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Gilbane Building Company 11 <br /> Prequalification Form for First-Tier Subcontractors under CM at Risk <br /> Orange County Crisis Diversion Facility <br /> SECTION 2. GENERAL REQUIREMENTS <br /> 2.1. Number of Construction Protects Under Contract <br /> How many projects do you CURRENTLY have under contract or in progress and what is their total dollar value? <br /> A: Number of Projects Under Contract: <br /> B: Current Projects Contract Amount: $ <br /> C: Current Amount Remaining to Bill: $ <br /> (Prequalification Ratings Matrix: If section completed give 1 point. If not,give 0 points.) <br /> 2.2. Largest Job Completed <br /> What was your largest job COMPLETED within the last three years? _ <br /> A: Dollar Amount: $ <br /> B: Location: <br /> C: Year Completed: <br /> (Prequalification Ratings Matrix: Take dollar amount of largest job completed within the last three years and multiply by <br /> 1.25. If the result is larger than the estimated budget for this bid package give 4 points. If the result is smaller,give 0 <br /> points.) <br /> 2.3. Office Location <br /> Will this project be managed and directed from an office in NC? An office in NC is defined as "The principal place <br /> from which the trade or business of the bidder is directed or managed," per GS143-59(c). <br /> =Yes I=No <br /> (Prequalification Ratings Matrix. If office location is managed and directed from NC office give 1 point. If not,give 0 points.) <br /> 2.4. Litigation/Claims Last 5 Years <br /> Has your company been involved in any judgments, claims, arbitrations, mediation proceedings, or suits within the <br /> last five years,whether resolved or still pending resolutions? =Yes =No <br /> If yes, state the project name(s),year(s), case number and reason why: <br /> (Prequalification Ratings Matrix: If company has been involved in any litigation indicated above without adequate <br /> explanation,give 0 points.If no,or if adequate explanation provided,give 3 points.) <br /> 2.5. Litigation/Claims Currently Outstanding <br /> Are there currently any judgments, claims, arbitration or mediation proceedings or suits pending or outstanding <br /> against your company, its officers, owners or agents? DYes =No <br /> If yes, state the project name(s),year(s), case number and reason why: <br /> (Prequalification Ratings Matrix: If there are currently any litigation indicated above against your company without <br /> adequate explanation,give 0 points.If no,or if adequate explanation provided,give 3 points.) <br /> Page 7 112 <br />