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(480) 962-4007
2840 N. Norwalk, Mesa, AZ 85215
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MTV General Contractors, Inc.
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ABOUT
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Subcontractor Form
Subcontractor Form
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Subcontractor Form
Name
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
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Virgin Islands, U.S.
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Country
Phone
Fax
License Number:
License Number:
License Number:
License Number:
License Number:
Federal ID #
Email
Estimating Contact:
Contact Title:
Website
Year Business Started:
Union/Signatory:
Yes
No
Subcontractor
Yes
No
Vendor/Supplier:
Yes
No
Referred By:
Date
MM slash DD slash YYYY
Trade Categories – List categories of work you are qualified to perform:
Areas of Work: Please check only Locations in which you want to bid:
Phoenix Metro Area
East Valley
West Valley
Northern Arizona
Southern Arizona
Western Arizona
Eastern Arizona
Project Types – Please check the type and size of building project your company has completed
Commercial
Churches
Fuel Stations
Custom Homes
Multi-Family Housing
Educational Facilities
Healthcare
Retail
Correctional Facility
Design/Build/Assist
High Rise Office Bldg.
Mid Rise Office Bldg.
Other
Preferred Project Size
Up to $250K
Up to $500K
$1M
$5M
$5M+
Has your company had experience with LEED projects?
Yes
No
Performance Reference – Provide a minimum of five recently completed jobs with five DIFFERENT General Contractors, Contact Names and corresponding references for the above selected project types. Additional job list and company brochure appreciated. Project Name
GENERAL CONTRACTOR & CONTACT NAME
TELEPHONE NUMBER
FAX NUMBER
SUBCONTRACT VALUE
PROJECT NAME
GENERAL CONTRACTOR & CONTACT NAME
FAX NUMBER
TELEPHONE NUMBER
SUBCONTRACT VALUE
Annual Volume- What was the average annual volume of work completed in the last three years.
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
$
$
$
Bonding Company and Agent’s Name and Telephone
Company
Agent
Phone
Please enter your company’s bonding limits:
Date of Last Bond
Amount $
Bond Rate %
Bonding Capacity:
$ Per Job
$ Aggregate
Is your Company a certified:
MBE
WBE
DBE
VBE
SBE
Native American
N/A
Provide number of:
Office Personnel
Field Supervisors
Ave. Field Labor
List the name and title of the Company’s Principle:
Name
Title
List the name and title of the Company’s Principle:
Name
Title
List the name and title of the Company’s Principle:
Name
Title
Safety – In the past 5 years, has your company had an fatalities, falls over 10’, or been cited by OSHA for a “serious” or “willful” violation?
Yes
No
Worker’s Compensation: Please list your Worker’s Compensation Modifier or EMR for the last 3 years.
Yr/Rate
Yr/Rate
Yr/Rate
What is your limit to Liability Insurance?
CAPTCHA
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