Subcontractor Form Company Information Company Name Address City State - None -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Owner Name License # Primary Contact Name Primary Contact Title Primary Contact Phone # Primary Contact Email Company Website Geographic Area Served Typical Project Size ($) Annual Volume of Work ($) # of Employees General Small Business Yes No Veteran-Owned Small Business Yes No Service-Disabled Veteran-Owned Small Business Yes No HUBZone Small Business Yes No Small Disadvantaged Business/8(a) Company Yes No Women-Owned Small Business Yes No Not a Small Business as defined by SBA Yes No Trades Trades Performed (select all that apply) ACT Carpentry Caulking Ceramic Tile Concrete D, F, & H Demolition Drywall EIFS Electrical Fire Sprinkler Flooring Glass & Glazing HVAC Masonry Millwork Painting Plumbing Roofing Sitework Specialties Steel ReferencesReference 1 Project Name Project Location Work Performed Contract Amount Contact Name Contact Phone # Reference 2 Project Name Project Location Work Performed Contract Amount Contact Name Contact Phone # Reference 3 Project Name Project Location Work Performed Contract Amount Contact Name Contact Phone # Leave this field blank