CUF Form

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City of St. Louis
Commercially Useful Function (CUF) Review – Part I
I General Information
1. Date of Interview:
2. Project Name:
3. Contracting Agency:
4. M/W/DBE Name:
5. Firm Address, City, State, Zip:
6. Name of President/CEO:
7. Telephone:
Fax:
Cell:
8. MBE
E-Mail:
WBE
DBE
9. Are you certified by the: City of St. Louis
State of Missouri
Metro (formerly Bi-State)
MoDOT
Small Business Admin
IDOT
SLMBC
______YES
______YES
______YES
______YES
______YES
______YES
______YES
______NO
______NO
______NO
______NO
______NO
______NO
______NO
10. What is the principal’s percent of ownership in the company?
11. Who are the officers of the company and their individual ownership in the company:
12. What is your business organization?
Partnership
Corporation
Limited Liability Company
13. What is the age of your company?
14. What is the bonding capacity of your company?
15. What is the financial strength of your company any liens and/or tax problems?
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City of St. Louis
Commercially Useful Function (CUF) Review – Part I
I General Information (cont.)
16. Please list major customers or projects of the business for the last two year (list most
recent first). If new business, list previous business references.
Customer
Telephone
Contact
Person
Type of Project
Contract
Amount
Year
**
***
SUB NU
SUB NU
SUB NU
SUB NU
SUB NU
SUB NU
SUB NU
SUB NU
SUB NU
** Indicate whether you were a (P) Prime Contractor; (JV) Joint Venture; (SUB) Subcontractor
*** Indicate Union (U) or Non-Union (NU).
II Taxes
1. Current with City Taxing & Licensing Requirements?
Yes
No (explain)
III Insurance
1. Name of Insurance Company
2. Agents Name and Telephone Number
3. Amount of Coverage
4. Type of Coverage
5. Current Certificates for Workmen/s Compensation, General Liability
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City of St. Louis
Commercially Useful Function (CUF) Review – Part I
IV. Bonding
1. Name of Bonding Company
2. Agents Name and Telephone Number
3. Single Limit (per project)
Aggregate Limit
$
$
4. Amount currently available $
V. Banking
1. Name and Address of Bank
2. Name and Telephone Number of Account Manager
3. With bank since
4. Current Line of Credit $
5. Amount in use $
6. Secured by:
Corporate Signature
Personal Signature
Inventory
Other (describe)
7. Terms Rate
Accounts Receivable
Repayment
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City of St. Louis
Commercially Useful Function (CUF) Review – Part I
VI. Project Information
1. Name of general contractor or prime sub-contractor
2. What is the scope of your contract? Do you have a copy of the contract
specifications?
3. Do you understand the contract’s exclusions and liquidated damages clauses?
4. Have you prepared and submitted a schedule of values and unit cost?
5. What is the total dollar amount of your proposed contract?
6. Has your attorney reviewed your proposed contract?
7. Did you bid this work?
(Please provide copy of proposal)
8. Does your proposed contract include administrative costs and overhead?
9. Are you required to bond this project?
10. Are you willing and able to bond this project?
11. Do you have a Letter of Intent to perform work or provide services? Yes
No
12. What is the expected duration of your contract?
Start date
End Date
13. Provide a copy of quotes and fax transmittals you received from manufacturers
and/or suppliers, if applicable. (This information is required.)
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City of St. Louis
Commercially Useful Function (CUF) Review – Part I
VI. Project Information (cont.)
14. Are you planning to subcontract any of the work? Yes
No
If so, to which M/W/DBE and/or non M/W/DBE firm(s)? What are the dollars?
Proposed Subcontractor
M/W/DBE (yes or No)
Subcontract Amount
15. Do you have the adequate insurance to perform the work associated with this
project? Yes
No
16. Will you have a dual check arrangement with General Contractor and/or material
supplier(s)? Yes
No
17. Are special licenses, certifications, or permits required to perform your scope of
work? Yes
No
Does your firm have the special licenses, certifications,
or permits? (If yes, please list) Yes
No
18. Are you self performing or in a Joint Venture with another subcontractor?
If you are in a Joint Venture with another subcontractor you must attach a copy
of the Joint Venture agreement, which should include percentage of Joint
Venture, officers of Joint Venture, responsibility matrix and organizational chart.
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City of St. Louis
Commercially Useful Function (CUF) Review – Part I
VII. Project Workforce
1. Have you operated as union
non-union
both
2. How many tradesmen, by craft, for this project?
3. Who is your project manager for this contract?
How long has this person been employed with your firm?
4. What is the estimated weekly total amount of your payroll for this project?
5. What is the total dollar amount you will need to meet your monthly payroll
expenses?
6. What is the total dollar amount you will need to fulfill the obligations of your
contract?
7. Is the prime contractor or subcontractor assisting you (financially) with your
payroll?
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City of St. Louis
Commercially Useful Function (CUF) Review – Part I
VIII. Project Equipment/Supplies
1. List equipment owned by your company and provide insurance, license number
and VIN information as appropriate.
2. What equipment will you need to complete your work?
3. List equipment leased by your company that you are planning to use on this
project, and answer the following questions regarding your lease arrangement.
a. Is this a long term or short term lease?
b. Is the lease paid for by company check? (Provide cancelled check and
copy of lease agreement.)
c. Will equipment be leased from the general contractor or another on-site
subcontractor or one of their subsidiaries?
d. Is the equipment being leased specialized or scarce?
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City of St. Louis
Commercially Useful Function (CUF) Review – Part I
VIII. Project Equipment/Supplies (cont.)
4. Where will supplies be purchased?
DBE
WBE
MBE
Non M/W/DBE
5. Will they be delivered to the job site by the supplier?
If not, how will they be delivered and stored?
6. Is the supplier an M/W/DBE listed by you as a subcontractor/supplier?
7. Will the supplier have a drop off point for supplies to be stored on site?
IX. Other Contractors Needs
1. Are there any support services needed by your firm to assist you on this project?
2. Are you aware of the programs offered by the BDD office?
3. Have you talked with your (union representatives) in regards to providing
operators, carpenters, laborers, etc. on the project?
4. Are you aware of the workforce goals in regards to women and minorities on this
project?
5. Are there other barriers to success and or completion of project?
6. Are estimated confirmed?
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City of St. Louis
Commercially Useful Function (CUF) Review – Part I
For Internal Use Only
X. Contractor/Subcontractor Analysis
XI.
BDD Office
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