Contractor Pre-Qualification Form 01. NAME OF COMPANY: ______________________________________________________________________
02. CONTACT PERSON OR PERSONS: _____________________________________________________________
03. OFFICE PHONE:_____________________________ CELL PHONE:____________________________________
04. FAX NUMBER: _____________________ EMAIL ADDRESS:________________________________________
05. COMPANY WEB SITE: ______________________________________________________________________
06. OTHER PHONE NUMBERS: ___________________________________________________________________
07. SERVICES OR PRODUCTS SOLD: ______________________________________________________________
08. GEOGRAPHIC AREA SERVED: ________________________________________________________________
09. LENGTH OF TIME IN BUSINESS: _____________________________________________________________
10. PROVIDE TWO MOST RECENT PROJECT REFERENCES BY LISTING PROJECT NAME, PROJECT OWNER OR
SUPERVISOR AND THEIR CONTACT PHONE NUMBERS:
(A) ________________________________________________________________________________________
(B) ________________________________________________________________________________________
NOTE: Provide all information requested above. Fax this completed form to (402) 489-8065 for processing. Thank you for your interest.
THIS INFORMATION IS KEPT CONFIDENTIAL AND IS NOT SOLD OR OTHERWISE RELEASED FROM OUR FILES.
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