Thank you for expressing an interest in working on future projects with us. Please fill out this form to prequalify with Wolverine Fire Protection Co. This is an annual process. Submitting your completed form with attachments will get your firm added to our corporate database for future consideration of work.

GENERAL INFORMATION

Your Name (required)

Fed. ID

Address

City, State, Zip

Phone (required)

Fax

Email (required)

Website (required)

CorporationLLCPartnershipSole Proprietor


TRADE

GEOGRAPHICAL LOCATIONS

Nationwide or list states

Contractors License

(1MB Limit)(File Types Allowed: pdf, doc, docx, txt, jpg, png, xls, xlsx)

BUSINESS INTEREST INFORMATION

(Please check all that apply, must be at least small/large)

Minority OwnedWomen OwnedVeteran OwnedHUB ZoneSDVOSB8aSmall BusinessLarge BusinessTribal 8a

INSURANCE, BONDING AND OTHER INFORMATION

Are you an Equal Opportunity Employer?
YesNo

Do you currently participate in E-Verify?
YesNo

Liability Insurance Carrier (required)

Worker's Comensation Carrierr (required)

Are you bondable?
YesNo

If yes, name of Surety Company

Capacity?
Per Job

Aggregate

Please Attach Certificate of Insurance


(1MB Limit)(File Types Allowed: pdf, doc, docx, txt, jpg, png, xls, xlsx)

SAFETY INFORMATION

Year

EMR

Year

EMR

Year

EMR

Please attach EMR Verification Letter


(1MB Limit)(File Types Allowed: pdf, doc, docx, txt, jpg, png, xls, xlsx)

Do you have a written Safety Policy?

YesNo

If yes, please attach Table of Contents.


(1MB Limit)(File Types Allowed: pdf, doc, docx, txt, jpg, png, xls, xlsx)

Please attach OSHA 300 & 300A Logs for the past 3 years.


(1MB Limit)(File Types Allowed: pdf, doc, docx, txt, jpg, png, xls, xlsx)

FINANCIAL INFORMATION

Annual Sales

Year

$

Year

$

Year

$

Current backlog

Current number of employees

Have you ever failed to complete work awarded to you?
YesNo

If yes, please comment

Are you listed in Dunn and Bradstreet?
YesNo

If yes, what is your number?

What is your rating?

QUALITY CONTROL PROGRAM INFORMATION

Do you have a written Quality Control Program?

YesNo

ISO Registered
YesNo

NQA1 Certified
YesNo

Other
YesNo

Description

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