Subcontractor Financial Application - Thompson Electric, Inc.

Thompson Electric, Inc. (Herein referred to as TEI) has established, and maintains, a Contractor/Vendor EHS Management Program that details the requirements for practices and procedures to protect its employees, Non-TEI employees, our customers' facilities, as well as , TEI's Munroe Falls, Ohio facilities, Only contractors and vendors that are TEI approved will be allowed to perform work on TEI work sites and at our permanent facilities.

In order to become an Approved Contractor or Vendor, the following documents must be completed and forwarded to TEI's Contractor Coordination Team for evaluation:

Please Note:

Incomplete applications will not be processed.
You may not save your information and come back to the application at a later time. Please double check that you have the required information (below) ready before starting the application.

Supporting Financial Documentation Checklist

Please provide the following:

Master Service Contract signed by company authorized representative*

N/A
Attached

Current completed and signed W-9*

N/A
Attached

Current copy of Certificate of Insurance*

See Example

N/A
Attached

Current copy of Ohio Bureau Workers Compensation Certificate*

N/A
Attached

Proof that your company is a member, in good standing, of the State of Ohio's Drug Free Workplace Program (when applicable)*

N/A
Attached

EEO Policy Acknowledgement Form signed by a company authorized representative*

EEO Form to be signed

N/A
Attached

Qualified Business, BDE, WBE, MBE, and Edge Businesses*

N/A
Attached

Files

If you have indicated 'Attached' to any of the above fields please attach related files here.

Drop files here or

Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 32 MB.

Project Bidding or General Services Description*

Company Information:

Company Name*

Website

Address*

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

Is mailing address different then above?*

Yes
No

Mailing Address

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

Phone*

Fax

Is this the address of the:*

Main Office
Regional Office
Branch Office

Is your company a subsidiary?*

Yes
No

Name of Parent Company

Address of Parent Company

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

Personal Information

This information is for the person completing this form.

Person completing this form

Name*

First Last

Title*

Email*

Direct Phone*

Extension*

Cell Phone*

Is the primary contact differnt than above?*

Yes
No

Name

First Last

Title

Email

Direct Phone

Extension

Cell Phone

Company Ownership, Staff, History

What year was your company established*

Federal ID Number*

Type of Company*

State of Incorporation*

Date of Incorporation*

License*

Contractor's License Number	State	Expires

File

Please attach a list of your contractor(s), authorization(s) to do business, and minority certifications in all states in which your company would like to be considered to work.

Drop files here or

Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 32 MB.

Are you signatory to a union agreement*

Yes
No

Which one(s)

List the primary corporate officers, partners, proprietors, members and/or shareholders of your company

Name	Title	Email

How many people do you currently employ?*
Total
Office Management
Field Supervision
Trade/Craft

Has your company ever operated under a different name or as a subsidiary of a different parent company?*

Yes
No

Please, list the other name(s)/arrangement(s) and dates of operation below:

For the following questions, if you answer yes, please attach necessary documentation related to each question.

Has your company, or any of its principles, ever petitioned for bankruptcy or failed in business?*

Yes
No

File

Drop files here or

Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 32 MB.

Have any of the owners, officers, or major stockholders of your company ever been indicted or convicted of any felony or other criminal conduct?*

Yes
No

File

Drop files here or

Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 32 MB.

Has your company ever been disbarred, or otherwise precluded from pursuing public work, or ever been found to be non-reponsive by a public agency?*

Yes
No

File

Drop files here or

Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 32 MB.

Has your compnay ever defaluted or been terminated (for any reason, including convenience) on a contract awarded to you?*

Yes
No

File

Drop files here or

Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 32 MB.

Has your company ever had a claim made against it for improper, delayed, defected or non-compliant work, or failure to meet warranty obligations?*

Yes
No

File

Drop files here or

Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 32 MB.

Is your company, or any of its owners, officers or major shareholder currently involved in any arbitration or litigation?*

Yes
No

File

Drop files here or

Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 32 MB.

Does your company have any outstanding judgments or claims against it?*

Yes
No

File

Drop files here or

Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 32 MB.

Have you had any litigation brought against your compnay in the past five (5) years asserting that you failed to make payments to anyone?*

Yes
No

File

Drop files here or

Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 32 MB.

Work Preferences

Please indicate the trade(s) that your compnay is interested in bidding:*

List the geographical areas in which you work:*

Indicate the size of project you have the most experience, and are competitive, in performing (indicate by entering 1). Show in preference order (2, 3 ...) other size projects you are capable of performing:

Under $100,000

Please enter a number from 1 to 6.

$100,000 to $200,000

Please enter a number from 1 to 6.

$200,00 to $500,000

Please enter a number from 1 to 6.

$500,00 to $1,000,000

Please enter a number from 1 to 6.

$1,000,000 to $2,000,000

Please enter a number from 1 to 6.

$2,000,000 to $5,000,000

Please enter a number from 1 to 6.

List the trades you normally perfrom with your own employees:*

Which percentage of your company's work is normally subcontracted?*

What trades do you normally subcontract?*

What is the largest contract your company has completed?

Amount:*

Year:*

Project Name:*

Scope:*

What is the largest dollar volume job you expect to do during this year?

Amount:*

Year:*

Project Name:*

Scope:*

What is the expected annual volume this year?

Total*

Please enter 'N/A' if using 'estimated number of projects' below.

OR

Estimated number of projects?*

Please enter 'N/A' if using 'total' above.

With an average dollar volume of:*

Please enter 'N/A' if using 'total' above.

What was the average annual volume of work performed over the past 3 years?

Year	Average Annual Volume

Additional Details & Verificaiton

What is your company's Dun & Bradstreet Number:*

Surety Company:*

Bonding Agent:*

Contact Person:*

Phone*

Fax*

Bonding Capacity

Bond Rate %*

Per Job $*

Aggregate Amt. Remaining $*

Phone*

Fax*

Italicized items must be confirmed in a letter from your surety company.

Please attach a list of current major projects giving name of project, address, owner, architect, general contractor, contract amount, scope of work and scheduled completion. Include contact people and phone numbers

Current Major Projects Upload(s)*

Drop files here or

Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 32 MB.

Please attach a list of completed major projects giving name of project, address, owner, architect, general contractor, contract amount, and scope of work. Include contact people and phone numbers

Completed Major Projects Upload(s)*

Drop files here or

Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 32 MB.

Please attach a copy of your latest audited financial statement. Your financial statement is strictly for Thompson Electric, Inc. and will be held in strict confidence.

Latest Audit Upload*

Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 32 MB.

Is the attached financial statement not for the identical company above?*

Yes
N/A

Explain the relationship and financial responsibility of the company whose financial statement is provided.

Please attach a letter from your surety verifying the bonding information provided above and signed by a representative as attorney-in-fact.

Latest Audit Upload*

Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 32 MB.

Does your company have a line of credit available at a financial institution?*

Yes
No

Name of Bank:

Amt. of line of credit:

Amt. Available:

Exp. Date:

Please provide the following information about your financial institution:

Name of Bank:*

Contact Person*

Address*

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

Phone*

Fax*

List three (3) of credit references:

Company 1:

Name:*

Contact Person:*

Address*

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

Phone*

Fax*

Company 2:

Name:*

Contact Person:*

Address*

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

Phone*

Fax*

Company 3:

Name:*

Contact Person:*

Address*

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

Phone*

Fax*

I hereby warrant and represent that I am an officer, or authorized agent, of the undersigned company, and have authority to execute this document on behalf of the undersigned. I further warrant and represent that the information contained in this pre-qualification form is true and correct to the best of my knowledge, and is based on personal knowledge and records obtained or kept in the ordinary course of our business.

We recognize that Thompson Electric, Inc. will rely on the accuracy of the information provided in this document and any attachments thereto in deciding whether to permit our company to bid and the award of work to our company. I understand that if Thompson Electric discovers that information contained herein is false, inaccurate or misleading, Thompson Electric will construe that this as a breach of any agreement between Thompson Electric and the undersigned; and Thompson Electric will have the right to terminate such agreement pursuant to the provisions governing termination for cause.

By our signature below, we authorize any third parties, including listed trade and bank references, to provide Thompson Electric, Inc. with information with information regarding our company.

Signature*

Name:*

Title:*

As agent for (Comapny Name):*

Date*

Supporting Financial Documentation Checklist

Company Information:

Personal Information

Company Ownership, Staff, History

Work Preferences

Additional Details & Verificaiton

Thompson is Now EVITP Certified

Request an Estimate