"*" indicates required fields Legal Name of Firm*List Any Other DBAsAddress* Address City State / Province / Region Zip Estimating Contact*Phone Number*Email* Average Work in Years (Last 5 Years)Type of Company* Corporation Sole Proprietor Partnership Other Date Established Month Day Year Union or Non-Union? Union Non-Union Qualified Minority Business? MBE WBE DVBE SBE LGBTQ Section 3 business? Yes No Experience Modification RateDIR #*Expiration Date* Month Day Year Federal ID*Scope of Work*Contractor's License #*Expiration Date* Month Day Year Work under contractAverage project size in place last yearBONDING AND INSURANCE INFORMATIONIs Subcontractor able to provide bid, payment and performance bonds? Yes No Bonding CompanyA.M. Best RatingDoes your firm use any Employee Leasing Companies? Yes No Can your General Liability, Auto and Umbrella policies name General Contractor and Owner as Additional Insured? Yes No Can your GL, WC and Umbrella policies give Waiver of Subrogation to Contractor and Owner? Yes No Attach all required supporting documents Drop files here or Select files Accepted file types: pdf, Max. file size: 50 MB, Max. files: 10. COMPLETED PROJECTS: LIST LAST 3 PROJECTS COMPLETEDProject #1Project #2Project #3CAPTCHA
