Vendor and Supplier Prequalification Questionnaire

Business and professional standing
Please note that information supplied in this section will be taken into account in assessing the outcome of this application where the circumstances of judgement are pertinent to future projects. It will not necessarily constitute a reason for rejection
Is your company or any of its Directors and Executive Officers the subject of ongoing or pending criminal or civil court action (Including for bankruptcy or insolvency) in respect of the business of the business activities currently engaged in?*

YesNo
If yes, please provide details
Has your company or any of its Directors and Executive Officers been in receipt of enforcement/remedial orders (such as those in relation to OSHA, Environmental Agencies, etc.) in the past 3 years?*

YesNo
If yes, please provide details:

References and additional information
Please provide references of current customers*
Please provide address, contact details and name of 2 references for works undertaken in the past 12 months.
Please provide any reference letters or testimonials your company has received within the last 12 months.
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Declaration
I confirm that the information provided in this form is a true and accurate record and correct as of date of submission.*

First NameLast Name
Signature*
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E-Z Bel Construction Vendor and Supplier Prequalification Questionnaire