350 Christy Creek Rd.
Morehead, KY 40351
SubContractor - PreQualification Application
1. GENERAL INFORMATION :
Date :
Company :
DBA :
Type of Entity :
Date:
FEIN :
NAICS Code:
State :
Date of Formation
Website :
REMIT TO ADDRESS :
2. HEAD QUARTER / PRIMARY ADDRESS :
Street Address :
Street Address :
City :
City :
State :
State :
Zip Code :
Zip Code :
Phone :
Phone :
Fax :
Fax :
3. CONTACT INFORMATION :
Your Information :
Job Title :
Email :
Phone :
Fax :
Job Title :
PO Email :
Primary Contact :
Fax :
Phone :
Alternate Contact :
Job Title :
Email :
Fax :
Phone :
Please provide copies of certificates with term date :
SAM.GOV (Registered)
"System for Award Management"
4. BUSINESS CERTIFICATIONS :
Entity Type
CORPORATION
LIMITED LIABILITY COMPANY
PARTNERSHIP
SOLE PROPRIETORSHIP
State of Formation
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Select state
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Select state
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West
Wisconsin
Wyoming
HUBZone
Serv. Disabled Vet (DVBE)
Minority Owned Business (MBE)
Woman Owned Business (WBE)
Small Business
DBE
Veteran
Large Business
Yes
No
Construction Services
PLEASE CHECK THE BOX TO THE LEFT OF EACH SERVICE PERFORMED BELOW THAT APPLIES.
5. TYPE OF SERVICES AVAILABLE :
Professional Services
PLEASE CHECK THE BOX TO THE LEFT OF EACH SERVICE PERFORMED BELOW THAT APPLIES.
Present Officers Names
Email
Phone
6. LEGAL / FINANCIAL INFORMATION
7. WORK HISTORY
A – Which Carriers Do You Currently Do Work For Directly:
B – What OEM/Carrier Certifications Does Your Team Have:
C – Tower Owner Approved Vender List: Is your company an approved vendor by the below tower companies?
**this does not necessarily mean working directly for the Tower Owner but approved to work on their towers under another contractor**
Below are emails/links to obtain approvals if needed
Vendor.Compliance@Americantower.com
Crowncastle.com/contact-us/contractors-contact.aspx
Vendors@sbasite.com
Tower Owners
D – Does Subcontractor have a subsidiary or affiliate?
Alarm Clearing
Civil / Ground Services
Crane Services
DAS Indoor
DAS Outdoor
Electricians (licensed)
Fire Safety/Prevention
Fuel Tanks and Refueling
MW Install
MW Alignment
Generator Services
HVAC Services (Licensed)
Janitorial Services
Landscaping
Paving (Concrete/Asphalt)
Pest Control (Licensed)
Plumbing (Licensed)
Physical Site Audit (Tower Climb)
Shelter Services
Small Cell
Snow Removal
Tiger Team
Tower modifications Labor
Tower Services (L&A specific)
Tree Services
Welding (Tower)
AM Studies
Environmental Studies
Site Acquisition Services
Title Services
DAS Design
Cultural Studies
FCC Compliance Analysis
Structural Analysis
Architecture Services
Engineering Services
RF Emission Studies
Surveys/Surveyor
MW Design
Crown Castle
SBA
American Tower
Yes
No
Subcontractor affiliation
Subcontractor subsidiary or affiliate "Name"
Subcontractor subsidiary or affiliate "Address"
E – Has Subcontractor ever failed to complete awarded work or been terminated for cause?
Yes
No
Explain What Happened:
(If yes, please explain in detail)
F – Does Subcontractor have any of the following?
None
Judgements
Arbitrations
Liens
Claims
Lawsuits
Explain What Happened:
(If yes, please explain in detail)
7.1 ADDITIONAL WORK HISTORY
Are you providing services for any Carriers or OEMs? If so, please list them below.
How many collocation/new build site installations have you completed, and for Which carriers?
List your fiber, DAS, AAV, and MW installation and design experience?
What testing equipment are you using?
Please list & identify, who you work for and are approved with :
Which carriers?
List installation and design experience?
PIM Tester
Sweep Gear
Fiber Tester
Other :
Specify all equipment you own and can provide.
How many in house crews do you have for your primary service (NOT sub-tier crews)?
Total
Total
Total
Total
Do you use subcontractors?
Tower Crews (3-4-Person):
Tiger Teams (2-Person) :
Civil Crews (2-Person) :
Audit Crews (2-3-Person) :
Yes
No
What work do you subcontract? (Please explain in detail)
SubContractor Prequalification Application Submission only required.