PA9601-CS 960208.'%. N I N 3 T ! T O T E 0 F
AIC H I T EC T 5
AlADocamenrA305
Contractor' s Qualification Statement
1986EDITION
TDis form is approt'ect and recommemled by the American Institute of Arcbitec:s
(A/A) and Fhe Assocfarecl General ConrracZors of Amenca (AGd) for use m el,aiucu-
ing the qualifications of contracers. No endorsement of the submitting par6, or
verification of the z'nfbrmc~rion Ls made by the ,-liA or AC-C.
The Undersi~':eci ce~ifies under oath that the information provided hereLq is true and suff,-
cienrly comple:e so as not to be misleading.
SUBMITTED TO:
ADDRESS:
SUBMITTED BY: Pav~me.nt 'Cor~_--ac'.icn and M~.i n~enanca, Inc.
NAME: C. David Walkar
ADDRESS: P.O. B~X 535457, -Carand Prairie, ~X 75053-5457
PRINCIPAL OFFICE: 3324 Rcy Orr_ Blvd. 8200 Grand Pr'~ie, %'X 75050
Corp. omtion
P.~r~ne.,'ship
Individual
Joint Venture
Other
NAME OF PROJECT (if applicable):
TYPE OF WORK (file separate form for each Ciass'idcation of
General Construe:Ion
Plumbing
(pl~¢ specify)
HVAC
Elec:rical
ORGANIZATION
1. I How mnny ?e:~s has .your otg~v!~don been
~ an~ 1/2 years
1.2 How ~y y~ ~ ~ o~on ~
. f~ and 1/2 years
1.2.1 Un~ w~ offi~ or ~ ~
n/a
1.3
If your orgaruzation is a corporation, answer, the followin~
1,3.1 Date of incozporatiom t~y 1992
1.3.2 St're of incorpor~on:
1,3.3 President's name:. C. Davi. ct
1,3.4 Vice-president's narneis):DLle
1.4
1.3.5 Secre~.'s name:
1,3.6 Treasurer's name b~,cc Sp_,nce_~
· If your organization is a pat'mership, answer the follovrlng:
1.4, 1 Date of organization:
1.4.2 Type of gaship (if applicable):
1.4.3 Name(s} Of gener:J. partner(s}:
1.5
If your organization hi individually owned. answe the fdibwing:
1.5.1 Date of organization;
1.5.2 Name of owner:
A305-1986
2
t
the [orm of your or~nniznrion ~s other ~un ~hose listed above, dem'ibe it and am'he the princlpah:
rl,/a
IICS~ING
2. I List jurisdictions md wade r'-!tL~3OrieS in which your ox'~mnizllion is levy qualified to do business,
md indic=e re~-u~on or license numbers, if appiicxble.
n,/a
2.2
List jurisciic~ons in which your org:hi~rion's parmez'shiI
3.2
3.3
, or ~ r~me is filed.
List me atc~odes of work that your organ/z~on norm
Pavement RecycLing and Stabilization
avi..
Cancrete Paving
Crack & Join= S~:~] ing; S~-~]coaTing
Bx'caVa= ion
Chirns and Suits. (I[ the aruwcr ~o any of the quations
3.2,1
3.2.2
3.2.3
performs with its own Eorces.
t~ow is .v~, plc~s~ attach details.)
Has your organization ever failed. a) complett. any work awnrded to it?
Aze there any judgments, c'laims, aeoitration p[oceedings or suits pending or outstanding
against your organization or its officers?
H~ your organization filed any law suits or t~uested arbitration with regard tn construc-
tion contracts within the last five yents?
Within the last five yeats. has any eftricer or pdncip'A o." your organ zation ever been an 'officer
principal oE another organization when it fai[cd to complete a co~x. ltructi. n contract? (If the arts wet
yc.i. ph.-a.sc attach details.) pc)
WARNING:
A305-1986
3
3.4
O
On a sep:u'~re she,,t, list insjot consu'uction projecls your orS:~i~tion hns in prop, ~jvin8 the
name of proiect. owner, architect, contract amount, percent complete ~d scheduled completion
ate.
5.4.1 S~recor~lwoczhofworkh~pro~ss~ndunderconwac~ 1 mi'llion
3.5
3.6
On a sep-aure sheet, ~sr ~he rnmjor projects your or~aon Ms cornplered in ~ze p'a~t five years,
givin8 the nmue of project. owne~, archi,ect, contract mnount, date of completion and percentage of
the cost of the work performed with your own forces. see a'r'ac.hed
3.5. I State average annual amount of consu'ucdon wo~ performed during the Fast five Fens:
8 million
On a separate shoe:, list nhe construc~on expe~ence ~nd present cornrn/une~rs of ~he key h~dlvid-
unls of Four orgxnization, see_ art, at.bed
~MENCES
4.1 Trade References:
Barnsco, Inc., P.O. Box 59910, Dallas, TX 75229 (214) 241-0112
Lat--~aore Mararia]~, P.O. Box 556, Mc.Kinne.v, ~X 75069 (214) 221-4646
Reynolds Asphalt, P.O. Box 370, Euless, ID( 76039 (817-267-3131
Box Crew Cement, 1800 Dove Lane, Midlot_bian, ~X 76065 (214) 299-6350
Dart Re~] Co., 2761 Oa~]~nd Avenue, Garland, TX 75041 (214) 864-8640
A-1 Re_-.~l, P.O. Box 7878, Fort Word_h, ~ 76111 (817) 831-3121
4.2
B~nkRefcrenccs:
OverconBankam4Trust, N.A.
P.O. Box 157
Burst, TX 76053-0157
~cOc~ Turn~ge 817-377-6552
4.3 Surer}.':
4.3.1 Name of bonding company:
Fidelity and Deposit Cn.Tany of Maryland
12222 Merit Drive, Suite ~360
Dallas, TX 75251
4.3.1 Name and addrt_"¢,~ ¢,f agent:
Mike Bendrickson
Cade~-/~ead Shreffler Insurance
P.O. Box ~]~9, Bedford, TX 76095
A305 -1986
RNANCING
Financial S tammenL
Attaci~ a ~nancial statement, preferably audited, including }our organization's latest
I~ance sheet and income statement showing ~e following
Cucr~t Assets (e.g., cash, joint venttin: accounts, accounts rec~vable? noms
mcflvable, accrued income, deposits, m~r,-Hab L, wentory and prepaid
expenses);
Net rnccd .~ssets;
Current Liabillde~ (c.g., accounts pa.vablc, notes .pa?~tc, accrued ~xpenses, pro-
vision for income taxes. advances, accrued salaries and accrued payroll taxes);
O~er Li~_hilities (e.g., capital, capital stock, authorized and outstanding shares
par values, earned surplus and retained earnings).
5. 1,2 Name and address of rum prepann~ attached fmandal smr~ent. and date thereoff
Dave N. Hardin, ~A, 2080 awy. 360, #135, Grand Prairie, ~X 75050
Financial Stat. ement prepared in-house
5.1 .} Is the attached ITmancial statement for the identical orgnvi~don named on page one.:
5.1.4 If not, e:~plain the relationship and .financial responsibility. of the orgnnizarion whose
fmandal statement is provided (e.g.. parent-subsidiary).
5.2
Will the org:wjzntion whose fmancbJ statement is attached act as guarantor of the conu'act for con-
struction?
A305-1986
Item 3.6 Construction Experience
Dwight Smith Project Manager - Dwight Smith has 26 years of
construction experience starting with Austin Road Company in Fort
Worth. Dwight was an estimatorand contract administrator for most
of the 24 years with Austin. Projects bid and supervised include
two City of Fort Worth Utility Cut and Repair Projects.
Dwight has experience in both new construction, rebuilding
streets and parking lots, patch and repair projects from $500.00 to
$6,000,000, including state, city and FAAprojects.
O
SIGNATURE
6.1 Dated;at 1I:30 am this 8th
February 19 96
Nnmc of Or~Uon: Paverent Construction and Maintenance, Inc.
:C. David Walker
Tide: President
6.2
d~.y o~
Mr, C, David Walker being
duly sworn deposes ~nd says ~.h~t ~.e infomudon provided herein is u'ue md sui~dendy complete so ~s not to be
misle'=ding.
5ubscribedmdswombeforemed-as eighth
Notary Public:
My Corm'mssion Lxpires: 11 - 17 - 9 6
19 96
~yof February
A305 -1986 6
· , 0 0
PAVEMENT COWSrAUCTION & MA|NTENARCE. IRe
Year 8uil~: lgg3 Contnct Amount $Slg. OOO.O0
Contact Person: Chuck~'cheafer Phone: 2H-~S8-4061) "~--~1~' -tt/l~i~:;>
Project: DFW Airport Se.fi AirfieJd Pavements
Owner/Engtneer: OFH/Turner Collie & eraden. Inc.
Year Built: t994 Contlact Amount $21q,000.00
Hc~ fi14~aOCY I-Ira- q ?
Conesot ~er~on:,arnn .~oh,~on~ho,e: ~-~a-~O~ ....w..!ml c-II &,,k- I~pr
Year 8nHt: 19~ Centred Amount $279,000.00
Contact Person: Lonnie Shun Phono: 817-2/5-357]
:::
Yea, Built:
/ec~: To.n of ~ddison Brookhaven Club Drive
Owner/' Enaineer: Town OF Addison
ear BuHt: 1q95 Contrac% Amoun
P~eject: Sign Shod Paving Project
Owner/Engineer: Texas DOT
Year Built: 1q94 ~(~ Contract Amount $39,000.00
: .........[,..1 .....: .....~ ....: .................Q~ N~Tm
.... : ..........:'~})~"R~'~'~ ..................../' ~ ' ~7
I- Io - ~ ~
+ k.