Prospective Construction Supplier Information Form

INSTRUCTIONS:

To qualify for construction opportunities at SLAC, construction subcontractors must meet several criteria. Please review the form before submitting. You must submit business information, a point of contact, and product and service information. Note that the form will not save your work.

Please be as thorough and complete as possible in your application, as this will ease our review process. Completing the prospective supplier information form does not guarantee solicitations or awards will be sent to your organization.

Thank you for your interest in working with SLAC!

General Information
This must be an external URL such as http://example.com.
Organization Point of Contact
If you met a SLAC Team Member at an event, please indicate here.
Location
Address
Does your organization have an additional location?
Additional Location
Please provide the address below if you indicate your organization has a secondary location.
Organization Information
SAM.gov
Are you registered with System for Award Management (SAM.gov)?
Unique Entity Identifier
Does your organization have a Unique Entity Identifier (UEI)? To be a SLAC supplier, you must have a UEI. See Become a SLAC supplier for more information about UEI requirements.
If you responded “Yes”, provide your organization’s UEI.
Organization Type
You may only select one.
Business Type
You may only select one.
Socioeconomic Status
Please check all that apply.
North American Industry Classification System (NAICS) Code
Provide the contractor's NAICS code for OSHA reporting purposes.
Drag to re-order taxonomy terms.
Drag to re-order taxonomy terms.
Please be sure to include all keywords relevant to your products or services.
Have you done business with other DOE laboratories?
Please indicate the other DOE laboratories you have done business with above.
Contractor Pre-Qualification Information
California Contractor License
Do you have a valid California Contractors' License?
Provide the name of the current surety. The surety must be listed on the Department of the Treasury's Listing of Approved Sureties.
Can you provide certification from the surety or its agent upon request?
Certification must include:
  • The number of times it has completed the contractor’s work in the past five (5) years.
  • Total bonding capacity of the contractor in USD.
  • Available bonding capacity in USD.
Safety Records
Your Contractor's California Experience Modification Rates (EMR) for the last three (3) years should be 1.0 or less.
Complete and attach the Subcontractor Safety Qualification Form.
One file only.
2 MB limit.
Allowed types: pdf.
Have you had any safety incidents in the past three years?
If you responded "Yes", indicating that there have been safety incidents within the past three years, provide a written explanation of the corrective measures implemented by your company to improve its safety if any of the following occurred:
  • Occurrence of any fatalities within the last three years.
  • Receipt of OSHA citations within the past five years.
  • Days Away or OSHA Recordable Incident Rates for the past three years are above the national average from Table 1 of the U.S. Bureau of Labor Statistics.
Adequate staffing with U.S. Citizens and Non-Citizens in accordance with the Federal E-Verify requirements. Contractor’s must show their ability to staff by providing a copy of the Contractor’s Company Information page printed directly from the E-Verify System.
One file only.
2 MB limit.
Allowed types: pdf.
Please attach a capability statement of relevant experience, including:
  • Description of the projects completed in the past three (3) years.
  • Contract value of self-performed work for each project.
  • References from owner’s representatives with a point-of-contact, name, and phone number for each project.

One file only.
2 MB limit.
Allowed types: pdf.
Additional Information
Financial Data
Can you provide audited financial statements for up to three (3) years?
Insurance
Do you meet the following insurance requirements?
  • Automobile Liability - $1,000,000 per occurrence.
  • Comprehensive General Liability
    • General aggregate $5,000,000.00
    • Subcontracts of less than $100,000: insurance limits not less than $2,000,000 per occurrence.
    • Subcontracts of $100,000 and over but less than $1,000,000: insurance limits not less than $3,000,000 per occurrence.
    • Subcontracts of $1,000,000 and over: insurance limits not less than $5,000,000 per occurrence.
    • Subcontracts of $25,000 and over requiring design by Subcontractor: Professional Errors and Omissions Insurance in the amount not less than $1,000,000 per claim.
  • Builder's All Risk - Full value of the work being performed under a Subcontract.
  • Workers' Compensation Insurance - $1,000,000 per person; $1,000,000 per accident.