Ausley Construction ® , Ocala, FL 34470
Ausley Construction is always looking to diversify its base of qualified subcontractors. In order to be considered please complete the following Subcontractor Prequalification Form.
Also, the items listed below will be required by all subcontractors working for Ausley Construction.
Subcontractor Pre-Qualification Statement
- Copy of your current Occupational and State licenses
- Certificates of the following insurances in specified amounts:
- General Liability - $1,000,000
- Worker's Compensation - statutory limits = $500,000
Legal Company Name:
Date:
Physical Address:
Mailing Address:
Phone:
Fax:
Email Address:
Web Address:
Federal Tax I.D.
Years in Business Under Present Name:
Geographic Area of Business Operations:
Contracting Scope:
AIA Divisions for which your company is qualified / licensed to perform:
Select Type of Business:
Total Number of Permanent Employees:
Preferred MINIMUM Project Size Your Company Seeks:
Preferred MAXIMUM Project Size Your Company Seeks:
List at least four (4) of the most significant projects your company worked on in the past 12 months.
PROJECT 1
Project Name:
General Contractor:
Address:
Contact:
Phone:
Fax:
Contract Amount:
PROJECT 2
Project Name:
General Contractor:
Address:
Contact:
Phone:
Fax:
Contract Amount:
PROJECT 3
Project Name:
General Contractor:
Address:
Contact:
Phone:
Fax:
Contract Amount:
General Information
Work History
PROJECT 4
Project Name:
General Contractor:
Address:
Contact:
Phone:
Fax:
Contract Amount:
Licenses
License Number:
License Number:
License Number:
Jurisdiction:
Jurisdiction:
Jurisdiction:
Category:
Category:
Category:
Does your firm have a written safety program:
What is your Worker's Comp Experience Mod Rate:
In the previous 3 years, has your firm been cited for a serious violation (OSHA):
If yes, List violations:
Safety
Value of work presently bonded:
Total Bonding Capacity:
Bonding Surety:
Bonding Agent:
Contact:
Phone:
Insurance Agent:
Contact:
Phone:
Insurance and Bonding
Bank:
Address:
Contact:
Phone:
Fax:
Account Number:
Has your firm failed to complete a contract:
Has your firm been involved in bankruptcy or reorganization:
Does your firm have any pending judgement claims or suits:
Bank References
General Contact
Name / Title:
Phone:
Cell Phone:
Fax:
Email:
Contact Information
Estimating Contact
Name / Title:
Phone:
Cell Phone:
Fax:
Email:
Office Contact
Name / Title:
Phone:
Cell Phone:
Fax:
Email:
Address:
1521 SE 36th Ave., Suite 1
Ocala, Florida 34470
Phone:
(352) 629-8177
Fax:
(352) 629-6083
PROJECT GALLERY
