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)

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


    (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)

    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