10.
11.
Construction Contractor’s
Qualification Statement
On Schedule A-1, attached list major engineered construction projects completed by this organization in
the past five (5) years. (If joint venture, list each participant’s projects separately).
On Schedule A-2, attached, list current projects under construction by this organization, (If joint venture,
list each participant’s projects separately).
Name of Surety Company and name, address, and phone number of agent
Mike Regan, Cross Agency (508) 259-5795
401 Edgewater Place
Wakefield, MA 01880
Is your organization a member of a controlled group of corporations as defined in I.R.C. Sec 1563:
LlYes [3No
If yes, show names and addresses of affiliated companies.
Furnish on Schedule A-3., attached, details of the construction experience of the principal individuals of
your organization directly involved in construction operations.
Has your organization ever failed to complete any construction contract awarded to it?
LlYes xINo
If yes, describe circumstances and provide details on attachment
Has any Corporate officer, partner, joint venture participant or proprietor ever failed to complete a
construction contract awarded to him or her in their own name or when acting as a principal of another
organization?
LlYes LEINo
If yes, describe circumstances and provide details on attachment
In the last five years, has your organization ever failed to substantially complete a project in a timely
manner?
LlYes KINo
If yes, describe circumstances and provide details on attachment
Does your organization now have any legal suites or arbitration claims pending or outstanding against it
or any officers?
LlYes [ANo
If yes, describe circumstances and provide details on attachment
Has your organization had a contract partially or completely terminated for default (cause) within the
past five years?
LYes KINo
If yes, describe circumstances and provide details on attachment
List the licensed categories of work that your company normally performs with its own workforce
Bid Form —9 of 14
