10.
LL.
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
Everest Reinsurance Co
Mike Regan, Cross Agency, 401 Edgewater PI. Wakefield, MA 01880
508.259.5795
Is your organization a member of a controlled group of corporations as defined in |.R.C. Sec 1563:
OYes TANo
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?
LYes CXNo
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?
CYes XINo
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?
Oyes CXNo
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?
LYes INo
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?
OYes Wo
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
