Subcontractor Registration Form

 
Thank you for your interest in the Schlitterbahn Vacation Village. Please fill out the form below to be added to the Schlitterbahn Vacation Village subcontractor database. *Required field.

Company Name*
Address*
City*
State*
Zip code*
Phone*
Fax*
Contact First Name*
Contact Last Name*
Email*
Cell Phone
Website
Is your company MBE WBE
MBE/WBE certified by
Is your company an LBE
Is address the Main Office  Regional Office Branch Office
Name of parent company
Address of parent company
City
State
Zip code
Trades your company is bidding on*
Year company started*
Type of company Corp  Partnership  Proprietorship Sub S Corp
State of Incorporation
Date of Incorporation
Contractor's License No.
State
Expiration
State Sales Tax No.*

State Unemployment Insurance No.
Federal Tax ID No.*

How many people does your company presently employ
  Home Office
 Field Supervisory 
Trades People
Has your Company ever had a claim made against it for improper, delayed, defective or non-compliant work or failure to meet warranty obligations?*  Yes No
If so please explain
Is your Company or any of its owners, officers or major shareholders currently involved in any arbitration or litigation?*  Yes No 
If so please explain
Does your Company have any outstanding judgments or claims against it?*  Yes No
Please list any litigation brought against your Company in the past five (5) years asserting that you failed to make payments to anyone
List the geographical areas in which you work
List Unions which you have agreements with  
Union Name
Local Number
Agreement Expiration Date
Union Name
Local Number
Agreement Expiration Date
Union Name
Local Number
Agreement Expiration Date
Union Name
Local Number
Agreement Expiration Date
Union Name
Local Number
Agreement Expiration Date
List the trades you normally perform with your own forces
What percentage of the Company's work is normally subcontracted  
List the trades you normally subcontract

What is the largest contract your Company has completed

Amount
Year
Project name and scope
What is the largest dollar volume job you expect to do during this year
Amount
Year
Project name and scope
What is your expected annual volume this year $   #
What was the average annual volume of work performed over the past 5 years
Yr Vol
Yr Vol
Yr Vol
Yr Vol
Yr Vol
MBE/WBE Participation in work which you subcontract (average participation for last 3 years) MBE  WBE
Minority/Female workforce participation (average percentage utilization for last 3 years) MIN   FEM
Bonding Company
Name of Surety
Key Contact Person
Key Contact Phone
Bonding Capacity
Per Job
Aggregate
Date of Last Bond
Amount  
Bond Rate %
Please list the persons or entities who provide indemnification to your Surety
List three of your major suppliers  
Name  
Address, City, State, Zip  
Phone  
Contact  
Name  
Address, City, State, Zip  
Phone
Contact
Name
Address, City, State, Zip
Phone
Contact
List three contactors that you do business with  
Name  
Address, City, State, Zip
Phone
Contact
Name
Address, City, State, Zip
Phone
Contact
Name
Address, City, State, Zip
Phone
Contact
Trade Association Memberships
List local or national accredited training programs in which you participate (craft or management training)
List key office personnel and field supervisors  
Name
Year of Birth
Years Experience
Previous Employer
Name
Year of Birth
Years Experience
Previous Employer

Commercial General Liability
Insurance Carrier
Policy Form
Policy No.
Policy Period From To
Occurrence Based
Claims Made
Any exclusions from  Standard CGL Policy Yes No
Limits  
General Aggregate Current Max Obtainable
Products-Comp/Op Agg Current Max Obtainable
Personal/Adv. Injury Current Max Obtainable
Each Occurrence Current Max Obtainable
Fire Damage (any one fire) Current Max Obtainable
Med. Exp (any one person Current Max Obtainable
Deductible
Per Project Limits Yes No

Excess Liability

  
Insurance Carrier
Policy Form
Polity No.
Policy Period From To
Claims Made
Occurrence Based
Umbrella Or Excess
Each Occurrence Current Max Obtainable
Aggregate Current Max Obtainable

Worker's Compensation and Employer's Liability
Insurance Carrier
Policy Form
Policy No.
Policy Period From To
Limits
E.L. Each Accident
E.L. Disease-Policy Limit
E.L. Disease-Each Employee

Automobile Liability

  
Insurance Carrier
Policy Form
Policy No.
Policy Period From To
Combined Single Limit Current Max Obtainable
Bodily Injury (per person) Current Max Obtainable
Bodily Injury (per accident) Current Max Obtainable
Property Damage Current Max Obtainable

Professional Liability Insurance

  
Insurance Carrier
Policy Form
Policy No.
Policy Period From To
Office Policy Limit  
Deductible
Project Specific Limit Available
Extended Reporting Period (tail) Yrs
Prior Acts Yes No
We have attempted to answer the above questions in a full and complete manner to assure that our answers are not in any respect misleading either by expressing ourselves in a misleading or ambiguous manner or omitting information
Form Completed by*
Title*