Chicago g O'Hare T5 General Interest Form

Section A: General Information

Company Name: Federal Identification Number: Corporate Office:
Street Address

Date:

City

State

Zip Code

Phone: ( Primary Contact: Email:

Website: Phone: ( Fax: (

YES NO

) )
YES NO

Is your company MBE or WBE certified?

Is your company ACDBE certified?

YES NO

Has your company done business at any airport in the last five years?
If yes, please list airport(s):

Company Type:
Corporation Partnership Sole Proprietor
YES NO

Joint Venture

Individual

LLC

Is your company a subsidiary?

If yes, please list the parent company name:

President/Owner: List of Company Officers:

Total Number of Employees:

YES

NO

Is this company directly or indirectly signatory to any labor union agreement?

If yes, which union(s)?

What opportunities are you interested in at T5?

Concessions - Proceed to Section B Contracting - Proceed to Section C Services - Proceed to Section D

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Chicago O'Hare T5 General Interest Form

Section B: Concessions
NOTE: Only fill out the following section if you selected Concessions in Section A. Otherwise proceed to the next section.

What concession opportunities are you interested in?

Food

Retail

Please tell us about the goods/services your company is interested in providing travelers at Terminal 5:

Section C: Contracting
NOTE: Only fill out the following section if you selected Contracting in Section A. Otherwise proceed to next section.

Please list the trade tradework ork of your o r compan company:

General Contractor Framing (Metal Stud & Drywall) Electrical Plumbing Roofing E Excavation/Foundations ti /F d ti Landscaping Mechanical Sprinkler Structural Concrete Flooring Masonry M Low Voltage Controls Glazing Finish Carpentry Rough Carpentry Millwork/Cabinetry Fireproofing Fi fi

Specialties:

Groundup

Retail Fitout

Other

Section D: Services
NOTE: Only fill out the following section if you selected Services in Section A. Otherwise proceed to the next section.

Please tell us about the services your company is interested in providing travelers at Terminal 5:

S ti E Section E: L Legal l
Has your organization ever failed to complete any work awarded to it? If yes, please provide a brief explanation in the space below
YES NO

Are there any judgments, claims, arbitration proceeding or suits pending or outstanding against your organization or its officers? If yes, please provide a brief explanation in the space below

YES

NO

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Chicago O'Hare T5 General Interest Form

Has your organization or its principles ever filed for bankruptcy? If yes, please provide a brief explanation in the space below

YES

NO

S ti F Section F: R References f
Please list three references:
Company: Phone: Relationship: CONTRACTING ONLY: Project Scope: Project Duration: C Company: Phone: Relationship: CONTRACTING ONLY: Project Scope: Project Duration: Project Value: Project Value: Name: N Name:

Email:

Email:

Company: Phone: Relationship: CONTRACTING ONLY ONLY: Project Scope: Project Duration:

Name:

Email:

Project Value: FOR INTERNAL USE ONLY Date Entered: Initial:

Please follow the guidelines below to submit this form at a later date: Concessions: Email to jambrosio@us.westfield.com Contracting: Email to sgreenberger@us.westfield.com Services: Email to bpetrow@us.westfield.com

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Chicago O'Hare T5 General Interest Form