115 Main Street
N. Easton MA 02356
(508) 238-9100
(508) 238-9101 FAX
Subcontractor Qualification
WJ Driscoll Construction success is due in large part to the quality of the subcontractors that we employ. To ensure our continued success, we have developed systems for selecting new subs and monitoring current ones to make sure that they meet our high standards. Before any sub can work for WJD, they must first complete the qualification form below. Subcontractors who meet our standards are given the opportunity to bid our work. If their on-the-job performance matches our expectations, we will gladly ask them to continue to help us serve our customers.
 
1. Business Information
full company name
  
business type
address
  
city
  
state
  
 Zip
telephone
  
fax
  

 cell

  
e-mail
  
website
  
shop type
  
check if applies
  
green company
 
  
MBE
   
WBE
number of full-time employees
  
shop  field office
field specialty / types of work
(i.e. plumbing)
CSI Code
year established
  
federal tax ID
  
target markets
(check all
that apply)
  
Corporate Institutional
Retail Historic Preservation
Medical Residential
target regions
(check all
that apply)
 Boston  Central/Western MA
 North Shore  Cape Cod
 South Shore  New Hampshire
 Metro-West  Rhode Island
2. Contact Information
 
principal/owner
job title

cell phone

e-mail
 
    
estimator/project manager
  
job title
  
cell phone
  
e-mail
  
 
    
estimator/project manager
  
job title
cell phone
e-mail
     
3. Trade & Business References
Please list two business references:
business name
business address
contact person
contact phone
   
business name
business address
contact person
contact phone
 
Please list your three most recently completed projects:
project
  
value
  
general contractor
  
contact
  
contact telephone
  
     
project
  
value
  
general contractor
  
contact
  
contact telephone
  
     
project
  
value
  
general contractor
  
contact
  
contact telephone
  


Please list your annual sales volume for the last three years:

2005
2004

2003

  

4. Financial Information (Optional)
bank name
  
telephone
  
contact
  
     

5. Safety

Do you have a written safety program?
(You will be required to submit a copy to WJD.)

6. Insurance Information
Please enter your current insurance limits in the fields below. Before a contract for work is awarded by WJ Driscoll Construction , a Certificate of Insurance that meets or exceeds the following specifications and limits must be provided. In addition, we ask that each certificate include WJD Construction/Design named as additionaly insured, and Worker's Compensation coverage for all subcontractor employees, including working proprietors, partners, and executive officers.

general liability limit
  
  required: $1M
automotive liability limit
  
  required: $1M each accident

umbrella (excess liability)
  required: $5M
worker's compensation limit
  required: $500K
   
experience modifier rate 2005
experience modifier rate 2004

experience modifier rate 2003
Are you bondable:
   Yes No
bonding limit
  

single occurrence

 aggregate

  


7. WJ Driscoll Construction Programs
As a subcontractor working for WJ Driscoll Construction , you will be required to comply fully with our Job Safety Program (Mandatory MSDS, hard hats, and safety glasses), and our Job Close-Out Program.

8. Subcontractors

Will you be using any subcontractors to perform your scope of work?

  

If so, will you provide us with proof of insurance for your subcontractors? 

  

9. Release/Signature

I the authorized representitive authorize WJ Driscoll Construction , Inc. to secure any information necessary for the purpose of certifying that the statements described above are true and correct to the best of my knowledge.
Name:
  
Date:
  
     
 
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