[[[["field24","equal_to","Union"]],[["show_fields","field25,field26"]],"and"],[[["field32","contains","MBE"]],[["show_fields","field33,field35"]],"or"],[[["field32","contains","DBE"]],[["show_fields","field36,field37"]],"and"],[[["field32","contains","SBE"]],[["show_fields","field23,field38"]],"and"],[[["field32","contains","WBE"]],[["show_fields","field43,field44"]],"and"],[[["field32","contains","8a"]],[["show_fields","field41,field42"]],"and"],[[["field32","contains","Other"]],[["show_fields","field39,field40,field45"]],"and"]]
1
Subcontractor Pre-Qualification Form

Thank you for your interest in building a relationship with us!  Please fill in the form below to get started.

Date(today)
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Type of Applicationpick one!

General Information

Company Name
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Contact Person
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Company President's Name
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Company Phone
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Company Website
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Years in Business (Present Name)
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Physical Address:

Street
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City
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State
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Zip
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Mailing Address (if different)

Street
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City
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State
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Zipcode
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Labor Status
Local Name
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Local Number
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ClassificationSelect all that apply
Equal Employment Opportunity StatusSelect all that apply.
Certifying Agency-MBE Status
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Expiration Date MBE-Status
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Certifying Agency-DBE Status
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Expiration Date-DBE Status
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Certifying Agency-SBE Status
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Expiration Date-SBE Status
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Certifying Agency-WBE Status
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Expiration Date-WBE Status
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Certifying Agency-8a Certified Status
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Expiration Date-8a Certified Status
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Other Equal Employment Opportunity StatusList name of other EEO status
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Certifiying AgencyAgency Certifying Other EEO Status
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Expiration Dateof Other EEO Status
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Legal Information

Are you, your company or any of it's owners/officers currently involved in any litigation, mediation, arbitration, or prosecution or defense of formal claims in connection with any contract, project, or subcontract?

Has your company or any affiliated company or any of its principals ever filed for bankruptcy, failed in business, closed a business, defaulted or failed to complete on a contract, or been asked to post collateral against a loss?

PLease list any Korte & Luitjohan projects you have worked on in the past three (3) years:

1. Project Name
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Contract Amount:
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Project Details
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2. Project Name
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Contract Amount
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Project Details
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3. Project Name
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Contract Amount
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Project Details
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Banking References3 preferred - minimum of 1 required.
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Project References3 preferred - minimum of 1 required.
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Please upload any forms by clicking on the "Upload" button below.  You can select 1 or more files at a time. 

At a minimum we will need:

  • W-9
  • Union status Letters
  • Surety Letter

When you have selected all the necessary files, click the "Submit Form" button to submit the form to us. You should get a confirmation email right away, and a personal response within 2 days.

Upload Files
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