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Gilbane Building Company 6 <br /> Prequalification Form for First-Tier Subcontractors under CM at Risk <br /> Orange County Crisis Diversion Facility <br /> COMPANY NAME: <br /> Date Form Received by Gilbane: (To be completed by Gilbane) <br /> Bid Packages: <br /> If your firm is interested in prequalifying for this project, please check the box for your trade(s). If multiple bid packages are <br /> selected, please make sure that project experiences and references are provided to allow Prequalification Committee to <br /> evaluate your firm for EACH bid package selected. <br /> This is a preliminary list of Bid Packages and may change based on response and qualified bidders. <br /> Check Box if Bid Package Scope of Work General Scope Details Approximate Value <br /> Prequalifying ($) <br /> 0 TBD TBD TBD TBD <br /> n <br /> 0 <br /> u <br /> n <br /> u <br /> n <br /> u <br /> n <br /> n <br /> u <br /> n <br /> u <br /> n <br /> u <br /> u <br /> 0 <br /> u <br /> 0 <br /> u <br /> 0 <br /> 0 <br /> u <br /> 0 <br /> u <br /> 0 <br /> Page 2 12 <br />