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Corporation LLC Sole Proprietorship Partnership Other

MBE WBE DBE

For example: janitorial, window cleaning, floor care, landscaping, ...

under $200K $200K..$500K $500K..$1MM above $1MM

High-rise office Building Mid-rise office Building Retail Stores Schools Restaurants Hotel/Motels Hospitals Residential Sport/Entertainment Industrial High Tech/Labs Correctional Facilities

Please include project Amount, Year, Name and location

Please include project Amount, Name and location

business license liability insurance worker's compensation auto insurance certifications W-9 Bank References Contractor's references Supplies references Surety information OSHA 300 logs

Is your Company or any of its owners, officers or major shareholders currently involved in any arbitration of litigation? No Yes

Does your Company have any outstanding judgments or claims against it? No Yes

Has your company or any of its owners, officers or major stock holders been investigated for or charged with alleged labor law violations including alleged violations of the Immigration Control and Reform Act; state or local laws regarding employment of immigrants; prevailing wage laws; wage and hour laws or other federal, state or local labor laws? No Yes

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