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THE AMERICAN INSTITUTE OF ARCHITECTS
AIA DOCUMENT A3O5
CONTRACTOR'S QUALIFICATION STATEMENT
1986 EDITION
This form is approved and recommended by The American Institute of
Architects (AIA) and The Associated General Contractors of America
(AGC) for use in evaluating the qualifications of contractors. No
endorsement of the submitting party or verification of the information is
made by the AIA or AGC.
The Undersigned certifies under oath that the information provided herein is
true and sufficiently complete so as not be misleading.
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SUBMITTED TO: |
General Public Viewing |
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ADDRESS: |
CCR: CAGE CODE: 1MJV4 |
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Type of Organization |
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SUBMITTED BY: |
Jack Gaynor |
Corporation __ |
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NAME: |
TRG Environmental
Services |
Partnership __ |
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ADDRESS: |
7305 Yardley Way, Tampa, FL 33647 |
Individual _X |
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Joint Venture __ |
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PRINCIPAL OFFICE: |
TRG Environmental Services
7305 Yardley Way, Tampa, FL 33647 |
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Other ________ |
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NAME OF PROJECT (if
applicable): |
N/A |
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TYPE OF WORK (file
separate form for each Classification of Work): |
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_____ General
Construction |
_____HVAC |
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_____ Plumbing |
_____Electrical |
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X Other: Commercial, Industrial, Military
Painting
Contractor / Mold Remediation / EPA
Lead-Based Paint Removal Certified / Lead-Based Paint Abatement /
Asbestos, Lead, Indoor Air Quality, Renovation / Remodel Military
Contractor; Asbestos Abatement (Government Facilities) |
AIA DOCUMENT A305 ·
CONTRACTOR'S QUALIFICATION STATEMENT · 1986 EDITION · AIA · C1986
THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE,NW. WASHINGTON,DC.
20006
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1. |
ORGANIZATION |
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1.1 |
How many years has your
organization been in business as a Contractor? |
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ELEVEN (11) YEARS + |
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1.2 |
How many years has your
organization been in business under its present business name? |
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ELEVEN (11) YEARS + |
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1.2.1 |
Under what other or
former names has your organization operated? |
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NONE |
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1.3 |
If your organization is
a corporation, answer the following: |
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1.3.1 |
Date of incorporation: |
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1.3.2 |
State of incorporation: |
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1.3.3 |
President's name: |
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1.3.4 |
Vice President's name(s): |
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1.3.5 |
Secretary's name: |
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1.3.6 |
Treasurer's name: |
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1.4 |
If your organization is
a partnership, answer the following: |
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1.4.1 |
Date of organization:- |
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1.4.2 |
Type of partnership (if
applicable): |
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1.4.3 |
Name(s) of general
partner(s): |
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1.5 |
If your organization is
individually owned, answer the following: |
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1.5.1 |
Date of organization:
November 13, 1996 |
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1.5.2 |
Name of owner: Jack W.
Gaynor |
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1.6 |
If the form of your
organization is other than those listed above,
describe it and name the principals: |
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2. |
LICENSING |
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2.1 |
List jurisdictions and
trade categories in which your organization is legally qualified to do
business and indicate registration or license numbers, if applicable. |
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Florida
– Painting Contractor - PA2741 |
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Florida
– Asbestos Consultant - ZA0000274 |
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Florida
– EPA Lead-Based Paint Abatement Contractor - Region
IV: State of Florida Section 402 TSCA:
FL-2595-1 |
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Florida
– Mold Remediation Certification: T7859568 |
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*Florida
– Asbestos Contractor - CJ-C056689 - *(Owner is a Licensed Asbestos
Abatement Contractor) |
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2.2 |
List jurisdictions in
which your organization's partnership or trade name is filed. |
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Florida |
AIA DOCUMENT A305 ·
CONTRACTOR'S QUALIFICATION STATEMENT · 1986 EDITION · AIA · C1986
THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE,NW. WASHINGTON,DC.
20006
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3. |
EXPERIENCE |
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3.1 |
List the categories of
work that your organization normally performs with its own forces. |
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Painting &
Sandblasting -
Commercial, Industrial, Residential, Military Facilities |
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Remodel/ Renovation/Asbestos Abatement - Government Facilities |
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Mold Remediation - Commercial, Industrial,
Government Facilities, Residential |
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Lead-Based Paint Abatement/Stabilization - Commercial,
Industrial, Government Facilities, Residential |
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Environmental Consulting -
Commercial, Industrial, Government Facilities |
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3.2 |
Claims and Suits. (If
the answer to any of the questions below is yes, please attach details). |
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3.2.1 |
Has your organization
ever failed to complete any work awarded to it? |
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NO |
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3.2.2 |
Are there any
judgments, claims, arbitration proceedings or suits pending or outstanding
against your organization or its officers? |
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NO |
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3.2.3 |
Has your organization
filed any law suits or requested arbitration with regard to construction
contracts within the last five years? |
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NO |
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3.3 |
Within the last five
years, has any officer or principal of your organization ever been an
officer or principal of another organization when it failed to complete a
construction contract?(If the answer is yes, please attach details.) |
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NO |
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3.4 |
On a separate sheet,
list major construction projects your organization has in progress, giving
the name of project, owner, architect, contract amount, percent complete and
scheduled completion date. See our Website www.trge.org |
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3.4.1 |
State total worth of
work in progress and under contract. $ 0.00 |
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3.5 |
On a separate sheet,
list the major projects your organization has completed in the past five
years, giving the name of project, owner, architect, contract amount, date
of completion and percentage of the cost of the work performed with your own
forces. |
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3.5.1 |
State average annual
amount of construction work performed during the past five years. |
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$ 250,000.00 |
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3.6 |
On a separate sheet,
list the construction experience and present commitments of the key
individuals of your organization. |
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See our Website www.trge.org |
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AIA DOCUMENT A305 ·
CONTRACTOR'S QUALIFICATION STATEMENT · 1986 EDITION · AIA · C1986
THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE,NW. WASHINGTON,DC.
20006
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4. |
REFERENCES |
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4.1 |
Trade References: |
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Sherwin-Williams, 17331 Dona Michelle Drive, Tampa, FL 33647 |
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Sunbelt
Rentals, Inc., 611 Templeton Ave., Charlotte, NC 28203 |
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EHS, L.L.C.,
7469 White Pine Road, Richmond, VA 23237 |
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4.2 |
Bank References: |
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Wacovia Bank,
P.O. Box 563962,
Charlotte, NC 28256-3962 |
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4.3 |
Surety: |
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Bonding and
Insurance Specialists Agent, Inc. (BISA), 9340 South Harlem Avenue,
Bridgeview, IL 60455 |
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4.3.1 |
Name of bonding
company: |
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Bonding and
Insurance Specialists Agent, Inc. (BISA), 9340 South Harlem Avenue,
Bridgeview, IL 60455 |
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4.3.2 |
Name and address of
agent: |
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Mr. Jere
Weiland (800) 752-1123
Republic Insurance Services, Inc.,
P.O. Box 1692, Clearwater, Florida
33757-1692 |
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5. |
FINANCING |
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5.1 |
Financial Statement: |
N/A |
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5.1.1 |
Attach a financial
statement, preferably audited, including your organization's latest balance
sheet and income statement showing the following items: |
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Current Assets (e.g.,
cash, joint venture accounts, accounts receivables,notes receivable, accrued
income, deposits, materials inventory and prepaid expenses); Net Fixed
Assets; Other Assets; Current Liabilities (e.g.,accounts payable, notes
payable, accrued expenses, provision for income taxes, advances, accrued
salaries and accrued payroll taxes); Other Liabilities (e.g., capital,
capital stock, authorized and outstanding shares par values, earned surplus
and retained earnings). |
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5.1.2 |
Name and address of
firm preparing attached financial statement, and date thereof: |
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TRG
Environmental Services, 7305 Yardley Way, Tampa, FL 33647 |
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5.1.3 |
Is the attached
financial statement for the identical organization named on page one?
Yes |
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AIA DOCUMENT A305 ·
CONTRACTOR'S QUALIFICATION STATEMENT · 1986 EDITION · AIA · C1986
THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE,NW. WASHINGTON,DC.
20006
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5.1.4 |
If not, explain the
relationship and financial responsibility of the organization whose
financial statement is provided (e.g., parent-subsidiary). |
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5.2 |
Will the organization
whose financial statement is attached act as guarantor of the contract for
construction? Yes |
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6. |
SIGNATURE |
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6.1 |
Dated this December 31,
2007 |
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Name of Organization:
TRG Environmental Services |
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By: |
______________________________ |
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Jack Gaynor |
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Title: Owner |
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6.2 |
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Mr. Jack W. Gaynor
being duly sworn deposes and says that the information provided herein is
true and sufficiently complete so as not to be misleading |
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Subscribed and sworn
before me this |
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Notary
Public: __________________________ |
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My Commission
Expires: ___________________ |
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AIA DOCUMENT A305 ·
CONTRACTOR'S QUALIFICATION STATEMENT · 1986 EDITION · AIA · C1986
THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE,NW. WASHINGTON,DC.
20006
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