Holder Construction Company

Trade Contractor’s Prequalification Statement

Submitted To: / Contact’s Name / Submitted By: / Contact’s Name / Date: / Date
Holder Construction Company - Atlanta
3333 Riverwood Parkway, SE Suite 400
Atlanta, GA 30339
Telephone: 770-988-3000 / Company & Location Information:
Firm: / Company Legal Name /
Address: / Office Address /
Holder Construction Company - Charlotte
2359 Perimeter Pointe Parkway, Suite 250
Charlotte, NC 28208
Telephone: 704-357-4200 / City: / City /
State: / State /
Zip: / Zip /
Holder Construction Company - Dallas
4600 Fuller Drive, Suite 375
Irving, TX 75038
Telephone: 972-870-4260 / Phone: / Phone /
Main Preconstruction Contact Person:
Name: / Name /
Holder Construction Company - Washington DC
2355 Dulles Corner Boulevard, Suite 501
Herndon, VA 20171
Telephone: 703-796-4400 / Title: / Title /
Office Phone: / Office Phone /
Extension: / Office Phone Extension /
Holder Construction Company - Phoenix
2325 East Camelback Road, Suite 520
Phoenix, AZ 85016
Telephone: 602-224-5050 / Cell: / Cell /
Email: / Email /
Holder Construction Company - San Jose
2033 Gateway Place, 5th Floor
San Jose, CA 95110
Telephone:408-516-4401
References: Please list four different general contractors for whom you have performed similar scopes of work regarding similar facilities.
1. / Project / 2. / Project /
(Project) / (Project)
General Contractor / General Contractor /
(General Contractor) / (General Contractor)
GC’s Project Manager Name and Phone Number / GC’s Project Manager Name & Phone Number /
(GC’s Project Manager Name & Phone Number) / (GC’s Project Manager Name & Phone Number)
Approximate Contract Value / Approximate Contract Value /
(Approximate Contract Value) / (Approximate Contract Value)
3. / Project / 4. / Project /
(Project) / (Project)
General Contractor / General Contractor /
(General Contractor) / (General Contractor)
GC’s Project Manager Name & Phone Number / GC’s Project Manager Name & Phone Number /
(GC’s Project Manager Name & Phone Number) / (GC’s Project Manager Name & Phone Number)
Approximate Contract Value / Approximate Contract Value /
(Approximate Contract Value) / (Approximate Contract Value)
Company Information:
Self-PerformedScopes of Work: / Scopes of Work /
Subcontracted Scopes of Work: / Scopes of Work /
Type of Firm: / Corporation / ☐ / Partnership / ☐ / Individual / ☐ / Other / Other /
Parent Company: / Same / ☐ / Name: / Name /
Years in business as Contractor under present firm name: / Years / License Number: / License Number. /
States in which your company will do business: / List out all States. /
Is your organization union? / Yes / ☐ / No / ☐ /
If so list the affiliation(s) and local(s): / Affiliation(s) and Local(s) /
Provide information which would indicate the size and capacity of your organization, including the number or permanent employees engaged in (do not count the same employee twice):
Estimating: / Number / Field Supervision: / Number / Tradespeople: / Number /
Clerical / Accounting: / Number / Management: / Number /
Is your organization a registered DBE contractor? / Yes / ☐ / No / ☐ /
If so list certification type / number / body: / Click here to enter text. /
Is your organization currently registered with Dun & Bradstreet? / Yes / ☐ / No / ☐ /
If yes, what is your D & B number? / D & B Number /
What is your organization’s Experience Modification Rate (EMR)? / Modification Rate /
If over 1.0, attach past three (3) years OSHA 300 logs.
Has your firm ever failed to complete a contract or been assessed schedule related damages? / Yes / ☐ / No / ☐
Has your firm had any subcontractors fail to complete a contract in the last five years / Yes / ☐ / No / ☐ /
Are there any judgments, claims, liens, or suits pending or outstanding against your firm? / Yes / ☐ / No / ☐ /
Has your firm been a party to any lawsuits, arbitration, or mediation with regard to construction projects in the last five years? / Yes / ☐ / No / ☐ /
*(If answer to any of the above questions is yes, please attach explanation to this form)
Annual Billing:
This year’s projected billing: / $ / Billing / Three Years Ago - Billing: / $ / Billing /
Last Years - Billing: / $ / Billing / Four Years Ago - Billing: / $ / Billing /
Two Years Ago - Billing: / $ / Billing / Five Years Ago - Billing: / $ / Billing /
Five Largest Projects Completed in the Last Five Years:
Project / General Contractor, Contact and Phone Number / Contract Amount
Project / General Contractor, Contact and Phone Number / $ / Contract Amount /
Project / General Contractor, Contact and Phone Number / $ / Contract Amount /
Project / General Contractor, Contact and Phone Number / $ / Contract Amount /
Project / General Contractor, Contact and Phone Number / $ / Contract Amount /
Project / General Contractor, Contact and Phone Number / $ / Contract Amount /
Major Projects Under Contract:
Project / % of Contract Complete / Completion Date / Contractor / Total Contract Value
Project / % Complete / Date / Contractor / $ / Click here to enter text. /
Project / % Complete / Date / Contractor / $ / Click here to enter text. /
Project / % Complete / Date / Contractor / $ / Click here to enter text. /
Project / % Complete / Date / Contractor / $ / Click here to enter text. /
Project / % Complete / Date / Contractor / $ / Click here to enter text. /
Total value of projects under contract: (including those not listed above) / $ / Click here to enter text. /
Percent of negotiated / bid contracts / % / % Negotiated / % Bid /
Current Pursuits: Current projects you are current a candidate for. (Indicate size and schedule)
Project / Start Date / Contractor / Total Contract Value
Project / Date / Contractor / $ / Click here to enter text. /
Project / Date / Contractor / $ / Click here to enter text. /
Project / Date / Contractor / $ / Click here to enter text. /
Project / Date / Contractor / $ / Click here to enter text. /
Project / Date / Contractor / $ / Click here to enter text. /
Bonding Information
What is your bond rate for this project (as a percentage) / % / Rate /
Aggregate Limit: / $ / Aggregate Limit / Single Project Limit: / $ / Single Project Limit /
Please list the names of your bonding agent and surety:
Bonding Agent / Surety /
(Bonding Agent) / (Surety)
Street Address / Street Address /
(Street Address) / (Street Address)
City, State, Zip / City, State, Zip /
(City, State, Zip) / (City, State, Zip)
The answers to the foregoing questions and all statements herein contained are true and correct.
Reviewer’s Position / Reviewer’s Position /
(Reviewer’s Name) / (Reviewer’s Position)

* Holder Construction reserves the right to request Audited Financials which is defined as a Balance Sheet, and Income Statement, an Auditor’s Report and Footnotes.

Holder Construction Version 04/16/2013Page 1 of 3