Injury Illness Prevention Plan - Flipbook - Page 76
Health and Safety Program Manual
Teamwrkx
Construction, Inc.
Issue Date: 10/16/23
Revision Date: 10/16/23
Subcontractor Safety Management
Reference: S-1
ORGANIZATION. Please indicate your firm’s legal structure:
This firm is a: ( ) C Corporation ( ) S Corporation ( ) Partnership
( ) Sole Proprietor ( ) Limited Liability Company
Federal Employer Identification Number: __________________________
Names, Titles and ages and length in position of Officers, Managers, or Principals:
__________________________________________________________________________________________
Name Title Age Time in Position
________________________|____________________|_____________________|______________________
________________________|____________________|_____________________|______________________
________________________|____________________|_____________________|______________________
Is your firm a qualified minority business? ________ Certification No.: _____________________
WORK CLASSIFICATION
Please list the type(s) of work you are interested in bidding:
Please list the geographic areas you prefer to work in:
WORK EXPERIENCE
Please attach a list of the major projects your firm currently has in progress showing the project
name,
location, owner, architect/engineer, general contractor, contract amount, percent complete and scheduled
completion date, and contact person.
Please attach a list of the major projects your firm has completed in the last three years showing the project
name, location, owner, architect/engineer, general contractor, contract amount and completion date, and
contact person.
FINANCIAL INFORMATION
Please attach your firm’s most current financial statements (audited, if available), for the entity that will be
signing the subcontract.
5
