LAX: Theme Building General Interest Form

Section A: General Information

Company Name: Federal Identification Number: Corporate Office: Street Address: City: Phone: Contact Name:
YES NO

Date:

State: Website: Contact Phone:

Zip:

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
YES NO

Sole Proprietor

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 agreeme

If yes, which union(s)?

What opportunities are you interested in at LAX: Theme Building?

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

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 at the Theme Building:

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LAX: Theme Building General Interest Form

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 tradework of your company:

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

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 at the Theme Building:

Section E: Legal
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

Has your organization filed any lawsuits or requested arbitration with regards to construction contracts within the last (5) years? If yes, please provide a brief explanation in the space below

YES

NO

YES

NO

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

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LAX: Theme Building General Interest Form

Section F: References
Please list a minimum of three client references:
Company: Phone: Relationship: CONTRACTING ONLY: Project Scope: Project Duration: Company: Phone: Relationship: CONTRACTING ONLY: Project Scope: Project Duration: Company: Phone: Relationship: CONTRACTING ONLY: Project Scope: Project Duration: Company: Phone: Relationship: CONTRACTING ONLY: Project Scope: Project Duration: Please follow the guidelines below to submit this form at a later date: Concessions: Email to swestmore@us.westfield.com Contracting: Email to nlau@us.westfield.com Services: Email to eklafter@us.westfield.com Name: Email:

Project Value: Name: Email:

Project Value: Name: Email:

Project Value: Name: Email:

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

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LAX: Theme Building General Interest Form