LandSouth Subcontractor Qualification Form

To be considered for any LandSouth Construction projects, please take a minute to fill out the form below.

Company Name

Main number

Website

Address

City

State

Zip

Company / Division Lead

First Name

Last Name

Title

History

Year Established

Prior Year Volume

License Number

Number of Employees

Scopes of Work

Scopes

Services

Current / Recent Contracts

Project Name

Location

Type

Contract Amount

Percent Complete

General Contractor

Office Contact

Office Phone

Superintendent

Superintendent Phone

References & Suppliers

Company Name

Address

City

State

Zip

Contact Name

Phone

Fax

Bonding Capacity

Bondable

yes no

Typical Rate / Percentage

Value Currently Bonded

Limit Per Project

Total Capacity

Agent Company

Agent Name

Phone

First Name

Fax

Does this company have a written safety program?

Has this company been cited by OSHA in the last 3 years?

Has this company failed to complete a contract?

Does this company have past due account balances?

Has any principal of this company filed for insolvency or bankruptcy?

Does this company have judgments, claims, or suits?

Certification

By submitting this form you hereby certify that the information provided is true and correct.

I Agree