Please Direct Any Questions, and Return the Complete Package To

Absher Construction Company is interested in maintaining and developing vital business partnerships with our subcontractors and suppliers. As a team, it is our desire to offer our clients competitive pricing and services, an excellent work product, and projects delivered on time, in budget per our contractual agreements.

In an effort to deliver the best to our clients, we want to ensure that everyone participating in the project has the resources, financial stability, experience and ability to perform. To that end, it is important to us to have current company information on all of our subcontractors and suppliers that will allow us the opportunity to ensure qualified companies are on all of our projects, and that our subs/suppliers are getting the most work they can with our company.

We have developed a comprehensive subcontractor/supplier information request that we would like to have you complete and returned to us at your earliest convenience. This information will be held in strictest confidence and will be used to help us evaluate how we can best maximize our working relationship. Once we have this initial information, we will request periodic updates just to keep current with you.

Please direct any questions, and return the complete package to:

Absher Construction Company

P.O. Box 280

Puyallup, WA 98371

Attn: Lane Tanabe

Phone: 253-845-9544 Ext. 1440

Direct Line: 253-446-3440

Fax: 253-848-4667

We very much appreciate the time and effort in completing this information request. We look forward to a long and successful business partnership.

Sincerely,

Lane Tanabe Jeff Richards

Chief Financial Officer Director of Estimating

SUBCONTRACTOR/SUPPLIER INFORMATION REQUEST

INSTRUCTIONS: We appreciate your effort in fully completing the following information for our records. We endeavor to keep a complete and accurate profile of the companies we do business with and are grateful for your help in keeping our records current.

I.  COMPANY INFORMATION

»Full Company Name:

Street Address:

Post Office Box:

City: State: Zip:

Phone: Fax: Web Site:

Person to Contact: E-Mail Address:

»This address is the: Main Office Regional Office Branch Office

»Federal Tax ID Number UBI Number

»Contractor’s License Numbers State Type of License or Work Licensed For Expiration

»Worker’s Compensation Numbers State Other ID Numbers Description State

II.  ORGANIZATION INFORMATION

»The Organization is a: C Corporation Sub S Corporation Partnership Sole Proprietorship

»State of Incorporation Year Under Current Ownership Since:

»Owners:

NAME PERCENT OWNERSHIP

%

%

%

%

%

»Executive Officers:

NAME TITLE

»If the above company is owned or controlled by a parent company, provide the following:

Full name of parent company

Main office street address

Main office mailing address

City State Zip

Phone Fax Website

»List below any divisions, subsidiaries or affiliates of the company listed above:

NAME LOCATION

»Business Classification:

Large Business Small Business

Historically-Underutilized-Business (HUB) Zone Contractor Federal City of Tacoma

If you need assistance in determining whether your business is considered a Small Business Concern, contact your local U.S. Small Business Administration Office – Size Specialist located at 1200 Sixth Avenue, Suite 1700, Seattle, WA 98101-1128, (206) 553-7310. www.sba.gov.

For our information please check the categories that apply to your company, thank you.

Federal Certified:

HubZone Certified

8(a) Small Business Certified

State Certified:

Women-Owned Business Certified

Minority-Owned Business Certified

Women and Minority-Owned Certified

Disadvantaged Business Enterprise Certified

Federal Self-Certified (Central Contractor Registration & On-line Representations and Certifications Application):

Women-Owned Business Self-Certified

Minority-Owned Self-Certified

Veteran Small Business Self-Certified

Service-Disabled Veteran Business Self-Certified

Small Disadvantaged Business Certified

III.  FINANCIAL INFORMATION

»Annual Sales Volume each of the last three years

Year Sales Volume

Please attach your most recent Financial Statement that has been prepared by an independent accounting firm (it is strictly for Absher’s accounting/purchasing department and will be treated confidentially))

»Bonding Company Name:

Street Address:

Post Office Box:

City: State: Zip:

Phone: Fax: Web Site:

Person to Contact: E-Mail Address:

»With this Bonding Company since (Year):

»Previous Bonding Companies:

Years: through

Years: through

»Total Bonding Capacity $ Single Project Limit $

»Cost of Performance & Payment Bond (Percent Rate) %

»Top three largest projects that were bonded:

Project Name Contract Value Year Completed

$

$

$

»Top three largest projects overall:

Project Name Contract Value Year Completed

$

$

$

»Largest aggregate work program bonded: $ Year:

»Value of work currently bonded: $

(Please provide a current letter of Bondability from your Bonding Company (not your agent))

»Insurance Agent Name:

Street Address:

Post Office Box:

City: State: Zip:

Phone: Fax: Web Site:

Person to Contact: E-Mail Address:

»With this Insurance Agent since: Year:

»Insurance Carrier Name

»With this Insurance Carrier since (Year):

»Previous Insurance Carriers:

Years: through

Years: through

»Insurance Coverage (list the limits of your insurance coverage):

Worker’s Compensation

General Liability

Each Occurrence

General Aggregate

Personal Injury (each occurrence)

Products/Completed Ops aggregate

Automobile Liability

Combined Single Limit (each occurrence)

Excess/Umbrella Liability

Each Occurrence

Aggregate

»Does your policy include residential/condominium coverage? Yes No

(In lieu of the above listing of limits, you may provide a copy of your current insurance certificate)

»Primary Bank Name:

Street Address:

Post Office Box:

City: State: Zip:

Phone: Fax: Web Site:

Person to Contact: E-Mail Address:

»Value of Line of Credit $

Highest amount used in the last year: $

Amount currently available: $

Terms of security (receivables, personal guarantees, etc.):

»Has your Company or any of its principals ever petitioned for bankruptcy, failed in business, defaulted or been terminated on a contract awarded to you? Yes No

»Are there any outstanding judgments, claims or suites pending against you? Yes No

»Have any of the principals of your Company ever been indicted or convicted of a felony or other criminal activity? Yes No

»Has your Company or any of its principals ever been suspended, disbarred or otherwise precluded from pursuing public work or ever been found to be non-responsive by a public agency? Yes No

»If the answer to any of the above three questions is yes, please explain below:

IV.  CAPABILITIES

»Your company operates as a: Union Shop Non-Union Shop Merit Shop

»List craft union contracts and/or labor agreements to which you are signatory:

Name of Union/Agreement Expiration Date

»List trade associations with which your organization is affiliated:

»Please check the type of building projects your Company has completed:

High Rise Office Hotels/Motels Industrial

Mid Rise Office Healthcare/Hospitals/Labs Correctional Facilities

Commercial/Retail Residential/Condominiums Military

Educational Facilities Sports/Entertainment Design Build/Design Assist

»Preferred Bidding Range: Maximum Minimum

»Client/Contractor References:

Company Name:

Street Address:

Post Office Box:

City: State: Zip:

Phone: Fax: Web Site:

Person to Contact: E-Mail Address:

Company Name:

Street Address:

Post Office Box:

City: State: Zip:

Phone: Fax: Web Site:

Person to Contact: E-Mail Address:

Company Name:

Street Address:

Post Office Box:

City: State: Zip:

Phone: Fax: Web Site:

Person to Contact: E-Mail Address:

»Trade/Supplier References:

Company Name:

Street Address:

Post Office Box:

City: State: Zip:

Phone: Fax: Web Site:

Person to Contact: E-Mail Address:

Company Name:

Street Address:

Post Office Box:

City: State: Zip:

Phone: Fax: Web Site:

Person to Contact: E-Mail Address:

Company Name:

Street Address:

Post Office Box:

City: State: Zip:

Phone: Fax: Web Site:

Person to Contact: E-Mail Address:

»Past and Current Projects with Absher Construction in the last 10 years:

Project Name / Contract
Value / Completion
Date / Project Manager Name / Superintendent Name

»Current and Committed Contracts in Progress:

Project Name / General
Contractor / Current Contract Value / Percent
Complete / Projected Completion Date

V.  PERSONNEL/SAFETY/QUALITY

»Executive Management Team:

NAME TITLE

»Project Managers/Engineers:

NAME TITLE

»Field Supervisors:

NAME TITLE

»Total number of employees: Office Personnel Field Supervisory Avg. Field Labor

»Classes of work you are qualified to perform with your own forces:

»Work you normally subcontract to others:

»List your company’s Experience Modification Ratio (EMR) for the three most recent years.

Year EMR

»From your OSHA 300 log and 300A, please provide the following current information:

Number of lost workday cases:

Number of restricted workday cases:

Number of cases with medical treatment only:

Number of fatalities:

Employee hours worked:

»Do you have a written safety program? Yes No

»Do you have a program that assures a drug-free workplace? Yes No

»Do you have a written quality assurance manual? Yes No

»Do you use an in-house scheduling program? Yes No

»Do you do estimating in-house? Yes No

»Do you have an in-house training program? Yes No

»Do you have Design/Build capabilities or in-house Engineering? Yes No

VI.  ABSHER CONTRACT DOCUMENTS

»Absher Subcontract/Supplier Contract has been reviewed and approved. Yes No

»Indemnity form has been reviewed and approved. Yes No

»Payment Procedures have been reviewed and approved. Yes No

Date this information request was completed/updated:

Completed By:

Title: