Subcontractor Prequalification

Georgia Green Energy Services

4040 Shirley Drive SW
Atlanta, GA 30336

404.334.3323

For any additional questions, please email us at

vendors@gagreenenergysvc.com

Contact Person for Clarification

Phone

Date of Response

CONTACT INFORMATION

Contractor Name

Telephone No.

Fax No.

Street Address

City

State

Zip Code

Web Address

Principal Name

Phone

CFO Name

Phone

Lead Estimator Name

Phone

Under current management since(Date)

ESTIMATING CONTACT FOR INVITATIONS TO BID

Name

Title

Email Address

BUSINESS TYPE

Check One:

Sole OwnerPartnershipCorporationLLC

State(s) of Electrical License

Date of Registration

Years in Business

Other name(s)your company has operated under

Parent Company Name

Parent Company Information(if Applicable)

Telephone No.

Street Address

City

State

Zip Code

PERSONNEL AND MANAGEMENT TEAM

Administration

Project Executive

Field Supervisor

Accounts Payable

Others

KEY PERSONNEL (CONSTRUCTION, ESTIMATING, SAFETY, ACCOUNTING)

1 Name

Position

Years with Company

Total Years of Relevant Experience

Construction Experience

2 Name

Position

Years with Company

Total Years of Relevant Experience

Construction Experience

3 Name

Position

Years with Company

Total Years of Relevant Experience

Construction Experience

4 Name

Position

Years with Company

Total Years of Relevant Experience

Construction Experience

DIVERSITY STATUS INFORMATION

If so, where is your company registered?

City

State

DIVERSITY, EQUITY, INCLUSION

Does your company have a D.E.I. Action Plan?

YESNO

Does your company include training/orientation on sexual harassment in the workplace?

YesNo

If yes, briefly explain

UNION AFFILIATIONS

List any labor organizations which your company may have an agreement with:

Labor Number	Union Name	Agreement Expiration
			×

(1)

TYPE OF WORK PERFORMED (TRADES)

Indicate types of work performed through direct hire and types subcontracted.

Types of work (Trade)	% Self Perform	% Subcontracted
			×

(1)

RELEVANT EXPERIENCE/ REFERENCES

List three (3) most recently completed contracts.

Client Name

Address

Contact Person

Phone No.

Type of Work

Date Completed

Client Name

Address

Contact Person

Phone No.

Type of Contract

Type of Work

Date Completed

Client Name

Address

Contact Person

Phone No.

Type of Contract

Type of Work

Date Completed

GEOGRAPHIC AREA

List the geographic areas in which you work:

COMPETITIVE MARKET

Indicate the size of project in which you are most competitive. Show in preference order (i.e. 1, 2,3,4...)

Under $100,000

$100,000 - $250,000 $250,000 - $500,000 $500,000 - $1 Million 1 Greater than $1 Million

MARKET EXPERIENCE

Please Check Type of Work that you can Perform

Please List EVSE Related Projects that your Firm has completed in the past 5 Years

Amount ($)

Year Completed

Project Name

Scope of Work

What is your annual volume this year From EV related projects

Amount ($)

No. of Projects

FINANCIAL INFORMATION

Annual Dollar Volume for the Past 3 Years (If Applicable - Estimation is OK)

20 --------------------- 20 --------------------- 20 $ --------------------- 

Largest Job During:

The last 3 years $:

Total Work in Progress Currently

(i.e. Current Contract Value) $

Bank References

Bank Name

Bank Address

Contact Person

Contact Person Phone No.

Amount of Bank Line Credit ($) Secured

N/AYesNo

Surety and Insurance

Bonding References

Name

Address

Contact Person

Phone No.

Total Bonding Capacity ($)

Maximum Single Project Bonding Capacity ($)