Contractor's Surety Survey Initial Information Requirements to Qualify for Bonding Credit 1046 1/2 E. Hwy. 50 - Salida, Colorado, 81201 (719)539-0144 - (800)571-2026 - Fax (719)539-4696 This Applies to Construction Bonds Only Please Feel Free to Contact Us, Should You Have Any Questions.
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Name		Phone
Address		Fax
City		E-Mail
State	Click to Select Colorado Kansas New Mexico Utah Wyoming	Type of Organization	Click to Select Corporation Partnership Limitsd Partnership Proprietorship
Date Business Formed		Date Incorporated
	If Successor to Prior Business, Name of Predecessor Organization

LIST OF OFFICERS AND KEY PERSONNEL

Name	Position and Responsibility	Age	Percent Ownership	Years in Construction	Years With Company	Social Security Number

LIST OF AFFILIATED, SUBSIDIARY, OR RELATED COMPANIES IN WHICH THIS FIRM OR ITS STOCKHOLDERS HAVE AN INTEREST

Name	Address	Stock Ownership	Type of Business	Endorsement by Principal or Stockholders
		yes no		principal stockholders
		yes no		principal stockholders
		yes no		principal stockholders
		yes no		principal stockholders
		yes no		principal stockholders

Name Surety Company Presently Providing Contract Bonds
Through Which Agency
If Change Derired, Why
What Company Was Surety Prior to Current One
For How Long
State Limits and Carrier of Liability, Property, and Compensation Insurance

SCOPE OF OPERATION

Type of Construction Engaged In	Click All That Apply General HVAC Plumbing Electrical Excavating Concrete Sewer Water Lines Paving Roofing Painting Bridge Work Masonry Manufacturing
Other
Geographical Area
Percent Work Done As:
Primary Contractor
Subcontractor
Percent of Work Bonded
Percent of Work Public
Percent of Work Private
Percent of Average Job Sublet
Percent of Average Job Made Up of Materials
Are Bonds Required of Subcontractors	yes no
What is the Largest Work on Hand Handled in the Past Year
All Time
Year
What Size Contracts Do You Think Your Organization is Best Able to Handle
How Many
Are You a Union or Non-Union Contractor	union non-union

LIST OF LARGEST JOBS THE FIRM HAS COMPLETED

Contract Price	Description of Job	Year Completed	Bonded?	Owner or General Contractor	Name and Address of Architect/Engineer
			yes no
			yes no
			yes no
			yes no
			yes no

Has Contractor or Any of the Owners Ever:
Defaulted on a Contract	yes	no	If Yes, Give Details
Caused a Surety to Pay a Loss	yes	no	If Yes, Give Details
Petitioned for Bankruptcy	yes	no	If Yes, Give Details
Is This Organization Presently Engaged in Any Litigation	yes	no	If Yes, Give Details
With Respect to Present Work on Hand:
Were Bids in Line With Other Bidders	yes	no	If Not, Give Details
Are Projects All on Schedule	yes	no	If Not, Give Details
Are Any of the Jobs in Dispute	yes	no	If Yes, Give Details
Is Equipment Adequate for Work Program Desired	yes	no	If Not, What Expenditures Are Anticipated

CREDIT INFORMATION

List Principal Suppliers:

Name	Address	City & State	Phone

Accountant's Name	Address	Phone	Person to be Contacted

FINANCIAL DATA

Date of Organization's Year End
What Method of Accounting is Used in Preparing Statements	Click to Select % of Completion Completed Contract Simple Accrual Cash
On What Basis of Accounting Are Taxes Paid	Click to Select % of Completion Completed Contract Simple Accrual Cash
Have Stockholders Elected to be Considered a "Sub Chapter 'S' Corporation	yes no
When Was Contractor Last Checked by the I.R.S.
Is Personal Indemnity of the Owners/ Stockholders Available	yes no

Life Insurance in Force:
Name	Carrier	Beneficiary	Amount	Surrender Value

Is Buy/Sell Agreement in Affect	yes no
What Are Buy-Out Provisions
How is Continuity of the Business to be Funded
Have Operations Been Profitable Since Last Statement Date	yes no
How Frequently Are Job Costs Reviewed
By Whom
Have Any Changes Occured Since Last Statement Date Such as Purchase of Additional Equipment or Other Fixed Assets, Loans to Officers, Investments, Withdrawals or Dividends That Would Significantly Affect the Financial Condition
Are Any New Ventures Contemplated	yes no

SURETY CREDIT NEEDS

Desired Annual Sales Volume		3 Years From Now
Desired Maximum Uncompleted Work-On-Hand at Any One Time		1 Year From Now
Desired Maximum Single Job Size		1 Year From Now
The Information Given Above is True to the Best of My Knowledge and Belief.	by:	Title: