Fillable Contractor/Vendor Pre-Qualification Form (PQF) (CenterPoint Energy)

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Contractor/Vendor Pre-Qualification Form (PQF) (CenterPoint Energy)

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The Contractor/Vendor Pre-Qualification Form (PQF) (CenterPoint Energy) form is 5 pages long and contains:

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  • 6 check-boxes
  • 91 other fields

Country of origin: US
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Contractor/Vendor Pre-Qualification Form (PQF)
GENERAL INFORMATION
1. Company Name: Telephone: Fax:
2. Contact for Requesting Bids:
Title: Telephone: Fax:
3. Officers
Years With Company
4. Form of Business: Sole Owner Partnership Corporation Joint Venture
Is your company a subsidiary of another company?
If yes, name of Company
Is your business a division of another company?
If yes, name of Company
Is your business franchised by another company?
If yes, name of Company
Has your company engaged in business with CenterPoint Energy within the last 12 months?
If yes, name of CNP location where you are doing business
Are you an employee or relative of an employee of CenterPoint Energy?
If yes, explain:
Business Classification Definitions
Minority Business Enterprise (MBE) -- A minority-owned business, as used in this form, refers to a business that is at least 51-
percent owned by one or more minorities, and whose management and daily business operations are controlled by one or more
minorities.
Asian-Indian -- A U.S. citizen whose origins are from India, Pakistan and Bangladesh.
Asian-Pacific -- A U.S. citizen whose origins are from Japan, China, Taiwan, Korea, Vietnam, Laos, Cambodia, the Philippines,
Samoa, Guam, the U.S. Trust Territories of the Pacific or the Northern Marianas.
African-American -- A U.S. citizen having origins in any of the Black racial groups of Africa.
Hispanic -- A U.S. citizen of true-born Hispanic heritage, from any of the Spanish-speaking areas of Latin America or the
following regions: Mexico, Central America, South America, and the Caribbean Basin only.
Native American -- A person who is an American Indian, Eskimo, Aleut, or Native Hawaiian, and regarded as such by the
community of which the person claims to be a part. Native Americans must be documented members of a North American tribe,
band or otherwise organized group of native people who are indigenous to the continental United States and proof can be
provided through a Native American Blood Degree Certificate (i.e., tribal registry letter, tribal roll register number).
Small Disadvantaged Business (SDB) -- A small disadvantaged business, as used in this document, refers to a small business
1) that is at least 51-percent owned by one or more individuals who are both socially and economically disadvantaged, or a
publicly-owned business whose stock is at least 51-percent owned by one or more socially and economically disadvantaged
individuals and 2) whose management and daily business operations are controlled by one or more such
individuals.
Women Business Enterprise (WBE) -- A women-owned business, as used in this form, refers to a business that is at least 51-
percent owned by one or more women, and whose management and daily business operations are controlled by one or more
minorities.
5. Business Classification
Is your business currently certified as a Minority-Owned Business by any government agency or
purchasing council? Yes No
If yes, please identify from previous list:
Certifying Agency:
Certification Number:
Expiration Date:
Is your business currently certified as a Women-Owned Business by any government agency or
purchasing council? Yes No
Certifying Agency:
Certification Number:
Expiration Date:
Is your business currently certified as a Small Disadvantaged Business by any government agency or
purchasing council? Yes
No
6. How many years has your organization been in business under your present firm name?
7. Contact for Insurance Information:
Title:
Telephone: Fax:
8. Insurance Carrier
If service provider, Please attached a copy of your current ACORD Agreement
9. Are you self insured for Worker’s Compensation Insurance? Yes No
10. General Information PQF Completed By:
Title: Telephone: Fax:
FINANCIAL INFORMATION
11. References:
Customer/Location
Type of
Work/Material
Size
$M
Customer Contact Telephone
12. Are you now or have you ever been involved in any bankruptcy or reorganization proceedings?
If yes, please attach details. Yes No
13. Are you subject to liquidation or debt reduction procedures under state law?
If yes, please attach details. Yes No
14. Are you subject to pending liquidation or regulatory proceedings in state or federal courts which could cause a
substantial deterioration of your financial condition?
If yes, please attach details. Yes No
15. Are you subject to any significant collection lawsuits or outstanding judgments which would significantly affect your
ability to remain solvent?
If yes, please attach details. Yes No
16. Are there any overdue amounts owed to any division or subsidiary of CenterPoint Energy, Incorporated?
If yes, please attach details. Yes No
17. Does your company have any ongoing or pending litigation?
If yes, please attach details. Yes No
18. Financial Information PQF Completed By:
Title: Telephone: Fax:
VENDOR PRODUCT/FACTORY INFORMATION
19. Factory Location(s)
20. Quality Control Program
21. Union Affiliation/Contract Expiration
22. Factory Contact:: Telephone:
Daytime:
Night/Emergency:
Email: Fax:
23. Vendor Product/Factory PQF Completed By:
Title:
Telephone:
Fax:
CONTRACTOR SERVICES INFORMATION
24. Major Equipment Owned:
25. Type of Services Usually Sub-Contracted:
26. Bonding Company:
Name:______________________________________________________________
Address:____________________________________________________________
Bonding Capacity:_____________________________________________________
27. Major jobs completed in the past three years:
Customer/Location
Type of Work Size
$M
Customer Contact Telephone
28. Major jobs in progress:
Customer/Location
Type of Work Size
$M
Customer Contact Telephone
29. Contractor Services PQF Completed By:
Title: Telephone: Fax:
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ContractorVendor Pre-Qualification Form (PQF) (CenterPoint Energy)

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Completed 22 July 2021

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