Subcontractor Qualifications - Chervenell Construction

General Company Information

Interested in becoming a subcontractor or supplier with Chervenell Construction? We are committed to building strong partnerships with qualified subcontractors who share our dedication to safety, quality, and integrity. This Subcontractor Qualifications Form is designed to help us better understand your company’s experience, capabilities, and commitment to excellence. The information you provide will assist us in evaluating your firm for potential opportunities and ensuring that our projects are supported by reliable, skilled, and safety-conscious trade partners.

We appreciate your time and effort in completing this form, and we look forward to the possibility of working together to deliver exceptional results for our clients and communities.

Company Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Fax

Email

Website URL

Year Business Started

Estimating Contact

First Name

Last Name

Estimating Contact Email

Estimating Contact Phone

Ext.

Contact Signer

First Name

Last Name

Contract Signer Email

Contract Signer Phone

Ext.

A/P Contact

First Name

Last Name

A/P Email

A/P Phone

Ext.

Company Details

Union Signature

Yes

No

Contractor Type

Subcontractor

Vendor/Supplier

Vendor's License(s) (use the + Add button to include additional entries. You can add as many as needed.):

State	License#

Federal ID #

Minority Business Enterprise Certificate

Choose File

Organization Structure

Business Organization Structure

Corporation

LLC

Partnership

Sole Proprietor

Personnel Numbers (use the + Add button to include additional entries. You can add as many as needed.):

Office Personnel	Field Supervisors	Avg. Field Labor

How many staff have you added in past 12 months (all categories)?

How many staff have you deducted in the past 12 months (all categories)?

Trade Categories – List specs or categories of work you are qualified to perform and interested in receiving invitations on. Please request a list of CSI codes within your sections to clarify exact scopes that pertain to you:

Past Work

Other

Regions/Location – Please identify areas in which you are interested in working:

Tri-Cities – Benton/Franklin Counties

Yakima – Yakima/Klickitat/Kittitas Counties

Moses Lake/Othello – Chelan/Douglas/Grant/Adams Counties

Walla Walla – Walla Walla/Columbia/Garfield/Asotin/Whitman Counties

Lewiston/Clarkston

Pullman/Lewiston

Wenatchee

Oregon – Eastern Oregon (Must Be Licensed in State to Bid)

Performance Reference – Please provide a minimum of five recently completed jobs with five different General Contractors, Contact Names and corresponding references for the above selected project types (use the + Add button to include additional entries. You can add as many as needed.):

Project	General Contractor & Contact Name	Phone	Fax	Contract Value

Annual Volume

What is the average annual volume of work completed in the last three years?

Year

Avg. Annual Value

Year

Avg. Annual Value

Year

Avg. Annual Value

What is next years forecast volume?

What is value of all work currently under contract

Project Sizes

To better assess the size and value of contracts you are interested in or capable of performing, please fill in the values below:

Average Project Size or Contract Value

Largest Contract Value Completed

Smallest Contract Value You are Interested in

Largest Contract Value You are Interested in

Bonding Company

Fill in the company’s name, agent information, and bonding limits.

Company Name:

First Name

Last Name

Agent Phone:

Bond Rates (please enter rates for)

Volume	Bond % Rate

Single Project Bonding Capacity

Aggregate Bonding Capacity

Company's Principals

Provide the name and title of your Company’s Principals

Company's Principals (use the + Add button to include additional entries. You can add as many as needed.):

Name	Title

Safety Record

In the past 5 years, has your company had any fatalities or been cited by OSHA for a “serious” or “willful” violation?

Yes

No

If “yes” to any of these questions, please provide a brief description of each occurrence.

Worker's Compensation

Please list your Worker’s Compensation Modifier or EMR for the last 3 years:

Year

Rate

Year

Rate

Year

Rate

Insurance

What is your limit to Liability Insurance?

Aggregate

Per Occurrence

Umbrella

Please Upload Blanket Insurance Certificate

Choose File

Additional Insured

I confirm that all information provided is true and accurate to the best of my knowledge, and I acknowledge and agree to the terms and conditions outlined in this form. I consent to have this website store my submitted information so they can respond to my inquiry.