SUB-CONTRACTOR QUESTIONNAIRE

Sub-Contractor Questionnaire

*Please fill out all required fields

First Name

Last Name

Legal Company Name

Company Corporate HQ Address

City

State

Zip

Business Telephone Number

Operations Point of Contact (POC)

Operations POC Title

Operations POC's Telephone Number

Operations POC's Email Address

Safety Officer's Name

Safety Officer's Telephone Number

Safety Officer's Email Address

Safety Officer's Title

Year Company was Founded

State of Incorporation

Type of business (LLC, S-Corp, C-Corp)

EMR Rating for 2020, 2021 & 2022

Has your company been cited for OSHA violations in the past 10 years? If yes, please explain and provide dates associated with the violation and what steps have been taken to ensure compliance.

If you answered no to the above question, do you have a safety program in process? If so, what date will it be completed?

If you answered yes, please upload a copy of your safety manual here.

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How many W-2 employees does your company employ?

How many civil crews do you currently have available?

How many Tower Crews do you currently have available?

What would you say your companies core competencies are?

Please upload a copy of your Certificate of Insurance showing PCI GlobalCom as the additionally insured. See bottom of page for sample document.

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Please upload a signed copy of our Master Services Agreement (MSA) here. See bottom of page for sample document.

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Please upload a signed copy of our Non-Disclosure Agreement (NDA) here. See bottom of page for sample document.

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What is your preferred geographical project location? Required

Please upload a copy of your capabilities brief here.

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Please list at least three references for projects your company was a sub-contractor on. Please provide the name, email address, telephone number and the date of the project.

Please upload a copy of your organizational chart here.

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Thanks for submitting!

Please list at least three references for projects your company was a sub-contractor on. Please provide the name, email address, telephone number and the date of the project.

Please see the sample documents below, including CUI, MSA, NDA, and COI sample documents. This section is for reference only, please submit your completed documents above.

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