Subcontractors

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Name fo Business*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Fax*

Estimating Contact Name*

First Last

Estimating Contact Cell*

Estimating Contact Email*

Trades Performed*

States willing and able to perform work in*

Total Number of Employees*

Total Number of Field Employees (non-supervisory)*

Is your company union?

Can you provide services under any labor scenario?

Ideal Project Size (by Dollar Volume):*

Affiliated Companies (if any):

Please list any MBE/WBE/SBE/etc. business designations that may apply to your company.

Annual Volume Last Year*

Annual Volume Two Years Ago*

Annual Volume Three Years Ago*

Experience Modification Rate Last Year*

Experience Modification Rate Two Years Ago

Experience Modification Rate Three Years Ago*

Has your company received any OSHA citations in the last three years?

How many?*

General Contractor References*

Please list out company, contact person, phone, and email. Up to 3 references.

Vendor/Supplier References*

Please list out company, contact person, phone, and email. Up to 3 references.

Miscellaneous Notes & Comments

Name

This field is for validation purposes and should be left unchanged.