NIAGARA FALLS UNIVERSAL CONTRACTOR APPLICATION

NIAGARA FALLS UNIVERSAL CONTRACTOR APPLICATION

NIAGARA FALLS HOUSING RENOVATION PROGRAM

Center City Neighborhood Development Corp.

Highland Community Revitalization Committee, Inc.

Niagara Falls Neighborhood Services, Inc.

Niagara Falls Community Development Dept.

Four Agencies. One Application. One Goal: Renovate Homes in the City of Niagara Falls.

This is the contractor application for the U.S. Department of Housing and Urban Development (HUD) and/or New York State-funded housing rehabilitation program. Qualified contractors contract with homeowners for housing rehabilitation work described in detailed specifications. A loan or grant of state or federal funds to the homeowner is used to pay all or a part of the rehabilitation work. The work is monitored by the agency providing the grant or loan. Housing rehabilitation contracts are awarded through a sealed bid process.

Once qualified, contractors can bid on housing rehabilitation contracts for the programs administered by the City of Niagara Falls Community Development Department, Center City Neighborhood Development Corporation, Highland Community Revitalization Committee, Inc. and Niagara Falls Neighborhood Housing Services Corporation (“Agency” or “Agencies”).

If you have any questions concerning this application, or concerning any of the information or documentation required for the application, please contact any of the following:

City of Niagara Falls, Department of Community Development

Dean M. Bailor, Jr. (716) 286-8818, Fax 286-8809, email: [email protected] Carnegie Building, 1022 Main Street – P.O. Box 69, Niagara Falls, New York 14302

Niagara Falls Neighborhood Housing Services Corporation: Vergil Fiorentini, (716) 285-7778, Fax 285-5416

479 – 16^th Street, Niagara Falls, New York 14303 Highland Community Revitalization Committee, Inc.

Charletta Tyson, Executive Director, (716) 282-2325, Fax 524-2672

2616 Highland Avenue (Renaissance Center) Niagara Falls, New York 14305 Center City Neighborhood Development Corporation

John Drake, Executive Director, (716) 282-3738, Fax 282-9607 1824 Main Street, Niagara Falls, New York 14305

Personal and Business Information

We collect personal information from or about you such as your name, business name, email address, mailing address and telephone number(s). We also collect business account information, financial statements and income information, insurance information, personal and business credit reports, credit history, credit scores and social security numbers. This information is reasonably required for ordinary business purposes. The information collected from and about you will be shared among the City of Niagara Falls, New York Community Development Department, Center City Neighborhood Development Corporation, Niagara Falls Neighborhood Services Corporation and Highland Community Revitalization Committee, Inc.

NIAGARA FALLS HOUSING RENOVATION PROGRAM

Center City Neighborhood Development Corp.

Highland Community Revitalization Committee, Inc.

Niagara Falls Neighborhood Services, Inc.

Niagara Falls Community Development Dept.

Name of Company:

Business Address: Owner’s Name(s):

Phone: Email:

Alternate Contact:

No. of Years in Business

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Is your business a:

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Has the company or any of its principal owners/officers/partners ever defaulted on a contract? _____Yes ____ No

Has the company or any of its principal/owners/partners currently filed for bankruptcy or voluntary dissolution in the past 7 years? ____Yes ____ No

Is company currently the subject of litigation? ____Yes ____No

Are there any liens against the company or its principal/owner/partner which might affect its ability to perform? ____Yes ____No

Trades your company performs in-house:

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Have you ever done work for any of these agencies?

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 Niagara Falls Neighborhood Housing Services Inc.

 Center City Neighborhood Development Corporation.

 Highland Community Revitalization Committee.

 City of Niagara Falls Community Development Dept.

Business Bank:

Address:

MATERIALS SUPPLIERS:

Company Address $ Amount of Credit

1. 2. 3.

JOBS COMPLETED IN THE LAST 6 MONTHS:

Customer Name Address Phone $ Job Size

1. 2. 3.

SUBCONTRACTORS USED WHTHIN THE LAST 6 MONTHS:

Company Address Trade

1. 2. 3.

INSURANCE

Agents Name Company Name Phone

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________________________________________________________________________________

What dollar range of jobs do you prefer?

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Have your insurance agent forward, an Insurance Certificate that: 1. Lists the Certificate Holder and Additional Insured

2. Provides a ten day notice of cancellation

3. Shows limits of liability and workers compensation coverage

4. Lists insured operations specifically as “general contractor” or for your specific trade(s) Please include the following with your application submission:

□ IRS Form W-9 □ Cert. of General Liability

□ Lead Paint Certification Documents (Firm and Worker) □ Workman’s Compensation Certificate

□ NYS Letter of Certification of M (Minority/Women) Business Entrepreneur

□ Other Certifications: (Environmental Hazard Abatement, Etc.)_______________________________________________

PERMISSION TO OBTAIN CREDIT INFORMATION AND BACKGROUND CHECK

I/We, the undersigned, understand that credit information will be obtained on my/our company as well as a background check will be performed on both my business and owner/s. By signing below, I/we agree that this information may be obtained as deemed necessary. Further consideration of my/our company may be refused without this permission or this application may be withdrawn if any discrepancies are discovered:

Signed: ______________________________________SS# At later date Date:_____________

Signed: ______________________________________SS# At Later Date Date:_____________

INSURANCE REQUIREMENTS

The low bidding contractor must show proof of having the following insurance coverage at the time the rehabilitation contract is awarded:

1. Comprehensive General Liability:

Bodily Injury: $1,000,000 each occurrence, $2,000,000 aggregate Property Damage: $1,000,000 each occurrence, $2,000,000 aggregate

NOTE: It is our requirement that the City of Niagara Falls be named as additional insured. The policy declaration page must read exactly as follows:

CERTIFICATE HOLDER:

Niagara Falls Neighborhood Housing Services Inc. Center City Neighborhood Development

479 – 16^th Street Corporation

Niagara Falls, NY 14303 1824 Main St.

Niagara Falls, NY 14305 Highland Community Revitalization Committee, Inc.

2616 Highland Ave. (Renaissance Centre) Niagara Falls, NY 14305

ADDITIONAL INSURED: City of Niagara Falls, New York

Department of Community Development 1022 Main Street, P.O. Box 69

Niagara Falls, NY 14302

2. Workmen's Compensation Insurance: Required for all of the general contractor's

employees and the employees of his subcontractors engaged in work on the contract premises, in accordance with the local and State laws governing same.

NIAGARA FALLS HOUSING RENOVATION PROGRAM

Center City Neighborhood Development Corp.

Highland Community Revitalization Committee, Inc.

Niagara Falls Neighborhood Services, Inc.

Niagara Falls Community Development Dept.

REQUIRED DOCUMENTATION

Please submit this application with the following documents. All agreements

covered below whether written, oral, tacit or otherwise shall be reduced to

writing and submitted as applicable. Additional comments, if applicable, may

be attached to this affidavit.

Contractor Requirements Yes / No / N/A

1.

Current financial statement, balance sheet, or

latest IRS return.

2.

Certificate of Incorporation.

3.

Partnership Agreements.

4.

Joint Venture Agreements.

5.

Business Certificate (DBA)

6.

Certificate of insurance, showing statutory coverage ( worker's comp.).

7.

Signed credit and performance authorization forms (6) with names and address

of references included. (Forms are attached).

8.

Authorization to obtain personal and business credit reports. Placement on this

list does not exclude the contractor from meeting any additional requirements as

may be set forth in each bid document

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NIAGARA FALLS HOUSING RENOVATION PROGRAM

Center City Neighborhood Development Corp.

Highland Community Revitalization Committee, Inc.

Niagara Falls Neighborhood Services, Inc.

Niagara Falls Community Development Dept.

PERFORMANCE & CREDIT REFERENCES

IMPORTANT

PLEASE EXECUTE THE ATTACHED:

- THREE (3) CREDIT REFERENCE FORMS

- THREE (3) PERFORMANCE REFERENCE FORMS

- AUTHORIZATION TO OBTAIN PERSONAL AND BUSINESS CREDIT

REPORTS

These Authorizations are Necessary in Order for

Your References to Release Information

(Please Sign Next to the "X" Only)

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PERFORMANCE REFERENCES

Applicants Company Name: ____________________________________________________ Mailing Address: ____________________________________________________________ Phone Number: _____________________________________________________________ TO WHOM IT MAY CONCERN:

The above-referenced contractor wishes to establish eligibility for Niagara Falls housing renovation contract participation. Your name was given as a performance reference. Please assist in this effort by providing the following information:

1. Address where work was performed: 2. Type of Work Performed:

3. Date Work Began: _______________ 4. Date Completed:_________________

5. Progress of Work: Expeditious Moderate Slow

6. Were you satisfied with the effort involved? Yes _____ No_____

7. Performance Rated: Excellent Good Fair Poor. 8. May we contact you by Telephone? Yes _____ No_____

9. Remarks:____________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________

Performance Reference Signature Telephone Number Thank You for your time.

Sincerely,

Rehabilitation Specialist

X_____________________________________ Contractor's Signature Authorizing Information

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PERFORMANCE REFERENCES

Applicants Company Name: ____________________________________________________ Mailing Address: ____________________________________________________________ Phone Number: _____________________________________________________________ TO WHOM IT MAY CONCERN:

The above-referenced contractor wishes to establish eligibility for Niagara Falls housing renovation contract participation. Your name was given as a performance reference. Please assist in this effort by providing the following information:

1. Address where work was performed: 2. Type of Work Performed:

3. Date Work Began: _______________ 4. Date Completed: _________________

5. Progress of Work: Expeditious Moderate Slow

6. Were you satisfied with the effort involved? Yes _____ No_____

7. Performance Rated: Excellent Good Fair Poor. 8. May we contact you by Telephone? Yes _____ No_____

9.

Remarks:____________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________

_______________________ ________________

Performance Reference Signature Telephone Number Thank You for your time.

Sincerely,

______________________________________ Rehabilitation Specialist

X_____________________________________ Contractor's Signature Authorizing Information

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PERFORMANCE REFERENCES

Applicants Company Name: ____________________________________________________ Mailing Address: ____________________________________________________________ Phone Number: _____________________________________________________________ TO WHOM IT MAY CONCERN:

The above-referenced contractor wishes to establish eligibility for Niagara Falls housing renovation contract participation. Your name was given as a performance reference. Please assist in this effort by providing the following information:

1. Address where work was performed: 2. Type of Work Performed:

3. Date Work Began: _______________ 4. Date Completed: _________________

5. Progress of Work: Expeditious Moderate Slow

6. Were you satisfied with the effort involved? Yes _____ No_____ 7. Performance Rated: Excellent Good Fair Poor. 8. May we contact you by Telephone? Yes _____ No_____

9.

Remarks:___________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________

_______________________ ________________

Performance Reference Signature Telephone Number Thank You for your time.

Sincerely,

______________________________________ Rehabilitation Specialist

X_____________________________________ Contractor's Signature Authorizing Information

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CREDIT REFERENCES

Referenced Company: _______________________________________________________________________

Mailing Address: ___________________________________________________________________________

___________________________________________________________________________

Phone Number: ____________________________________________________________________________

Credit Reference: ___________________________________________________________________________

The above referenced contractor wishes to establish eligibility for the Niagara Falls Housing Renovation Program contract participation. Your name was given as a credit reference. Please assist in this effort by providing the following information:

1. Date account was established: ___________________________________________________________

2. Current balance:______________________________________________________________________

3. High credit allowed to charge:___________________________________________________________

4. How do you rate this account: ___________________________________________________________

___________________________________________ _____________________________

Credit Reference Signature Date

___________________________________________ Phone Number

X___________________________________________ Contractor Signature Authorizing Information

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CREDIT REFERENCES

Referenced Company: _______________________________________________________________________

Mailing Address: ___________________________________________________________________________

___________________________________________________________________________

Phone Number: ____________________________________________________________________________

Credit Reference: ___________________________________________________________________________

The above referenced contractor wishes to establish eligibility for the Niagara Falls Housing Renovation Program contract participation. Your name was given as a credit reference. Please assist in this effort by providing the following information:

1. Date account was established: ___________________________________________________________

2. Current balance:______________________________________________________________________

3. High credit allowed to charge:___________________________________________________________

4. How do you rate this account: ___________________________________________________________

___________________________________________ _____________________________

Credit Reference Signature Date

___________________________________________ Phone Number

X___________________________________________ Contractor Signature Authorizing Information

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CREDIT REFERENCES

Referenced Company: _______________________________________________________________________

Mailing Address: ___________________________________________________________________________

___________________________________________________________________________

Phone Number: ____________________________________________________________________________

Credit Reference: ___________________________________________________________________________

The above referenced contractor wishes to establish eligibility for the Niagara Falls Housing Renovation Program contract participation. Your name was given as a credit reference. Please assist in this effort by providing the following information:

1. Date account was established: ___________________________________________________________

2. Current balance:______________________________________________________________________

3. High credit allowed to charge:___________________________________________________________

4. How do you rate this account: ___________________________________________________________

___________________________________________ _____________________________

Credit Reference Signature Date

___________________________________________ Phone Number

X___________________________________________ Contractor Signature Authorizing Information

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To: Housing Rehabilitation Agency From: Firm Applying for Contract

Participation: ________________________________________________________________________

Business Name: ________________________________________________________________________

Address: ________________________________________________________________________

Re: Authorization to obtain personal and business credit reports

As a principal of the above referenced firm, I hereby submit an application to apply for certification as a preferred contractor.

As a principal of the applying firm I understand that, as part of the certification process, a personal credit report on me will obtained. In addition, I understand that a business credit report will also be ordered for the referenced firm.

By my signature below, I give authorization to obtain the personal and business credit reports as mentioned above.

X_____________________________________ Signature

Print Name

Title

___________________________________ _______________________________

Date Witness