Subcontractor Prequalification Form for PSCO Vendors

This form is for you to fill out to start the qualification process to be an approved subcontractor for Philadelphia Sign. If you have questions you can call the main office at (856) 829-1460 or send a message.

Step 1: Form W-9
Step 2: Subcontractor Form

Form W-9

Thank you for your interest in working with Philadelphia Sign. To get started, we need your W-9 form uploaded. If you do not have one, please visit the IRS website here to download a copy to fill out.

Company Name

Upload W9

Company

Company Name

DBA

Pay-to Address

Address Line 1
Address Line 2
City
State
Zip

Shipping Address

Address Line 1
Address Line 2
City
State
Zip

Contact Information

Contact Name
Phone
Fax
Cell
Email

Licenses and certifications

Does your company have a contractor's license?

YesNo

If so, is it held:

by the company?or an individual employee?
License Number
Expiration Date
License Type

What area does it cover? (List specific city, county, and/or state)
Do you have any additional licenses(master electrician license, electrical contractor’slicense, other)?YesNo
What welding certifications, if any, are held by your company?

NOTE: You will need to provide a copy of the welding certification for each certified employee. You will also need to provide copies of all licenses for all individual employees and for all governing entities. Attach a separate page if there are multiple licenses to be listed.

Photos and Documentation

PSCO requires photos and documentation of your previous work for review prior to approval as our vendor. Provide the following:

Photo of behind the wall for remote channel letters.
Weld photos from a multi---stage structure. You must provide progression photos, showing plug welds, cap ring, and flange welding.

Business Enterprise

Is your business:

minority-ownedwoman-owneddisadvantaged-ownednone of the above
Unions represented

Capabilities

Check all that apply.

Steel erectionSteel fabricationInstallation of new footingsElectrical installation of signsSign assemblyStructural engineeringElectrical engineering

Equipment

Check all that apply.

45’ bucket truck100’ crane35’ servicetruck65’ crane115’ crane55’ servicetruck85’ crane70’ service trucknone of the above

Coverage Area

Please provide a map of the area serviced. Note “Installation” and “Service” if different.

Insurance Coverage

Insurance coverage. Please attach, or forward, a copy of your insurance certificate. PSCO’s requirements are:

Commercial general liability:$1,000,000
Automobile liability:$1,000,000
Worker’s comp:$500,000

In addition, you must show that excess/umbrella liability limits are carried. You must provide a copy that shows the additional insured certificate holder as Philadelphia Sign Company; the certificate must have a cancellation clause of 30 days minimum written notice.

Refer to the sample certificate of insurance.

Trade references

These can be owners, architects,subcontractors, orsureties. Include company and contact name, address, and phone number. Applicationsthat do not include trade references will not be processed.

Company 1

Company Name
Contact
Phone
Email
Address Line 1
Address Line 2
City
State
Zip

Company 2

Company Name
Contact
Phone
Email
Address Line 1
Address Line 2
City
State
Zip

Include any additional information, notes, or comments that you want to have considered with this application.

Safety

Does your company have a safety program?YesNo
Are daily inspections made of all cranes/trucks?YesNo
Are the inspections documented?YesNo
Do you abide by all local/county/state/fed OSHA and regulatory agencies?YesNo
Number of OSHA violations in the last 3 years
Number of OSHA violations in the past year
Please indicate your insurance safety rating (DART RATE)
How often are safety meetings conducted?
Cranes required to be certified?YesNo
How often?

PSCO requires that:

OSHA

All work shall be performed in accordance with all applicable laws and regulations regarding employee health and safety. It is the contractor’sresponsibility to determine if the state has an OHSA approved state plan for the work being performed and to determine which portions of the state plan apply.

Overview

Philadelphia Sign Company (PSCO) has several policies regarding the recycling, reuse and disposal of all sign components along with internal environmental office policies that at all times are fully comply with the standards and regulations set forth by the United States Environmental Protection Agency, the Occupational Safety and Health Administration and all other federal, state and local agencies in regards to all company operations. The list, while extensive, includes the proper disposal of any and all signs (whether damaged or reusable) along with all sign components. PSCO understands that disposing of these items must be done in an appropriate and environmentally conscious manner that allows our company to have a limited negative impact on our environment and to comply with the laws of sustainability. The practice of sustainability is a tremendous asset to our customers, clients, and employees alike and it is our company’s policy that all of our employees follow the policies and practices outlined in this document.

Environmental

All materials provided and work furnished shall be in compliance with all federal, state, and local laws and regulations regarding the environment, including but not limited to the Federal Clean Air Act, Resource Conservation and Recovery Act, Toxic Substances Control Act, and the Safe Drinking Water Act, and all applicable materials recycled.

Our Environmental Policy Synopsis

Philadelphia Sign Company is committed to operating a businessin an ethical,safe and environmentally friendly manner. We work very closely with our suppliers, vendors, clients, and employees to ensure that our products and services are of the highest quality, the most cost---effective and the highest regard for sustainability and environmental consciousness.

Company Procedures for Disposal, Recycling, and Reuse of signage, sign components and other materials

Procedure for handling all returned, old, damaged or unused signs and sign components: PSCO requires that all signage removed from a job site must follow one of the procedures below for proper disposal or re---use:

Any damaged or old signsthat can no longer be used must be taken down so that each component (illumination, electrical, metals, plastics, etc.) can be properly disposed of or reused.
Any component or sign deemed reusable will be stored at our shop for reuse when applicable and will be fully inspected again before any re---use to ensure that all safety and environmental controls are met.
Any component that cannot be repaired or reused due to their physical condition, due to a safety issue/concern issue, or due to regulatory compliance (local, state, or federal) must be handled in the appropriate manner and disposed of correctly.

I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above.