SUBCONTRACTOR APPLICATION FORM
    
 
ITJAS001
Dear Contractor,
IEI is happy to supply you with information about performing work on HUD owned properties. We will be pleased to review your application once properly completed. PLEASE READ EVERYTHING CAREFULLY BEFORE PROCEEDING FURTHER.

Thank you for your time and interest. Should you have any questions, please contact us.
IEI
Subcontractor Resource Dept: 816-600-5711 / tlederle@ieinc.net
IEI New application
Change to existing
I. CONTRACTOR INFORMATION
Company Name:*
Street Address:
Suite:
City:
State:
Zip Code:
Contact Person(s):
1)
 
2)
Type of Organization:
Federal Tax ID or SSN:
Choose all that apply  
Small business?
Yes No
Disadvantaged business?
Yes No
Woman-owned business?
Yes No
Service Disabled Veteran Business?
Yes No
HUB Zone Business?
Yes No
8(A) Contractor?
Yes No
If you, or any of your immediate family members, are related to or have any affiliation with any principal or employee of HUD or IEI, give names and explain relationships?
Please list all available numbers, including area code, where you might be contacted. The time frame associated with some work is limited; therefore, it is important that we are able to contact you quickly.
Office:
Fax:
Home:
Mobile:
Email:
Other:
II. SERVICES
The following is a list of job categories. Please check the type of work for which you are qualified and wish to perform.
Property Preservation
Lawn, Tree, Snow Care
Environmental; Mold, Lead, Asbestos, Hazardous Waste
Electrical, Plumbing, Roofing, General Contractor
Demolitions
Termite/ Pest Inspection & Control
Septic & Well Inspection
Engineering
III. COVERAGE AREA
Please select in which county(s) you are interested in performing the above-described work:
 

IV. LICENSING
It is a requirement for your company to supply IEI with a copy of each license required to perform any work you have specified you perform. Please list below all contractor licenses, business licenses, etc., held and the corresponding license number that is currently on file with the state.
Also, if you use a sub-contractor to perform any of the work requiring a license, you will be required to submit a completed "License Acknowledgement" and to maintain a current copy of their license in our records at all times.
License Type:
License #:
License Type:
License #:
License Type:
License #:
License Type:
License #:
V. INSURANCE REQUIREMENTS:
Any contractor that wishes to perform work on HUD properties is required to have the following insurance certifications submitted prior to any work being awarded. This is in accordance with the clause of FAR 52.2228-5, insurance-work on a Government installation. Each time a contractor submits for a work category to be added, a revised Insurance Certificate MUST be received which includes the new category prior to any of that type of work being awarded.
SELECT
TYPE OF INSURANCE
REQUIRED MINIMUM COVERAGE
General Liability $1,000,000 per occurrence
Automobile Liability (Comprehensive form) $1,000,000 per person
Bodily Injury $300,000 per occurrence
Property Damage $20,000 per occurrence
Workers Compensation $100,000
Contractor is required to obtain and maintain the above amounts of minimum insurance coverage's throughout the period that work is performed on HUD owned properties. Contractor also agrees to obtain identical certificates from any and all sub contractors used in the performance of said work. Copies of the subcontractors' certificates must be also be provided to IEI, who must issue copies to HUD. If contractor uses different insurance agents to provide each different type of insurance.
VI. PRICING REQUIREMENTS
Please indicate your required compensation for the following work order types:
Initial Inspection:
Winterization:
Securing:
Initial Clean-out:
Lawn Cut - Initial:
Routing(BMI) Inspection:
Lawn Cut Routine: