| 1. Company General Information |
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| 3. Last Fiscal Year-End and Current Business Financial Statements, including Profit and Loss, as prepared by an outside accountant or CPA |
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| 4. Personal Financial Statements on all major stockholders or partners of business |
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| 5. Describe Your Current Uncompleted Projects |
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| 6. Type of Organization |
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| 7. Please list residence address of all Officers (of a Corp.), Partners (of Partnership), or Principal (of a Proprietorship). Be sure to include zip codes |
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| 8. Contractors License Information |
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| 9.In What Class of Construction do you Specialize? |
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| 10. How long has this Organization been in business? |
| Number of years: |
| 11. Do you have an ownership interest in any other Business? Fully describe |
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| 12. Describe any previous Organization(s), including dates and reasons for disposition |
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| 13. Do you have any Affiliated Companies? If so, describe |
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| 14. How many Contracts do you normally have underway at any one time? |
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| 15. Average size, largest job your Co. has ever done (in $), please describe |
Owner
Address of Owner:
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| 16. In dollars, what is the largest amount of Uncompleted Work on Hand you have ever carried? |
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| 17. What were your gross sales in each of the past 3 fiscal years? |
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| 18. Bond Contract Information |
Have you ever had a contract Bonded before?
If yes, provide Name of Surety:
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| 19. Financial Information |
When is your Fiscal Year End?
Who prepares your Fiscal Year End Financial Statement?
Phone #
Do you have Interim Financial Statements prepared? If so, how often?
Other
Is your Financial Statement fully audited? If not, do you have plans to have your next Fiscal Year End Financial
Statement audited? Has your organization ever been audited by IRS?
Are your taxes current at this time?
If not, please explain:
On what accounting basis are your financial statements prepared?
Percentage of Completion: %
Please list Completed Contracts recently performed.
Who is the bookkeeper of your organization?
Phone #
What is their construction experience?
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| 20. Have you ever failed to complete a contract? If yes, give details |
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21. Are you presently involved in any disputes, liens, surety claims? If yes, fully describe
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| 22. With whom do you bank? |
Branch
Phone #
Name of Officer with whom you deal
Do you have an established line of credit? How much?
What is given as collateral to secure this line of credit?
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| 23. Employees Information |
List Key Employees, including Principals
Present position, years construction, experience, age, summarize education, magnitude and type of work handled, and in what capacity?
How long with your firm? years |
| 24. Suppliers Information |
Please list five of your suppliers (Name, Address, Phone, Person to Contact)
Approximately how many Suppliers do you deal with? |
| 25. SBA loans |
Do you currently have an SBA loan?
If yes, which bank?
How much was the total loan?
What is the outstanding balance
Are payments current ?
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| 26. Equipment Information |
Do you have adequate equipment to process your jobs, or do you usually lease or rent?
Are you contemplating buying any significant equipment in the next year? If so, what?
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| 27. Personal Financial Statement |
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| 28. Comments |
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INDEMNITY AGREEMENT - READ CAREFULLY
I/we the undersigned hereby declare that the above statements are true and correct. I/we hereby apply to
CSIS Inc. for a Contractors License Bond pursuant to the appropriate sections of the
Business and Professions Code. I/we agree individually and as a firm to fully indemnify and hold
CSIS Inc. harmless from and against any and all claims or demands or legal expense of any kind or nature
which arise by reason of the execution of any bond issued pursuant to this application.
I/we further understand the bond applied for is a credit relationship, and hereby authorize
CSIS Inc. or its authorized agents, to gather such credit information it considers necessary and appropriate
for purposes of evaluating whether such credit should be granted or continued. I/we agree to pay Surety an advance
premium for the first year or a fractional part thereof that is fully earned and to pay annually thereafter such
annual premium for surety ship as is billed until satisfactory evidence of discharge or release of liability shall
be furnished to Surety by the obligee.
Initials:
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