P & P-COS-13-73 COMM. OF PROP. & PROC. APPROVED: 3-26-73 REVISED 3-18-08 GOVERNMENT OF THE VIRGIN ISLANDS OF THE UNITED STATES CONTRACTOR’S QUALIFICATION STATEMENT CONTRACTOR .……………………………………………………….. ADDRESS ………………………………………………………………. DATE ....…………………………………………………………………. TEL. NUMBER .…………………………………………………………. CEL. NUMBER .………………………………………………………..... P & P-COS-13-73 COMM. OF PROP. & PROC. APPROVED: 3-26-73 REVISED 3-18-08 - 2 - 1. How many years experience in construction work has your organization had (a) As a General Construction …………..……………………………………………………………………… (b) As a Sub-Contractor ..….…………………………………………………………………………………… 2. List the construction contracts your organization has under way on this date: Contract Amount Class of Work Percent Completed Location Name of Owner 3. List contracts your organization has completed in the past three years: Contract Amount Class of Work Completed Location Name of Owner P & P-COS-13-73 COMM. OF PROP. & PROC. APPROVED: 3-26-73 REVISED 3-18-08 - 3 - 4. Have you ever failed to complete any work awarded to you? …………………………………….................... If so where and why? ………………………………………………. …………………………………………. …………………………………………………………………………………………………………………… ..………………………………………………………………………………………………………………….. 5. Has any officer or partner of your construction ever been an officer or parent of some other organization that failed to complete a construction contract? …………. If so, state name of individual, other organization and reason therefore ……………………………………………………………………………………………… ………………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………….. 6. Has any officer or partner of your organization ever failed to complete a construction contract handled in his own name? ………………………………….. If so, state name of individual, name of Owner and reason therefore ……………………. …………………… …………………………………………………………………………………………………………………... …………………………………………………………………………………………………………………... 7. In what other lines of business are you financially interested? ………………………………………………… …………………………………………………………………………………………………………………... …………………………………………………………………………………………………………………... …………………………………………………………………………………………………………………... P & P-COS-13-73 COMM. OF PROP. & PROC. APPROVED: 3-26-73 REVISED 3-18-08 - 4 - 8. What is the construction experience of the principal individual of your organization? Individual’s Name Present Position or Office Years of Construction Experience Magnitude and Type of Work In what Capacity 9. In what manner have you inspected this proposed work? Explain in detail. ………………………………………………………………………………………………………………….... ………………………………………………………………………………………………………………….... 10. Explain your plan or lay out for performing the proposed work. ……………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………. .…………………………………………………………………………………………………………………… .…………………………………………………………………………………………………………………… .…………………………………………………………………………………………………………………… .…………………………………………………………………………………………………………………… .…………………………………………………………………………………………………………………… .…………………………………………………………………………………………………………………… .…………………………………………………………………………………………………………………… .…………………………………………………………………………………………………………………… P & P-COS-13-73 COMM. OF PROP. & PROC. APPROVED: 3-26-73 REVISED 3-18-08 - 5 - 11. The work, if awarded to you, will have the personal supervision of whom? ………………………………....... …………………………………………………………………………………………………………………… .…………………………………………………………………………………………………………………... 12. Do you intend to do the transportation on the proposed work with your own equipment? .……………………. …………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………… 13. If you intend to sublet the transportation or perform it through an agent, stat estimated amount of sub-contract or agent’s contract, and , if known, the name and address of sub-contract or agent, amount and type of his equipment and financial responsibility. …………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………… 14. Do you intend to do grading and foundation work with your own forces? …………………………………….. If so, give type of equipment to be used. ……………………………………………………………………….. …………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………… 15. If you intend to sublet the grading and foundation work or perform it through sub-contract, give the name and address of sub-contractor, if known of his equipment and financial responsibility. …………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………… 16. Do you intend to sublet any other portion of the work? ………………………………………………………... P & P-COS-13-73 COMM. OF PROP. & PROC. APPROVED: 3-26-73 REVISED 3-18-08 - 6 - 17. If so, state amount of sub-contract, and if known, the name and address of the sub-contractor, amount and type of his equipment and financial responsibility. …………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………… 18. From which sub-contractors do you expect to require a bond? ……………………….. ………………………. …………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………… 19. What equipment do you own that is available for proposed work? Quantity Item Description, Size, Capacity, Etc. Condition Years of Service Present Location