Contract Questionnaire Request

The Following Is A Checklist Of The Information Necessary To Help You Set Up A Bond Line:

  • Copies of the last three fiscal year-end corporate financial statements, including work in progress & completed contract schedules
  • Current interim corporate financial statement and work in progress report (if fiscal statement is over six months old with an aging of accounts receivables)
  • Current personal financial statements for all indemnitors and/or owners
  • Bank Line of Credit Agreement and current balance
  • Business Plan
  • Most Recent Federal and Personal tax returns
  • Buy/Sell agreement
  • Specimen Copy of Subcontract agreement
  • Certificate(s) of Insurance (for all lines carried)
  • Resumes of Owners/Key employees
  • Brochure and/or Letters of Recommendation on the accomplishments of your company
  • Article of Incorporation (Corp) or Certificate of Formation (LLC)

On An Ongoing Basis, We Will Engage With You To Do The Following:

  • A complete and comprehensive Financial Trend Analysis of your financial results – this involves the review and analysis of your past three to five years of financial statements. The analysis will be similar to that of the Surety Company and will allow us to see how they are looking at your financial condition and trends, so that we can anticipate concerns and proactively address issues to negotiate the most favorable terms for you.
  • Review work in progress schedules regularly to monitor project performance and identify profit fades, profit improvements, under billings and gross profit in your backlog.
  • Initial and annual narratives to the surety on your organization, operations, performance, surety needs, and business goals.
  • Arrange periodic meetings with you and your surety to maintain a positive relationship and address results and needs.
  • Review any unusual bond forms, contract terms and conditions, and advise management of possible onerous terms and conditions that may present potential concerns for the surety.
  • When appropriate and with your permission, secure and maintain a strong back-up surety relationship for your growing needs.
  • Maintain a strong in-house/agency line of credit to provide the most efficient handling of your routine bonding needs.
  • Assist in business planning in order to meet surety needs.
  • Provide advice on your company’s capitalization requirements and key financial ratios that are conducive to meeting your business goals while maintaining and growing your surety capacity and relationship.

Contractor Questionnaire

(Fill in N/A for not applicable)

 Corp Part. Prop. Sub S.Corp

List of the corporate officers, partners or proprietors of your firm:

Name: SSN: Date Of Birth: Postition: % Owned: Home Address: Spouse Indemnitor:
 Yes No
 Yes No
 Yes No
 Yes No
 Yes No
 Yes No

Previous Bonding Companies:

Name: Reason For Leaving

List Five Of Your Largest Contracts:

Job Name: Contract Price: Gross Profit: Completion Date: Bonded?  Yes No
Owner: Architect/Engineer: Fax or Email:
Job Name: Contract Price: Gross Profit: Completion Date: Bonded?  Yes No
Owner: Architect/Engineer: Fax or Email:
Job Name: Contract Price: Gross Profit: Completion Date: Bonded?  Yes No
Owner: Architect/Engineer: Fax or Email:
Job Name: Contract Price: Gross Profit: Completion Date: Bonded?  Yes No
Owner: Architect/Engineer: Fax or Email:
Job Name: Contract Price: Gross Profit: Completion Date: Bonded?  Yes No
Owner: Architect/Engineer: Fax or Email:

List Your Major Suppliers:

Name: Address: Fax Number: Contact:

List Five Subcontractors (or contractors if your a subcontractor) That You Do Business With:

A.
B.
C.
D.
E.

List Three Architects You Have Done Business With:

A.
B.
C.

List Key Personnel, Foreman Or Supervisors:

Name Position Year of Birth Years of Experience Previous Employer

List Any Subsidiaries And Affiliates:

Firm Name Ownership Type Business NANDA Code

SERVICE FEE AGREEMENT (If applicable)

This agreement is for a service fee. A service fee may or may not be part of the premium charged by a surety company.

This agreement is made between Dale Group, Inc. and (hereinafter referred to as Insured) on this Day of 20

It is agreed that a fee is being charged for the Producer providing the services of marketing, bond issuance and all other related customer service duties. This fee is continuous and annually renewable until mutually cancelled by both parties.

(This form needs to be signed and dated)
PERSONAL FINANCE STATEMENT AS OF:
Name of Individual Social Security No. Date of Birth
Name of Spouse Social Security No. Date of Birth
Address Home Phone Number
ASSETS LIABILITIES
Account Balance Account Balance
Cash in Banks Loans Payable - Banks
Notes Receivable Notes Payable
Accounts Receivable Accounts Payable
Stocks/Bonds/Securities Taxes Payable
Real Estate - Residence Mortgages Payable
Real Estate -Investment/Other Other Liabilities
Cash Value Life Insurance
Personal Property TOTAL LIABILITIES
Other Assets NET WORTH
TOTAL ASSETS: TOTAL NET WORTH & LIABILITIES:
Salary Bonus/Others Spouse's Salary $ Bonus/Others
INCOME: TOTAL INCOME:

Supplenmentary Schedules Of Assets And Liabilities

(NOTE: All data listed above must appear in the appropriate schedules. Insert “None??? where appropriate)

CASH IN BANKS
Bank Name, Number, & Location Account No. Amount
Notes & Accounts Receivable
Name & Address of Debtor Amount Due Due Date Pledged(yes/no) Security
 Yes No
 Yes No
 Yes No
Stocks/bonds/securities
Name & Number(s) of Instrument No. Of Shares Price/Share Market Value Exchange & Call
REAL ESTATE (Residence/Investment/Other)
Location and Description Year Acq'd Cost Market Value Monthly Income Monthly Payment Mortgage Balance Mortgage or Lien Holder
Cash Value Of Life Insurance
Name of Insurance Beneficiary Face Value Cash Value Loans Outstanding
Other Assets
Description Title Holder Cost Market Value Age
Loans Payable
Name of Lender Address Balance Due Due in One Year How is it secured?
OTHER LIABILITIES
Description Payable to whom Amount Monthly Payment Due Date Security

BANK REFERENCE QUESTIONNAIRE

*Please forward to your bank for completion*

ACCOUNT STATUS

Credit/Borrowing Information

 Yes No

WORK ON HAND

Name of Contractor: Date as of:
Description of Job Starting Date Completion Date Bonded? Contract Price including cost of approved change order Total Cost Total Billed To Date including cost of approved change orders Total Cost to Date Total Revised Estimated Cost to Complete
1.
2.
3.
4.
5.
6.
Totals
Total Uncompleted Work Total Uncompleted Work by Subcontractor:
Bonded Unbonded
Signature Title

Blanket Authorization Form

Authority is hereby granted to any Individual, Firm, or Corporation and any financial institution to furnish Dale Group, Inc. upon its request, with any information concerning or pertaining to the undersigned’s financial standing, credit or manor of meeting obligations. A copy of this agreement shall be considered the same as the original. This authorization is to remain in force until rescinded by the applicant in writing.

Signed this Day of Year

RESUME

*This form is optional - fill it out or send an existing resume

PERSONAL DATA

EDUCATION

 Yes No

BUSINESS & PROFESSIONAL EXPERIENCE

(indicate firm name, length of time employed, occupation/position, reason for leaving and, if construction related, largest project you were involved in)

EMPLOYMENT HISTORY

(beginning with current job)

PROFFESSIONAL REFERENCES

Name Address Phone No. Length of Time Acquainted
Please leave this field empty.