Subcontractor Application - Catalyst Construction

Company Details

Company Name

Street Address

Street Address Address Line 2 City State ZIP Code

Do you have a different mailing address?

Yes

Mailing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Estimator Contact Name

First Last

Phone

Fax Number

Email Address:

Years in business under contact name:

Previous business name or employment if less than 5 years:

Employee ID number:

Company Type:(Required)

Corporation

DBA

Partnership

Joint Venture

LLC

Sole Proprietor

Individual

Union Affiliation(Required)

Union

Non-Union

Minority Business Enterprise status (if applicable):

MBE

WBE

DBE

SBE

MBE Status Certification:

Max. file size: 400 MB.

Estimated current gross annual revenue:(Required)

Total Number of Current Office Personnel(Required)

Total Number of Current Field Supervisors(Required)

Total Number of Current General Field Labor(Required)

Job Preferences + CSI Divisions

Preferred subcontract amount (check all that apply) *(Required)

$5-50k

$51-100k

$101-300k

$301-700k

$700k and Up

Preferred work radius from your company office:(Required)

CSI divisions (check all that apply):(Required)

02- Demolition

03- Concrete

04- Masonry

05- Metals

06- Wood, Plastics, Composites (carpentry, casework, millwork, etc.)

07- Thermal & Moisture Protection

08- Openings (windows, doors, etc.)

09- Finishes (metal studs, drywall, painting, flooring, etc.)

10- Specialties (hardware, bathroom partitions, etc.)

11- Equipment

12- Furnishings

13- Special Construction (PEMB suppliers, pools, etc.)

14- Conveying Equipment

21- Fire Suppression

22- Plumbing

23- HVAC

25- Integrated Automation

26- Electrical

27- Communications

28- Electronic Safety & Security

31- Earthwork

32- Exterior Improvements (paving, fencing, landscaping, etc.)

33- Utilities

Brief description of work performed (i.e. Hard Tile, Carpeting, & Wall Base.)(Required)

Contractor License Numbers

State

License Number:

Company's Principals:

Name:

Title:

Surety Information (if applicable):

Current Surety Company:

Broker Agent Name:

Phone Number:

Bond Rates:

Single Project Bonding Capacity:

Aggregate Bonding Capacity:

Safety Information:

Company Safety Officer:

Title:

Phone

Total Full-time Employees:

Total Part-time Employees

2021 OSHA 300 Information:

Number of Lost Time Incidents/Illnesses :(Required)

Number of recordable injury cases:(Required)

Number of Days Away from Work:(Required)

Number of Fatalities:(Required)

Total Employee Hours Worked:(Required)

2020 OSHA 300 Information:

Number of recordable injury cases:(Required)

Number of Lost Time Incidents/Illnesses :(Required)

Number of Days Away from Work:(Required)

Number of Fatalities:(Required)

Total Employee Hours Worked:(Required)

OSHA Citations

Number of recordable injury cases:(Required)

Number of Lost Time Incidents/Illnesses :(Required)

Number of Days Away from Work:(Required)

Number of Fatalities:(Required)

Total Employee Hours Worked:(Required)

2019 OSHA 300 Information:

Has your company received any OSHA citations in the last 3 years:(Required)

Yes

If yes, please provide: date of violation, violation type, and what has been done to prevent similar violations:

Safety Goals and Objectives

Do you have corporate safety goals and objectives?(Required)

Yes

Do you have a written safety and health program/manual?(Required)

Yes

Please attach copy of safety plan:

Max. file size: 400 MB.

Do your supervisors hold regular safety meetings?

Yes

How Often?

Do you have a competent person perform regular field safety inspections?

Yes

Who conducts the inspections?

Are inspection reports generated and documented?

Yes

Who receives copies of the reports?

Safety Training

Do you have documented pre-job or new employee occupational safety & health orientation program?

Yes

Who conducts the training?

Does you company hold regularly scheduled safety meetings for employees?

Yes

How often?

Drug Free Workplace

Does your company have a Drug Free Workplace Program?

Yes

Does your program include the following testing? (check box for each)

Pre-employment

Random

Post Incident

Reasonable Suspicion

Injury Incident Investigation

Does your company conduct injury, incidents, and near-miss investigations?

Yes

Who conducts the investigations? (name, title)

Litigation Information

Any active litigation with owners/ GCs?

Yes

Please explain:

In the past five (5) years, has your company been involved with any of the following:

Any judgements against you?

Yes

Please Explain:

Has your company ever been assessed liquidated damages?

Yes

Please Explain:

Any labor law violations?

Yes

Please Explain:

Have you ever defaulted or failed to complete a contract?

Yes

Please Explain:

Have you ever been terminated from a contract?

Yes

Please Explain:

Have you ever had your contractor license(s) revoked or suspended?

Yes

Please Explain:

Please list 5 significant projects within the last 3 years:

Project Name:

Contract Amount:

Scope of Work:

Year Completed:

General Contractor:

Project Name:

Contract Amount:

Scope of Work:

Year Completed:

General Contractor:

Project Name:

Contract Amount:

Scope of Work:

Year Completed:

General Contractor:

Project Name:

Contract Amount:

Scope of Work:

Year Completed:

General Contractor:

Project Name:

Contract Amount:

Scope of Work:

Year Completed:

General Contractor:

Insurance Information

Please review the Catalyst Construction Inc. (CCI) subcontractor insurance requirements below.

View/Download Subcontractor Insurance Requirements (PDF)

We have reviewed the attached documents and we fully meet the CCI insurance requirements:

Yes

Please indicate which requirements you do NOT meet:

Additional Information

Please attach addition information or documentation which you believe would be important for us to review during our pre-qualification process:

Drop files here or

Max. file size: 400 MB.

Subcontractor Pre-Qualification

Company Details

Job Preferences + CSI Divisions

Company's Principals:

Surety Information (if applicable):

Safety Information:

2021 OSHA 300 Information:

2020 OSHA 300 Information:

OSHA Citations

2019 OSHA 300 Information:

Safety Goals and Objectives

Safety Training

Drug Free Workplace

Injury Incident Investigation

Litigation Information

In the past five (5) years, has your company been involved with any of the following:

Please list 5 significant projects within the last 3 years:

Insurance Information

Additional Information

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