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Date: 1/29/2020 Time: 3:38:18 AM

Mode: Add_New_Data

Maintain Subcontractor Company Profile
Supplier Code: -94616234
NOTE:
It is a requirement that your Certificate of Liability lists Dualite Sales & Service, Inc. not only as the "Certificate Holder," but also as "Additional Insured." with regards to General Liability and Auto insurance. We have found that faxing this form directly to them saves time and avoids confusion. All documents will need to be uploaded to the Dualite website under your company profile. Also, in the future, any certificates for Dualite Sales & Service, Inc. should only be sent to the address listed above. Any other addresses that your insurance agent may have on file for us should be removed.

Please read and complete the requirements below.
It is the policy of Dualite Sales & Service, Inc. that all contractors who offer Installation services meet the following insurance requirements prior to beginning any project:

CERTIFICATE HOLDER: Dualite Sales & Service, Inc.
1 Dualite Lane
Williamsburg, Ohio 45176		 Sample: Certificate of Liability Insurance
 
  • $2,000,000 - Recommended coverage
MINIMUM REQUIREMENTS ARE:
  • $1,000,000 - GENERAL LIABILITY
    • ($500,000 if Maintenance/Service only contractor) Include Products liability, completed operations, contractual liability, and broad form, property damage.

  • $1,000,000 - AUTO LIABILITY
    • ($500,000 if Maintenance/Service only contractor)
    Include owned, hired, and non-owned autos.

  • $500,000 - WORKER'S COMPENSATION & EMPLOYER'S LIABILITY
    • (Statutory or Minimum State Requirement)
     
  • Cancellation clause must provide for a 30 day written notice of the Certificate Holder.
  • Contractors with $500,000 maintenance coverage must increase their General and Auto coverage to $1,000,000 in order to be eligible for installation projects.

    • Company Profile - General - EXHIBIT A
    Company Company Name:
                
    Address:
                
    City: State:
    Zip Code:
    Main Telephone Number:
    Cell Phone:
    Fax Number:
    24 Hour Emergency Number:
    Owner(s) Name:
    Accounting Contact Name:
    Email Address:
    Office Phone: Fax:
    General Service Contact Name:
    Email Address:
    New as of 04-25-2014. If a new supplier: Upon submittal the above will receive an email notification.
    Office Phone: Fax:
    Shipping Address
    (if different than Company)    		 Company Name:
                
    Address:
                
    City: State:
    Zip Code:
    FedEx Address
    (if different than
    Shipping Address)    		 Company Name:
                
    Address:
                
    City: State:
    Zip Code:
    Remittance Address / Mailing Address
    (if different than above)    		 Company Name:
                
    Address:
                
    City: State:
    Zip Code:
    Payment Terms: Standard - No discount, paid 30 days after invoice date
    *When all documentation and photos, as outlined on our purchase order, have been sent with your invoice
    2% Discount - Paid 10 days after invoice date
    Please mark invoice with x% discount.
    *When all documentation and photos, as outlined on our purchase order, have been sent with your invoice.
     
     

    Company Profile - Additional Contact Information - EXHIBIT B
    Additional Contact Information #1 Contact Name:
    Job Title:
    Email Address:
    Office Phone: Cell Phone:
    Additional Contact Information #2 Contact Name:
    Job Title:
    Email Address:
    Office Phone: Cell Phone:
    Additional Contact Information #3 Contact Name:
    Job Title:
    Email Address:
    Office Phone: Cell Phone:
    Additional Contact Information #4 Contact Name:
    Job Title:
    Email Address:
    Office Phone: Cell Phone:
    Additional Contact Information #5 Contact Name:
    Job Title:
    Email Address:
    Office Phone: Cell Phone:

    Company Profile - Company Information - EXHIBIT C
    Services Select whether your company provides Primary, Secondary or None of the following services
    Manufacuring: Installation: Service: Electrical:
    NOTE: New as of 04/16/2014
    If Manufacuring is selected Primary or Secondary. You are required to printout, sign and upload Non-Competition and Nonsolicitation Agreement located near the bottom web page.
    Business Status
    Unionized: Yes No    Incorporated: Yes No
    Licensed: Yes No   Bonded: Yes No
    Special Business Class
    WBE (Women's Business Enterprise): Yes No
    Please upload WBE

    		    
    DBE (Disadvantaged Business Enterprise): Yes No
    Please upload DBE

    MBE (Minority Business Enterprise): Yes No
    Please upload MBE
    Business Information In business since: Click Here to Pick a date Federal ID Number:

    Please provide a W9 Form with your Federal ID Number below.
    Please upload W9

    Business License. If located in state(s) of California or Flordia, must upload
    Please upload Business License

    Hours of Operation
      from to   Su Mo Tu We Th Fr Sa
    Installation: Days
    Delivery: Days
    Office: Days
    Additional Notes:


    Number of Employees: Number of Crews:

    Operating Area or Base Zip Code: Radius: Miles
    Insurance Company Name:
    Address:
    City: State: Zip Code:

    NOTE: Please provide a Certificate of Liability Insurance.
    Please upload Certificate of Insurance
    File #01-Certificate
    File #02-Endorsement
    File #03-Endorsement
    File #04-Endorsement
    File #05-Endorsement
    File #06-Endorsement
    Worker's Compensation Please upload Worker's Compensation
     
     

    Company Profile - Rates - EXHIBIT D
    Services Offered
    PLEASE CHECK THE SIGN SERVICES THAT YOUR COMPANY OFFERS:
    Install
    Surveys
    Neon Signs and Wiring
    Pylon Signs over 50 ft
    High-rise (over 5 stories)
    Rappelling
    Primary Electric
    Foundations/Footings
    Electronics
    Other, please note:
    Service & Maintenance
    Cleaning
    Electrical Troubleshooting
    Electronic Repair
    Pressure Washing
    Fluorescent Repairs
    Parking Lot Lighting
    Pylon/Monument Signs over 50ft
    Painting
    Neon
    L.E.D. Repairs
    Other, please note:
    Manufacturing
    Wholesale
    Formed Faces
    Box Signs
    Neon (in house)
    Flex Faces
    Channel Letters
    UL Approved
    Crating/Shipping
    Digital Printing
    Other, please note:
    Service Response Time
    Standard hours
    Emergency hours
    Rates
    Surveys
      $
    Obtain Permits
      $ Per Hour
    One man and a crane
      $ Per Hour
    Two men and a crane
      $ Per Hour
    One man and a service truck
      $ Per Hour
    Neon Units
      $ Per Unit
    Fabrication Rate
      $ Per Hour
    One man with pickup/van for electrical or lamping
      $ Per Hour
    Apprentice Electrician
      $ Per Hour
    Journeyman Electrician
      $ Per Hour
    Notes:
    ** Actual time traveled not to exceed 1 hour at base labor rate **
    Pricing MATERIAL & EQUIPMENT PRICING
    • Ballast - - List less 50 %
    • Transformer - - List less 50 %
    • Lamp Prices - - List less 50 %
    • Misc. Materials & Electronic Ballasts at Cost - - Plus 20 %
    • Staging, Lifting at Cost - - Plus 15 %

    Company Profile - Equipment - EXHIBIT E
    Description of Crane, Bucket and Service Trucks
    Quantity Height Feet
    Maximum reach capabilities (other than renting crane): Feet
    Auger Max. Diameter?:New as of 04-09-2019. Inches
    Scissor Lift Max. Height?:New as of 04-09-2019. Feet
    Lift Max. Reach?:New as of 04-09-2019. Feet
    Back Hoe?:New as of 04-09-2019. Yes No 0
    Dump Truck?:New as of 04-09-2019. Yes No 0

    Company Profile - Safety - EXHIBIT F
    Does your company have a safety program: Yes No
    How often are safety meetings conducted: x per
    Are daily inspections performed and documented of all cranes and /or trucks: Yes No
    Does your company abide by all local, county, state, and Federal / OSHA regulations? Yes No
    Are you a DOT company?: Yes No
    Indicate the number of Federal OSHA citations or complaints in the past three years:
     
     

    Company Profile - OSHA - EXHIBIT G
    Dualite Sales & Service, Inc. 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’s responsibility to determine if the state has an OSHA approved state plan for the work being performed, and to determine which portions of the state plan apply.

    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, Clean Water Act, Resource Conservation and Recovery Act, Toxic Substances Control Act, and the Safe Drinking Water Act.
    Crane Operators Certificate(s): This section is for you to upload crane certifications for each individual that operates cranes for your company in accordance with OSHA regulation: Subpart CC - Cranes and Derricks in Construction. This certification goes into effect November 10, 2018 and Dualite must maintain certificate records of each of your crane operators by this date in order to continue business with your compnay. Please visit OSHA's website for more information. http://www.osha.gov/pls/publications/publication.html
    Are your crane operators required to be certified by OSHA regulation, Subpart CC - Cranes and Derricks in Construction? Yes No
    #1 Name (Full):   Certificate #: Expires: Click Here to Pick a date
    W-2 Employee: Yes No            Subcontractor: Yes No            Organization of Certificate:
    Please upload certificate
    #2 Name (Full):   Certificate #: Expires : Click Here to Pick a date
    W-2 Employee: Yes No            Subcontractor: Yes No            Organization of Certificate:
    Please upload certificate
    #3 Name (Full):   Certificate #: Expires: Click Here to Pick a date
    W-2 Employee: Yes No            Subcontractor: Yes No            Organization of Certificate:
    Please upload certificate
    #4 Name (Full):   Certificate #: Expires: Click Here to Pick a date
    W-2 Employee: Yes No            Subcontractor: Yes No            Organization of Certificate:
    Please upload certificate
    #5 Name (Full):   Certificate #: Expires: Click Here to Pick a date
    W-2 Employee: Yes No            Subcontractor: Yes No            Organization of Certificate:
    Please upload certificate

    Company Profile - Agreement - EXHIBIT H
    ***** Dualite requires digital uploading of all documents to our website *****
    Special Instructions and your Password will be sent to you once you are approved as a Dualite installer
    *** You are required to sign all purchase orderfrom Dualite Sales and Service, Inc. and upload to our web site
    Contractor: Company:
    Name and Title:
    Signature:
    Date: Click Here to Pick a date       Date format: 00/00/0000
    Non-Competition and
    Nonsolicitation Agreement    		 Please print, sign, and upload BOTH PAGES in 1 document. Link to NonCompetition and NonSolicitation agreement
    Please upload
    Subcontractor Agreement
    New as of 09-10-2018.    		 Please print, sign, and upload. Link to Subcontractor Agreement
    Please upload
    Reserved for Dualite Personnel Uploaded Subcontractor Agreement: Yes No
    Reserved for Dualite Personnel
    New as of 05-10-2019.    		 Information needed from subcontractor:
    Maximum 500
    Reserved for Dualite Personnel Status :    Reason: Maximum 500      Reviewed by:    Date:
    User:      Change Date:      Change Time: