Construction Subcontractor Questionnaire

Choose one of the following

Sole Proprietorship
Partnership
Corporation

Location

Great Raleigh Area
Regional (150 mile Radius)

Expertise (please check all that apply)

Legal Reference:

Accounting Reference:

Insurance Reference:

Bank Reference:

What is your safety insurance EMR rating?

Does your company have a written safety policy?

Yes
No

Has your company ever been fined by OSHA?

Yes
No

Awards:

Work in progress:

Major work completed in the last three years: (please list in descending order according to size)

Insurer's Name:

Have you been involved in any claims for defective for in the last three years?

Yes
No

Are you currently involved in any construction claims, if yes please explain

By checking the box below, you are authorizing that the above information is true and correct to the best of your knowledge

Information is True and Correct

When Submit Form is clicked a client email program will open such as Microsoft Outlook. Please make no changes and simply send the email. Thank your for your assistance.