Company Name

Street Address

City

State

Zip Code

Phone

Email

Person of Contact

Organization Organization Corporation Public Private Partnership

Services Provided by Your Company

Project History (check all that apply) Project History (check all that apply) Municipal Hospitals Schools Storage Facilities Warehouses Residential Houses Apartment Complex Medical Center Fire Department Supermarket Malls

Please list your largest 5 project sizes and dollar values in the last 24 months:

A - Name

A - Sector

A - Square Foot

A - Cost

B - Name

B - Sector

B - Square Foot

B - Cost

C - Name

C - Sector

C - Square Foot

C - Cost

D - Name

D - Sector

D - Square Foot

D - Cost

E - Name

E - Sector

E - Square Foot

E - Cost

Do you work under the following conditions? (Check all that apply) Do you work under the following conditions? (Check all that apply) Prevailing Wage Labor Rates Union Labor Rates Non-Union Labor Rates

How many years has your company been in business? How many years has your company been in business? Less than 2 years 2 - 5 years 5 - 10 years 10+ years

Company size (Employees/laborers) Company size (Employees/laborers) 5 - 10 10 - 20 20 - 49 50 +

Please Provide up to 5 References:

A - Company Name

A - Contact Name

A - Contact Phone

A - Project Value and Size

B - Company Name

B - Contact Name

B - Contact Phone

B - Project Value and Size

C - Company Name

C - Contact Name

C - Contact Phone

C - Project Value and Size

D - Company Name

D - Contact Name

D - Contact Phone

D - Project Value and Size

E - Company Name

E - Contact Name

E - Contact Phone

E - Project Value and Size

Please provide your service areas, and the furthest you will travel for a project.