THIS FORM MUST BE SUBMITTED WITH ALL RESPONSES TO THIS iFB
CONSTRUCTION CONTRACTOR’S
QUALIFICATION STATEMENT
On Schedule A, 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 B, attached, list current projects under construction by this organization, (If joint
venture, list each participant’s projects separately).
On Schedule C, attached, provide a list of project awards Vendor has received from the City of
Nashua in the past 5 years. Please include project detail, City department and City project lead.
On Schedule D, attached, furnish References. Include at least three (3) professional references
(business name, contact, email address & phone number). References may be contacted as part of
our preliminary bid review to assist project committee in assessing Vendor qualifications. Current
City of Nashua personnel and elected officials shall not be used as references.
Name of Surety Company and name, address, and phone number of agent.
“The OWMo Casualty
The RowleuAgency -(4o3) aau- ase ra
US Constluhan Ave Concur, WH _0330~
Is your organization a member of a controlled group of corporations as defined in I.R.C. Sec. 1563?
L}yes [XINo
If yes, show names and addresses of affiliated companies.
N\A
Has your organization ever failed to complete any construction contract awarded to it?
[ lYes SINo
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?
LTyes KYNo
If yes, describe circumstances and provide details on attachment.
CQ -1 of 7
