Major Works Pre-Qualification Application

Major Works Pre-Qualification Application
Please complete the following application to qualify for placement on the Powder River Energy Corporation (PRECorp) Qualified Bidders List (QBL). Contractors must be on the PRECorp QBL to bid on PRECorp construction projects. An incomplete application will not be considered.

You are notified that PRECorp complies with the prevailing wage laws of the State of Wyoming and requires all contractors to comply. Pre-qualification of bidders will be in accordance with the policies, guidelines, and specifications of PRECorp and/or RUS.

Questions concerning this application my be directed to PRECorp's Purchasing and Contract Administrator located at 200 S. Garner Lake Road, Gillette, WY 82716 or telephone (307) 685-3560
ADMIN: General notes
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References

List references of past work completed. Please make sure to provide references for each of your fields of expertise.
Applicant Firm:
Reference 1 Firm Name*
Reference 1 Address

Street Address

Street Address Line 2

CityState

Postal / Zip Code
Reference 1 Contact Name*

First NameLast Name
Reference 1 Contact Number*
Reference 1 Project*
Reference 1 Dollar Amount*
ADMIN: Reference 1 Notes
Reference 2 Firm Name*
Reference 2 Address

Street Address

Street Address Line 2

CityState

Postal / Zip Code
Reference 2 Contact Name*

First NameLast Name
Reference 2 Contact Number*
Reference 2 Project*
Reference 2 Dollar Amount*
ADMIN: Reference 2 Notes
Reference 3 Firm Name*
Reference 3 Address

Street Address

Street Address Line 2

CityState

Postal / Zip Code
Reference 3 Contact Name*

First NameLast Name
Reference 3 Contact Number*
Reference 3 Project*
Reference 3 Dollar Amount*
ADMIN: Reference 3 Notes

Supervision and Personnel information
Provide the following to the drop box below:

Attach a list of all supervisors and key employees, their titles, qualifications, years of experience, professional/trade certifications, and professional/trade memberships
Are you part of a Lineman Apprentice Program?*

YesNo
What lineman apprentice program are you a part of?
Supervision and Personnel Documents*

Note: it is the obligation of the contractor to ensure updated certificates are provided to PRECorp annually.
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ADMIN: Confirm Supervision and Personnel Uploads

Attach a list of all supervisors and key employees, their titles, qualifications, years of experience, professional/trade certifications, and professional/trade memberships
ADMIN: Supervision and Personnel Notes

Insurance Information
Provide workers compensation AND unemployment insurance to the drop box below. Please provide one of the following types of proof of coverage:

Proof of workers' compensation and unemployment insurance from the state of Wyoming (if a Wyoming-based company).Extra-territorial certification from the state of Wyoming for workers' compensation and unemployment insurance (Companies based out of California, Colorado, Idaho, Montana, Nevada, North Dakota, Ohio, Oregon, South Dakota, Utah, or Washington)A letter from your insurance provider stating that workers' compensation and unemployment insurance are not required by the state that your company is incorporated or doing business in.
Provide proof of liability insurance to the drop box below. You should include the following:

$2 million minimum public liability$2 million minimum automobile liability
Insurance Documents*

Note: it is the obligation of the contractor to ensure updated certificates are provided to PRECorp annually.
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ADMIN: Confirm Insurance Uploads

Proof of Coverage$2 million minimum public liability$2 million minimum automobile liability
ADMIN: Insurance Notes

Financial Information
Provide the following to the drop box below:

Last fiscal year's balance sheetLast Income StatementA completed vendor application package
Click here to download the Vendor Application Package.
Financial Documents*

Note: it is the obligation of the contractor to ensure updated certificates are provided to PRECorp annually.
Cancelof
ADMIN: Confirm Financial Uploads

Last fiscal year's balance sheetA completed vendor application packageAccounting has reviewed and approved financials
ADMIN: Financial Notes

Finalization
If you feel there are any documents that should be included that have not been previously requested, please attach them here:

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Submitted Date*

MonthDayYear
Date
Name of Authorized Agent*

First NameLast Name
Title*
Authorized Agent's Signature*

Clear
Should be Empty:

Business Information