & Layout                       6110         Wood Framing                          11150    Parking Control Equipment
1400          Material Testing                      6250         Prefinished Paneling / FRP            11160    Loading Dock Equipment
1430          Security Guard Firms                  6400         Architectural Woodwork                11170    Solid Waste Handling Equipment
1435          Chemical Toilets                      6415         Countertops                           11190    Detention Equipment
1440          Cleaning Services                     6500         Structural Plastics                   11200    Water Treatment Equipment
1480          Jobsite Trailers                      6600         Plastic Fabrications                  11210    Supply/Treatment Pumps
1530          Temporary Fencing                     7100         Dampproofing/Waterproofing            11220    Mixers And Flocculators
2110          Excav., Removal, Haz. Matl            7160         Cementitious & Reactive W.P.          11225    Clarifiers
2115          U.G Storage Tank Removal              7170         Bentonite Waterproofing               11230    Water Aeration Equipment
2145          Groundwater Treatment Sys.            7180         Traffic Coatings                      11240    Chemical Feed Equipment
2210          Subsurface Investigation              7210         Building Insulation                   11250    Water Softening Equipment
2220          Demolition                            7240         Exterior Insul. Finish Syst.          11260    Disinfectant Feed Equipment
2250          Shoring And Underpinning              7410         Metal Roof And Wall Panels            11270    Fluoridation Equipment
2300          Earthwork                             7510         Built-Up Bituminous Roofing           11285    Hydraulic Gates
2310          Asphalt Paving                        7570         Coated Foamed Roofing                 11295    Hydraulic Valves
2360          Soil Treatment / Termite Cntrl        7620         Sheet Metal Flashing/Trim             11300    Waste Treatment/Disposal Equip.
2455          Driven Piles                          7720         Roof Accessories                      11310    Sewage And Sludge Pumps
2475          Caissons                              7810         Applied Fireproofing                  11320    Grit Collecting Equipment
2500          Site Utilities                        7920         Joint Sealants                        11330    Screening/Grinding Equipment
2620          Drywells                              8110         Steel Doors And Frames                11335    Sedimentation Tank Equipment
2632          Storm Drainage                        8210         Wood Doors                            11340    Scum Removal Equipment
2660          Ponds And Reservoirs                  8300         Specialty Doors / Won Doors           11345    Chemical Equipment
2770          Curbs And Gutters                     8320         Detention Doors And Frames            11350    Sludge Hand./Treatment Equip.
2780          Unit Pavers                           8360         Overhead Doors                        11360    Filter Press Equipment
2790          Athletic/Recreation Surfaces          8460         Automatic Entrance Doors              11365    Trickling Filter Equipment
2815          Fountains                             8500         Windows                               11370    Compressors
2820          Fences And Gates                      8600         Skylights                             11375    Aeration Equipment
2830          Retaining Walls                       8700         Hardware                              11380    Sludge Digestion Equipment
2840          Striping                              8800         Glazing                               11385    Digester Mixing Equipment
2870          Site Furnishings                      8950         Translucent Wall/Roof Assem.          11390    Pkg. Sewage Treatment Plants
2890          Traffic Signs And Signals             9210         Cement Plaster                        11400    Food Service Equipment
2895          Markers And Monuments                 9250         Gypsum Board                          11600    Laboratory Equipment
2900          Planting, Landscape & Irrig.          9310         Ceramic Tile                          12310    Manufactured Metal Casework
2905          Native Plant Salvage                  9400         Terrazzo                              12320    Manufactured Wood Casework
3150          Concrete Accessories                  9510         Acoustical Ceilings                   12490    Window Treatments
3200          Concrete Reinforcement                9650         Resilient Flooring                    12600    Systems Furniture
3300          Cast-In-Place Concrete                9670         Fluid Applied Flooring                13110    Cathodic Protection
3400          Pre-Cast Concrete                     9680         Carpet                                13120    Pre-Engineered Structures
3520          L.W. Conc. Roof Insulation            9900         Paints And Coatings                   13150    Swimming Pools
3530          Gypsum Concrete                      10115         Markerboards                          13200    Storage Tanks
4000          Masonry                              10160         Metal Toilet Compartments             13230    Digester Covers/Appurtenances
4400          Stone                                10200         Louvers And Vents                     13280    Hazardous Material Remediation
4720          Cast Stone                           10260         Wall And Corner Guards                13400    Measurement/Control Instrument
4910          Unit Masonry Restoration             10270         Access Flooring                       13700    Security Access/Surveillance
5120          Structural Steel                     10300         Fireplaces And Stoves                 14200    Elevators
5140          Structural Aluminum                  10350         Flagpoles                             14300    Escalators And Moving Walks
5150          Wire Rope Assemblies                 10400         Identification Devices                14550    Conveyors
5200          Metal Joists                         10430         Exterior Signage                      14600    Hoists And Cranes
5300          Metal Deck                           10500         Lockers                               15300    Fire Protection Piping
5330          Aluminum Deck                        10520         Fire Protection Specialties           15400    Plumbing Fixtures/Equipment
5510          Metal Stairs And Ladders             10550         Postal Specialties                    15700    Heating, Ventilating, A/C Equip.
5520          Handrails And Railings               10605         Wire Mesh Partitions                  15935    Building Systems Controls
5530          Gratings                             10650         Operable Partitions                   16000    Electrical
5560          Metal Castings                       10705         Exterior Sun Control Devices          16700    Communications
5650          Railroad Track/Accessories           10800         Toilet, Bath, Laundry Access.
5700          Ornamental Metal                     10880         Scales




       SubQual, LLC                            Subcontractor Prequalification RENEWAL Web Form, rev. 12/09/09                      Page 5 of 5

				
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