Subcontractor Form

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Subcontractor Form

Name
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code 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.
$ $ $
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:
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?
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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Corporate Headquarters:

MTV General Contractors, Inc.
2840 N. Norwalk
Mesa, AZ 85215
(480) 962-4007

Arizona Licenses:

ROC #B-01-074507
ROC# A-137612

Washington License:

MTVGEGC 883MP

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