California Department of Transportation
 

Contractor Interest Form for Emergency Work

Immediately following storms, earthquakes or other natural disasters, Caltrans often elects to immediately contract with highway construction firms to begin clean-up and repair work.  To maximize Caltrans' readiness for future disasters and to give all contractors an opportunity to tell us about your capabilities and experience, we are inviting contractors to register their interest with Caltrans.

Completion of this form will enter your company's name and information into a Caltrans registry of contractors interested in possibly receiving contracts for emergency repairs or equipment rental in the event of a disaster.

DISCLAIMER: Registering with Caltrans does not represent any express or implied promise by Caltrans to award emergency contracts now or in the future. Caltrans is not bound to select contractors from the registry. Data entered will be held in confidence and will not be shared with other firms without the contractors consent.

Fields marked with * are required.

Company Information
Name of Firm*
  Main office Branch office
Street*
City*
State* Zip
Phone (Day)* ( ) -
Phone (24 hr) ( ) -
FAX( ) -
email
Contractor's License(s)

California Contractor's License. Make the appropriate selection under License No. 1. If you have more than one license, fill out No. 2 and No. 3, otherwise leave them blank.

California Contractor's
License No. 1 *
(If you don't have a license, select "None" under "Type")

California Contractor's License No. 
Type *
Expires //

California Contractor's
License No. 2
California Contractor's License No.  
Type
Expires //
California Contractor's
License No. 3
California Contractor's License No.  
Type
Expires //
Bonding and Certification

Surety Bond? Yes No Coverage $

Certified As (check all that apply)Small Business DBE DVBE

Preferred Work Locations

Check those regions which your firm prefers to work and can quickly mobilize if needed.

Northwestern California
Eastern Sierra/Owens Valley
Sacramento Valley
Central Coast
San Joaquin Valley
Greater Los Angeles Area/Orange Co.
Bay Area
Ventura/Santa Barbara Region
Northeastern Calif/Northern Sierra
Inland Empire/Deserts
Southern Sierra
San Diego/Imperial
 
Preferred Type of Work

Check those types of work your firm has proficiency with under emergency conditions.

Earthwork/Debris Removal
Roadway Construction(Flexible)
Roadway Construction (Rigid)
Rock Slope Protection
Erosion Control
Blasting
Traffic Control
Striping
Drainage(Culverts,Underdrains)
Guardrail
Structural Demolition
Temporary Bridge Erection
Walls(Retaining,Soldier Pile, etc)
Bridge Construction
Dewatering
 

Other work not shown

Key Equipment

Indicate how many of the following items your firm has available on short notice.

Dump Truck
Crawler Excavator
Dozer
Backhoes
Wheel Loader
Motor Grader
Pavers
Scrapers
Truck-mtd Cranes
Pile Drivers
 

Describe any special equipment your firm has, useful in emergency highway/bridge repairs.

Preferred Type of Contract Prime Contractor - Construction
Subcontractor - Construction
Operated Equipment Rental Contract
Preferred Contract Size Range

Has your firm worked under Caltrans specifications before?
Yes No

Do you want your information shared with other firms?
Yes No

Thank you for your submittal.