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PRRIP - ED OFFICE FINAL 11/10/2008 <br />Platte River Recovery Implementation Program <br />CONTRACTOR PREQUALIFICATION FORM <br />FOR HABITAT CREATION, RESTORATION AND MAINTENANCE <br />SERVICES <br />Terms and Preparation Instructions: <br />This Prequalification Form will provide the Platte River Recovery Implementation Program (Program) <br />with information necessary to establish contractor prequalification for habitat creation, restoration and <br />maintenance services. It must be properly filled and executed in order to receive consideration for <br />prequalification. All answers and other entries must be specific, complete in detail, and typewritten or <br />printed. Pencil is not acceptable. Brochures and other information may be furnished to supplement the <br />form; however, it is essential that the form be completed in full. No fee is required in order to <br />prequalify. <br />PART I: GENERAL iNFORMATION <br />Company Name: Telephone Number: Fax Number: <br />Mailing Addreu: City, State, Zip Code: <br />Physical Address: City, State, Zip Code: <br />Name of Contact: Telephone Number: E-maii Address & Company <br />web address <br />Business Type: <br />? Corporation ? Partnership ? Individual ? Consolidated Company <br />Status: <br />? Prime Contractor ? Subcontractor Federel Tax ID: <br />Number of Employees (at peak): Age of Firm: Insurance Limit: <br />6 <br />Page 1 of 6