Pneumatic Dust Control in Grain Elevators: Guidelines for Design Operation and Maintenance (1982)

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Appendix B SAMPLE OF A CONTRACTOR'S QUALIFICATION STATEMENT The following Contractor's Qualification Statement, developed by the American Institute of Architects, illustrates the design of such a document. A qualification statement for designers and installers of pneumatic dust-collection systems for the grain industry would have to be tailored to the needs of that industry. 95

96 THE AMERICAN INSTITUTE OF ARCHITECTS AIA Document A305 Contractor's Qualification Statement 1979 EDITION Required in advance of consideration of application to bid or as a qualification statement in advance of award of contract. Approved and recommended by The /American Institute of Architects and The Associated Genera/ Contractors of America. The Undersigned certifies under oath the truth and correctness of all statements and of all answers to questions made hereinafter. SUBMITTED TO: ADDRESS: SUBMITTED BY: NAME: ADDRESS: PRINCIPAL OFFICE: Corporation Partnership Individual Joint Venture Other D D D D 1.0 How many years has your organization been in business as a General Contractor? 2.0 How many years has your organization been in business under its present business name? 2.1 Under what other or former names has your organization operated? AIA copyrighted material has been reproduced with the permission of The American Institute of Architects under permission number 82018. Further reproduction is prohibited. Because AIA Documents are revised from time to time. users should ascertain from the AIA the current editions of the Document reproduced herein. Copies of this AIA Document may be purchased from the American Institute of Architects or its local distributors. Copyright 1964, 1969, © 1979 by The American Institute of Architects, 1735 New York Avenue, N.W., Washington, D.C. 20006. Reproduction of the material herein or substantial quotation of its provisions without permission of the AIA violates the copy- right laws of the United States and will be subject to legal prosecution. AIA DOCUMENT A305 • CONTRACTOR'S QUALIFICATION STATEMENT • MARCH 1979 EDITION • AIA« ©1979 • THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 A30S-1979 1

97 3.0 If a corporation answer the following: 3.1 Date of incorporation: 3.2 State of incorporation: 3.3 President's name: 3.4 Vice-president's name(s): 3.5 Secretary's name: 3.6 Treasurer's name: 4.0 If an individual or a partnership answer the following: 4.1 Date of organization: 4.2 Name and address of all partners (State whether general or limited partnership): \.s 5.0 If other than a corporation or partnership, describe organization and name principals: 6.0 List states and categories in which your organization is legally qualified to do business. Indicate regis- tration or license numbers, if applicable. List states in which partnership or trade name is filed. AIA DOCUMENT A305 • CONTRACTOR'S QUALIFICATION STATEMENT • MARCH 1979 EDITION • AIA« ©1979 • THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 A305-1979 2

98 7.0 We normally perform the following work with our own forces: 8.0 Have you ever failed to complete any work awarded to you? If so, note when, where, and why: 9.0 Within the last five years, has any officer or partner of your organization ever been an officer or partner of another organization when it failed to complete a construction contract? If so, attach a separate sheet of explanation. 10.0 On a separate sheet, list major cowsmjction projects your organization has in process, giving the name of project, owner, architect, contract amount, percent complete, and scheduled completion date. 11.0 On a separate sheet, list the major projects your organization has completed in the past five years, giving the name of project, owner, architect, contract amount, date of completion, and percentage of the cost of the work performed with your own forces. 12.0 On a separate sheet, list the construction experience of the key individuals of your organization. AIA DOCUMENT A305 • CONTRACTOR'S QUALIFICATION STATEMENT • MARCH 1979 EDITION • AIA« ©1979 • THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 A305-1979 3

99 13.0 Trade References: 14.0 Bank References: 15.0 Name of Bonding Company and n' address of agent AIA DOCUMENT A30S • CONTRACTOR'S QUALIFICATION STATEMENT • MARCH 1979 EDITION • AIA« ©1979 • THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 A305-1979 4

100 16.0 Attach a financial statement, audited if available, including Contractor's latest balance sheet and income statement showing the following items: A. Current Assets (e.g., cash, joint venture accounts, accounts receivable, notes receivable, accrued income, deposits, materials inventory and prepaid expenses): B. Net Fixed Assets: C. Other Assets: D. Current Liabilities (e.g., accounts payable, notes payable, accrued expenses, provision for income taxes, advances, accrued salaries, and accrued payroll taxes): E. Other Liabilities (e.g., capital, capital stock, authorized and outstanding shares par values, earned surplus, and retained earnings): Name of firm preparing financial statement and da Is this financial statement for the identical organization named on page one? If not, explain the relationship and financial responsibility of the organization whose financial state- ment is provided (e.g., parent-subsidiary). Will this organization act as guarantor of the contract for construction? AIA DOCUMENT A305 • CONTRACTOR'S QUALIFICATION STATEMENT • MARCH 1979 EDITION • AIA» ©1979 • THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 A305-1979 5

101 17.0 Dated at this Name of Organization: day of 19 By: Title: 18.0 M that he/she is the Contractor(s), and that answers to the foregoing questionj true and correct. Subscribed and sworn befor Notary Public: My Commission Expires: being duly sworn deposes and says of 'atements therein contained are day of 19 'AIA DOCUMENT A305 • CONTRACTOR'S QUALIFICATION STATEMENT • MARCH 1979 EDITION • AIA« ©1979 • THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 A305-1979 6