Company Name:

Previous name(s) of your company:

Street Address:

City: State: Zip:

Phone: Fax:

License #:

Classification(s):

Years in business:

Briefly describe the all types of work your company performs: (Ex: site concrete, building concrete, window shades, etc.):

Please check all boxes that apply to your company:
 SBE Micro Business DVBE DBE MBE

List any additional certifications:

Union Affiliation:

If you are not affiliated with a union, are you qualified to bid prevailing wage projects?

Average job size (in dollars):

Largest job ever completed:

Bonding capacity:

Rate:

Estimator’s Name:

Estimator’s Email:

Project Manager’s Name:

Project Manager’s Email:

Project Manager’s Cell:

Do you have any experience with LEED Projects? Please give a short description of the project and your involvement (materials used, documentation provided, recycling, etc.)

Has your firm ever failed to complete any work awarded or been terminated from a project?  Yes No
If yes, please provide a complete explanation:

Are there any judgments, claims, arbitration proceedings, or suits pending or outstanding against your firm or its owners/principals? If yes, please provide a complete explanation:

Has your firm, or any other organization with which your owners/principals were involved during the past three years, ever been in bankruptcy or engaged in a voluntary or involuntary reorganization? If yes, please provide a complete explanation:

Has your surety ever finished one of your construction projects? If yes, please provide a complete explanation:

Has a complaint ever been filed with the Contractor’s State License Board against your firm? If yes, please provide a complete explanation: