Subcontractor Information Form

Year Established

Average Number of Employees

Average Gross Revenue

Federal Contracting Experience

Yes No

If Yes, What Volume

Renovation Experience

Yes No

If Yes, What Volume

Contractor Licenses

MD
VA
DC

Federal ID #

Do you have a Federal Government Security Clearance

Yes No

If Yes, What Is Your CAGE Code #

Name of Facility Security Officer

Delivery

UPS #
FedEx #

Business Size

Large Business
Small Business (Under $13 million revenue/year)

Certifying Agency & Minority Classification
(check all that apply)

SBA	DC	MWAA	WMATA
SBE WOSB SDB HUBZone VOSB SD-VOSB 8(a)	LSDBE	LDBE DBE MBE WBE	DBE

Union

Yes No

Geographic Areas Where Performing Work

MD VA DC

OSHA Experience Modification Rate (EMR)

Insurance Company

Agent

Recently Completed Project Reference (1)
Address
Size of Contract
Scope of Work
Contact Person
Telephone Number
Recently Completed Project Reference (2)
Address
Size of Contract
Scope of Work
Contact Person
Telephone Number
Financial Reference
Address
Contact Person
Telephone Number
Trade/Supplier Reference
Contact Person
Telephone Number

Dun & Bradstreet #
Are You Bondable?	Yes No
Bonding Company
Bonding Limit per Project
Total Bonding Program
Bid Range in Dollar Amount
Division/Specification
Capabilities Narrative
Special Equipment / Materials