Name of Company *
Trade *
Company Address *
Contact Person *
Email *
Phone Number *
Cell Number *
County/Parish *
Type of Ownership *CorporationPartnershipSole Proprietorship
Average Annual Revenues (averaged over previous three years) *
Liability Ins. Limit *
Number of Crews available *
Number of Employees *
Type of Business-Federal Certification: (Check ONLY those that apply.)
Small Business
Woman-Owned Business
Small Disadvantaged Business*
HUB Zone*
Veteran Owned
Service-Disabled Veteran Owned*
8(a)*
Those marked with an asterisk* require SBA application and approval. Please enter your SBA ID#:
Other Certifications (State, County, Local, etc.) Please List:
Check all boxes that apply:
Company has experience in disaster recovery work
Number of years:
Company has experience on U.S. Army Corps of Engineers projects
Company has worked/is working on a previous/current project with Kella Services
Services Provided (check all boxes that apply):
Emergency Road Clearance
Debris Removal
Tree Trimming & Removal
Stump Removal
Marine Debris
Sand Screening
HHW Removal
Mulch Haul Out
Grinding
Site Management
Personnel
Asbestos Abatement
Demolition
Other
If ‘other’ is selected, please provide a description:
Equipment Inventory and Description:
(Please enter the number of pieces you have for each of the following equipment.)
Skid Steer w/Bucket (Bobcat): *
Skid Steer w/Grapple (Bobcat): *
Skid Steer (Bobcat) Attachments: *
Tractor with Blade (snow removal): *
Tractor with Sander (snow removal): *
Snowplow: *
Air Curtain Incinerator: *
Water Truck: *
Vacuum Truck: *
Street Sweeper: *
Excavator Steel Track: *
Excavator Rubber Track or Rubber Tires: *
Dump Truck - Single Axle: *
Dump Truck - Double Axle: *
Dump Truck - Tri Axle: *
Dump Truck - Strong Arm/Super 10: *
Dump Truck Utility Truck & Trailer Combination: *
Dump Truck Tractor Trailer "NO FRAMELESS": *
Tractor Trailer Live Bottom: *
Double Barrel Knuckle Boom (Self-Loader): *
Single Barrel Knuckle Boom (Self-Loader): *
Bucket Truck: *
Provide size(s) of Bucket Truck(s):
Wheel Loader - Front End: *
Lightning Loader: *
Other Equipment - Describe:
I understand that contract pricing may not be fully established. Pricing for this work will be determined as specified in the Subcontract Agreement. The Subcontractor agrees to participate, supply needed information, and cooperate with the Contractor in the preparation of pricing proposals and the negotiation of this pricing. *
I certify that the above information is true, that I am authorized to sign this document on behalf of the Company named above, and that it is the Company’s intent to subcontract with Kella Services LLC. for disaster recovery, construction, utility work resulting from this solicitation. *
0 + 4 = ?Please prove that you are human by solving the equation *