Estimating - Ward Bros. Construction

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Estimating Form

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URL

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General Company Information

Legal Company Name*

Physical Address*

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

Mailing address the same as physical address?

Yes

Mailing Address

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

Company Website

Email*

CRA Number*

Years of Business Inception*

Business Type*

Corporation

Limited Partnership

General Partnership

Sole Proprietor

Limited Liablity

Other

Number of Employees*

1 – 5

6 – 10

11 – 25

26 – 50

51 – 100

100 +

Principals, Directors, Officers and Key Personnel

List all Principals, Directors, Officers and Key Personnel involved*

Name

Position

# of years in current Position

# of years with Company

Use the + sign to add all required personnel

Primary Contact Information

Estimator Name*

First Last

Estimator Phone

Estimator Email*

HSE Main Contact Name*

First Last

Phone

Email*

Related Work Experience

Describe scope (s) of work performed*

Does the Subcontractor perform any engineering, design or other professional services?

Yes

Is any portion of this work subcontracted to others?*

Yes

If Yes, Provide details:

What percentage of the work is performed in the following industries?

Commercial

Institutional

Industrial

Residential

Geographical Area(s) of Operations

Northern AB

Southern AB

In the past (3) years, how many contracts have been completed within the following thresholds?

< $100K

$100K – $250K

$250K – $500K

$500K – $1M

$1M – $2.5M

$2.5M – $5M

> $5M

Work Experience / Project References

Provide details of the largest contracts that have been completed in the past (3) years.

Project Name

Location

PM Name

PM: Owner or Contractor?

Phone

Contract Value

Date Completed

Use the + sign to add additional completed projects

Health and Safety Program

Do you have a formal Health, Safety & Environmental Program?*

Yes

Date last updated:

MM slash DD slash YYYY

Does the Subcontractor have a valid Certificate of Recognition (COR or SECOR)?*

Yes

Have you ever been cited, charged, issued any OHS Orders or prosecuted for any OHS non-compliance or environmental offenses in the past 5 years?*

Yes

If yes, provide details:

Briefly explain any incidents of loss, damage or injury that resulted in loss time and/or an insurance claim and any steps taken to mitigate the cause of loss, damage or injury:

Hazard Assessments

Are daily and task specific hazard assessments performed on all worksites that identify jobsite health and safety hazards?*

Yes

Are controls developed and implemented immediately?*

Yes

If any of above elements are marked ‘No’, please explain:

Inspections and Audits

Do you conduct health & safety inspections?*

Yes

Frequency?

Are workers involved in the inspection process?

Yes

If no, why?

Do you conduct health and safety program audits?*

Yes

Frequency?

Are corrections of the deficiencies documented?

Yes

If no, why?

Are inspection reports posted or communicated to workers?*

Yes

If no, why?

If any of above elements are marked ‘No’, please explain:

Please check all applicable training provided to your workers and supervisors?*

First Aid

Safe Trenching, Excavation and Ground Dist.

CSTS (Construction Safety Training System)

ESTS (Electrical Safety Training System)

Confined Space Entry & Rescue

WHMIS

H2S

Prime Contractor

Principles of Health & Safety Management

Leadership for Safety Excellence

Fall Protection

Emergency Response

Hazard Management

Personal Protective Equipment Use, Care & Maintenance

Asbestos Abatement

Supervisory Roles and Responsibilities

Other

If other, please provide

Quality Control Program

Does the Subcontractor have a formal Quality Control (QA/QC) Program?*

Yes

If ‘No’, please explain:

QAQC Contact Name

Phone

Bonding and Insurance

Does the Subcontractor have a surety facility in place?*

Yes

Name of Surety:

Is a Letter of Reference from the Surety Company available?

Yes

Is the facility secured by any financial and / or performance security?

Yes

If yes, specify the type of security:

Parent Company Guarantee

Personal Guarantee

Letter of Credit

General Security Agreement

Subordination Agreement

Other

If other, please explain:

Has any claim been made against a bond provided on your behalf?

Yes

If yes, provide details:

Has a surety company ever declined to provide a surety bond?*

Yes

If yes, provide details:

Supplier Credit References

List the names of the suppliers that extend credit to the Subcontractor.*

Supplier Name

Contact Name

Phone

Use the + sign to add additional required references

Has the Subcontractor, its shareholders or any related companies ever become insolvent or filed for bankruptcy?*

Yes

If yes, provide details:

Is the Subcontractor or any affiliated companies involved in any litigation, arbitration or mediation?*

Yes

If yes, provide details:

Have any liens been filed against the Subcontractor in the past (3) three years?*

Yes

If yes, provide details:

Has the Subcontractor or any affiliated companies ever failed to complete work under a contract?*

Yes

If yes, provide details:

Has the Subcontractor or any affiliated companies ever received a notice of default under a contract?*

Yes

If yes, provide details:

Acknowledgement of Information

The undersigned certifies that the information provided herein is true and sufficiently complete so as not to be misleading.

Name

First Last

Position

Date

MM slash DD slash YYYY

Prequalification Checklist

Health & Safety Program Manual.

Drop files here or

Max. file size: 128 MB.

Certificate of Recognition (COR or SECOR)

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Max. file size: 128 MB.

Quality Control Manual (if applicable)

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Max. file size: 128 MB.

WCB Employer Premium Rate Statement (last 3 years) & WCB Employer Report Card

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Max. file size: 128 MB.

Certificate of Insurance (General Liability and Automobile Insurance)

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Max. file size: 128 MB.

Current company organizational chart indicating project reporting structure

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Max. file size: 128 MB.