Bid and Performance Bond Application
 
Insurance Guide for Bid & Performance Bond
 
1. Company General Information
Company Name: *
Phone *
 Fax
 2. Company Address
MAILING
Street Address
City
State
 Zip
PREMISE
Street Address
City
State
 Zip
3. Last Fiscal Year-End and Current Business Financial Statements, including Profit and Loss, as prepared by an outside accountant or CPA
4. Personal Financial Statements on all major stockholders or partners of business

5. Describe Your Current Uncompleted Projects
6. Type of Organization
Sole Proprietorship
Corporation - list all stockholder names, titles, and % owned.
Partnership - list all Partners.
Social Security or Federal Tax ID Number:
7. Please list residence address of all Officers (of a Corp.), Partners (of Partnership), or Principal (of a Proprietorship). Be sure to include zip codes
8. Contractors License Information
Contractors License Number:
License Class:
In What Satets are you Licensed?
9. In What Class of Construction do you Specialize?
10. How long has this Organization been in business?
Number of years:
11. Do you have an ownership interest in any other Business? Fully describe
12. Describe any previous Organization(s), including dates and reasons for disposition
13. Do you have any Affiliated Companies? If so, describe
14. How many Contracts do you normally have underway at any one time?
15. Average size, largest job your Co. has ever done (in $), please describe

Owner

Address of Owner:
16. In dollars, what is the largest amount of Uncompleted Work on Hand you have ever carried?
17. What were your gross sales in each of the past 3 fiscal years?
Most Recent Year
Previous Year
Previous Year
18. Bond Contract Information
Have you ever had a contract Bonded before?

If yes, provide Name of Surety:
Year Bonded:
Job satisfactorily completed?
Bond Amount:
Why left?
Phone #
19. Financial Information
When is your Fiscal Year End?

Who prepares your Fiscal Year End Financial Statement?

Phone #

Do you have Interim Financial Statements prepared? If so, how often?
Other
Is your Financial Statement fully audited? If not, do you have plans to have your next Fiscal Year End Financial Statement audited? Has your organization ever been audited by IRS?

Are your taxes current at this time?

If not, please explain:

On what accounting basis are your financial statements prepared?

Percentage of Completion: %
Please list Completed Contracts recently performed.

Who is the bookkeeper of your organization?

Phone #

What is their construction experience?
20. Have you ever failed to complete a contract? If yes, give details
21. Are you presently involved in any disputes, liens, surety claims? If yes, fully describe
22. With whom do you bank?
Branch

Phone #

Name of Officer with whom you deal

Do you have an established line of credit? How much?

What is given as collateral to secure this line of credit?
23. Employees Information
List Key Employees, including Principals

Present position, years construction, experience, age, summarize education, magnitude and type of work handled, and in what capacity?

How long with your firm? years
24. Suppliers Information
Please list five of your suppliers (Name, Address, Phone, Person to Contact)

Approximately how many Suppliers do you deal with?
25. SBA loans
Do you currently have an SBA loan?
If yes, which bank?

How much was the total loan?

What is the outstanding balance

Are payments current ?
26. Equipment Information
Do you have adequate equipment to process your jobs, or do you usually lease or rent?

Are you contemplating buying any significant equipment in the next year? If so, what?
27. Personal Financial Statement
SECTION 1 - INDIVIDUAL INFORMATION
Your Name
Social Security #
Date of Birth
Street Address
City
State
 Zip
Years at Address
Phone #
Marital Status
Previous address if at above less than 5 years

Employer Name, Address, and Phone #
 
SECTION 2 - SPOUSE'S INFORMATION
Spouse's Name
Social Security #
Date of Birth
Spouse's Phone #
Spouse's Employer Name, Address, Phone #
28. Comments
 

INDEMNITY AGREEMENT - READ CAREFULLY

I/we the undersigned hereby declare that the above statements are true and correct. I/we hereby apply to Commercial Specialists Insurance Services, Inc/CSIS. for a Contractors License Bond pursuant to the appropriate sections of the Business and Professions Code. I/we agree individually and as a firm to fully indemnify and hold Commercial Specialists Insurance Services, Inc/CSIS. harmless from and against any and all claims or demands or legal expense of any kind or nature which arise by reason of the execution of any bond issued pursuant to this application.

I/we further understand the bond applied for is a credit relationship, and hereby authorize Commercial Specialists Insurance Services, Inc/CSIS. or its authorized agents, to gather such credit information it considers necessary and appropriate for purposes of evaluating whether such credit should be granted or continued.

Initials: *

E-mail Address *

Enter Text Above: *
 
 ©2005 Commercial Specialists Insurance Services. All rights reserved. 
License # 0D80851