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State of North Carolina <br />Prequalification for Single Prime Contractors <br />Section 1. MINIMUM REQUIREMENTS <br />1. a. General Company information (Primary /Main office location) <br />Company Name <br />Physical Address <br />Mailing Address <br />City /State Zip Code + 4 <br />Phone number Fax number <br />Primary Contact Name Secondary Contact Name <br />Primary Contact Email Address Secondary Contact Email Address <br />Organization <br />1. b. Business type (check box) LL Corporation LL Partnership LL Limited Liability Company LL Sole Proprietor LL Joint <br />Venture <br />1. c. Type of Work (check box) LL General Construction LL Electrical LL Mechanical LL Plumbing LL Other (please specify) <br />1. d. Licensing information (Please provide all North Carolina professional licenses required for you to perform your <br />services.) <br />NC License Type (check box) L- General Construction LL Electrical LL Mechanical LL Plumbing LL Other (please specify) <br />NC License number License Limit /Level State /County /City Privilege License (provide copy) <br />Bonding <br />1. e. (1) Attach letter, dated within the last 30 days, from your surety company, signed by their Attorney in Fact, <br />verifying their willingness to issue sufficient payment and performance bonds for this project, on behalf of your firm or <br />its agent licensed to do business in North Carolina, and verifying your company's capability and capacity based on your <br />current value of work. Surety company bond rating shall be rated "A" or better under the A.M. Best Rating system or <br />The Federal Treasury List. <br />Have you attached a surety letter? LL Yes LL No <br />Prequalification_Form_03 -01 -11 2 of 12 <br />Attachment number <br />F -1 Page 77 <br />