Contractor Qualification Renewal Form

Contractor Qualification Renewal Form

To renew your existing ASA Qualified Shotcrete Contractor (QSC) qualification, please complete this form, along with the attached Excel Projects Form to document 5 projects you’ve completed at the level of your qualification (Structural Levels I or II, Pool) within the last 5 years.

Renewal Fee:

    • $1000 (mbr), $2000 (nmbr)
    • A 50% discount may be applied if your Qualifying Individual (QI) attended an ASA Shotcrete Convention & Technology Conference within the last 5 years, during your current qualification period.

Renewal Process: Results of your renewal application review will be issued within 30 days upon receipt of all renewal materials and fee. Successful renewal will restart your qualification for a 5-year period from the month of your current qualification expiration. If you wish to upgrade to a new level, add a process or level, you will need to complete a new CQ application, submitting the requisite documentation and projects for that change, here: https://shotcrete.org/contractor-qualification/
Qualifying Individual:
Qualifying Individual:
First Name:
Last Name:

Current Qualification you are renewing:

Company Structure

Please review the copy of your original application which was attached to your renewal notification email. Review and describe any changes to your company in the areas indicated below. Each of the following fields require an answer. If there are no changes, enter NA.

Continuing Education

List participation on ACI 506, C660, C661 Committee work, ASA Committees, or ASA Convention, please list participation & dates.

Capability to Perform

Please provide details on and describe the changes in the volume of shotcrete work and changes in the percentage of the shotcrete portion of your company's work.

do you have any additional information you would like to supply regarding changes to your company or questions on the program?

Project Form

Click here to download the Excel Projects Form.  Document 5 projects completed within your 5-year qualification period, then upload here.

Maximum file size: 18.43MB

Disclosures

By submitting this renewal application, you reaffirm the agreements made upon your original application:

Code of Conduct

As an ASA Qualified Shotcrete Contractor we agree to ongoing compliance with the requirements and standards set forth in the ASA Shotcrete Contractor Qualification Program Description. We will not knowingly or purposefully violate any project specifications or requirements. We agree to maintain the required insurance coverage, staff our projects with trained and certified personnel, and strive to produce a high-quality product in a safe and professional manner.

Agreement

  1. The ASA decisions concerning qualification, including but not limited to the decision of the CQC shall be final and binding;
  2. The applicant will not institute legal action of any kind to challenge those decisions;
  3. Neither the ASA nor its members, officers, employees or representatives (including but not limited to the members of the CQC) shall be subject to any claim for legal or equitable relief (including but not limited to money judgements and injunctive relief) arising out of those decisions; and, in any event,
  4. Neither the ASA nor its members, officers, employees or representatives (including but not limited to the members of the CQC) shall be liable for consequential or incidental damages of any kind as a result of the ASA Qualification program. The applicant further agrees that if it commences legal action in violation of this agreement, it shall be responsible for paying all costs and expenses, including attorney fees incurred by ASA and/or its members, officers, employees or representatives in the course of defending that legal action.

Indemnification

In the event that any party asserts a claim for personal injury, property damage, economic loss of other damages against ASA and/or its members, officers, employees or representatives arising out of or relating to the acts or omissions of an ASA Qualified Shotcrete Contractor, the ASA Qualified Shotcrete Contractor shall, upon request, defend and indemnify ASA and/or its members, officers, employees or representatives and hold them harmless from all damages, judgement, costs, losses and expenses, including attorney fees, resulting from said claim.

Authorization

I have read and agreed to the above disclosures. I authorize the verification of the information provided on this form and declare that it is accurate to the best of my knowledge. By submitting this application, I authorize my consent.

 

Renewal Fees

    • $1000 (mbr), $2000 (nmbr)
    • A 50% discount may be applied if your Qualifying Individual (QI) attended an ASA Shotcrete Convention & Technology Conference within the last 5 years, during your current qualification period.
Select Fee Option:

Billing Details

Billing Address
Billing Address
City
State/Province
Zip/Postal
Country
CC Number
CC Number