Company Information

• Name
• Address Line 1
• Address Line 2
• City
• State (two-letter code, please)
• Phone
• Fax
• Website
• Owners
• Number of Office Staff
• Number of Field Staff
• Company type -- Choose one -- Corporation Joint Venture Individual Partnership Sole Proprietorship

• Check any of the following that describe your company

  • Minority Business
  • Woman Owned

Your Information

• First name
• Last name
• Phone
• Email

Licensing

Please indicate in which states your company has a license and the number associated with it.

• • • D.C.
    • D.C. License No.
  • • Delaware
    • Delaware License No.
  • • Maryland
    • Maryland License No.
  • • Virginia
    • Virginia License No.
  • • Other
    • Other License No.

Experience

• Rank your company's level of experience in each project type.

  Project type	0%	25%	50%	75%	100%
  Food Service
  Lodging
  Office Space
  Renovations
  Retail Space

• Please provide a list of construction projects completed in the past year. Please include the Project Name, City & State where the project was located, contract amount, type of work completed, Owner name, Architect and completion date.

Suits & Claims

• In the past five years, has your business ever failed to complete any projects that were awarded? If yes, please provide details.
• In the past five years, has your business ever filed any law suits or requested arbitration in regard to construction contracts? If yes, please provide details.

• Are there currently any claims, judgments, arbitration proceedings, suits pending or outstanding against your business?

  • Yes
  • No

Supplier References

• Supplier Reference 1

  • First name
  • Last name
  • Company name
  • Address line 1
  • Address line 2
  • City
  • State (2-letter abbreviation)
  • Phone
  • Email

• Supplier Reference 2

  • First name
  • Last name
  • Company name
  • Address line 1
  • Address line 2
  • City
  • State (2-letter abbreviation)
  • Phone
  • Email

• Supplier Reference 3

  • First name
  • Last name
  • Company name
  • Address line 1
  • Address line 2
  • City
  • State (2-letter abbreviation)
  • Phone
  • Email

Client References

• Client Reference 1

  • First name
  • Last name
  • Company name
  • Address line 1
  • Address line 2
  • City
  • State (2-letter abbreviation)
  • Phone
  • Email

• Client Reference 2

  • First name
  • Last name
  • Company name
  • Address line 1
  • Address line 2
  • City
  • State (2-letter abbreviation)
  • Phone
  • Email

• Client Reference 3

  • First name
  • Last name
  • Company name
  • Address line 1
  • Address line 2
  • City
  • State (2-letter abbreviation)
  • Phone
  • Email

Agreement and Signature

• By submitting this application, I affirm that the facts set forth in it are accurate and complete.
• I understand that submission of this Qualification Form does not guarantee my business will be an approved subcontractor/vendor for Brown Contracting Company, Inc. It also does not guarantee a contract for any future projects.