Work Type Please list the types of work your organization self-performs: State five-year average sales of work What is your company’s backlog amount? $ Pleases indicate if your company is: Union Merit Shop If your company is union, list to which unions you are signatory: If your company is union, list to which agreements you are signatory (e.g., NMA): Current Ratio (Current Assets / Current Liabilities) Net Return on Revenue (Income before Tax / Revenue) Quick Ratio (Cash + Accounts Receivables / Current Liabilities) Working Capital Available (Current Assets Minus Current Liabilities) Debt to Equity (All Liabilities / Stockholders Equity) Bond Rate (%) Bonding Capacity, Aggregate Amount ($M) Bonding Capacity, Single Project ($M) Three largest contracts in the last three years – Please include client name, project, location, value, and project start / completion: Client ($M) $ Start/ Finish Client ($M) $ Start/ Finish Client ($M) $ Start/ Finish Financial Information – please complete the table below. Include an audited copy of your latest financial statement and a letter from your bonding company:
Safety Provide your company’s safety statistics in the table below. Include a copy of your OSHA 300 log, an EMR confirmation letter and a description of OSHA citations, if applicable, with your submission. Current Year Previous Year Before Last Experience Modification Rate (EMR) Number of Days Away from Work Number of Medical Attention Cases Only Total Recordable Injury Rate (TRIR*) Total Lost Workday Injury Rate (LWIR*) Number of Fatalities Hours Worked OSHA Citations *Injury Rate Formula = # of Injuries x 200,000 ÷ Hours Worked Indicate if any of the following are included in your company’s safety program? A copy of your safety program must be available for review upon award of contract. YES NO YES NO Written Safety Program ☐ ☐ Excavation Program ☐ ☐ New Hire Orientation ☐ ☐ Fall Protection Program ☐ ☐ Foreman Training ☐ ☐ Scaffold Program ☐ ☐ Supervision Training ☐ ☐ Lock Out Tag Out Program ☐ ☐ Pre-Job Safety Hazard Analysis ☐ ☐ Hand Tool Program ☐ ☐ Tool Box Talks ☐ ☐ Construction Crane Program ☐ ☐ Accident Investigation ☐ ☐ PPE Program ☐ ☐ Daily Task Safety Analysis Process ☐ ☐ Confined Space ☐ ☐ List any third-party review programs (ISNetworld, PICS, PEC, etc.) in which your company participates. Provide a certificate of your status for each program. Project Controls Does your company use a software application to develop project schedules? If so, list the software name:___ Indicate the number of schedulers your company employs:_ Indicate if your schedules are cost-loaded: Yes No Indicate if your schedules are man-hour-loaded: Yes No Quality
Indicate if any of the following are included in your overall quality program. A copy of your quality plan must be available for review upon award of contract. YES NO YES NO Quality Control System Manual Welder Qualification Process Project Quality Plan NDE Program Foreman Training PWHT Program Inspection and Test Plans Nonconformities Reporting Document Management Program Purchasing Process Auditing Process Material Management List any certifications (e.g., AISC) or certificates of authority (e.g., ASME) your company has attained: Market Segments – Approximate the percentage of work your company performs in each market segment. Power Industry % New Generation Environmental Upgrades Nuclear Facilities % % % Metals Industry % Integrated Steel Mill Blast Furnace Coke Battery % % % Process Industry % Refineries Chemical / Food Processing Material Conveyance % % % Other % % Trade Organizations – List any of which your company is a member: Geographic Areas – List all states in which your company is willing to work: Please return completed form to: