PCI - SUBCONTRACTOR'S QUALIFICATION STATEMENT

SUBCONTRACTOR'S QUALIFICATION STATEMENT
Required Fields

Company Name:

Company President:

Business Start Date:

Federal Tax Number:

Business Status:
(check all the apply)

S.B.E.

S.D.B.E.

W.O.S.B.E.

Large Business

8(a)

HUBZone

Certification Number:

Corporation?

Yes

DUNS Number:

Contractor's License Number:

Maximum Job Size:

Company Street:

Company P.O. Box:

P.O. Box Zip Code:

City:

State:

Street Zip Code:

Phone Number:

Ext:

Fax Number:

Other Number:

Email Address:

Web Page URL:

CONTACT CATEGORY:

Sub-Contractor

Professional Services

MISC.

Manufacturer

Material Supplier

Contact Name:

Title:

Cell Phone:

Email:

Type of Work

Locations You are Interested In

Comments: