Contractor Name:
Business Address:
City
State
Zip Code
Baltimore City Certified?
(if applicable)
MBE
WBE
M/WBE
Financial Statement Submitted:
Compiled
Reviewed
Audit
Application Fees:
$100
$500
$1000
Payable to the
Director Finance
Application Contact:
Email:
Submit Completed Applications to:
OFFICE OF
BOARDS
&
COMMISSIONS
4 South Frederick Street, 4
th
Floor
Baltimore, Maryland 21202
410.396.6883
General Instructions and Information
The Office of Boards and Commissions (OBC) manages the prequalification process. Prequalification in approved
categories is required for all construction contractors seeking to perform work of $50,000 or greater on City of
Baltimore construction. OBC governing rules and other prequalification information can be found online at:
www.publicworks.baltimorecity.gov/Contractor-Consultant-Prequalification. If you have questions regarding the
application or prequalification, please contact OBC at (410) 396-6883 or OBC.Contractors@baltimorecity.gov.
For Minority and/or Woman-Owned business certification with the City of Baltimore, contact the Law Department at
(410) 396.4355 or http://law.baltimorecity.gov/minority-and-womens-business-opportunity-office.
Application:
Contractor prequalification is valid for 2 years; however, your most recent financial statement must be submitted
annually prior to the anniversary date in order to maintain a valid status. Contractors must “renew” their
prequalification status by submitting a new application every 2 years.
Please allow at least 45 days for your application to be processed. Once your application is approved, you will receive
a “Prequalification Certificate” listing the approved categories of work via standard mail.
Fees:
The fee for prequalification is based upon the type of financial statement submitted as shown below. Only checks and
money orders will be accepted and are to be made payable to the “Director Finance.”
Statement Type Fee
Max Work
Capacity
Compiled $100
$1.5 Million
Reviewed $500
$8 Million
Audited $1,000
> $8 Million
Work Capacity Rating:
The “Work Capacity Rating” (WCR) is the maximum value of total work/capacity (public/private) OBC will allow.
Generally, WCR is calculated by multiplying the contractor’s working capital by 10. Actual calculations may vary.
Project Information and Categories
OBC uses the “Project List” to verify your experience. Please be sure to list the related categories requested in order
reduce processing delays. All categories/areas of work requested must be self-performed. The category list is
available for download on the OBC website.
Check List: Before submitting this application, please make sure you have:
Included the appropriate fee. (Returned checks due to insufficient funds are subject to suspension of status, additional fees and/or
penalties.) Applications without the appropriate fee will not be processed.
Submitted an Affirmative Action Plan for approval of the (available on the OBC website)/Provided proof of an approved/current
Affirmative Action Plan.
Provided contact names and phone numbers for listed projects, noting the related OBC categories. (A separate attachment is
permitted.)
Submitted a complete Financial Statement.
Responded in detail to all questions on the Experience Statement.
Included a current list of equipment owned by your company. (If equipment is leased, a sign letter stating this must be submitted.)
Included the completed and notarized affidavits.
Included the Category List with the selected the areas of work requested clearly marked.
Obtained a “Good Standing” rating with the Maryland Department of Assessments and Taxation.
EXPERIENCE STATEMENT
1. How many years has your company been in business as a contractor under your present
business name? __________
2. How many years of experience does your company have (a) as a Prime Contractor? __________
(b) as a Sub-Contractor? _________
3. Has your company ever:
(Yes or No)
(a) Failed to complete work awarded? __________
(b) Defaulted on a municipal/governmental contract? __________
(c) Been terminated for default? __________
(d) Been debarred or suspended from working in any jurisdiction?
If you answer “yes” to any of the above, please provide an explanation including where, and why in a
separate attachment.
4. Has any officer or partner of your organization ever been an officer or partner of some other
organization that failed to complete a contract? __________ If yes, please provide an explanation
including the name of the individual, the Owner of the contract, and why in a separate attachment.
5. Has any officer or partner of your organization ever failed to complete a contract handled in his own
name? __________ If yes, please provide an explanation including the name of the individual, the
Owner of the contract, and why in a separate attachment.
6. In what other lines of business are your company financially interested?
7. What is the construction related experience of the principal individuals of your organization?
(Resumes and/or a separate document may be attached)
Individual's Name
Present Position,
Capacity or Office
Years of
Experience
Areas of Expertise
PROJECT INFORMATION
List projects completed in the past three (3) years. Requested OBC categories must be listed with the related project(s).
A prepared project list document (organized as below) may be attached in lieu of this form.
Name of Project
Location
Project Owner
Name/Contact #
Prime Contractor
Name/Contact #
(if sub)
Work Performed
Contract
Amount
Year
Completed
Related OBC Categories
Example: Project 123ABC
CBD Water/Sewer Main Repair
Baltimore, MD
City of Baltimore, DPW
Mr. John Doe
(410) 555-5555
N/A
Repaired 100 ft. of water mains
and 200 ft. of sewer mains; Hauled
away all debris
$500,000
2016
B02551 - Water Mains
B02552 - Sewer Construction
G90054 - Hauling
MUST BE EXECUTED BY ALL APPLICANTS
Part I
AFFIDAVIT FOR QUALIFICATION
I,
the undersigned, first
being duly sworn and under oath, say and affirm this day of
(Month)
that I hold the office of of
(Year)
(Office Held) (Name of Business Entity)
which is applying to the Mayor and City Council of Baltimore, a municipal
corporation of the State of Maryland, for qualification to bid on contracts for construction, maintenance,
repair or demolition of physical facilities of the City, and that to the best of my knowledge and belief neither
the above business nor any of its officers, directors, partners, nor any employee or other person involved in
obtaining its contracts with the State of Maryland, the City, or any county or other subdivision of the State
has ever been convicted of, had probation before judgment imposed, or has pleaded guilty or nolo
contendere to any charge of bribery, attempted bribery, or conspiracy to bribe, extortion, fraud or similar
malfeasance prohibited under either Article 27 of the Annotated Code of Maryland, or the criminal statutes
of any other State or the federal government.
I further affirm that to the best of my knowledge and belief neither
(Name of Business Entity)
nor any of the above mentioned persons connected with it has failed to comply
with all applicable federal, state and local laws, executive orders, rules and regulations relevant to contract
acquisition and performance.
If affirmation cannot be given, please indicate the reason and list any conviction, plea, or imposition of
probation before judgment with the date, court, official or administrative body, the sentence or disposition, the
name(s) of the person(s) involved, and their current position and responsibilities with the business.
CORPORATE
SEAL
(Signature) (SEAL)
Affiant
Name of Business Entity
Subscribed and sworn to before me, a Notary Public, the year and date first above.
Notary Public
My Commission Expires:
Part II
AFFIDAVIT FOR BUSINESS ENTITY
STATE OF
(CITY) (COUNTY) OF
ENTITY FORM: Sole Proprietorship Corporation Non Profit
LLP LLC Other: ________________
being duly sworn, deposes and says
that I'm of the
(Office Held) (Name of Business Entity)
the entity described in and which executed this application; that I'm familiar with the books of the said
corporation showing its financial conditions; that to the best of their knowledge, information and belief the
accompanying financial statement, taken from the books of the said entity, is true and accurate
statement of the financial condition of the said entity as of the date thereof; that to the best of my
knowledge, information and belief the answers to the foregoing interrogatories are true; that this application
is being submitted for the express purpose of inducing the party to whom it is submitted to award the
submitter a contract; and that any depository, vendor, agency or other party herein named is hereby
authorized to supply such p[arty with any information necessary to verify these statements.
(Officer must sign here)
(SEAL)
Sworn to before me this
______day of Year______________
Notary Public
Date incorporated
In what State
Capital paid in cash $ _________________________________________________________
Names of
Officers or Partners
% of stock owned
_____________ _______________ _____________________ ____________
(Title) (Name)
_____________ _______________ _____________________ ____________
(Title) (Name)
_____________ _______________ _____________________ ____________
(Title) (Name)
_____________ _______________ _____________________ ____________
(Title) (Name)
_____________ _______________ _____________________ ____________
(Title) (Name)
Names of Directors: % of stock owned
_______________ ______________________________ ____________
_______________ ______________________________ ____________
CORPORATE
SEAL
SELECT
CODE CATEGORY
A02210 GRADING
A02601 PORTLAND CEMENT CONCRETE PAVING
A02602 BITUMINOUS CONCRETE PAVING
B02551 WATER MAINS
B02552 SEWER CONSTRUCTION
B02553 DUCT LINE CONSTRUCTION
B02554 DRAINAGE STRUCTURES (MANHOLES, INLETS, ETC.
C02300 PILE DRIVING
C02934 BULKHEADS AND JETTIES
C03300 CONCRETE CONSTRUCTION
C03420 PRECAST CONCRETE CONSTRUCTION
C05100 STRUCTURAL STEEL ERECTION
C09900 BRIDGE PAINTING
D02240 EROSION CONTROL
D02241 GABION CONSTRUCTION
D02620 CURBS, GUTTERS, SIDEWALKS
D02710 FENCING AND GUARD RAIL
D02800 LANDSCAPING
E13001 THREE-STORY AND UNDER
E13002 OVER THREE STORY
E13003
E13003 WATER AND/OR SEWER WASTE TREATMENT PLANTS
AND PUMPING STATIONS
E13004 Rehabilitation of Structures
E13005
Architectural Concrete Structures- Spec. In Museums, Libraries
& Hist. Structure
E13006
Renovation Of Historical Structures-Spec.in Museums, Libraries,
Etc.
Category descriptions can be found on the OBC website.
E: Building Construction (General)
D: Roadside Improvements
C: Highway Bridges and Highway Grade Separation Structures
B. Utilities
A: Paving
F02110 Building And Structure Demolition
F02120 Interior Demolition
F02200 Earthwork And Site Preparation
F03300 Concrete Construction
F04200 Masonry
F04500 Masonry Restoration, Cleaning, Repointing
F05120 Structural Steel, Ironwork
F06130 Heavy Timber Construction
F07100 Waterproofing
F07200 Insulation
F07500 Roofing - Industrial
F07501 Roofing - Residential
F08100 Doors And Frames
F08500 Windows
F08800 F08800 Glazing
F09100 Lath And Plaster
F09510 Ceiling
F09650 Flooring (Tile/ceramic)
F09900 Painting
F15400 Plumbing
F15600 Mechanical (H.V.A.C)
F16000 Electrical
G90001 Jacking, Tunneling, Boring
G90002 Incinerator Construction, Refractory Work, Etc.
G90003 Fire Protection Systems
G90004 Concrete Median Barriers
G90005 Audio And/or Video Systems
G90006
Scarifying, Planning, Recycling And Repairing Exist. Asphalt
Pavements
G90007 Cleaning And Cement Mortar Lining Of Water Mains
G90008 Electronic Protection Systems
G90009 Foundations, Underpinning, Drilled-In Caissons
G90010
Stream Restoration - OBSOLETE. Replaced with G90128 -
Urban Stream Restoration
G: Other Specialties
F: Building Construction and Maintenance Specialties
G: Other Specialties
G90011 Installation For Cable Communication Systems
G90012 Installation Of Elevators
G90013 Dredging
G90014 Food Service Equipment And Machines
G90015 Casework And Cabinet Work
G90016 Railroad Track Construction
G90017 Brick Pavers, Architectural Paving
G90018 Gunite Construction
G90019 Drilling And Blasting
G90020 Water And Wastewater Scada And Pcs Systems Integrator
G90021 Erection Of Steel Storage Tanks
G90022 Slurry Wall Construction
G90023 Erection Of Miscellaneous Metals
G90024 Placing Of Reinforcing Steel
G90025 Street Lighting And Power Lines
G90026 Highway And Bridge Deck Grooving And Saw Cutting
G90027 Highway Signing And Lighting
G90028 Sheet Metal Construction
G90029 All Types Of Pavement Markings
G90030 Installation Of Steel Roof Decks
G90031 Installation Of Prefabricated Siding And Walls
G90032 Pipe And Structural Welding
G90033 Epoxy Patching And Injection
G90034 Pile Jacketing
G90035 Installation Of Water Wells And Pumps
G90036 Soil Boring
G90037 Dam, Lock And Spillway Construction
G90038 Underwater Repairs To Structures
G90039 Concrete And Masonry Structural Repairs
G90040 Pressure Grouting
G90041 Installation Of Playground Equipment
G90042 Installation Of Valves Pressure Tappings And Line Stoppings
G90043 G90043 Carpet And Resilient Flooring
G90044 G90044 Shoring, Scaffolding And Decking
G90045 G90045 Clearing and Grubbing
G90046 G90046 Concrete And Brick Retaining Walls
G90047 Construction Of Tennis Courts And Running Tracks
G90048 Installation Of Metal Deck Forms And Shear Studs For Bridges
G: Other Specialties
G90049 Tunnels, Subway Construction
G90050 Ground Water Control (Dewatering)
G90051 Industrial Air-Coiled Heat Exchanger (Equipment)
G90052 Repair And Painting Of Tanks
G90053 Subaqueous Pipelines, Outfalls, Cables, Etc.
G90054 Hauling
G90055 Coating And Lining Pipes, Tanks, Etc.
G90056 Sandblasting And Underwater Coating & Epoxy Resins
G90057 Submarine Cable Removal
G90058
Wastewater Collection System Maintenance(Cleaning, Lining
And Minor Repairs)
G90059
Rigging Into Place, Setting Lining-Up & Leveling Heavy Mfg.
Equipment
G90060
Bridge Crane Monorail & hoist Installs., conveyor Sys.,
Pneumatic Tube Sys.
G90061 Tree Removal And Pruning
G90062 Prefabricated And Modular Structures, Mobile Offices
G90063
Installation Of Grandstand, Bleachers, Band Platforms, Portable
Stages, Etc.
G90064
Installation Of Window Guards, Railings, Wire Partitions,
Folding Gates.
G90065 Aluminum Siding And Awning
G90066
Office, Toilet, Demountable & Folding Partitions, Incl. Related
Work Thereto.
G90067 Chalk Boards, Tack Boards
G90068 Lockers, Shelving
G90069 Water Meter Vault Adjustment And Cleaning
G90070 Composition Wood Flooring, Seamless Flooring
G90071 Sound Barriers (Fanwalls)
G90072 Automatic Temperature Control Systems
G90073 Swimming Pool Construction And Repair
G90074 Hardwood Flooring And Wood Floor Refinishing
G90075 Chemical Grouting, Compaction Grouting
G90076 Earth/Rock Anchors
G90077 Drywall
G90078 Process Instrumentation And Control Systems
G90079 Impact Attenuators
G90080 Petroleum Equipment Installation
G: Other Specialties
G90081
Surfacing & Re-Surfacing Of Tennis Courts, Playgrounds &
Running Tracks
G90082 Lining And Sealcoating Of Parking Lots
G90083 Sandblasting/water blast/steam Clean
G90084 Parking Control Equipment
G90085 Cathodic Protection/Corrosion Control
G90086 Asbestos Removal/Encapsulation/Control
G90087 Installation Of Gymnasium Equipment
G90088 Fabrication And Installation Of Floating Dock Structures
G90089 Automatic Meter Reader (AMR) Manufacturer/Installer
G90090
G90090 Erection/Rehabilitation Of Elevated Awwa Steel Water
Storage Tanks
G90091 Installation And Maintenance Of Telecommunication Systems
G90092 Hazardous Waste Excavation, Removal, And Containment
G90093 Electronic Traffic Control Systems
G90094 Installation Of Automotive Lift And Lubrication Systems
G90095 Architectural Concrete
G90096 Hazardous Paint Removal
G90097 Hazardous Paint Removal On Elevated Structures
G90098
G90098 Installation And Maintenance Of Bowling Lanes And
Equipment
G90099 Lining Sewers And Drains Via Cured In-Place Pipe
G90100 Roller Compacted Concrete For Dam Construction
G90101 Post Tension Rock Anchors For Dam Construction
G90102
Micro Tunneling For Pipeline Installation OBSOLETE. Replaced
with G90134, G90135
G90103 G90103 Carpentry
G90104
Lg. Reinforced Concrete Pre-stressed & C.I.P. Box Culverts,
Diversion Structs. & Junc. Chambers
G90105 Synthetic Liner Installation, Subtitle D, For Landfill Construction
G90106
Digital Closed Circuit Television (CCTV) Inspection Of Utility
Pipes
G90107 Sanitary Sewer Bypass Pumping
G90108 Cleaning And Maintenance Of Siphon Structures
G90109 Sewer System Root Control (Chemical)
G90110 Pipe Bursting For Sanitary Sewer Construction
G: Other Specialties
G90111
Sewerage System Maintenance (Collection System, Pump
Stations And Treatment Plants)
G90112
Specialized Door System Installation, I.E. Overhead, Revolving,
Collapsible, Rolling Door, Etc.
G90113
Installation Of Horizontal Underwater Post-Tensioned Anchor
Bars For Dam Rehabilitation
G90114 Installation Of Flood Warning Systems
G90115
Maxi-Horizontal Directional Drilling For Utilities Including
Water, Sewer & Storm Water
G90116 Slip Lining Of Sanitary Sewers Pipe
G90117 Signage & Graphics/design, fabrication & Installation
G90118 Tunnel Boring Machine (TBM) Excavation
G90119
Subsurface Environmental Remediation And/or Removal Of
Underground Storage Tank
G90120 Landfill Gas Extraction Systems Construction
G90121 Landfill Gas Well Driller
G90122 Installation Of Inter-Active Fountains
G90123
Construction/Repair Cryogenic Air Separation Industrial Gas
Equipment
G90124 Environmental Engineering Concrete Structures
G90125 Installation Of Ice Rink Refrigeration System
G90126 Intelligent Transportation Systems - ITS
G90127 Dry Stone Masonry Construction
G90128
Urban Stream Restoration
Please contact our office for the complete list of specific criteria and
required documentation prior to requesting this category.
G90129 Large Diameter Sewer Cleaning Contractors
G90130 Sewer House Connection Rehabilitation Contractors
G90131 Skate Park Construction
G90132 Park Rehabilitation
G90133
Carbon Fiber Reinforced Repair Of Pipelines Greater Than
48Inch Diameter
G90134 Micro-tunneling of Less Than 30-Inch Inside Diameter Pipeline
G90135 Micro-tunneling of 30-Inch and Larger Inside Diameter Pipeline
G90136
G90136 External Post Tensioning Repair of Pre-stressed
Concrete Cylinder Pipe (PCCP) Contractors
G: Other Specialties
G90137
Manufacturing And Installation Of Storm Water Inlet Opening
Screens And Inserts
G90138
Challenge Course Construction - Contractor must demonstrate a
minimum of 2 years experience in the installation of Challenge
Courses and be a Professional Vendor Member of the
Association for Challenge Course technology (ACCT)
G90139
Elevator Repair and Maintenance - Please contact our office for the
complete list of specific criteria and required documentation prior to
requesting this category.
