Plan Room

User Registration

Welcome and thanks for your interest in our projects. Please fill out the information below.

Registration Info

 
Company Name: *
Title:  
Contact Name: *
Phone: *
  Extension: 
Cell:  
Fax:  
Address 1: *
Address 2:  
City: *
State: *
  Zip: *   Country: *
 
Email: *
Trades:
(Select up to 5)
*
 
Minority Status  









Labor Status  

Bondable  
Type of Business  




State of Incorporation  














































Year Business Started  
What is your area of operation?  
Areas of Work  












































Will you travel outside of your area of operation?  

(1)Corporate Officer/Partner/Proprietor (Name - Position - Percent Owned)  
(3)Corporate Officer/Partner/Proprietor (Name - Position - Percent Owned)  
(2)Corporate Officer/Partner/Proprietor (Name - Position - Percent Owned)  
Were there any changes in ownership in the past 2 years?  

If so, please explain.  
Number of Employees: During the past year.  
Number of Employees: During the past 5 years.  
Annual Sales Volume: Prior Year #1  
Annual Sales Volume: Prior Year #2  
Annual Sales Volume: Prior Year #3  
Annual Sales Volume: Prior Year #4  
Annual Sales Volume: Prior Year #5  
List the type(s) of work your firm usually performs with its own crew.  
Has your firm ever failed to complete any work awarded to it?  

If so, please explain in detail.  
Is your firm or any of its owners or officers currently involved in any litigation, arbitration, or mediation?  

If so, please explain this in detail.  
(1)Major projects currently in progress (Project - Owner - Architect - Contract Amount - Projected Date of Completion)  
(2)Major projects currently in progress (Project - Owner - Architect - Contract Amount - Projected Date of Completion)  
(3)Major projects currently in progress (Project - Owner - Architect - Contract Amount - Projected Date of Completion)  
(4)Major projects currently in progress (Project - Owner - Architect - Contract Amount - Projected Date of Completion)  
(5)Major projects currently in progress (Project - Owner - Architect - Contract Amount - Projected Date of Completion)  
Do you have a safety director?  

Do you have written safety guidelines?  

Do you hold safety meetings on a regular basis?  

If so, how often and who attends?  
Has OSHA issued any citations to your firm in the last 5 years?  

If so, please describe the incident and state what action was taken by your firm to prevent a repeat citation?  
Does your firm conduct pre-employment drug testing and post accident drug and alcohol testing?  

Workers Compensation Experience Modification Rates: Prior Year #1  
Workers Compensation Experience Modification Rates: Prior Year #2  
Workers Compensation Experience Modification Rates: Prior Year #3  
Workers Compensation Experience Modification Rates: Prior Year #4  
Workers Compensation Experience Modification Rates: Prior Year #5  
Name, Address, and Phone Number of your bank  
 
Username: *
Password: *
Confirm Password: *