Contractor Application Form - Grand Prairie Housing and Neighborhood Services

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Home
About GPHNS
- About GPHNS
- FAQs
Housing Services
Neighborhood Services
Home Buyers
- Home Buyer Resources
- FAQs
Contact
Log In

Contractor's Application Form

NOTE: ALL CONTRACTORS MUST BE LICENSED AND BONDED WHEN APPLICABLE WITH THE CITY OF GRAND PRAIRIE.

Step 1 of 3 - Company Information

33%

Please Attach:
1) General Liability Certificate of Insurance $1 million, Automobile Liability $1 million, Employer Liability $1 million
2) Workmen’s Compensation Certificate of insurance Statutory
3) Subcontractor List with applicable copy of general liability and/or Workmen’s Compensation
4) Assumed Name Certificate and/or EIN documentation
5) Completed W-9
6) Lead-Base Paint Renovation & Remodeling Training (HUD approved)
7) SAM registration
8) DUNS number
Name of Company
Race
SS#
Owner's Name
First Last
Owner's Address
Street Address Address Line 2 City State ZIP Code
Office Phone
Email
Fax
Office Hours
Time

:
Time

:
After what time may we call you at home?

:

Are you a General Contractor (all phases of work)?
- Yes
- No
When were you established as an Independent Contractor?
MM slash DD slash YYYY
What is your specialty?
Can you contract in all areas of the City?
- Yes
- No
List all suppliers starting with largest volume credit account

Name, Address, and Phone number
List three most recent jobs completed

Name, Address, and Phone number
Do you carry bodily injury and property damage insurance?
- Yes
- No
How much?
Do you carry workers compensation?
- Yes
- No
How much?
Do you guarantee your work for one (1) year?
- Yes
- No
If not, how long?
Do you comply with nondiscrimination policy concerning employees and contractors?
- Yes
- No
If not, state why?
Yearly gross volume of contracted work
- $0 –25,000
- $25,000 – 50,000
- $50,000 – 100,000
- $100,000 - 150,000
- ABOVE

I CERTIFY THAT THE ABOVE INFORMATION IS TRUE AND COMPLETE.
I authorize the program to verify all information on this application and obtain a credit report.
Signature
Date
MM slash DD slash YYYY
File
Max. file size: 50 MB.
ALL INSURANCE IN FAVOR OF THE CITY OF GRAND PRAIRIE WITH A 30-DAY NOTICE OF CANCELLATION UPON BEING PLACED ON THE BIDDERS LIST, YOU MUST PICK UP A CONTRACTOR’S GENERAL SPECIFICATIONS HANDBOOK

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PY 2020-2021 CAPER Notice
2020 – 2024 CONSOLIDATED ANNUAL PLAN
PY21 NOTICE OF INTENT TO REQUEST RELEASE OF FUNDS
Emergency Housing Voucher Program Availability
PY2021 Community Development Block Grant (CDBG) and HOME Programs

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