Trade(s) Performed:*

Company Name:*

Estimator/Contact:*

Fax Number:

Cell Phone Number:

Phone Number:*

Email:*

Address:*

Street Address City State / Province / Region ZIP / Postal Code

Name:*

First Last

Owner's Name:*

First Last

Do you perform your work? Please select all that apply:*

Union
Open Shop
Prevailing Wage
Both

Years in Business under this name:*

Years in Business under other names:

Number of Full-time Employees:

Number of Part-time Employees:

What percentage of the work do you self-perform?:*

What percentage of your work is

Commercial:*

Residential:*

Public:*

Volume of work, in dollars, for the past 3 years:*

Can you provide design/build services (for MEP subcontractors only)? I.E. REDCOM will provide floor plans/structural drawings and performance criteria for MEP systems, Vendor to design systems and provide sufficient drawings for Building Permit:*

Yes
No

Can you provide the following insurance? Please select all that apply:*

Commercial General Liability – $1,000,000 each occurrence and $2,000,000 Annual Aggregate
Automobile Liability – $1,000,000 each accident
Commercial Umbrella – $5,000,000
Workers’ Compensation and Employers’ Liability – $500,000 each accident, $500,000 for bodily injury by accident, and $500,000 each employee for injury by disease
None of the above

If you answered none of the above, what is your current insurance:

What regions/areas does the company service:

New Jersey
Connecticut
Maryland/Delaware

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What percentage of your work is